SUMMARY OF the 1 er CONGRESS ENPT

Organized By The Team Of The Hospital Of The Free University Of Amsterdam This congress arised under other omens, initially it was entirely in English, and my English being failing kind...

For starting well, the Doctor E COLEMAN, psychologist in the United States, had the ungrateful task to have to define the transsexualism. He harnessed himself with his mission, first of all presenting ethnological topo with again Hijras in India, Xaniths of Oman, and well of others. He drew up the list of the scales used by the " psychiatrists ", that of Harry BENJAMIN most known, those of SHIVELY and CECCO specific to certain problems on the transsexualism. Then it studied the sexuality of the TS, explaining its incomprehension in front of cases of homosexual TS F/m using their vagina in the sexual relations. - It should be noted that Mr. MASSIP during the Conference of Right decided for a closing of the input of the vagina so that he cannot be useful (the sexuality of the others looks at it?). - the question was to know how a gay can be attracted and to live with a TS F/m without this one did not make a phalloplastie. According to COLEMAN and BOCKTING, doctors' do not have to lose sight of the fact that the evaluation of the identity of kind and the orientations sexual their customers are two quite distinct things and that there should not be discrimination; however COLEMAN asserted the right to the TS to leave the stereotypes that one allotted to them. Moreover, certain TS refuse the stereotypes and do not want to reject the female share present in any human being. Indeed, why would one require that a FTM is more male than another man?

Then, the Doctor PETERSEN, psychometrist in Canada, presented using slides of many statistics carried out thanks to a questionnaire sent to private clinics specialized in the sexual processing of " redetermination ". He announced that the test of real life (real life test) is of a twelve months minimum, that the usually practised tests psys are: RORSCHAH 2, WAIS-r 6 and MMPI 12. Dr. PETERSEN indicated to finish that three private clinics refuse to operate TS lesbians (idem for the gay TS) against sixteen which accept.

To conclude one morning rich in studies " Psys ", the Doctor K ZUCKER, psychologist in Toronto, made us a speech on the disorders of identity of kind in the very young children. He commented on a projection of photographs where the audience could discover cases of dressing-up of fifteen month old children and acknowledged that it became increasingly obvious, even for the " psys ", that there were at the beginning a problem or a hormonal influence.

Professor P. COHEN-kettenis announced that during the twenty last years, much of time was spent to find a processing psychiatric but that none functioned. According to it, the " Psys " should not seek " to cure " the TS but rather to help them before and after the operations. The current tendency would be to develop teams (medical teams) with a psychological support. The framework of the private doctor is presented according to COHEN-kettenis like not being sufficient.

Then, the Doctor A.j. KUIPER, psychologist with CONSIDERING presented a report/ratio on the effectiveness of the work of the doctors, which proves to be some times called into question, the postoperative medical follow-up and the rate of satisfaction of the patients. The figures are obvious: the preoperative rate of suicide (1) is 20 % whereas that post-operative is only 2 %. the people who regret the operations are very rare cases; on the other hand it can happen that certain TS M/f wish to turn over behind for purely social reasons.

Doctor ASSCHEMAN of CONSIDERING made a very complete talk on the hormonal processing and their effects (1). Inter alia, at TS F/m the change of the voice is the first irreversible effect. This change is carried out within six weeks in three months. 90 % of TS F/m obtain the stop of the menstruations. There is however a risk of obesity (10 %) and acne. On the other hand, the anti-oestrogens do not have any effect.

For TS M/f, it also should be stressed that the processing does not have any effect over the length of the penis, nor on the level of the voice but there reduction of the testicles is. On 402 come patients TS M/f, 47 are transfered to refuse the processing whereas 303 were followed during more than six months. For the operations, the stop of the hormonal processing must be made six weeks front, to avoid cases of thrombosis whose ASSCHEMAN listed only four cases.

The Doctor A. GREVEN, phoniatric specialist with CONSIDERING, gave explanations on the possibilities in phoniatry (surgery or course of installation of the voice).(1)

The Professor EICHER, gynaecologist in Germany, detailed the techniques of vaginoplastie. (1) If for the beginner, the vaginoplasties all are similar, it is an error to believe it and it is necessary well to study the question before an operation. Many surgeons (Canada, Sweden, Netherlands, Switzerland and even of Serbia) were present and displayed their results using photographs on posters in the hall, from where a significant number of different techniques! That made two years that the vaginoplastie is applied to SEEN with creation of a clitoris. The technique preached by the Swedish surgeon, Dr. Jan ELDH, met a keen interest on behalf of its fellow-members. According to EICHER, 50 % of TS M/f feel pleasure with their grafted clitoris but probably while masturbating. Some is dissatisfied because their vagina is too short, but there are there too several procedures to lengthen that-ci.(1) If the technique of vaginoplastie used consists in taking the skin of the scrotum to create the vagina, there arrives that hairs push inside what is likely to cause infections and pains. In general, one can note, after the intervention which the social standing improves.

Doctor J Joris HAGE succeeded Professor EICHER on the most perilous operation: Phalloplastie.(1) There too, as many surgeons, as many techniques. The results displayed in the hall were incredibly different. Once again, the choice of the surgeon in this type of operation should not be done with the light one. Thus one could see the " fruit " of the work of the surgeon Japanese pr. Takao HARASHINA, certainly the only one to have practised this kind of operation in his country. Dr. MA SHIUH of Taiwan, explained that it managed to build penises of ten centimetres. Apart from the problems of the urinary channel, another difficulty remains of topicality for all the surgeons: the rejection of the prostheses péniennes, especially because of the absence of cavernous body.

Only Dr. MEYER, surgeon working with Dr. DAVERIO, announced, with surprised many surgeons who them, had met only failures, that for three years in twelve operations where a prosthesis pénienne AMS had been used, there had been no rejection. He stressed that he does not put the DINAFLEX in top of the " nipple " and that between the construction of the penis and the installation of the prosthesis, he waits approximately a year, they also approached the defects of these prostheses. Lastly, Dr. HAGE had to recognize with regrets that they would need more volunteers to perfect their technique.

Mr. VAN DER REIJT which had already taken part in the preceding Conference, made a summary of the legal situation. He enumerated the countries having adopted a law: Sweden in first (1972), Germany (1980), Italy (1982), the Netherlands (1985) and Turkey in 1988. - the countries which ratify the change of sex: Austria, Norway, Denmark and perhaps Spain. - countries having delivered favorable judgements: Switzerland, Belgium (1987), Luxembourg (1988), France following its judgment, and in a less sure way Liechtenstein, Poland and Finland. - countries having until now refused: the United Kingdom, Portugal, Greece, Ireland and Cyprus.

Concerning Hungary, Bulgaria, Malta and Iceland we do not have any indication.

Then, the ceremony of closure Congress took place. I noted bitterly that the French presence with the first conference, apart from the representatives of the Council of Europe, had been limited to Mrs. CHILAND, psychologist, Mrs. BODON-bruzel, psychiatrist working with the BRETON pr. in Paris, Dr. Of FRANCE, andrologue-sexologist, Mrs. Camille CABRAL and myself. Many TS, doctors and lawyers were amazed to see the " preserving " character of France, as well at the legal level as medical, with inter alia the interventions of Mesdames CHILAND and BODON-bruzel.

As for the second conference, only Dr. CHILAND, Dr. SECCARELLI (Psychological) and myself remained present. I must specify that I could not attend all the meetings of the second congress since per same hour of the meetings were held in various places. (1) a more detailed article will be developed on this subject. By hoping for not to have made errors of comprehension or interpretations. - Armand Hotimsky Link: http://www.caritig.org/cdt/anciens/Cdta05/Congr%E8sENTP1.html