Sex Reassignment Surgery Demographics in the Netherlands

Our favorite folks in Amsterdam have provided data set on MTF transsexuals receiving SRS in their clinic covering 40 years. The paper is openly available online, not behind a paywall, so you may read it for yourself. But I have a few observations and comments regarding the data and the authors’ comments.

First, let’s look at the data, reorganized into putatively HSTS vs. AGP. (Yes, given all we know about MTF transwomen, I will assume that all non-exclusively androphilic transwomen are AGP.)

Table 1

Demographics of transgender women undergoing primary genital gender-affirming surgery at the authors’ institution between January 1980 and January 2020

Demographics	Total	Vaginoplasty	Orchiectomy	GCV
Number	n=1531	n=1468	n=44	n=19
Age at surgery (SD=1)	33 (25–44)	33 (24–44)	32 (26–45)	54 (45–60)
Sexual orientation (self report) n=	699	645	42	12
HSTS n= (%)	372 (53)	357 (55)	13 (31)	2 (17)

As the authors noted, “Individuals who opted for GCV (vulvaplasty only, no vaginoplasty) were generally older, had no history of puberty suppression, and were more frequently sexually oriented towards women.” The same could be said for orchiectomy as well. HSTS are must more likely to want/need vaginoplasty over other possible choices as one would expect, so as to be able to have vaginal intercourse with men.

The authors made a comment that I found ahistorical. They believe that GCV is a relatively new procedure. It is not. In fact, Christine Jorgensen had GCV only in 1952, as reported by her surgeon, Dr. Christian Hamburger, as neither of them desired to facilitate sex with men. Similarly, “orchies”, as we called them back in the 1970s, was common for both HSTS and AGP in the early 20th through the mid- to late-20th Century due to greater ease of obtaining them. (Some of this was due to the Eugenics Movement, which was only too happy to sterilize “perverts”.)

Finally, the authors wrote about encouraging “fertility preservation” but seem to lament that it isn’t possible for those who begin puberty blockers early, “The increase in individuals starting puberty suppression at early pubertal stages, when serum testosterone concentrations are insufficient for spermatogenesis, may lead to an increase in individuals without options for preservation of fertility.” This strikes me as “unclear on the the concept” as why would such MTF early transitioners, who are all HSTS (as even this clinic’s own data attests), want or need to cryostore sperm. Just who will they impregnate, their future husbands?

Reference:

Van der Sluis, et al., “Surgical and demographic trends in genital gender-affirming surgery in transgender women: 40 years of experience in Amsterdam”, British Journal of Surgery, Volume 109, Issue 1, January 2022, Pages 8–11, https://doi.org/10.1093/bjs/znab213

Advertisement