Background: The aims of our study were to identify studies that evaluated patient satisfaction after transsexual surgery, analyze existing questionnaires, and summarize their development, psychometric properties, and content.
Methods: A systematic review of the English-language literature was performed. Patient-reported outcome measures designed to assess patient satisfaction and quality of life following transsexual surgery were identified. Qualifying instruments were assessed for content and adherence to international guidelines for development and validation.
Results: From 796 articles, 19 studies had sufficient data and met the inclusion criteria. Included were a total of 2299 patients and 17 patient-reported outcome measures: 10 generic instruments that assessed quality of life, 4 specific for female genital or sexual satisfaction, 2 specific for transsexual body image or gender dysphoria, and 1 specific for plastic surgery. The questionnaires were analyzed by reviewers to assess the adherence to the rules of the US FDA and the Scientific Advisory Committee of the Medical Outcomes Trust. We identified 17 individual questionnaires that were included. All measures were limited by either their development, their validation, or their content.
Conclusions: There is a need for a new self-assessment tool, which should include functional, psychorelational, and cosmetic components, to measure satisfaction and quality of life of patients who have undergone transsexual surgery.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Keywords: Body image; Feminization; Masculinization; Patient-reported outcome; Plastic surgery; Quality of life; Questionnaire; Satisfaction; Sex reassignment; Transgender; Transsexual.