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EditorialGender Dysphoria: The Role of Sex Reassignment Surgery

Miroslav L. Djordjevic,1 Christopher J. Salgado,2

Marta Bizic,1 and Franklin Emmanuel Kuehhas3

1 School of Medicine, University of Belgrade, Serbia2 School of Medicine, University of Miami, FL, USA3University of Vienna, Austria

Correspondence should be addressed to Miroslav L. Djordjevic; [email protected]

Received 1 July 2014; Accepted 1 July 2014; Published 10 July 2014

Copyright © 2014 Miroslav L. Djordjevic et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

This special issue represents a comprehensive, multidisci-plinary look on gender dysphoria. We invited investigatorsto contribute original research articles as well as reviewarticles that will further encourage the continuing efforts tounderstand the role of gender dysphoria, sex reassignmentsurgery, modalities of surgical treatment, and the patient’sevaluation of hormonal, psychosocial, and psychosexual out-comes. We were particularly interested in articles describingnew operative procedures, the modifications of old ones, themodalities of postoperative follow-up, the role of hormonalsupport, and the recommendations for the future. As a result,we have assembled this special issue with eight excellentpapers providing authoritative and concise information ongender dysphoria patients and covering almost all aspects oftheir treatment.

In “An overview of neovaginal reconstruction optionsin male to female transsexuals,” M. Bizic et al. reviewednumerous methods that have been described for vaginalreconstruction in the treatment of transgenders. The choiceof surgical option for vaginoplasty depends on the surgeon’sexperience as well as on the patient’s wishes and expec-tations. Sometimes a multidisciplinary approach is neces-sary in prevention of postoperative complications and poorpsychosocial and psychosexual outcome. S. Vujovic et al.investigated the importance of prenatal hormone exposurein the development of transsexualism by measurement offinger lengths in a sample of Serbian patients. In theirpaper entitled “Finger length ratios in Serbian transsexuals,”both FtM and MtF patients were included and compared to

cisgendered females and males. The results obtained supportthe biological origins of transsexualism.

The authors of “Personality disorders in persons withgender identity disorder” assessed personalities and person-ality disorders (PD) by comparing gender dysphoric andcisgender persons using the art’s most frequently appliedinstrument, Structured Clinical Interview (SCID-II). Duisinet al. obtained significant results, some of which were similarto previous studies, while others diverged. Evaluation ofPD’s comorbidity with gender dysphoria is important forthe optimization of treatment during the pretransitory andtransitory periods, but for some patients it is relevant in thepostoperative period as well. A paper entitled “Assessmentof self-perception of transsexual persons: pilot study of 15patients” by J. Barisic et al. investigates the self-perception oftranssexuals by using the Rorschach test, an important anduseful tool in psychological examination of candidates for sexreassignment surgery. The value of this pilot study lies in itsexamination of adaptive capacities for transition, which is ofgreat importance in prediction of the outcome.

The complex anatomy of the clitoris is a subject areawith which reconstructive surgeons must remain completelyabreast. In their paper “The role of clitoral anatomy in femaleto male sex reassignment surgery,” V. Vukadinovic et al.confirmed the significance of comprehensive understandingof the clitoral anatomy as a basis for a successful outcomeafter metoidioplasty. In addition, they pointed out the role ofthe clitoris in achieving a normal sexual life after transitionfrom female to male, following either metoidioplasty or

Hindawi Publishing Corporatione Scientific World JournalVolume 2014, Article ID 645109, 2 pageshttp://dx.doi.org/10.1155/2014/645109

2 The Scientific World Journal

total phalloplasty. Preliminary results from an Italian groupof researchers, described by S. Bogliolo et al. in “Roboticsingle-site surgery for female-to-male transsexuals: preliminaryexperience,” showed us the importance of minimally invasiveprinciples for hysterectomy and bilateral oophorectomy inFTM patients. Following the experience of laparoscopicapproaches in reconstructive surgery, authors take a stepbeyond with recommendations on robotic surgery.

The paper entitled “Psychosocial adjustment to sex reas-signment surgery: a qualitative examination and personalexperiences of six transsexual persons in Croatia” presentsN. Jokic-Begic’s personal clinical experience in the specificcultural and religious environment of the Balkans. Exchangeof the clinical observations of insights from the personallives of transgender persons worldwide is significant, as itcreates a medical and scientific ambience for overcomingthe difficulties and obstacles gender dysphoric patients facethroughout the process of transition and psychosocial adjust-ment after SRS. The authors stress the importance of socialand medical support which sometimes highly correlates withthe prolongation of transition period.

Finally, the paper fromP. Tiewtranon’sgroup entitled “Thedevelopment of sex reassignment surgery in Thailand: a socialperspective” retrospectively evaluated the development of sur-gical procedures inThailand. It describes how rich experienceteamed with a dedication to surgical excellence providesthe ideal environment for successful surgical treatment oftranssexuals.The experiences described prove that guidelinesfor sex reassignment surgery are both simple to understandand useful to apply.

Acknowledgment

This project was supported by Ministry of Science, Republicof Serbia, no. 175048.

Miroslav L. DjordjevicChristopher J. Salgado

Marta BizicFranklin Emmanuel Kuehhas

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