Kate,
Concise reason for Johns Hopkins closing down their SRS facility: an internal
(flawed) report that said the surgery did not do much good for patients. Here
is my source (so you can make your own judgement on authoritativeness):
>From _Crossdressing, Sex, and Gender_, Vern. L. Bullough and Bonnie Bullough,
Unviersity of Pennsylvania Press, Philadelphia, 1993:
p. 259:
"... the Johns Hopkinds Gender Identity Clinic was established in 1965, and the
clinic's first sex reassignment surgery was performed in 1966."
p. 263-4:
"In 1979 the Johns Hopkins hospital announced that it was discontinuing SRS,
and although there were probably a variety of reasons for this decision, a
study done by the head of the clinic, John Meyer, was given as the official
reason. He reported that in 1971 a follow-up study had been begun on one
hundred transsexual patients: thirty-four who had ben operated on and sixty-six
who had not. All had applied to the Gender Identity Clinic and been evaluated.
Twenty-four had SRS at Johns Hopkins, and ten went elsewhere. The sixty-six
remaining patients were initially evaluated but either changed their minds or
were turned down for surgery. Some had gone through trial periods living in
the role before surgery, and some had not. Only 50 percent of the sample
could be located for the follow-up study, monstly those who had the surgery.
The fact that so many could not be located, however, does not mena that they
did not have the surgery. They might have had it done elsewhere and
intentionally cut their ties with Johns Hopkins. One M-F [sic] patient who had
difficulty with a poorly constructed phallus asked to have it removed but did
not ask for any other changes. No other operative patient indicated they
wanted to have their surgery undone. However, a scale of adjustments was
constructed that measured frequency of address change, job and educational
level, marriage adjustment, and frequency of psychiatric contact. The
operative patients did not score significantly better on the scale than the
unoperated patients who had gone through a variety of experiences including
psychotherapy, hormonal treatment, crorss-living, or none of the above. On the
strength of these findings, the author concluded that SRS offered no advantages.
"Though it is clear that Meyer's research was fraught with so many
methodological flaws (including slef-selected samples, no real measure of
adjustment, and poor response rates), that many peer review journals would have
rejected it, it did receive publication in part because there had been so few
long-term follow-up studies. One rare exception to flawed studies such as
Meyer's was the work of ira Pauly, who in 1968 reported a generally favorable
outcome form SRS according to available data. In 1981, after the Meyer report,
Pauly again reviewed the literature covering follow-up studies on
trnassexualism and still found generally favorable results. Of the 283
male-to-female patients reported, he found that the resutls were reported as
satisfactory for 71 percent of the sample, uncertain for 18 percent, and
unsatisfactory for 8 percent; 2 percent had commited suicide. Among the
eighty-three female-to-male patients, the satisfaction rate was 81 percent
while 13 percent were uncertain, and 5 percent reported dissatisfaction
(percentages rounded off). There were no suicides amont the F-M group."
B&B go on to discuss a large number of other studies on satisfaction with SRS,
finding a range of results, but largely favorable. There are bibliographical
footnotes for all the cited studies.
Steve
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