Male-to-Female Sex Reassignment Surgery in Transsexuals

ABSTRACT

The technique of male-to-female sex reassignment surgery in a sample of 500 patients is described in detail and illustrated by 27 figures. Appropriate technique and care results in a naturally looking vulva and a functioning vagina. The complication rate is low, and most complications can be overcome by adequate correctional interventions.     

Demystifying Intuition: What It Is,What It Does,and How It Does It

Definitions of intuition are discussed and two working definitions are proposed. This is followed by a list of eight unresolved problems concerning intuition. It is suggested that all of these problems can be resolved by cognitive-experiential self-theory (CEST), a dual-process theory of personality according to which people process information with two systems, an experiential/intuitive system that is an associative learning system that humans share with other animals and a uniquely human verbal reasoning system. Intuition is considered to be a subsystem of the experiential/ intuitive system that operates by exactly the same principles and attributes but has narrower boundary conditions. The next section includes a presentation of the most relevant aspects of CEST with an emphasis on the operating rules and attributes of the experiential/intuitive system. This is followed by demonstrating how the operation of the experiential/intuitive system can resolve each of the unresolved problems concerning intuition. The article closes with a comparison of the advantages and disadvantages of the experiential/intuitive and rational/analytic systems. It is concluded that neither system is generally superior to the other, as each has important advantages and disadvantages.     

Care of the Patient Undergoing Sex Reassignment Surgery

SUMMARY

Sex reassignment surgery (SRS) has proven to be an effective intervention for the patient with gender dysphoria. As with any surgery, the quality of care provided before, during, and after SRS has a significant impact on patient outcomes. This article is intended to help primary care providers who are already familiar with routine transgender care to understand the specialized processes involved in SRS. Topics include guidelines for the recommendation of SRS, feminizing and masculinizing surgical procedures, suggested timelines for various interventions, expected course and recovery, risks and complications, and revisional surgery that may be required.     

变性术后患者心理状况的影响因素分析及对策

变性术后的患者是个特殊的弱势群体,心理问题非常突出,它是生理、个人、家庭、社会等多种因素交互影响的结果;因此,通过社会、家庭及个体的共同努力,帮助其建立良好的个体心理模式,稳定其心理状态,可促进其心理的健康发展,这对于变性手术的成功和帮助变性后患者重新走向社会有重要意义.     

变性术后患者心理状况的影响因素分析及对策

变性术后的患者是个特殊的弱势群体,心理问题非常突出,它是生理、个人、家庭、社会等多种因素交互影响的结果;因此,通过社会、家庭及个体的共同努力,帮助其建立良好的个体心理模式,稳定其心理状态,可促进其心理的健康发展,这对于变性手术的成功和帮助变性后患者重新走向社会有重要意义。     

Supporting Transgender and Sex Reassignment Issues

SUMMARY

For the care provider unfamiliar with supporting transsexual and transgender persons, as well as their partners, it becomes an imperative to be able to identify this population's unique needs, transition concerns and relationship dynamics. New challenges arise as transgender clients become more prevalent within the GLBT community and contact community clinical resources. These include distinguishing between sexual orientation and the complexities of gender identity; differentiating actual transgender issues and ordinary relationship concerns; and recognizing characteristics of strong relationships versus those doomed to fail when one or both partner's needs can no longer get met.

This article reviews an abundance of stereotypes adversely affecting transgender individuals, relationships and which can taint the treatment environment. At a core level, there exists the need for care providers to recognize when having a transgender identity stops being a disorder, such as when the client is no longer gender dysphoric, and where the care provider needs to advocate the individual's right of self-determination. This includes recognizing when situational depression or anxiety and social discrimination are the actual root of ongoing individual and relationship concerns. With basic transgender knowledge, effectively supporting transgender persons and their relationships is possible for cross-specialty providers, and is recommended.     

Evolution of Gonadal Axis After Sex Reassignment Surgery in Transsexual Patients in the Spanish Public Health System

ABSTRACT

Although the effects of hormone therapy on cardiovascular risk factors and bone metabolism have been studied, data are lacking on the gonadotropin profile after gonadectomy in the sex reassignment process (SRP). Accordingly, whether measurement of the gonadotropin profile is useful in order to adjust the postsurgical dose of gonadal hormones is unknown. We studied the evolution of LH, FSH, prolactin, testosterone, and estradiol in 50 transsexual persons, 41 male-to-female transsexuals (MtF) and 9 female-to-male transsexuals (FtM), following a proto-colized regimen of hormone therapy for 12–24 months before and after genitoplasty. The increase in gonadotropins after surgery was greater in the FtM than in the MtF (66% vs. 50%), with the increase continuing more than one year after surgery. No variable was significantly associated with this different level of gonadotropins.     

Sex Reassignment Technology: The Dilemma of Transsexuals in Islam and Christianity

The birth of people with confused or ambiguous sex makeup as a biological fact since the annals of history has posed the challenge of accommodating them within the binary gender of sociocultural systems. In this process, the role of religion as a defining factor in social engineering has been paramount. Major religions, such as Islam and Christianity, have addressed this issue within the frame of their God-ordained laws by devising a set of moral and legal imperatives specific to the “third gender.” Modern developments in medicine and biology, however, have made sex reassignment possible for this category of people, today called transsexuals. The question is: How do Islam and Christianity respond to it. After presenting an analytical view of both Muslim scholars and Christian religious authorities on the legitimacy of sex reassignment for transsexuals, this paper attempts to explore if such a dilemma can be resolved.     

Critical Psychology: What It Is and What It Is Not

Critical psychology alerts us to the limitations of mainstream research in the discipline, and it promises to put 'social' issues on the agenda in the whole of psychology. A starting point of the stance of critical psychological research is that the claims that psychologists make about human beings often seem to vanish almost as quickly as they are discovered. People, a group or culture do not behave or think like the model would predict, and, more importantly, we find that our awareness, our reflection on a process described by a psychologist changes that process. It is in the nature of human nature to change, to change as different linguistic resources, social practices, and representations of the self become available, and for human nature to change itself as people reflect on who they are and who they may become. That means that any attempt to fix us in place must fail. But it will only fail in such a way that something productive emerges from it if we do something different, and one place to do something different is in psychology. We need to step back and look at the images of the self, mind and behaviour that psychologists have produced, the types of practices they engage in, and the power those practices, those 'technologies of the self' have to set limits on change. When we appreciate this, we can start to look at what psychologists might do instead as part of a genuinely critical approach.     

Form and Function in Motor Mimicry Topographic Evidence that the Primary Function Is Communicative

Motor mimicry is behavior by an observer that is appropriate to the situation of the other person, for example, wincing at the other's injury or ducking when the other does. Traditional theories of motor mimicry view this behavior as an indicator of a vicarious cognitive or empathic experience, that is, of taking the role of the other or of “feeling oneself into” the other person. However, Bavelas, Black, Lemery, and Mullett (1986) have shown that motor mimicry of pain is affected by communicative variables and acts as a nonverbal message indicating that the observer is aware of and concerned about the other's situation. This raises a more general question: Is communication its primary or secondary function? We propose (i) that motor mimicry functions as a nonverbal, analogic, relationship message about similarity between observer and other and (ii) that this message is encoded according to Gestalt principles of form, in that the observer physically mirrors the other. In other words, the observer maintains a relationship with the other. The special case of left/right leaning when observer and other are facing each other permits a test of our theory against two theories that treat motor mimicry as an indicator of vicarious experience. The results of three experiments showed that when motor mimicry by an observer facing someone who is leaning left or right occurs, it is both displayed and decoded in the form consistent with a communication theory; this form is called reflection symmetry. We conclude that, because of the topography of the response, the primary function of motor mimicry must be communicative and that any relationship to vicarious processes is secondary. A similar analysis of other nonverbal behaviors may well reveal that they are also expressions to another person rather than expressions of infrapsychic states.     

Racism: What It Is and What It Isn't

The words `racist' and `racism' have become so overused that they nowconstitute obstacles to understanding and interracial dialogue aboutracial matters. Instead of the current practice of referring tovirtually anything that goes wrong or amiss with respect to race as`racism,' we should recognize a much broader moral vocabulary forcharacterizing racial ills – racial insensitivity, racial ignorance,racial injustice, racial discomfort, racial exclusion. At the sametime, we should fix on a definition of `racism' that is continuouswith its historical usage, and avoids conceptual inflation. Isuggest two basic, and distinct, forms of racism that meet thiscondition – antipathy racism and inferiorizing racism. We should alsorecognize that not all racially objectionable actions are done froma racist motive, and that not all racial stereotypes are racist.     

Job Function,Sex, and Environment As Correlates of Work Perceptions and Attitudes1

The present study examined job function and sex differences in perceptions of the physical and social work environment and the relationship of the work environment to work perceptions and attitudes when function and sex are controlled. Research indicated that job function, but not sex, was related to environment perceptions for 426 employees in a state government agency. The social environment also emerged as a significant predictor of work involvement, trust, and satisfaction. Significant interactions between job function and environment indicated that the social environment was negatively related and the physical environment positively related to work perceptions for managerial employees. The reverse was found for employees in other job functions.     

Enlarged Range of Free Flaps for Phalloplasty in Transsexual Reassignment Surgery

ABSTRACT

Our concept for complete phalloplasty which we applied in 66 female-to-male transsexuals, using free prelaminated osteofasciocutaneous fibula or fasciocutaneous forearm flaps, consisted of the following three operative stages:

1. mastectomy, ovariohysterectomy, urethra lengthening, colpectomy, and neourethra prelamination

2. after 3–6 months, neophallus creation with free sensate and prelaminated osteofasciocutaneous fibula (n = 41) or radial forearm flaps (n = 25)

3. 3–6 months later, urethral connection, neoscrotum formation and testicle prosthesis implantation.

Results: After mastectomy 2 hematoma had to be removed, and twice colpectomy revision was needed because of hematoma. No complications occurred after ovariohysterectomy. Partial flap necrosis took place in 1 patient of the forearm group and total necrosis in 2 patients of the fibula group. Eleven patients presented urethral stricture, and 9 a fistula. In 7 patients an operative stricture expansion was required, and in 6 patients surgical closure of the fistula. Overall patients' satisfaction was excellent.

Conclusions: The applied results demonstrates the effectiveness of such a multistage and interdisciplinary approach for female-to-male transsexual and it shows, that the fibula flap is an equal routine method extending the therapeutical range of gender assignment operations in female-to-male transsexuals.     

Arise for It Is Day:

No abstract available for this article.     

Two Critical Issues in Primary Prevention: What It Is and How To Do It

Definition of primary prevention and of end-state and stressful life variable models are presented to guide the design and conduct of primary prevention activities.