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We performed an in-depth interview to ascertain the psychosocial and functional status in 10 of 22 male-to-female transsexuals who underwent vaginoplasty from May 1985 to December 1988. Followup from 5 to 48 months was available for 14 patients. Our patients comprised a well educated, mostly employed, law abiding group with a low incidence of drug use. Most patients were able to develop strong support systems and showed a marked decrease in suicidal tendencies postoperatively. Functionally, the majority of the patients were able to lubricate the neovagina and have painless intercourse with a potential for orgasm. The cosmetic result was judged to be good, with no patient reporting being discovered of having had a prior operation by the sexual partner. We experienced a 21% rate of vaginal stenosis with 40% of these patients fully functional after a corrective operation.