Disorder of gender identity preceded by a gender dysphoria of childhood
Prognosis is generally very good, particularly for born-female patients. Most patients are lost to follow-up and go on to live ordinary lives in their new gender role. The technical success of surgery and a subsequent legal recognition of a change of sex relates strongly to good psychological and social outcome.
Disorder of gender identity preceded by a diagnosis of dual role transvestism
Prognosis is slightly more guarded. Regrets about gender reassignment surgery are associated with poor family and friend support, a lack of an earlier history of childhood gender dysphoria, and a lack of attraction to the same biological sex. In born-male patients, completed military service, a history of typically masculine, physically demanding jobs, and a comparatively late age (>30 years) at first request for surgery have been found to be negative prognostic factors in sex-reassignment evaluations.
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