Objective: The aim of the study was to evaluate the quality of body image during a Sex Reassignment Program in a sample of gender dysphoric adults comparing subjects with early onset versus late onset subjects. Design and Method: The sample was composed of 70 gender dysphoric adults (35 transwomen and 35 transmen) before and one year after hormonal treatment. The clinical sessions and the WHO quality of life questionnaire (WHOQOL-100) were used to collect data; in particular we considered the Body Image subscale and some data about plastic surgery. The questionnaire was administered at the beginning of hormonal therapy and at least one year after hormonal treatment to compare the quality of the body image. Results: The majority of the subjects showed a better quality of body image one year after hormonal treatment: the Body Image subscale showed higher scores both in transmen and in transwomen. The comparison between early onset subjects versus late onset subjects didn’t show any statistical significant differences in the quality of body image. Also, no differences have been found between transmen and transwomen. Conclusions: The hormonal treatment showed a positive impact on body image. The quality of the body image doesn’t seem to be influenced by the age of onset.