A new study has found that rates of depression, anxiety, suicidal ideation and substance-use disorders were “significantly higher” among those who underwent transgender surgery to change sex.
The study, Examining gender-specific mental health risks after gender-affirming surgery: a national database, was published in The Journal of Sexual Medicine, and sought to evaluate mental health outcomes in individuals with gender dysphoria who have undergone surgery.
The researchers, from the University of Texas, said that “transgender individuals face heightened psychological distress, including depression, anxiety, and suicidal ideation, partly due to stigma and lack of gender affirmation”.
They determined to examine the mental health impacts on people who underwent “gender-affirming surgery”, focusing on 107,583 patients aged 18 and over with gender dysphoria, some who underwent surgery and others who did not
Six cohorts were created based on gender and surgery status: Cohorts A-D included patients with or without surgery, and Cohorts E-F allowed for gender comparison among those with surgery -with propensity scores controlled for age, race, and ethnicity.
Mental health outcomes including depression, anxiety, suicidal ideation, substance use disorder, and body dysmorphic disorder, were assessed over two years after surgery using clinician-verified codes.
Body dysmorphic disorder (BDD) was analyzed separately and not conflated with gender dysphoria cohorts to ensure the distinction between these conditions.
The data showed that depression, anxiety, suicidal ideation and substance-use disorders were “significantly higher” among those who underwent surgery than those without surgery.
MEN AND WOMEN
Males who had undergone surgery had depression rates of 25% – in contrast to 11.5% of males who had not. Anxiety rates among that group were 12.8% compared to 2.6% in the cohort without surgery.
For females those with surgery had 22.9% depression rates compared to 14.6% without surgery – and anxiety rates for females with surgery was also higher (10.5%) compared to 7.1% without surgery.
The researchers concluded that: “Gender-affirming surgery, while beneficial in affirming gender identity, is associated with increased risk of mental health issues, underscoring the need for ongoing, gender-sensitive mental health support for transgender individuals’ post-surgery.”
The study found that surgeries that aimed to “feminize individuals” showed “particularly high” rates of depression and substance abuse two years after the operaiions.
“Findings suggest the necessity for gender-sensitive mental health support following gender-affirming surgery to address post-surgical psychological risks,” the researchers wrote.
Jonathan Alpert, a Manhattan-based psychotherapist and author, told Fox News that the study findings highlight the “often overlooked” psychological risks that accompany surgeries to change gender.
“While these surgeries can be critical in helping individuals align their physical appearance with their gender identity, they are not a cure-all for the mental health challenges many transgender individuals face,” Alpert said.
“These findings suggest that surgery alone doesn’t eliminate the complex psychological burdens that stem from societal stigma and personal struggles with identity,” he added.
“In fact, taking a scalpel to treat a psychological disorder can sometimes lead to more issues, as the study results are elucidating.”
A gender-affirming approach to treating gender-dysphoria in young people in particular has now become controversial after a landmark report, the Cass Review, concluded that children who think they are transgender should not be rushed into treatment they may regret,
The report by paediatric consultant, Dr Hilary Cass, called for an end to the prescribing of powerful hormone drugs to under-18s, which critics say were acting as a pathway to more invasive medical procedures such as surgeries.
Regarding puberty blockers, the research carried out by the Cass Review found their was no support for the claim that hormone treatment reduced the elevated risk of death by suicide in this population.