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Context The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person’s body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. Objective To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons.

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KEY POINTS. More than one million people are living with HIV in the United States of America (USA); one in seven are unaware of their status. The HIV epidemic is driven by sexual contact and is heavily concentrated among certain key populations, in particular gay men and other men who have sex.