Transsexuality: Research Shows the Incidence of Regret Following Gender-Affirming Surgeries to be Worrying

Gender-affirmation surgery is, without a doubt, a highly controversial and sensitive topic. In many states across the nation, bans are in place or being mulled over to discourage people from going ahead with them. This is often because of the belief that those who undergo them, especially the young, may later regret the decision.

Trans Sexuality

Trans Sexuality

The question then is: how common is it that transsexual people regret undergoing sex-change surgery? And does the procedure have any effect on suicide rates among transsexuals?

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The Controversy of Regret

As with the topic of gender-affirmation surgeries, there are controversies over the number of transsexuals who regretted going for a sex change. Those in opposition often suggest that a high proportion of these people regret while sex-change advocates say those figures are inflated.

For instance, Charlie Evans, a former transgender man who founded the charity Detransition Advocacy Network, told Sky News in 2019 that “hundreds” of young transsexuals in regret sought her help for detransition. Several other news outlets, including some in the U.S., have also reported trans people wanting to return to their birth-assigned sex.

Detransition is the process of halting or reversing gender transition. This may be temporary or permanent.

Trans advocates, however, believe that the incidence of regret is exaggerated. They view figures spread by the media as false and an attempt to portray people who opt for sex change as being confused or misled. They describe transsexuals who regret as being of a greatly low proportion and they seem to have a point.

Studies suggest that only a fraction of transsexuals wished they had not gone under the knife. This ranges from about 1 percent to 5 percent.

A review of 27 studies published in the journal PRS Global Open showed that the overall incidence of regret after sex change surgery was 1%. Also, a 50-year Swedish study published in 2014 reported a regret rate of 2.2 percent.

Read Also: Why It’s Often Better to Delay Gender-Affirming Surgery Until Adulthood: Expert Insights in a Q&A

It is key to note that the observed rates in studies may not paint the most accurate picture. They do not necessarily take into account people who do not speak out publicly about their dissatisfaction or fail to seek medical help.

Whether a person regrets having gender-affirming surgery or not depends on several factors. These include the quality of care, societal support, and the individual’s mental state.

How Common Is Detransitioning?

There isn’t much information about the number of transsexuals who detransition, with only a few formal studies done. This, therefore, leaves room for almost anybody to claim whatever suits their narrative. Those opposed to a sex change could claim that a large number of trans people opt for it while advocates say it is not common.

Trans advocates say media coverage tends to make detransitioning seem more common than it is. This, they say, drives fallacies about the process and the reason why some people opt for it.

A retrospective case-note review published in 2021 put the detransitioning rates between less than one percent and eight percent. However, both studies reporting low and high rates have been observed to have methodological limitations.

Trans people who choose to halt or reverse their sex change do so for diverse reasons. Regret is not the only reason they do so, according to studies. Other reasons include pressure from parents, family members, a spouse, or an employer.

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Results from the 2015 U.S. Transgender Survey showed that around eight percent of respondents indicated ever detransitioning. Around 62 percent of those who detransitioned stated that they transitioned again.

Regret is often nowhere among the top reasons for reversing the sex change process – at less than one percent. A 43-year cohort study published in The Journal of Sexual Medicine in 2018 reported that 0.3 percent of trans men and 0.6 percent of trans women expressed regret after gonadectomy.

What is the Suicide Risk Among Trans People?

Trans people are believed to be at a higher risk of mental health issues, including anxiety and depression. This can stem from factors including stigma, lack of social support, and poor access to care. As a result, they are at a high risk of suicidal ideation.

Suicide rates among transsexual and transgender people can vary significantly. Underreporting and gender misidentification in official records are among the factors that count against rate accuracy. Also, studies tend to be limited by sample sizes and methods of data collection.

What research has shown, however, is that trans people have a disturbingly high risk of suicide. Studies have associated external pressures, including family rejection and societal opposition, with greater suicide attempts.

A 2019 paper in Pediatrics showed that transgender adolescents had higher rates of suicidal ideation compared to cisgender adolescents. They had higher odds of all outcomes, including passive death wish, planning suicide attempt, and suicide attempt.

Read Also: Functional Neuroimaging Reveals Distinctive Brain Connectivity Patterns as Potential Predictive Markers for Suicide Risk

Interestingly, research suggests that gender-affirming surgery may reduce the incidence of suicide attempts among transgender people.

A 2023 review in Cureus reported that the majority of the studies that were reviewed showed a link between surgery and reductions in suicidality. However, the authors noted that results showing a reduction or an increase had limitations including a lack of statistical significance measure or comparisons between before and after outcomes.

Advocates say improving social acceptance, fighting discrimination, and providing gender-affirming care can help to cut suicide rates among trans people.

References

Tanner, L. (2023, March 5). How common is transgender treatment regret, detransitioning? AP News. Retrieved from https://apnews.com/article/transgender-treatment-regret-detransition-371e927ec6e7a24cd9c77b5371c6ba2b

Knox, L. (Year, Month Day). Media’s ‘detransition’ narrative is fueling misconceptions, trans advocates say. NBC News. Retrieved from https://www.nbcnews.com/feature/nbc-out/media-s-detransition-narrative-fueling-misconceptions-trans-advocates-say-n1102686

Bustos, V. P., et al. (2021). Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. Plast Reconstr Surg Glob Open, 9(3), e3477. https://doi.org/10.1097/GOX.0000000000003477

Dhejne, C., Öberg, K., Arver, S., & Landén, M. (2014). An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets. Arch Sex Behav, 43(8), 1535-1545. https://doi.org/10.1007/s10508-014-0300-8

Hall, R., Mitchell, L., & Sachdeva, J. (2021). Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: retrospective case-note review. BJPsych Open, 7(6), e184. https://doi.org/10.1192/bjo.2021.1022

Wiepjes, C. M., et al. (2018). The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets. J Sex Med, 15(4), 582-590. https://doi.org/10.1016/j.jsxm.2018.01.016

Thoma, B. C., et al. (2019). Suicidality Disparities Between Transgender and Cisgender Adolescents. Pediatrics, 144(5), e20191183. https://doi.org/10.1542/peds.2019-1183

Jackson, D. (2023). Suicide-Related Outcomes Following Gender-Affirming Treatment: A Review. Cureus, 15(3), e36425. https://doi.org/10.7759/cureus.36425

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