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1.
Rev. argent. cir. plást ; 27(1): 15-20, jan.-mar. 2021. tab, fig, ilus
Article in Spanish | LILACS | ID: biblio-1223459

ABSTRACT

Introducción. La ausencia vaginal tiene un impacto devastador en paciente transgénero de hombre a mujer, por lo tanto, es primordial crear una neovagina de funcionamiento normal con satisfacción sexual, apariencia estética óptima y a su vez las características de micción femenina. Para tal objetivo existen diferentes procedimientos quirúrgicos. La genitoplastia feminizante con colgajo pene escrotal invertido cumple con las necesidades y expectativas del paciente.1-6 Método. En este caso se realizó un análisis descriptivo y retrospectivo de 28 pacientes, transgénero, en los cuales se realizó genitoplastia feminizante con colgajo pene escrotal invertido, con edades entre 18 y 46 años, en un período de 2,5 años desde febrero de 2018 a agosto de 2020. Resultados. La vitalidad del colgajo fue un 100% con una satisfacción sexual del 96,4%, con bajo porcentaje de complicaciones (3%) que incluyen hematoma, dehiscencia y estenosis. Estéticamente la satisfacción fue del 100%. Para muchas pacientes la genitoplastia feminizante es la etapa final de muchas mujeres transgénero en su proceso de confirmación de género.


Introduction. Vaginal absence has a devastating impact on a male to female transgender patient, therefore, it is essential to create a normally functioning neovagina with sexual satisfaction, optimal aesthetic appearance and in turn the characteristics of female urination. For this purpose there are different surgical procedures. Feminizing Genitoplasty with inverted scrotal penis flap meets the needs and expectations of the patient.1-6 Method. In this case, a descriptive and retrospective analysis of 28 transgender patients was performed, in which Feminizing Genitoplasty was performed with an inverted scrotal penis flap, aged between 18 and 46 years, over a period of 2.5 years from february 2018 to august 2020.For many patients, Feminizing Genitoplasty is the final stage for many transgender women in their gender confirmation process. Results. The vitality of the flap was 100% with a sexual satisfaction of 96.4%, with a low percentage of complications in 3% that include hematoma, dehiscence and stenosis, aesthetically we present 100% satisfaction


Subject(s)
Humans , Male , Adult , Surgical Flaps/transplantation , Transsexualism/surgery , Vagina , Retrospective Studies , Skin Transplantation , Reconstructive Surgical Procedures/methods , Transgender Persons
2.
Ciênc. Saúde Colet. (Impr.) ; 25(6): 2347-2356, Mar. 2020.
Article in Portuguese | LILACS | ID: biblio-1101039

ABSTRACT

Resumo O Processo Transexualizador é o principal serviço direcionado à saúde trans-específica no Brasil, o qual oferta aquisições como hormonioterapia e cirurgias de redesignação sexual à população trans. Neste artigo, analisaram-se os sentidos produzidos em torno do procedimento cirúrgico, da nova genitália, sobre gênero e transexualidade entre mulheres que realizaram cirurgia de redesignação sexual no Hospital Universitário Cassiano Antônio de Moraes (HUCAM), localizado em Vitória, Estado do Espírito Santo, Brasil. Foi realizada pesquisa qualitativa com entrevistas narrativas gravadas em áudio, e realizada análise de conteúdo. Foram selecionadas 09 participantes a partir da metodologia bola de neve. Conclui-se que as cirurgias estão relacionadas à busca pela humanização dos corpos. As compreensões sobre ser mulher não se limitaram a um estatuto biológico para os gêneros. A transexualidade foi apresentada como uma experiência de transição entre os gêneros. A cirurgia de redesignação sexual foi apontada como estratégia para a construção de um corpo em consonância com a experiência das participantes nas relações sociais de gênero, cujo sucesso é avaliado sob signos de beleza, prazer e passabilidade.


Abstract The Transsexualization Process is the main service directed to trans-specific health in Brazil, which provides services such as hormone therapy and sexual reassignment surgeries to the trans population. In this article, the significance surrounding the surgical procedure, the new genitalia, gender and transsexuality among women who underwent sexual reassignment surgery at the Cassiano Antônio de Moraes University Hospital (HUCAM), located in Vitória, Espírito Santo State, Brazil, was analyzed. Qualitative research was carried out, narrative interviews were recorded, and thematic content analysis was performed. The sample was composed of 9 participants selected by snowball sampling. The conclusion drawn is that the surgeries are related to the search for the humanization of bodies. The comprehension about being a woman was not limited to a biological status for gender. Transsexuality was presented as a transitional experience between genders. The sexual reassignment surgery was seen as a strategy of corporal correction in line with expectations about social relationships in gender by participants, the success of which is evaluated from the standpoint of beauty, pleasure and passability.


Subject(s)
Humans , Male , Female , Transsexualism/surgery , Brazil , Qualitative Research , Gender Identity
3.
Rev. bras. cir. plást ; 34(1): 65-72, jan.-mar. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-994547

ABSTRACT

Introdução: A cirurgia de adequação genital tem se mostrado uma opção segura e confiável, com redução drástica na disforia e melhora da qualidade de vida das pessoas transgênero. A técnica mais estudada e utilizada é a inversão peniana com suas modificações, com aparência estética e funcionalidade adequadas, porém sem padronização da técnica cirúrgica. Índices de até 38% de satisfação parcial e 15% de insatisfação podem levar até 66% dos casos a realizar procedimentos adicionais. O objetivo é sugerir refinamentos estéticos na aparência da vulva e comparar com algumas das técnicas descritas, buscando aumentar a satisfação estética e funcional pós-operatória. Métodos: Estudo retrospectivo com 7 pacientes submetidas à cirurgia de readequação sexual entre agosto de 2017 e fevereiro de 2018. O clitóris é feito com a glande em formato de tridente, utilizando a coroa para construir os corpos cavernosos do clitóris e aumentar a área de sensação erógena. Faixa de prepúcio é usada para aumentar a cobertura do clitóris e cobrir a face interna dos pequenos lábios, que são definidos com o uso de suturas. Resultados: Sensibilidade adequada e satisfação com o resultado e capacidade de orgasmo em todas as pacientes observadas. Não houve estenose, fístula ou necrose do clitóris com essa técnica. Somente 1 caso precisou de procedimento adicional para melhor definição estética. Conclusão: A técnica apresentada tem alta satisfação das pacientes e sensibilidade erógena, com algumas vantagens em relação a outras técnicas. Porém, estudos prospectivos com número maior de pacientes são necessários para definir a técnica cirúrgica mais efetiva.


Introduction: Sex reassignment surgery is a reliable and safe option, which has drastically reduced dysphoria and improved the quality of life of transgender individuals. The most studied and used technique is penile inversion with modifications, which results in appropriate esthetic appearance and functionality, but the surgical technique has not been standardized. Partial satisfaction rates up to 38% and dissatisfaction rates of 15% may cause up to 66% of cases to undergo additional procedures. The objective is to suggest esthetic refinements to the appearance of the vulva and compare some of the techniques described, seeking to increase the postoperative esthetic and functional satisfaction. Methods: A retrospective study with 7 patients undergoing sex reassignment surgery between August 2017 and February 2018 was conducted. The clitoris is constructed with the glans in the form of a trident, using the corona to build the corpus cavernosa of the clitoris and increase the area of erogenous sensation. A section of the prepuce is used to increase the coverage of the clitoris and cover the inner surface of the labia minora, which are defined with the use of sutures. Results: Adequate sensitivity and satisfaction with the result and capacity of orgasm in all patients were observed. There was no stenosis, fistula, or necrosis of the clitoris with this technique. Only 1 case needed an additional procedure for better esthetic definition. Conclusion: The technique presented leads to high patient satisfaction and erogenous sensitivity, with some advantages compared to other techniques. However, prospective studies with larger numbers of patients are needed to define a more effective surgical technique.


Subject(s)
Humans , Transsexualism/surgery , Vulva/surgery , Vulva/physiopathology , Reconstructive Surgical Procedures/methods , Esthetics , Sex Reassignment Procedures/adverse effects , Sex Reassignment Procedures/methods , Sex Reassignment Surgery/adverse effects , Sex Reassignment Surgery/methods , Sex Reassignment Surgery/rehabilitation , Transgender Persons
4.
Cad. Saúde Pública (Online) ; 35(4): e00110618, 2019. tab
Article in English | LILACS | ID: biblio-1001644

ABSTRACT

The article examines health itineraries followed by Brazilian travestis, trans men and trans women in the affirmation of their gender, based on the survey Trans Uerj: Health and Citizenship of Trans People in Brazil. The survey's main objectives were to gauge the trans/travesti population's diversity and sociodemographic profile; and to map the various ways they access their rights as citizens, especially to healthcare services and body modification technologies. Interviewers, mainly trans people and travestis, applied 391 questionnaires in the city of Rio de Janeiro and its metropolitan region to interviewees of different social classes, schooling levels and gender identity configurations, contacted through the interviewers' social networks. For defining respondents' gender identities the survey used an original method based on self-definitions, which were then aggregated into 6 categories for data analysis purposes. This article discusses the multiple strategies used by this trans population in gender affirmation processes to gain access to regulated and/or unregulated use of hormones and surgical procedures.


O artigo examina os itinerários de saúde seguidos por travestis e mulheres e homens trans brasileiros na afirmação do seu próprio gênero, com base no inquérito Trans Uerj: Health and Citizenship of Trans People in Brazil. O inquérito teve como objetivos avaliar a diversidade e o perfil sociodemográfico da população trans/travesti e mapear as diversas maneiras pelas quais garantem seus direitos de cidadania, principalmente nos serviços saúde e em tecnologias de modificação do corpo. Os entrevistadores, majoritariamente pessoas trans e travestis, aplicaram 391 questionários na cidade e Região Metropolitana do Rio de Janeiro, com entrevistados/as de diferentes classes sociais, níveis de escolaridade e configurações de identidade de gênero, contatados através das redes sociais dos entrevistadores. A definição da identidade de gênero dos entrevistados usou um método original baseado nas autodefinições; as definições foram agregadas depois em seis categorias para fins de análise dos dados. O artigo discute as múltiplas estratégias utilizadas pela população trans nos processos de afirmação de gênero para obter acesso ao uso regulado e/ou não regulado de hormônios e procedimentos cirúrgicos.


El artículo examina los itinerarios de salud seguidos por travestis brasileños, hombres trans y mujeres trans para la afirmación de su género, está basado en la encuesta Trans Uerj: Health and Citizenship of Trans People in Brazil. Los objetivos principales de esta encuesta fueron evaluar la diversidad de la población trans/travesti y su perfil sociodemográfico; así como mapear los diferentes caminos gracias a los que consiguen tener acceso a sus derechos como ciudadanos, especialmente en lo que concierne a servicios de salud y técnicas de modificación corporales. Se entrevistaron principalmente a personas trans y travestis, de quienes se recabaron 391 cuestionarios en la ciudad de Río de Janeiro y su región metropolitana, procedentes de diferentes clases sociales, niveles educacionales y configuraciones de identidad de género, que fueron contactados a través de redes sociales por parte de los entrevistadores. Con el fin de definir las identidades de género de quienes respondieron la encuesta, se usó un método original basado en autodefiniciones, que posteriormente fueron añadidas a 6 categorías para fines de análisis de datos. Este artículo discute las múltiples estrategias utilizadas, por parte de esta población trans en procesos de afirmación de género, para conseguir acceso al uso de hormonas reguladas y/o irregulares, así como procedimientos quirúrgicos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Somatotypes , Transsexualism/surgery , Transvestism/surgery , Transgender Persons/statistics & numerical data , Gender Identity , Self Medication , Social Support , Socioeconomic Factors , Transsexualism/classification , Brazil/epidemiology , Surveys and Questionnaires , Self Report , Transgender Persons/legislation & jurisprudence , Health Services Accessibility , Hormones/administration & dosage
5.
Int. braz. j. urol ; 44(2): 407-408, Mar.-Apr. 2018.
Article in English | LILACS | ID: biblio-1040040

ABSTRACT

ABSTRACT Introduction After the diagnosis of transsexualism is confirmed therapy commences with psychotherapeutic preparation for the conversion, and after conversion, long-term patient rehabilitation is maintained for at least two years. The indication for surgery is chronic discomfort caused by discord with the patient's natural gender, intense dislike of developing secondary sex characteristics and the onset of puberty. The surgical conversion of transsexuals is the main step in the complex care of these problematic patients (1). This surgery was first described by Benjamin H, using a flap of inverted penile skin (2) and is considered the gold standard since then. Male-to-female transsexual surgical techniques are well defined and give good cosmetic and functional results. Sex reassignment surgery promotes the improvement of psychological aspects and social relationships as shown in the World Health Organization Quality of Life Assessment applied in the patients submitted to this procedure (3). Techniques include the creation of a normal appearing female introitus, a vaginoplasty allowing sexual intercourse and the capability of clitoral orgasm (4). Various methods for neovaginoplasty have been described and can be classified into five categories, i.e. pedicled intestinal transplants, penile skin grafts, penile skin flaps, non-genital skin flaps and non-genital skin grafts (5). In our Hospital, we use penile and scrotal skin flaps. Until now, 174 procedures have been performed by our team using this technique with high rates of satisfaction (3). Patients and methods We present a step-by-step male to female transsexual surgery. Conclusion Surgical gender reassignment of male transsexuals resulted in replicas of female genitalia which enabled coitus with orgasm (1). With this video we show step by step that a surgery using penile skin flaps is able to be performed with good cosmetic results.


Subject(s)
Humans , Male , Female , Surgical Flaps , Transsexualism/surgery , Sex Reassignment Surgery/methods , Treatment Outcome
6.
Trends psychiatry psychother. (Impr.) ; 39(1): 43-47, Jan.-Mar. 2017. graf
Article in English | LILACS | ID: biblio-846398

ABSTRACT

Abstract Introduction: Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA). The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.


Resumo Introdução: O transexualismo (CID-10) é uma condição caracterizada por forte e persistente dissociação com o gênero atribuído. A cirurgia de redesignação sexual (CRS) e a terapia hormonal (TH) permitem que indivíduos transexuais se sintam mais congruentes com seu gênero e, por isso, têm desempenhado papel importante nos últimos 70 anos. O fator neurotrófico derivado do cérebro (BDNF) parece desempenhar um papel fundamental na recuperação do trauma cirúrgico agudo e vulnerabilidade ambiental à psicopatologia. Nós hipotetizamos que o BDNF pode ser um biomarcador de alívio do sofrimento de incongruência de gênero pós-CRS. Objetivos: Mensurar os níveis séricos de BDNF no pré e pós-operatório em indivíduos transexuais como biomarcador de alívio de estresse relacionado à incongruência de gênero após a CRS. Métodos: Trinta e duas pessoas transexuais masculino para feminino submetidas a cirurgia e tratamento hormonal foram selecionadas de nossa amostra inicial. O nível sérico de BDNF foi avaliado antes e depois da CRS pela técnica ELISA. O tempo decorrido entre as coletas de sangue pré e pós-CRS foi medido. Resultados: Não houve diferença significativa nos níveis de BDNF pré e pós-CRS ou em relação ao tempo decorrido entre a CRS e a coleta. Conclusão: O alívio do sofrimento relacionado à incongruência de gênero pós-CRS não pode ser avaliado apenas pelo BDNF. Soluções cirúrgicas podem não fornecer uma solução rápida para o sofrimento associado ao transexualismo, e a CRS pode servir como um passo em direção à, em vez de conclusão da, construção da identidade de gênero de uma pessoa.


Subject(s)
Humans , Male , Female , Adult , Stress, Psychological/blood , Transsexualism/blood , Brain-Derived Neurotrophic Factor/blood , Sex Reassignment Surgery , Gender Dysphoria/blood , Postoperative Period , Transsexualism/surgery , Transsexualism/psychology , Transsexualism/drug therapy , Blood Chemical Analysis , Enzyme-Linked Immunosorbent Assay , Biomarkers/blood , HIV Infections/complications , HIV Infections/blood , Prospective Studies , Treatment Outcome , Hormone Replacement Therapy , Preoperative Period , Gender Dysphoria/surgery , Gender Dysphoria/psychology , Gender Dysphoria/drug therapy
7.
Rev. méd. Chile ; 143(8): 1015-1019, ago. 2015. ilus
Article in Spanish | LILACS | ID: lil-762667

ABSTRACT

Do transsexual people in Chile have a right to have their gender identity or their sex reassignment legally recognized? The absence of any legislation on gender identity or transsexualism could lead us to believe that it is not the case. However, a quantitative review of decisions issued by Chilean courts during the last years on name-and sex-change requests filed by transsexual people reveals that most of these courts have accepted these requests. From the perspective of the well-being of transsexual people, this is a positive result. However, the fact that a few rejections exist reminds us of the need to enact an explicit legislation in this issue. Lastly, a qualitative analysis of those decisions suggests that the traditional reluctance of courts to interpret the law in a creative way has been overcome in these cases by the use of knowledge and discourses belonging to healthcare sciences. This is an example of an epistemological complementariness between medicine and law.


Subject(s)
Female , Humans , Male , Names , Transgender Persons/legislation & jurisprudence , Transsexualism/psychology , Chile , Gender Identity , Judicial Role , Legislation, Medical , Sex Reassignment Surgery/legislation & jurisprudence , Transsexualism/surgery
8.
Interface comun. saúde educ ; 16(42): 637-649, jul.-set. 2012.
Article in Portuguese | LILACS | ID: lil-651752

ABSTRACT

Os(as) transexuais exibem uma discordância entre sexo biológico e gênero. Em busca de uma adequação, optam por cirurgias, como: neocolpovulvoplastia (mudança do sexo masculino para o feminino), faloplastia (mudança inversa), mastectomia, histerectomia, e hormonioterapia. Este trabalho investigou as situações vividas por essas pessoas na busca de uma harmonia com seus corpos, incluindo os períodos pré e pós-cirúrgicos. Foram entrevistados quatro transexuais que já haviam realizado a cirurgia ou estavam em vias de realizá-la. Observou-se a importância das intervenções cirúrgicas e hormonais, assim como a mudança do nome civil, como condição para uma vida melhor. Constatou-se que a fila de espera no Sistema Único de Saúde (SUS), o protocolo pré-operatório de dois anos, o custo das cirurgias nas clínicas particulares e a falta de regulamentação jurídica para a mudança de documentação são algumas das maiores dificuldades encontradas para a realização do processo transexualizador.


Transsexual people show a discrepancy between biological sex and gender. In seeking to resolve this, they choose surgery such as neocolpovulvoplasty (change from male to female), phalloplasty (inverse change), mastectomy, hysterectomy and hormone therapy. This study investigated the situations experienced by these people in their search for harmony with their bodies, including before and after surgery. Four transsexuals who had undergone surgery or were on track to achieve it were interviewed. The importance of hormonal and surgical interventions was observed, as well as a change in legal name, as conditions for a better life. It was noted, however, that the waiting list in the Brazilian National Health System (SUS), the preoperative protocol of two years, the cost of surgery in private clinics and the lack of legal regulation for changes in documentation are some of the greatest difficulties encountered in achieving the sex change process.


Los(las) transexuales muestran una discrepancia entre sexo biológico y género. En busca de um ajuste, optan por cirugías, como neocolpovulvoplastia (cambio de hombre a mujer), faloplastia (cambio inverso), mastectomía, histerectomía y terapia hormonal. Este estudio ha investigado las situaciones vividas por estas personas en busca de la armonía con sus cuerpos, incluyendo el pre y post-operatorio. Fueron entrevistados cuatro transexuales que ya habían realizado la cirugía o estaban por hacerlo. Se observó la importancia de las intervenciones hormonales y quirúrgicas, así como cambiar el nombre legal, como condición para una vida mejor. Se observó que la lista de espera en el Sistema Único de Salud (SUS), los dos años del protocolo pre-operatorio, el coste de las cirugías en clínicas privadas y la falta de regulación legal para el cambio de la documentación son algunas de las mayores dificultades en su aplicación.


Subject(s)
Humans , Male , Female , Adult , Gender Identity , Transsexualism/surgery , Transsexualism/psychology , Unified Health System
9.
Int. braz. j. urol ; 38(1): 97-107, Jan.-Feb. 2012. ilus, tab
Article in English | LILACS | ID: lil-623321

ABSTRACT

PURPOSE: The aim of this study is to thoroughly report on surgical outcomes from 332 patients who underwent male to female gender reassignment surgery (GRS). MATERIAL AND METHODS: Records from 332 patients who underwent GRS from 1995 to 2008 were reviewed. All patients were submitted to penile inversion vaginoplasty with glans-derived sensate clitoroplasty. Mean age was 36.7 years (range 19-68 years). Surgical complications were stratified in 6 main groups: genital region, urinary tract, gastrointestinal events, wound healing disorders and unspecific events. RESULTS: Progressive obstructive voiding disorder due to meatal stenosis was the main complication observed in 40% of the patients, feasibly corrected during the second setting. Stricture recurrence was found in 15%. Stricture of vaginal introitus was observed in 15% of the cases followed by 12% and 8% of vaginal stenosis and lost of vaginal depth, respectively. Rectal injury was seen in 3% and minor wound healing disorders in 33% of the subjects. CONCLUSION: Regarding male to female GRS, a review of the current literature demonstrated scarce description of complications and their treatment options. These findings motivated a review of our surgical outcomes. Results showed a great number of adverse events, although functionality preserved. Comparision of our outcomes with recent publications additionally showed that treatment options provide satisfying results. Moreover, outcomes reaffirm penile inversion vaginoplasty in combination with glans-derived sensate clitoroplasty as a safe technique. Nevertheless, discussing and improving surgical techniques in order to reduce complications and their influence on patient's quality of life is still strongly necessary and theme of our future reports.


Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Young Adult , Genitalia, Male/surgery , Sex Reassignment Surgery/methods , Transsexualism/surgery , Follow-Up Studies , Postoperative Complications , Prospective Studies , Sex Reassignment Surgery/statistics & numerical data
10.
São Paulo; Revista dos Tribunais; 2011. 571 p.
Monography in Portuguese | LILACS | ID: lil-655572

ABSTRACT

Dar visibilidade e impor respeito às diferenças de caráter sexual, bem como inserir os direitos das pessoas lésbicas, gays, bissexuais, transexuais, travestis e transgêneros no sistema jurídico é um projeto antigo da coordenadora desta obra. Escrita por juristas que se notabilizaram na abordagem dos diversos aspectos relacionados ao tema, a presente obra é um passo decisivo para a sistematização do direito homoafetivo. São apresentados, inicialmente, os possíveis modelos de enquadramento jurídico das uniões homoafetivas. Seguem-se temas: A proteção dos direitos humanos e a vedação à discriminação por orientação sexual Da união homoafetiva como uma família constitucionalmente protegida.Afetividade como norteador das relações familiares. O reconhecimento da homoparentalidade O cabimento dos alimentos nas uniões homoafetiva.Dano moral e o direito à livre orientação sexual Homoparentalidade e filiação.Da partilha de bens Uso do nome social e a adequação do prenome antes da realização de cirurgia genital Seguro DPVAT ao beneficiário homossexualPlanos de saúde Criminalização da discriminação por orientação sexual sob o enfoque do direito fundamental à tolerância Licença paternidade e a adoção. Trata-se, assim, de obra que, acima de tudo, contribui decisivamente para desconstruir o preconceito ainda tão forte em nossa sociedade.


Subject(s)
Humans , Civil Rights/legislation & jurisprudence , Homosexuality/history , Sexual Partners , Spouses , Marriage/legislation & jurisprudence , Domestic Violence , Family , Gender Identity , Names , Prejudice , Religion , Transsexualism/surgery
11.
Rev. Col. Bras. Cir ; 37(6): 426-434, nov.-dez. 2010. ilus
Article in Portuguese | LILACS | ID: lil-625234

ABSTRACT

OBJETIVO: Mostrar a experiência do tratamento cirúrgico do transgenitalismo (masculino/feminino) realizado no Programa de Transgenitalização do Hospital Universitário Clementino Fraga Filho, - UFRJ. MÉTODOS: A seleção dos pacientes para operação de transgenitalismo obedeceu à avaliação de equipe multidisciplinar, atendendo aos critérios definidos, após dois anos de acompanhamento conjunto: diagnóstico médico de transexualismo; paciente maior de 21 anos; ausência de características físicas inapropriadas para a mudança; apoio de pelo menos um familiar próximo. RESULTADOS: De 1997 a 2004 foram atendidas dezessete, pessoas quinze confirmaram a condição transexual, uma foi afastada por ter trazido exames falsos. Do total de dezesseis transexuais, foram realizadas seis operações. As pacientes operadas situavam-se na faixa de 25 a 40 anos com média de 31 anos. O procedimento cirúrgico foi concluído sem dificuldades técnicas em todas as pacientes . Uma paciente apresentou estenose do neo meato e em outra foi necessário encurtar um pouco mais a uretra. CONCLUSÃO: A técnica operatória não oferece maiores dificuldades em sua execução, mas pode depender das condições locais e da criatividade do cirurgião. A dificuldade maior está em preparar estes pacientes para que não haja frustrações ou expectativas demasiadas.


OBJECTIVE: To describe the experience of male-to-female sex reassignment surgery conducted at the Transgenitalization Program of the Clementino Fraga Filho University Hospital -UFRJ. METHODS: The selection of patients for operation followed the evaluation of a multidisciplinary team, meeting the criteria after two years of follow-up: medical diagnosis of transsexualism, patient over 21 years, no physical characteristics unsuitable for change, support at least one close relative. RESULTS: From 1997 to 2004 seventeen patients were followed, fifteen of which had confirmed transsexual condition, one was dismissed for bringing false examinations. Of the total of sixteen transsexuals, six operations were performed. The operated patients were in the age range of 25 to 40 years with an average of 31. The surgical procedure was completed without any technical difficulties in all patients. One patient had stenosis of the neo meatus and in another it was necessary to shorten the urethra. CONCLUSION: The technique provides no major difficulties in implementation, but may depend on local conditions and surgeon's creativity. The greatest difficulty is to prepare these patients so that there are neither frustrations, nor too many expectations.


Subject(s)
Adult , Female , Humans , Male , Transsexualism/surgery , Brazil , Gynecologic Surgical Procedures/methods , Hospitals, University , Retrospective Studies
12.
Scientific Journal of Kurdistan University of Medical Sciences. 2009; 13 (4): 78-87
in Persian | IMEMR | ID: emr-92801

ABSTRACT

Gender identity disorder consists of the patient's consistent desire to identify with the opposite sex and feels significant discomfort or the inability to deal with this condition. In patients resistant to treatment [Individual Psychotherapy, Psychoanalysis] operational procedure has been utilized and has been authorized in Iran through a religious decree issued by the country's late leader, Ayatollah Khomeini since 1964. A study into the instances of surgery procedures in the country has proven positive results. The procedure consists of cross-sectional study in small scale on 12 transsexual individuals consisting of 9 men and 3 women. All of the participants had sexual reassignment surgery at an average of six years prior to the study. They all were from middle class families and held an average age of 25. The participants were subjected to MMPI-1 questionnaire, [MF] MMPI-2, The Bem Sex-Role inventory and the Bem Gender Traits Test. The study showed that the patients have responded positively to the treatment in psycho-social dimension and had obtained a normal grade at the MMPI-1 test. According to the results of the Bem and MF tests they have also accepted their new identity and role. Results of Semi structural interview included all of sample agreed with their decision. Neither of the patients has expressed regret of undertaking the surgery. Multiple factors include economic status of the patients, satisfying interpersonal relationships, efficient support system, sexual partners and satisfactory sexual life, suitable familial reactions and possibility of extra surgery have prominent role to adjust them with their new identity and role in the society


Subject(s)
Humans , Male , Female , Transsexualism/surgery , Gender Identity , Sexual Partners , Economics , Cross-Sectional Studies , Patient Satisfaction
13.
Article in English | IMSEAR | ID: sea-41227

ABSTRACT

OBJECTIVE: To determine the neurovascular profiles in the pelvis and penis for applying to sex reassignment surgery. MATERIAL AND METHOD: Dissection of the pelvis and penile shaft was performed in 12 soft-preserved and 32 fresh adult male cadavers respectively. The neurovascular structures were located and documented, and the distances between anatomical landmarks were measured. Thirty-two specimens from the glans penis were obtained for immunohistochemical analysis to analyze its innervation and blood supply. RESULTS: Several anatomical variations of penile arterial supply were found. They are the presence of the accessory pudendal artery, multiple cavernous and bulbourethral arteries. The unilateral dorsal artery was observed in 10 of 32 cadavers, predominantly on the left. From the root to the neck of the penis, the dorsal nerves were divided into two groups. The first group of fibers innervating the glans coursed along the dorsolateral surface of the shaft and pierced the entire area of the corona. The other group diverged to distribute throughout the lateral surface to innervate the lateral and ventral portions. The mean distance between the left and right medial main branches that terminated in the glans was 1.18 cm. Immunohistochemical analysis revealed that the main nerves, after entering the glans, divided into terminal branches that concentrated around urethra. A mean distance from the main nerves to the epithelium was 0.71 cm. CONCLUSION: This detailed anatomy in the pelvis and along the penis should provide a valuable guide for sex reassignment surgery and intrapelvic operations.


Subject(s)
Dissection , Humans , Male , Pelvis/anatomy & histology , Penis/blood supply , Perineum/blood supply , Thailand , Transsexualism/surgery
14.
Rio de Janeiro; Garamond; 2006. 250 p. (Sexualidade, gênero e sociedade).
Monography in Portuguese | LILACS | ID: lil-601634

ABSTRACT

A obra enfoca a transexualidade como objeto de uma reflexão propositadamente provocativa: Qual é a capacidade do sujeito de subverter normas de gênero?A autora não discute gênero a partir da referência biológica, mas das performances que os sujeitos – como os que se submetem a cirurgias de mudança de sexo – atualizam em suas práticas cotidianas para serem reconhecidos como membros legítimos do gênero com o qual se identificam. Para tanto, Berenice faz uma revisão histórica contextualizando a problemática transexual, desde o seu surgimento na metade do século passado, como uma patologia, até a atualidade, na qual com a entrada das Ciências Sociais e da voz dos próprios sujeitos envolvidos nas discussões, se pretende desconstruir o transexualismo como doença.


Subject(s)
Humans , Sexual Behavior/psychology , Transsexualism/surgery , Gender Identity
15.
Article in English | IMSEAR | ID: sea-39003

ABSTRACT

Many years ago Thai society considered transsexualism (Gender identity disorder or Gender dysphoria) which is commonly known as Kathoey (a word originally used to denote hermaphrodites), Sao Prapet Song or Tut (as in 'Tootsie') were low class citizens, dirty dressing and had to hide in a dark corner selling their services as prostitutes. This made us unwilling to do sex reassignment surgery for this group of people because the idea of eradicating normal sexual organs for the purpose that was not accepted by the society. Consequently the authors have experience in cases where these people wandered seeking doctors who had no competency nor enough experience to do the surgery. The authors could not inhibit the desire of these people who usually suffer from gender identity disorder from strongly wishing to change their genital sex to the sex they want. The outcome of the surgery was not satisfactory for the patients. There were complications and sequelae which caused the authors to correct them later which might be more difficult than doing the original surgery. In addition there were more studies about the etiology and affect of the disorder on these people that changed the social point of view. The women who wanted to be a him and men who would like to be a her should be considered as patients who need to be cured to set the harmony about their genetic sex and the desire to be the opposite sex and also to be regarded by others as a member of that other sex. The treatments of transsexualism usually begin with conventional psychiatric and endocrinological treatment to adjust the mind to the body. For those who failed conservative treatment in adjusting the mind to the body then sex reassignment surgery will be the only way to transform their body to their mind and give the best result in properly selected patients. Preecha Tiewtranon, the pioneer in sex reassignment surgery in Thailand, did his transsexualism case in 1975 together with Dr. Prakob Thongpeaw. Sex reassignment surgery has been taught in Chulalongkorn University Hospital since 1983. (At present, it is the only medical school in Thailand that has sex reassignment surgery systematically taught and with good results). There have been many versions of development of the surgical techniques to gain better and better results.


Subject(s)
Female , Gender Identity , Humans , Male , Thailand , Transsexualism/surgery , Urogenital Surgical Procedures
16.
Arq. bras. endocrinol. metab ; 45(4): 407-414, ago. 2001.
Article in Portuguese | LILACS | ID: lil-289967

ABSTRACT

O transexualismo masculino é uma condiçäo que exige a atuaçäo de profissionais de diversas áreas para o diagnóstico e tratamento. De vital importância é o correto diagnóstico, uma vez que o tratamento cirúrgico é irreversível e, se incorretamente indicado, pode levar até ao suicídio. Os elementos diagnósticos säo essencialmente clínicos e um período-teste de observaçäo de dois anos é recomendado antes da realizaçäo da cirurgia. Nesse período säo utilizados recursos psicoterápicos e prescrita medicaçäo anti-androgênica e estrogênica para adequaçäo dos caracteres sexuais secundários. No presente artigo de revisäo säo abordados os conceitos necessários à conduta nos casos de transexualismo, bem como as opçöes terapêuticas disponíveis.


Subject(s)
Humans , Male , Transsexualism/diagnosis , Androgen Antagonists/therapeutic use , Estrogens/therapeutic use , Psychotherapy , Transsexualism/etiology , Transsexualism/surgery
18.
Rev. psiquiatr. Urug ; 59(330): 35-44, jun. 1995.
Article in Spanish | LILACS | ID: lil-239277

ABSTRACT

En el presente trabajo describimos la experiencia realizada en el marco de las actividades del Departamento de Psicología Médica de la Facultad de Medicina, con tres pacientes transexulaes. Dos de los pacientes fueron diagnosticados como transexuales y se consideró pertinente la cirugía, no así con un tercero portador de una personalidad borderline en la cual se inscribía el trastorno en la identidad de género como expresión sintomática de la patología de base. Se realizó además una extensa revisión bibliográfica acerca del tema analizado los distintos enfoques teóricos en la literatura mundial que, correlacionados con los hallazgos clínicos, nos permitieron elaborar criterios de utilidad diagnóstica y terapéutica


Subject(s)
Humans , Male , Female , Adult , Transsexualism/psychology , Transsexualism/surgery
19.
Rev. chil. urol ; 51(2): 94-5, 1988.
Article in Spanish | LILACS | ID: lil-69958

ABSTRACT

El transexualismo es una anomalía de la "identidad sexual" de poca frecuencia de etiología hasta hoy desconocida. Corresponde a un "sexo psicológico" irrenunciable, opuesto a su genotipo, donde la Psiquiatría se ha demostrado ineficaz, y el tratamiento quirúrgico de "adaptacion genital", ha resultado de franco beneficio, al permitir a estos pacientes liberarse de tan penosa situación, mejorar su autoaceptación y posibilitar su realización personal y adaptación social


Subject(s)
Humans , Male , Transsexualism/psychology , Transsexualism/surgery
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