Presentation Authors: Francesca Vedovo*, Lisa Di Blas, Chiara Perin, Nicola Pavan, Marta Zatta, Stefano Bucci, Trieste, Italy, Girolamo Morelli, Pisa, Italy, Andrea Cocci, Augusto Delle Rose, Simone Caroassai Grisanti, Florence, Italy, Giorgio Gentile, Fulvio Colombo, Bologna, Italy, Luigi Rolle, Massimiliano Timpano, Turin, Italy, Paolo Verze, Lorenzo Spirito, Naples, Italy, Francesco Schiralli, Carlo Bettocchi, Bari, Italy, Alessandro Palmieri, Vincenzo Mirone, Naples, Italy, Carlo Trombetta, Trieste, Italy
Introduction: The available literature does not provide any questionnaire to evaluate sexual function after male to female (MtF) gender reassignment surgery (GRS). The assessment of sexual function in these patients is routinely performed by using tools designed for biological women, such as Female Sexual Function Index (FSFI). Such a limit leads to a suboptimal evaluation, especially in domains like lubrication and dyspareunia. Moreover, FSFI scores in MtF patients often are similar to those observed in non-transsexual women with sexual dysfunction. We aim at developing validate new questionnaire, the operated Male to Female Sexual Function Index (oMtFSFI) in order to assess sexual function in patients who underwent MtF GRS.
Methods: A panel of experts in gender dysphoria defined salient content areas to be explored. Ten MtF patients were administered the questionnaire in order to check its face validity. Their suggestions helped the expert revising the initial version. The revised oMtFSFI questionnaire presents 18 items and was applied in the present study. oMtFSFI with FSFI, Back Depression Inventory II and SF-36 questionnaires were web-based administered to 125 operated MtF patients, recruited during follow-up visits in 7 italian centres and to 80 women who provided self-ratings. The MtF participants completed oMtFSFI twice, three to four weeks apart.
Results: 65 MtF and 57 women completed the study. The two groups did not differ in their age (mean 38.5 SD 9.3 versus 37.7 SD 11.5 years old) or in their present vs not sexual activity in the last month (p=0.18). MtFs underwent GRS up to 19 years before (mean 5.1). Principal component analysis performed on the self-ratings provided by MtFs yielded a 3-domain structure (accounting for the 68.7% of the total variance): Sexual Dissatisfaction, Sexual Pain and Genital self-image. The same structure emerged when data from the whole group were analysed. For MtFs, Cronbach Alphas ranged from 0.64 to 0.93 for the three domains. After controlling for age and years from surgery, clear convergent associations with FSFI scales were found for Sexual Dissatisfaction and Sexual Pain but not for Genital Self-image; BDI did not account for additional variance.
Conclusions: These results support the reliability and psychometric validity of the oMtFSFI in the assessment of key dimensions of transsexual women sexual function. Further studies are needed to develop a diagnostic cut-off scores for a potential classification of operated MtF's sexual dysfunction.