Researchers reverse: Gender surgery offers 'no advantage' to mental health

Washington, D.C. Newsroom, Aug 4, 2020 / 11:00 am

The authors of a 2019 study which claimed so-called gender-transition surgery may improve the long-term mental health of recipients have issued a correction, nearly a year after publication. The authors now say they found "no advantage" to the mental health of those who received gender-transition surgery.

In October of 2019, the American Journal of Psychiatry published a report on the rates of mental health treatment among recipients of gender-transition surgery and hormone therapy. The report was entitled "Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries."

On Saturday, the authors of the study-Richard Bränström, Ph.D., and John E. Pachankis, Ph.D., issued a correction, saying that "the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care."

The 2019 AJP report had originally claimed that, among persons who had received gender-transition surgery, the number of mental health treatment visits declined over time. Persons diagnosed with gender incongruence are at higher risk of mental health disorders, the report said; around six times more likely to seek treatment for a "mood and anxiety disorder" than members of the general population, and "more than six times as likely to have been hospitalized after a suicide attempt."

However, the study had claimed that among those who had received gender-transition surgery, the "increased time since last gender-affirming surgery was associated with reduced mental health treatment."

This, the 2019 report concluded, "lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them."

That conclusion has now been reversed. 

Ryan Anderson, the William E. Simon Senior Research Fellow in American Principles and Public Policy at The Heritage Foundation, wrote on Monday that the correction was needed.

"So, the bottom line: The largest dataset on sex-reassignment procedures-both hormonal and surgical-reveals that such procedures do not bring the promised mental health benefits," he said.

Additionally, Anderson pointed out, the authors' correction revealed that recipients of gender-transition surgery were actually more likely to seek treatment for anxiety disorders:

"Individuals diagnosed with gender incongruence who had received gender-affirming surgery were more likely to be treated for anxiety disorders compared with individuals diagnosed with gender incongruence who had not received gender-affirming surgery."

After the study was first published in the fall of 2019, some claimed that the study's sample size was too small to make any conclusions.

Mark Regnerus, a sociology professor at the University of Texas critiqued the report's findings, writing in the journal Public Discourse that the sample size of people who had experienced the long-term effects of gender-transition surgery was too small, as most of the cases of surgery were relatively recent.

He noted that the study was based on a survey of nearly 10 million Swedes, 2,679 of those surveyed had reported experiencing gender incongruence, and 1,018 had undergone gender-transition surgery.

However, of this population, only 19 people reported their last surgery as having occurred 10 or more years prior. So, Regnerus concluded, the report's claim that the rate of people undergoing gender-transition surgery and subsequently seeking mental health treatment had declined over time was based on a sample of 19 people in a survey of nearly 10 million.

Regnerus wrote that "if a mere three additional cases among these 19 had sought mental health treatment in 2015, there would appear to be no discernible overall effect of surgery on subsequent mental health."

The data in the study revealed the limitations of finding the long-term effects of gender-transition surgery, he told CNA, as its use is a recent phenomenon.

"There is a declining number with each passing year, meaning simply that the practice of such surgery is far more common recently than it was several years ago," Regnerus said in a written statement to CNA in November, noting that the small sample size was not the fault of the authors, but simply reflected the "reality" of what remain historically untested procedures.

"It's important to keep some perspective here-how national debates and discourses are being driven by quite small shares of the population," Regnerus told CNA.