Researchers have theorized that transgender individuals seeking male to female (MtF) gender-affirming surgery fall into two age-related subgroups. A new Sexual Medicine study discusses characteristics found in each group.
According to the authors, the notion of two distinct groups is “controversial.” In their study, they categorized patients based on the age of gender dysphoria onset.
People with gender dysphoria feel a mismatch between their birth-assigned gender and the gender they identify with. Some describe feeling as if they were born in the wrong gender. Many decide to transition from one gender to the other through lifestyle changes, hormonal theory, and gender-affirming surgery.
The study involved 40 adults who had their first male-to-female gender-affirming surgery between 2012 and 2014. Each participant had had their penis and testes removed and a neovagina created.
Questionnaires related to health, body image, depression, anxiety, emotional status, and self-esteem were completed before surgery and again 12 months after surgery.
The participants were divided into two groups based on their age at gender dysphoria onset: 17 years and younger (the “younger group” – 19 people) or 18 years and older (the “older group” – 21 people). The median age of onset overall was 18.5 years.
On average, the younger group had their first gender-affirming surgery at a younger age (32.7 years) compared to the older group (43.8 years). Participants in the younger group were also more likely to have depressive symptoms at baseline; such symptoms were usually resolved after gender-affirming surgery.
The groups differed in their feelings of sexual attraction. At baseline, almost 53% of the participants in the younger group were attracted to men. For the older group, the rate was 19%. The remainders of each group were attracted to women, both men and women, or neither men nor women.
After surgery, attraction rates stayed the same for the younger group. In the older group, about 14% were attracted to men, and 86% were attracted to women, both men and women, or neither men nor women.
Participants in the younger group were more likely to be sexually active at both time points compared to the older group.
Age of gender dysphoria onset might provide clues to patients’ medical and psychological needs, the authors noted.
“The findings may have implications on the outcomes of psychotherapeutic, endocrinologic, and operative treatment and could ultimately influence therapeutic strategies,” they wrote.
Zavlin, Dmitry, MD, et al.
“Age-Related Differences for Male-to-Female Transgender Patients Undergoing Gender-Affirming Surgery”
(Full-text. Published online: January 9, 2019)