New Data Show “Gender-Affirming” Surgery Doesn’t Really Improve Mental Health. So Why Are the Study’s Authors Saying It Does?

Nov 14, 2019 by

by Mark Regnerus, Public Discourse:

Data from a new study show that the beneficial effect of surgery for transgender people is so small that a clinic may have to perform as many as 49 gender-affirming surgeries before they could expect to prevent one additional person from seeking subsequent mental health treatment. Yet that’s not what the authors say. That the authors corrupted otherwise-excellent data and analyses with a skewed interpretation signals an abandonment of scientific rigor and reason in favor of complicity with activist groups seeking to normalize infertility-inducing and permanently disfiguring surgeries.

A new study appearing last month in the American Journal of Psychiatry concluded that “gender-affirming” surgery is associated with reduced demand for subsequent mental health treatment in a sample of persons diagnosed with “gender incongruence.” Predictably, such news received wide media interest and coverage. And yet even a cursory reading of the study itself tells a far less optimistic story than the media narratives—as well as the authors’ own inexplicable confidence—have offered. Indeed, the analyses would seem to suggest the benefit of a hormonal or surgical course does not outweigh the demonstrable physical and financial costs of such treatments. Future studies might suggest otherwise, but not this one.

The study’s shortcomings have nothing to do with the data, nor the methods employed by its authors (and public health researchers) Richard Bränström and John Pachankis. The data come from the Swedish Total Population Register, a massive longitudinal survey effort that collected information from over 9.7 million Swedes, or about 95 percent of the country. No complaints there. The analyses are high-quality: the authors tracked respondents over time and assessed their use of mental health treatment (for a mood or anxiety disorder) in 2015, as well as other related measures (such as hospitalization after a suicide attempt), as a function of time since gender-affirming hormone and surgical treatment. Its measurement precision is excellent, and would satisfy most methodological purists. So far, all good news. But then come the scholarly interpretations of the study’s results, which are remarkably out of step with the far more modest conclusions they merit.

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