SEP 27, 2021 4:00 PM PDT

Gender-affirmation Surgery in Transgender Patients - Evidence for Regret?

Gender-affirming care is a broad term used to describe medical, psychosocial, and surgical interventions delivered to transgender individuals to affirm their gender identity. Transgender individuals have a gender identity that is in misalignment with their birth sex. Examples of gender-affirming care include hormonal treatments and gender-affirmation procedures, which aim to align an individual’s physical attributes with their gender identity. Transgender adolescents and young adults experience higher rates of behavioral health disorders such as anxiety and depression. According to the Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health, more than half of transgender and nonbinary youth included in the survey had seriously considered suicide in the prior twelve months. According to an article published by Columbia University, gender-affirming care dramatically improves this population's mental health and well-being. Despite this, legislative efforts to limit such treatments for transgender individuals under 18 years of age are ongoing in the United States.

Opponents of gender-affirming care, such as surgical procedures for transgender youth, cite that they are trying to prevent young people from making life-altering decisions that they could later regret. However, evidence suggests that such regret is rare. A systematic review and meta-analysis published in March 2021 reviewed the prevalence of regret among transgender individuals that had undergone gender-affirmation surgery (GAS). A total of 27 articles were chosen for the study and needed to have included patients aged thirteen or more who underwent GAS. Investigators found an extremely low prevalence of regret in transgender patients who underwent GAS. The most common reason participants reported regret was difficulty returning to social and family life as a new gender.

Gender-affirming care is highly individualized, and the decision of a transgender person to undergo gender-affirmation surgery is significant. However, it should be noted that gender-affirmation surgery is only one component of gender-affirming care. Legislation limiting or restricting access to gender-affirming care for youth can have far-reaching repercussions for a highly vulnerable patient population. Adverse mental health impacts could be massive and might include an increased risk of suicide. Such legislative efforts are therefore not only highly discriminatory but dangerous to society. Both the American Medical Association and the American Academy of Pediatrics have vehemently opposed legislative efforts to restrict access to care. As new research on the topic emerges, the scientific and medical communities should work together to ensure that evidence and not anecdote drives policy in this very delicate healthcare space.

 

Sources: CDC, The Trevor Project, Columbia, PRS Global Open

About the Author
MD
Dr. Christopher DiMaio is a Science Writer at Labroots. He received his MD from Penn State College of Medicine in 2014. His academic and professional interests include Neuroscience, Behavioral health, Immunology, and Healthcare improvement, among others. He is an active part of his community.
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