Date Published: May 14, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Gennaro Selvaggi, Cecilia Dhejne, Mikael Landen, Anna Elander.
The World Professional Association for Transgender Health (WPATH) currently publishes the Standards of Care (SOC), to provide clinical guidelines for health care of transsexual, transgender and gender non-conforming persons in order to maximize health and well-being by revealing gender dysphoria. An updated version (7th version, 2011) of the WPATH SOC is currently available. Differences between the 6th and the 7th versions of the SOC are shown; the SOC relevant to penile reconstruction in female-to-male (FtM) persons are emphasized, and we analyze how the 2011 WPATH SOC is influencing the daily practice of physicians involved in performing a penile reconstruction procedure for these patients. Depending by an individual’s goals and expectations, the most appropriate surgical technique should be performed: the clinic performing penile reconstruction should be able to offer the whole range of techniques, such as: metoidioplasty, pedicle and free flaps phalloplasty procedures. The goals that physicians and health care institutions should achieve in the next years, in order to improve the care of female-to-male persons, consist in: informing in details the individuals applying for penile reconstruction about all the implications; referring specific individuals to centers capable to deliver a particular surgical technique; implementing the surgery with the most updated refinements.
While many transsexual, transgender, and gender nonconforming persons find comfort with their gender identity, role, and expression even without surgery, for many other individuals surgery is essential and medically necessary to alleviate their gender dysphoria . For this group, relief from gender dysphoria cannot be achieved without modification of their primary and/or secondary sex characteristics to establish greater congruence with their gender identity. Moreover, surgery can help patients giving them more and better “passibility”: which means feeling more at ease in the presence of sex partners, in venues such as physicians’ offices, swimming pools, or health clubs.
Most recent reviews [18, 22] in penile reconstruction for female-to-male patients confirm the difficulty of this peculiar surgery, in terms of possible complications and limits of the final achievable outcomes, with surgery necessitating several steps and high number of revisions (see Table 3).
In this paper, we present differences between the 6th and the 7th versions of the SOC, and we intend to analyze how the 2011 WPATH SOC is influencing the daily practice of physicians involved in counseling and performing a penile reconstruction procedure in FtM individuals.
The World Professional Association for Transgender Health has currently published guidelines, named Standards of Care for persons affected by gender identity disorder.