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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2020

01-12-2020 | Transsexualism | Review

Quality of life in people with transsexuality after surgery: a systematic review and meta-analysis

Authors: Mehrdad Eftekhar Ardebili, Leila Janani, Zaher Khazaei, Yousef Moradi, Hamid Reza Baradaran

Published in: Health and Quality of Life Outcomes | Issue 1/2020

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Abstract

Background

Several reports have demonstrated varying results on the quality of life (QoL) of the transgender population. Therefore, the aim of this study was to conduct a systematic review and meta-analysis about the quality of life (QoL) of individuals during the post transsexual surgery period.

Methods

We searched major biomedical electronic databases, including Scopus, Google Scholar, Psychological Information Database (PsycInfo), Web of Science, PubMed, Excerpta Medica dataBASE (EMBASE), and ProQuest, for all relevant literature published in English up to December 2019. The included papers required to be cross sectional studies that reported quality of life in people with transsexuality post surgery. After selecting eligible studies, 2 authors extracted data of each study independently and resolved any inconsistency by consensus with the third reviewer. The risk of bias was assessed by 2 independent research experts by the Newcastle-Ottawa Scale (NOS).

Results

In this study, out of 497 articles extracted from the initial investigation, 8 articles with 1099 patients were ultimately selected for meta-analysis. The pooled mean of quality of life in transsexual individuals was obtained to be 70.45 (95%CI 55.87–85.03) and 59.17 (95%CI 48.59–69.74), based on World Health Organization Quality of Life (WHOQoL-BREF) and The 36-item short form of the Medical Outcomes Study questionnaire (SF36), respectively. Also, the results of the subgroup analysis for the weighted mean quality of life in male to female and female to male showed that the mean quality of life in female to male was 57.54 (95%CI 42.24–72.84) and it was 62.47 (95%CI 45.94–79.00) in male to female, based on SF36 questionnaire. Moreover, the weighted mean quality of life in female to male was 69.99 (95%CI 43.76, 96.23) and it was 70.65 (95%CI 53.11, 88.19) in male to female, based on WHOQoL-BREF questionnaire.

Conclusion

The results of this systematic review may support the approaches to transsexuality that facilitates sex reassignment. In this review, the means of quality of life after surgery were not compared to the means of quality of life before surgery or even before hormonal therapy which was due to inadequate number of primary studies.
Literature
1.
Berzonsky MD. Identity style and well-being: does commitment matter? Identity. 2003;3:131–42.
2.
Di Ceglie D. Gender identity disorder in young people. Adv Psychiatr Treat. 2000;6:458–66.
3.
Brassard A, Péloquin K, Dupuy E, Wright J, Shaver PR. Romantic attachment insecurity predicts sexual dissatisfaction in couples seeking marital therapy. J Sex Marital Ther. 2012;38:245–62.PubMed
4.
Beren SE, Hayden HA, Wilfley DE, Grilo CM. The influence of sexual orientation on body dissatisfaction in adult men and women. Int J Eat Disord. 1996;20:135–41.PubMed
5.
Snyder DK, Berg P. Determinants of sexual dissatisfaction in sexually distressed couples. Arch Sex Behav. 1983;12:237–46.PubMed
6.
Danafar A, Behian S. Gender identity disorder and social factors affecting it among Transsexualists, who referred to the social welfare organization in 2013-2015. Tolooebehdasht. 2017;16:75–87.
7.
Mousavi SM, Habibollahi S, Ghasemnejad SM. A comparison of life quality and social adjustment among normal people and those with gender identity disorder (transsexual). J Appl Environ Biol Sci. 2015;5:19–24.
8.
Zucker KJ, Bradley SJ. Gender identity disorder and psychosexual problems in children and adolescents. London: Guilford Press; 1995. p 3-20.
9.
De Vries AL, Steensma TD, Doreleijers TA, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011;8:2276–83.PubMed
10.
Kuhn A, Bodmer C, Stadlmayr W, Kuhn P, Mueller MD, Birkhäuser M. Quality of life 15 years after sex reassignment surgery for transsexualism. Fertil Steril. 2009;92:1685–9 e1683.PubMed
11.
Fredriksen-Goldsen KI, Kim H-J, Shiu C, Goldsen J, Emlet CA. Successful aging among LGBT older adults: physical and mental health-related quality of life by age group. The Gerontologist. 2014;55:154–68.PubMedPubMedCentral
12.
Yang X, Zhao L, Wang L, Hao C, Gu Y, Song W, Zhao Q, Wang X. Quality of life of transgender women from China and associated factors: a cross-sectional study. J Sex Med. 2016;13:977–87.PubMed
13.
Schalock RL. Quality of life: application to persons with disabilities. USA: AAMR; 1996. p 50-190.
14.
Shariati M, Nasiri Kalmarzi R, Abaei Hasani S, Goodarzi E, Hasanzadeh J, Ataee P, Rad F, Mansouri M, Khalafi B, Moradi G. The impact atopic dermatitis on the life quality of childrens 1-6 year. Int J Pediatr. 2018;6:7003–11.
15.
Motmans J, Meier P, Ponnet K, T'Sjoen G. Female and male transgender quality of life: socioeconomic and medical differences. J Sex Med. 2012;9:743–50.PubMed
16.
Newfield E, Hart S, Dibble S, Kohler L. Female-to-male transgender quality of life. Qual Life Res. 2006;15:1447–57.PubMed
17.
Vasegh Rahimparvar F, Mousavi MS, Rayisi F, Khodabandeh F, Bahrani N. Comparison of quality of life in gender identity disorders after sex reassignment surgery with normal women in Tehran, Iran, 2012. Iran J Obstet Gynecol Infertil. 2013;16:10–9.
18.
Weyers S, Elaut E, De Sutter P, Gerris J, T'sjoen G, Heylens G, De Cuypere G, Verstraelen H. Long-term assessment of the physical, mental, and sexual health among transsexual women. J Sex Med. 2009;6:752–60.PubMed
19.
De Cuypere G, Gijs L. Care for adults with gender identity disorder; 2014.
20.
Simon L, Zsolt U, Fogd D, Czobor P. Dysfunctional core beliefs, perceived parenting behavior and psychopathology in gender identity disorder: a comparison of male-to-female, female-to-male transsexual and nontranssexual control subjects. J Behav Ther Exp Psychiatry. 2011;42:38–45.PubMed
21.
Besharat MA. Relationship of alexithymia with coping styles and interpersonal problems. Procedia Soc Behav Sci. 2010;5:614–8.
22.
Michel A, Ansseau M, Legros J-J, Pitchot W, Mormont C. The transsexual: what about the future? European Psychiatry. 2002;17:353–62.PubMed
23.
Parola N, Bonierbale M, Lemaire A, Aghababian V, Michel A, Lançon C. Study of quality of life for transsexuals after hormonal and surgical reassignment. Sexologies. 2010;19:24–8.
24.
Wierckx K, Van Caenegem E, Elaut E, Dedecker D, Van de Peer F, Toye K, Weyers S, Hoebeke P, Monstrey S, De Cuypere G. Quality of life and sexual health after sex reassignment surgery in transsexual men. J Sex Med. 2011;8:3379–88.PubMed
25.
Nobili A, Glazebrook C, Arcelus J. Quality of life of treatment-seeking transgender adults: a systematic review and meta-analysis. Rev Endocr Metab Disord. 2018;19:199–220.PubMedPubMedCentral
26.
Group W. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403–9.
27.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000;283:2008–12.PubMed
28.
Iudici M, Cuomo G, Vettori S, Avellino M, Valentini G. Quality of life as measured by the short-form 36 (SF-36) questionnaire in patients with early systemic sclerosis and undifferentiated connective tissue disease. Health Qual Life Outcomes. 2013;11:23.PubMedPubMedCentral
29.
Lodhi FS, Montazeri A, Nedjat S, Mahmoodi M, Farooq U, Yaseri M, Kasaeian A, Holakouie-Naieni K. Assessing the quality of life among Pakistani general population and their associated factors by using the World Health Organization’s quality of life instrument (WHOQOL-BREF): a population based cross-sectional study. Health Qual Life Outcomes. 2019;17:9.PubMedPubMedCentral
30.
Malibary H, Zagzoog MM, Banjari MA, Bamashmous RO, Omer AR. Quality of life (QoL) among medical students in Saudi Arabia: a study using the WHOQOL-BREF instrument. BMC Med Educ. 2019;19:344.PubMedPubMedCentral
31.
Organization WH. WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996. Geneva: World Health Organization; 1996.
32.
33.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.PubMed
34.
Wells G: Shea B, O'Connell D., Peterson J, Welch V, Losos M, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. 2011.
35.
Kremelberg D. Practical statistics: a quick and easy guide to IBM® SPSS® statistics, STATA, and other statistical software. London: SAGE publications; 2010. p 83-100.
36.
StataCorp L. STATA finite mixture models reference manual. Release; 2017.
37.
WHOQOL-BREF W. Introduction, administration, scoring and generic version of the assessment—field trial version. Geneva: Switzerland; 1996.
38.
Skevington SM, Tucker C. Designing response scales for cross-cultural use in health care: data from the development of the UK WHOQOL. Br J Med Psychol. 1999;72:51–61.PubMed
39.
Organization WH. WHOQOL user manual: Programme on mental health. Switzerland: World Health Organization; 1998.
40.
41.
Framework IC. The MOS 36-item short-form health survey (SF-36). Med Care. 1992;30:473–83.
42.
Başar K, Öz G, Karakaya J. Perceived discrimination, social support, and quality of life in gender dysphoria. J Sex Med. 2016;13:1133–41.PubMed
43.
George A, Janardhana N, Muralidhar D. Quality of life of transgender older adults. Int J Soc Sci Humanit Invent. 2015;4:7–11.
44.
Gorin-Lazard A, Baumstarck K, Boyer L, Maquigneau A, Gebleux S, Penochet JC, Pringuey D, Albarel F, Morange I, Loundou A, et al. Is hormonal therapy associated with better quality of life in transsexuals? A cross-sectional study. J Sex Med. 2012;9:531–41.PubMed
45.
Thompson HM, Reisner SL, VanKim N, Raymond HF. Quality-of-life measurement: assessing the WHOQOL-BREF scale in a sample of high-HIV-risk transgender women in San Francisco, California. Int J Transgenderism. 2015;16:36–48.
46.
Ainsworth TA, Spiegel JH. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Qual Life Res. 2010;19:1019–24.PubMed
47.
Blanchard R. Typology of male-to-female transsexualism. Arch Sex Behav. 1985;14:247–61.PubMed
48.
Rakic Z, Starcevic V, Maric J, Kelin K. The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes. Arch Sex Behav. 1996;25:515–25.PubMed
49.
da Silva DC, Schwarz K, Fontanari AMV, Costa AB, Massuda R, Henriques AA, Salvador J, Silveira E, Rosito TE, Lobato MIR. WHOQOL-100 before and after sex reassignment surgery in Brazilian male-to-female transsexual individuals. J Sex Med. 2016;13:988–93.
50.
Pitts MK, Couch M, Mulcare H, Croy S, Mitchell A. Transgender people in Australia and New Zealand: health, well-being and access to health services. Fem Psychol. 2009;19:475–95.
51.
Nuttbrock L, Hwahng S, Bockting W, Rosenblum A, Mason M, Macri M, Becker J. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res. 2010;47:12–23.PubMed
52.
REZAEI AM, Azadi A, Ahmadi F, Vahedian AA. Comparison of depression, anxiety, stress and quality of life in dormitories students of Tarbiat Modares University; 2007.
53.
Movahed M, Hoseynzade Kasmani M. The relation of gender identity disorder and quality of life. J Soc Welf. 2011;12:111–42.
54.
Bauer GR, Hammond R, Travers R, Kaay M, Hohenadel KM, Boyce M. “I don't think this is theoretical; this is our lives”: how erasure impacts health care for transgender people. J Assoc Nurses AIDS Care. 2009;20:348–61.PubMed
55.
Bayat M, Bayat M. Quality of life for women in Mashhad. In: The strategic Thoughts, Women and Families; 2012. p. 575–87.
56.
Montazeri A, Gashtasbi A, Vahdani Nia MS. Translation, reliability and validity of the Persian standard SF36. [Article in Persian]. Payesh J. 2006;5:49–56.
57.
Norozi E, Mostafavi F, Hassanzadeh A, MOODI M, Sharifirad G. Factors related with quality of life among postmenopausal women in Isfahan, Iran, based on behavioral analysis phase of precede model; 2011.
58.
Hafariyan L, Aghaei A, Kajbaf M, Kamkar M, et al. Knowledge Res Appli Psychol. 2009;41:82–61.
59.
Wai H, Tsang P. Hong Kong men with low incomes have worse health-related quality of life as judged by SF-36 scores. Hong Kong Med J. 2006;12:351–4.PubMed
Metadata
Title
Quality of life in people with transsexuality after surgery: a systematic review and meta-analysis
Authors
Mehrdad Eftekhar Ardebili
Leila Janani
Zaher Khazaei
Yousef Moradi
Hamid Reza Baradaran
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Transsexualism
Published in
Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-020-01510-0

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