Alterations in body image, self-esteem and quality of life in a sample of Italian transgender individuals before gender-affirming surgery

Giuseppe Maniaci 1*, Caterina La Cascia 1, Crocettarachele Sartorio 1, Laura Ferraro 1, Alessandra Giammanco 1, Rosalia Anselmo 1, Giuseppe Oddo 1, Elisa Parrinello 1, Francesca Toia 2, Giovanni Zabbia 2, Adriana Cordova 2*, Daniele La Barbera 1*

1 Department of Biomedicine, Neuroscience and Advanced Diagnostic, Section of Psychiatry, University of Palermo, Palermo, Italy; 2 Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy *Adriana Cordova and Daniele La Barbera equally supervised the manuscript. They both are last authors.

DOI 10.36148/2284-0249-462


Mental health, alterations in body image, self-esteem, general and sexual quality of life among transgender individuals waiting for gender-affirming surgery versus cisgender individuals were investigated.


47 Italian transgender participants and 47 cisgender participants completed self-report measures.


Compared to cisgender ones, trans participants showed higher alterations in self-esteem, body image, and psychological, social, and sexual quality of life, together with a comparable level of mental health conditions (Tab. I). No significant differences emerged between trans men and trans women in terms of the variables taken into account (Tab. II). Moreover, trans individuals receiving hormone therapy are more likely to report both better quality of life and body image than those who are not receiving it yet (Tab. III).


The main psychological distress of individuals diagnosed with gender dysphoria seems related to the symptoms directly associated with their gender incongruence, such as body image, self-esteem, and quality of life. Healthcare professionals should consider providing surgery and hormonal therapy together with psychotherapy as best practices for such patients. 

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