{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:53:55Z","timestamp":1773269635618,"version":"3.50.1"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":2774,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment. Assessing and understanding the implication of such differences may be a key to developing appropriate and effective treatment and intervention strategies for this group. However, research in the area remains sparse and is often on small populations, making the generalization of results from current studies on individuals diagnosed with transsexualism difficult.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>(i) To describe and assess key sociodemographic and treatment-related differences between MtF and FtM individuals in a Danish population of individuals diagnosed with transsexualism; (ii) to assess possible implications of such difference, if any, for clinical treatment initiatives for individuals diagnosed with transsexualism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Follow-up of 108 individuals who had permission to undergo sex reassignment surgery (SRS, meaning castration and genital plastic surgery) over a 30-year period from 1978 to 2008 through the Gender Identity Unit in Copenhagen, Denmark. The individuals were identified through Social Security numbers. Clinical and sociodemographic data from medical records were collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The sex ratio was 1.16:1 (MtF : FtM). Mean age at first referral was 26.9 (standard deviation [SD] 8.8) years for FtM and 30.2 (SD 9.7) for MtF individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>As approximately half of MtF started cross-sex hormonal SR without attending a gender unit, future treatment needs to focus on this group of MtF individuals in order to accommodate the medical risks of self-initiated hormonal treatment.Earlier intervention with adolescents appears necessary since three-quarters of FtM individuals before age 12 had problems with their assigned sex. For both MtF and FtM, we found problems in areas of school, education, and employment and recommend further help in these core areas.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/sm2.48","type":"journal-article","created":{"date-parts":[[2015,4,11]],"date-time":"2015-04-11T00:19:25Z","timestamp":1428711565000},"page":"109-117","source":"Crossref","is-referenced-by-count":19,"title":["Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism"],"prefix":"10.1093","volume":"3","author":[{"given":"Rikke","family":"Simonsen","sequence":"first","affiliation":[{"name":"Psychiatric Center Copenhagen, Sexological Clinic \u00a0 , Copenhagen , Denmark"},{"name":"GIUUC \u00a0 , Copenhagen , Denmark"},{"name":"Department of Clinical Medicine \u00a0 , , Denmark"},{"name":"University of Copenhagen \u00a0 , , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gert Martin","family":"Hald","sequence":"additional","affiliation":[{"name":"Department of Public Health \u00a0 , , Denmark"},{"name":"University of Copenhagen \u00a0 , , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Giraldi","sequence":"additional","affiliation":[{"name":"Psychiatric Center Copenhagen, Sexological Clinic \u00a0 , Copenhagen , Denmark"},{"name":"GIUUC \u00a0 , Copenhagen , Denmark"},{"name":"Department of Clinical Medicine \u00a0 , , Denmark"},{"name":"University of Copenhagen \u00a0 , , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellids","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Psychiatric Center Copenhagen, Sexological Clinic \u00a0 , Copenhagen , Denmark"},{"name":"GIUUC \u00a0 , Copenhagen , Denmark"},{"name":"Department of Clinical Medicine \u00a0 , , Denmark"},{"name":"University of Copenhagen \u00a0 , , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,6,1]]},"reference":[{"key":"2023010704080589100_bb0010","article-title":"WHO ICD-10","author":"WHO collaborating Centre for Research and Training in Mental Health","year":"1995"},{"key":"2023010704080589100_bb0015","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/15532730802175148","article-title":"Clinical characteristics, psychiatric comorbidities and sociodemographic profile of transsexual patients from an outpatient clinic in Brazil. 2 ed","volume":"10","author":"Lobato","year":"2007","journal-title":"Int J Transgenderism"},{"key":"2023010704080589100_bb0020","article-title":"Standards of Care. WPATH","author":"The World Professional Association for Transgender Health","year":"2011"},{"key":"2023010704080589100_bb0025","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/BF01542888","article-title":"Issues in diagnosis and treatment of transsexualism","volume":"12","author":"Roberto","year":"1983","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0030","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1046\/j.1464-410X.2001.02323.x","article-title":"Male-to-female transsexualism: A technique, results and long-term follow-up in 66 patients","volume":"88","author":"Krege","year":"2001","journal-title":"BJU Int"},{"key":"2023010704080589100_bb0035","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s10508-006-9074-y","article-title":"Follow-up of sex reassignment surgery in transsexuals: A Brazilian cohort","volume":"35","author":"Lobato","year":"2006","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0040","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0924-9338(02)00703-4","article-title":"The transsexual: What about the future?","volume":"17","author":"Michel","year":"2002","journal-title":"Eur Psychiatry"},{"key":"2023010704080589100_bb0045","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1365-2265.2009.03625.x","article-title":"Hormonal therapy and sex reassignment: A systematic review and meta-analysis of quality of life and psychosocial outcomes","volume":"72","author":"Murad","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2023010704080589100_bb0050","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/BF02437545","article-title":"The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes","volume":"25","author":"Rakic","year":"1996","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0055","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1017\/S0033291704002776","article-title":"Sex reassignment: Outcomes and predictors of treatment for adolescent and adult transsexuals","volume":"35","author":"Smith","year":"2005","journal-title":"Psychol Med"},{"key":"2023010704080589100_bb0060","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.psychres.2005.01.008","article-title":"Transsexual subtypes: Clinical and theoretical significance","volume":"137","author":"Smith","year":"2005","journal-title":"Psychiatry Res"},{"key":"2023010704080589100_bb0065","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/BF01542666","article-title":"Psychosocial differences between Dutch male and female transsexuals","volume":"17","author":"Verschoor","year":"1988","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0070","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/BF02437841","article-title":"An epidemiological and demographic study of transsexuals in The Netherlands","volume":"25","author":"van Kesteren","year":"1996","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0075","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1023\/A:1020611416035","article-title":"Masculinity, femininity, and transsexualism","volume":"31","author":"Herman-Jeglinska","year":"2002","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0080","first-page":"182","article-title":"Male and female transsexuals: A comparison","volume":"33","author":"Tsoi","year":"1992","journal-title":"Singapore Med J"},{"key":"2023010704080589100_bb0085","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.eurpsy.2006.10.002","article-title":"Prevalence and demography of transsexualism in Belgium","volume":"22","author":"De Cuypere","year":"2007","journal-title":"Eur Psychiatry"},{"key":"2023010704080589100_bb0090","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/BF02437583","article-title":"Transsexualism in Germany: Empirical data on epidemiology and application of the German Transsexuals\u2019 Act during its first ten years","volume":"25","author":"Weitze","year":"1996","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0095","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1600-0447.1995.tb09763.x","article-title":"Psychosocial functioning of transsexuals in Belgium","volume":"91","author":"De Cuypere","year":"1995","journal-title":"Acta Psychiatr Scand"},{"key":"2023010704080589100_bb0100","doi-asserted-by":"crossref","first-page":"e16885","DOI":"10.1371\/journal.pone.0016885","article-title":"Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden","volume":"6","author":"Dhejne","year":"2011","journal-title":"PLoS ONE"},{"key":"2023010704080589100_bb0105","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1600-0447.1998.tb09986.x","article-title":"Clinical characteristics of a total cohort of female and male applicants for sex reassignment: A descriptive study","volume":"97","author":"Landen","year":"1998","journal-title":"Acta Psychiatr Scand"},{"key":"2023010704080589100_bb0110","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1023\/A:1024051201160","article-title":"On the incidence and sex ratio of transsexualism in Sweden, 1972\u20132002","volume":"32","author":"Olsson","year":"2003","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0115","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.psychres.2007.07.022","article-title":"Clinical characteristics of patients with gender identity disorder at a Japanese gender identity disorder clinic","volume":"157","author":"Okabe","year":"2008","journal-title":"Psychiatry Res"},{"key":"2023010704080589100_bb0120","article-title":"Evaluacion endocrinologia y tratamiento hormonal de la transsexualidad en la Unidad de Trastornos de Identidad de Genero en Andalucia (Malaga)","author":"Esteva de Antonio","year":"2001"},{"key":"2023010704080589100_bb0125","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/BF01542341","article-title":"Male-to-female and female-to-male transsexuals: A comparison","volume":"17","author":"Kockott","year":"1988","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0130","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1192\/bjp.157.2.265","article-title":"Clinical features of patients attending a gender-identity clinic","volume":"157","author":"Burns","year":"1990","journal-title":"Br J Psychiatry"},{"key":"2023010704080589100_bb0135","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/BF01541653","article-title":"Psychosocial characteristics of applicants evaluated for surgical gender reassignment","volume":"13","author":"Dixen","year":"1984","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0140","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s11136-013-0497-3","article-title":"Determinants of quality of life in Spanish transsexuals attending a gender unit before genital sex reassignment surgery","volume":"23","author":"Gomez-Gil","year":"2014","journal-title":"Qual Life Res"},{"key":"2023010704080589100_bb0145","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s10508-007-9307-8","article-title":"Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain","volume":"38","author":"Gomez-Gil","year":"2009","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0150","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1192\/bjp.131.4.405","article-title":"Male transsexualism in Singapore: A description of 56 cases","volume":"131","author":"Tsoi","year":"1977","journal-title":"Br J Psychiatry"},{"key":"2023010704080589100_bb0155","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1007\/s10508-009-9594-3","article-title":"Sexual orientation versus age of onset as bases for typologies (subtypes) for gender identity disorder in adolescents and adults","volume":"39","author":"Lawrence","year":"2010","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0160","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s10508-005-1793-y","article-title":"Sexuality before and after male-to-female sex reassignment surgery","volume":"34","author":"Lawrence","year":"2005","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0165","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/j.1743-6109.2012.03006.x","article-title":"Sociodemographic and clinical features of gender identity disorder: An Italian multicentric evaluation","volume":"10","author":"Fischer","year":"2013","journal-title":"J Sex Med"},{"key":"2023010704080589100_bb0170","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/BF01542067","article-title":"Heterosexual and homosexual gender dysphoria","volume":"16","author":"Blanchard","year":"1987","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0175","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1192\/S0007125000192852","article-title":"Social and economic aspects of transsexualism","volume":"117","author":"Hoenig","year":"1970","journal-title":"Br J Psychiatry"},{"key":"2023010704080589100_bb0180","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/BF01541980","article-title":"Male and female transsexualism: The Danish experience with 37 patients","volume":"11","author":"Sorensen","year":"1982","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0185","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.genhosppsych.2011.11.008","article-title":"School refusal by patients with gender identity disorder","volume":"34","author":"Terada","year":"2012","journal-title":"Gen Hosp Psychiatry"},{"key":"2023010704080589100_bb0190","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.eurpsy.2010.04.009","article-title":"A European network for the investigation of gender incongruence: The ENIGI initiative","volume":"27","author":"Kreukels","year":"2012","journal-title":"Eur Psychiatry"},{"key":"2023010704080589100_bb0195","article-title":"European Union lesbian. gay, bisexual and transgender survey. EU publishing office","author":"European Union Agency for Fundamental Rights","year":"2013"},{"key":"2023010704080589100_bb0200","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0022-3999(98)00085-3","article-title":"Transsexualism: A review of etiology, diagnosis and treatment","volume":"46","author":"Cohen-Kettenis","year":"1999","journal-title":"J Psychosom Res"},{"key":"2023010704080589100_bb0205","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s10508-009-9562-y","article-title":"The DSM diagnostic criteria for gender identity disorder in adolescents and adults","volume":"39","author":"Cohen-Kettenis","year":"2010","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0210","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s10508-005-4343-8","article-title":"Early history of the concept of autogynephilia","volume":"34","author":"Blanchard","year":"2005","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0215","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/BF01542098","article-title":"Cross-gender identity in transvestites and male transsexuals","volume":"23","author":"Doorn","year":"1994","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0220","article-title":"A Retrospective Study of Epidemiological and Clinical Aspects of 28 Transsexual Patients. 11 ed","author":"O'Gorman","year":"1982"},{"key":"2023010704080589100_bb0225","author":"Overview of the Danish Education System","year":"2014"},{"key":"2023010704080589100_bb0230","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.socscimed.2013.02.019","article-title":"Managing uncertainty: A grounded theory of stigma in transgender health care encounters","volume":"84","author":"Poteat","year":"2013","journal-title":"Soc Sci Med"},{"key":"2023010704080589100_bb0235","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/13691050601065909","article-title":"\"It's really a hard life\": Love, gender and HIV risk among male-to-female transgender persons","volume":"9","author":"Melendez","year":"2007","journal-title":"Cult Health Sex"},{"key":"2023010704080589100_bb0240","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1023\/A:1018725201811","article-title":"Changes in the sexual orientation of six heterosexual male-to-female transsexuals","volume":"27","author":"Daskalos","year":"1998","journal-title":"Arch Sex Behav"},{"key":"2023010704080589100_bb0245","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1600-0447.1996.tb10638.x","article-title":"Prevalence, incidence and sex ratio of transsexualism","volume":"93","author":"Landen","year":"1996","journal-title":"Acta Psychiatr Scand"},{"key":"2023010704080589100_bb0250","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1600-0447.1993.tb03364.x","article-title":"The prevalence of transsexualism in The Netherlands","volume":"87","author":"Bakker","year":"1993","journal-title":"Acta Psychiatr Scand"},{"key":"2023010704080589100_bb0255","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/j.1600-0447.1993.tb03467.x","article-title":"Personality traits and disorders among transsexuals","volume":"88","author":"Bodlund","year":"1993","journal-title":"Acta Psychiatr Scand"},{"key":"2023010704080589100_bb0260","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1176\/appi.psychotherapy.1974.28.1.4","article-title":"The transsexual syndrome in males 1. Primary transsexualism. 1 ed","volume":"28","author":"Person","year":"1974","journal-title":"Am J Psychother"},{"key":"2023010704080589100_bb0265","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1176\/appi.psychotherapy.1974.28.2.174","article-title":"The transsexual syndrome in males 2. Secondary transsexualism. 2 ed","volume":"28","author":"Person","year":"1974","journal-title":"Am J Psychother"},{"key":"2023010704080589100_bb0270","article-title":"Befolkningens uddannelsesniveau. Danmarks Statistiks Forlag","author":"Klaus Fribert Jacobsen","year":"2004"},{"key":"2023010704080589100_bb0275","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1111\/j.1743-6109.2008.00799.x","article-title":"Transsexualism in Serbia: A twenty-year follow-up study","volume":"6","author":"Vujovic","year":"2009","journal-title":"J Sex Med"},{"key":"2023010704080589100_bb0280","author":"Statistics Denmark. Registered Unemployment","year":"2014"},{"key":"2023010704080589100_bb0285","author":"Undervisningsministeriet. Den aktuelle ledighed og besk\u00e6ftigelse","year":"2014"},{"key":"2023010704080589100_bb0290","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/BF01542468","article-title":"Developmental profile of 200 male and 100 female transsexuals in Singapore","volume":"19","author":"Tsoi","year":"1990","journal-title":"Arch Sex Behav"}],"container-title":["Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050116115300490?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050116115300490?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/smoa\/article-pdf\/3\/2\/109\/48424703\/smoa_3_2_109.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/smoa\/article-pdf\/3\/2\/109\/48424703\/smoa_3_2_109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,7]],"date-time":"2023-01-07T04:17:50Z","timestamp":1673065070000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/smoa\/article\/3\/2\/109\/6956369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,1]]},"references-count":57,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/sm2.48","relation":{},"ISSN":["2050-1161"],"issn-type":[{"value":"2050-1161","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,6]]},"published":{"date-parts":[[2015,6,1]]}}}