Abstract
Two groups of patients served as subjects for the study. Group I consisted of seven biological males (three whites and four blacks) who received surgery before the organization of the CWRU Gender Identity Clinic; Group II consisted of 14 postsurgical patients (eight biological males, two white, six black; and six white biological females) from the CWRU Gender Identity Clinic. A nine-page, 59-item questionnaire was constructed to collect systematic follow-up data for Group II. Data were collected up to 2 years postsurgery at varying intervals, measuring the sexual, psychological, environmental, economic, parental, family, medical, and social adjustment and functioning of each patient. While surgery provided in the context of a comprehensive Gender Identity Clinic program may lead to moderate social-sexual gains, researchers must begin to focus on the psychological problems not broached by surgery. The recommendation that psychotherapy be attempted with these patients (both pre- and postsurgery) is an important outgrowth of the study. Moreover, the need for a more systematic approach to follow-up, including the use of standardized interviews and clinical assessment tools and adequate control groups, is discussed.

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