Psychological Pathologies and Sexual Orientation in Transgender Women Undergoing Gender Confirming Treatment

Nikolaos A. Papadopulos, Jean Daniel Lellé, Dmitry Zavlin, Peter Herschbach, Gerhard Henrich, Laszlo Kovacs, Benjamin Ehrenberger, Hans Guenther Machens, Jürgen Schaff

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background There are few studies evaluating depression, self-esteem, and mental health after gender confirming treatment of transgender women. Most of these studies include different surgical techniques and nonvalidated questionnaires. With our survey, we are aiming to assess psychopathologies and mental health as well as sexuality among a group of patients treated by the same surgeon performing our self-developed combined surgical technique. This vaginoplasty approach is characterized by constructing the vaginal cavity with parts of the penile and scrotal skin as well as the longitudinally incised urethra. Materials and Methods Forty-seven transgender women who underwent gender confirming treatment between 2007 and 2013 were included in a retrospective study. The assessment of our study group was performed by means of self-developed indication-specific questionnaires and 3 standardized questionnaires that can be compared with norm data. Results Preoperative psychotherapy was mostly considered as helpful by the patients, yet postoperatively, only a third of our study participants were still under therapeutic treatment. Furthermore, we could show a change in sexual preference toward a more bisexual orientation. Gender confirming treatment satisfied the expectations for most of the patients and, in their opinion, should have been performed earlier. Results of the standardized Patient Health Questionnaire 4, a short depression screening questionnaire, did not significantly differ from healthy norm data. The Freiburg Personality Inventory, Revised, revealed normal emotionality and sane self-assessment within our study group. High self-esteem and significantly higher scores than norm data were found for the Rosenberg Self-esteem Scale. Conclusions Gender confirming treatment with the combined technique is an important part of a multi-structured treatment of transgenders and does have effects on psychological well-being. It seems to decrease psychopathologies and implicates several ameliorations for transgender women. Findings need to be verified in prospective studies including preoperative evaluations.

Original languageEnglish
Pages (from-to)312-316
Number of pages5
JournalAnnals of Plastic Surgery
Issue number3
StatePublished - 1 Mar 2020
Externally publishedYes


  • depression
  • gender dysphoria
  • quality of life
  • sex reassignment surgery
  • transgender


Dive into the research topics of 'Psychological Pathologies and Sexual Orientation in Transgender Women Undergoing Gender Confirming Treatment'. Together they form a unique fingerprint.

Cite this