Long term results of sexual reassignment surgery: A 2011 Swedish Study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043071/

This article is from 2011, long before the current transgender movement began. The results of this study are interesting.

This study was performed in Sweden, and followed sexual reassignment patients from 1973-2003. In 30 years, a total of 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) were identified in this study. THIRTY YEARS, and a total of 324 individuals surgically changed their gender.

Transsexualism (ICD-10), or gender identity disorder (DSM-IV), is a condition in which a person's gender identity - the sense of being a man or a woman - contradicts his or her bodily sex characteristics. The individual experiences gender dysphoria and desires to live and be accepted as a member of the opposite sex. Gender identity disorder remains a psychiatric diagnosis in both the DSM 5 (released March 2013) and the newly updated DSM 5 TR which came out in March 2022. The DSM IV was the current diagnostic manual when this study was performed in 2011.

“The treatment for transsexualism includes removal of body hair, vocal training, and cross-sex hormonal treatment aimed at making the person's body as congruent with the opposite sex as possible to alleviate the gender dysphoria. Sex reassignment also involves the surgical removal of body parts to make external sexual characteristics resemble those of the opposite sex, so called sex reassignment/confirmation surgery (SRS). This is a unique intervention not only in psychiatry but in all of medicine. The present form of sex reassignment has been practised for more than half a century and is the internationally recognized treatment to ease gender dysphoria in transsexual persons.” Sadly, no one notes here the need for psychiatric treatment. Remember, gender dysphoria is indeed a mental health issue.

“We studied mortality, psychiatric morbidity, accidents, and crime following sex reassignment. More specifically, we investigated: (1) all-cause mortality, (2) death by definite/uncertain suicide, (3) death by cardiovascular disease, and (4) death by tumour. Morbidity included (5) any psychiatric disorder (gender identity disorders excluded), (6) alcohol/drug misuse and dependence, (7) definite/uncertain suicide attempt, and (8) accidents. Finally, we addressed court convictions for (9) any criminal offence and (10) any violent offense.”.

The Findings:

There were no substantial differences between female-to-males and male-to-females. Immigrant status was twice as common among transsexual individuals compared to controls, living in an urban area somewhat more common, and higher education about equally prevalent. Transsexual individuals HAD BEEN HOSPITALIZED FOR PSYCHIATRIC MORBIDITY OTHER THAN GENDER IDENTITY DISORDER prior to sex reassignment about FOUR TIMES more often than controls.

Sex-reassigned transsexual persons of both genders had approximately a three times higher risk of all-cause mortality than controls.

Sex-reassigned persons had a higher risk of inpatient care for a psychiatric disorder other than gender identity disorder than the control group of the same birth years. This held after adjustment for prior psychiatric morbidity, and was true regardless of whether sex reassignment occurred before or after 1989. In line with the increased mortality from suicide, sex-reassigned individuals were also at a higher risk for suicide attempts.

The findings were expanded a bit here. “Mortality from suicide was strikingly high among sex-reassigned persons, also after adjustment for prior psychiatric morbidity. In line with this, sex-reassigned persons were at increased risk for suicide attempts. Previous reports suggest that transsexualism is a strong risk factor for suicide, also AFTER sex reassignment, and our long-term findings support the need for continued psychiatric follow-up for persons at risk to prevent this.” Anecdotally, I can validate this. Among the patients I see who identify as trans, regardless of hormones or validating their gender transition, their underlying mental health does not improve. In many, it worsens DESPITE their trans treatment and acknowledgment by society.

Inpatient care for psychiatric disorders was significantly more common among sex-reassigned persons than among matched controls, both before and after sex reassignment. It is generally accepted that transsexuals have more psychiatric ill-health than the general population prior to the sex reassignment. It should therefore come as no surprise that studies have found high rates of depression, and low quality of life also after sex reassignment. Notably, however, in this study the increased risk for psychiatric hospitalisation persisted even after adjusting for psychiatric hospitalisation prior to sex reassignment. This suggests that even though sex reassignment alleviates gender dysphoria, there is a need to identify and treat co-occurring psychiatric morbidity in transsexual persons not only before but also after sex reassignment.

This was 2011. This provides validity to the concerns we have right now. Untreated mental illness that mingles into the gender dysphoria ideology and the culture of healthcare that will willingly give hormones and surgery to someone under the age of 18, The underlying mental health issues do not go away because we switched genders.