PROGNOSIS FOR TRANSEXUALISM
The numbers of known cases of sex reassignment followed by a second reassignment to the original sex are few (four known and probably no more than ten) and the number of such cases published, fewer still. The transsexual with such a history apparently rushes into the initial surgery prematurely, impulsively, and even against psychological advice. In contrast, for those sex-reassignment applicants who pass the two-year real life test, surgery confirms the status they have already achieved, and they continue to do well. They do well according to the criteria of earning a living, not being arrested, settling down with a partner, not needing a psychiatric referral, and saying that they are contented in their new status and do not regret the change.
The surgical prognosis is guarded. Male-to-female transsexuals may need follow-up surgery to keep the vaginal canal functional and patent. The end result, however, only rarely is persistently unsatisfactory. Female-to-male transsexuals may have problems, eventually correctable, of urethral stricture, and they always have the problem of impotence for which no successful surgical technique has yet been devised.
The hormonal prognosis is satisfactory for both male-to-female and female-to-male transsexuals. Some male-to-female transsexuals, particularly those few in show business, are unsatisfied with hormonally induced breast growth. They seek and obtain either augmentation mammoplasty or silicone injections. The latter are dangerous to health and are absolutely contraindicated.
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