From 69 transsexual patients (48 men, 21 women) having consulted the Basel University Psychiatric Outpatient-Department between 1970 and 1990, 13 men-to-woman- and 4 woman-to-man-transsexuals could be examined in a follow-up (5-20 years after the operation). The social conditions and the quality of life of the 13 men-to-woman-transsexuals had significantly deteriorated: 9 of the 13 depend on life annuity or on social welfare assistance. The patients live socially very isolated. Eight of them report almost not being able to experience sexual pleasure, 10 suffer from anxieties, depression or addictions. Three regret having demanded the operation and two have passed a second operation for restoration of the original state. The 4 woman-to-man-transsexuals showed slightly better results: 2 of them are fully professionally active and live in constant personal relationships of several years of duration. The 2 others, however, suffer from depression and problems of addiction and give the impression of affective lability. The results lead to the following conclusions: 1. the criteria of indication for the operation of the transsexuals should be observed thoroughly, especially the psychotherapeutic accompaniment before the operation during at least 1 year; 2. the question of emotional stability, of frustration tolerance and of the danger of an outbreak of psychosis are to be examined carefully; 3. the professional and social integration before and after the operation is of central importance.