• Although hundreds of "sex transformation" operations have been performed, little is known about the long-term postoperative adjustment. Available outcome data suggest that sex reassignment surgery in male patients is followed by a better social as well as inner adjustment in the vast majority, at least for the first several years after surgery. Surprisingly, only a handful of cases with poor outcomes have been reported.
This report concerns a 53-year-old biological male with a lifelong gender dysphoria who, although subjectively pleased with the surgery, developed a paranoid psychosis five years after sex conversion surgery.
Van Putten T, Fawzy FI. Sex Conversion Surgery in a Man With Severe Gender DysphoriaA Tragic Outcome. Arch Gen Psychiatry. 1976;33(6):751-753. doi:10.1001/archpsyc.1976.01770060071010