Male to female gender reassignment surgery: Surgical outcomes of consecutive patients during 14 years

IntroductionGender dysphoria is a state where the individual shows a strong and persistent identification with the opposite gender and a belief of being born in the wrong sex. Gender reassignment surgery (GRS) is a complex surgical undertaking. Although this group of patients is rapidly increasing worldwide, the literature is limited in terms of the outcome. Sweden has a long history of GRS in male-to-female (MtF) patients. In this study, we present the surgical outcome, mortality and short-term post-operative complications in MtF GRS surgery at our centre over a period of 14 years.Material and methodsThis is a retrospective cohort study on consecutive patients who underwent primary MtF GRS at the Department of Plastic and Reconstructive Surgery at Karolinska University Hospital from 2000 to 2013. Demographics along with surgical complications were registered and analysed.ResultsDuring the study period, a total of 205 primary MtF GRS were performed. Median age of patients was 33 years (range 18–76). Major complications such as deep infection, rectovaginal fistula and pulmonary embolism were rare. Minor complications affected approximately one in four patients. The most common minor complication were bleeding and infection.ConclusionsMtF GRS can be performed with a low rate of major complications. Our data indicate that increasing surgical experience leads to shorter operating times and less complications. This suggests that GRS surgery should be performed at few centres so that surgical experience and volume may be optimized.