Study of 100K+ Adults Finds Transgender Surgeries Linked to Worse Mental Health Outcomes

A new 10-year retrospective study of gender-dysphoric patients 18 and over concludes that transgender surgeries increase the risk of mental health issues. This study was published in the Journal of Sexual Medicine and is the largest sample size of any study on the topic.

The study results state, “From 107 583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery.”

Male adults with gender dysphoria who received surgery had depression rates of 25%, while those who didn’t receive surgery had a depression rate of 11.5%. 12.8% of males with surgery had anxiety compared to 2.6% of those who didn’t receive surgery. 22.95% of females with surgery had depression compared to 14.6% of those without surgery. The anxiety rates were 10.5% for the surgery group and 7.1% without surgery.

The authors said the results are more reliable based on the methodology, although the non-randomized sample means they could not adjust for confounding factors, including social support. The authors state, “By leveraging ICD-10 codes, we provide a more accurate representation of patient demographics and clinical outcomes, minimizing recall and reporting biases that often limit survey-based research.”

The strongest study that shows improved mental health outcomes from transgender surgeries for those with gender dysphoria relied on surveys filled out by the patients and was published in 2021. A 2011 study concluded that self-reported data is unreliable due to biases. The authors wrote, “These findings support the hypothesis that social desirability and recall bias are likely to affect the self-reported use of mental health services in a population survey… Roughly 75% of those recorded as users of mental health services users in the RAMQ’s register did not report using mental health services in the CCHS-1.2.”

The latest study with a more reliable methodology shows worsening mental health outcomes across the board for individuals who move forward with transgender surgery. The authors concluded, “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.”

Despite the results showing worse mental health outcomes after transgender surgeries, the authors state that the surgery is “beneficial in affirming gender identity” and shows the need for ongoing mental health support.

Eithan Haim, a Texas Children’s Hospital whistleblower, accused the authors of “ignoring the most obvious cause of declining mental health.” Haim appeared on The HighWire to discuss the case that was brought against him for releasing information to journalist Christopher Rufo about the hospital continuing to provide “gender-affirming care” despite the claim that they stopped providing that type of medical care.

In 2022, Texas Attorney General Ken Paxton issued a formal opinion calling “so-called sex change procedures” on children and the prescription of puberty blockers child abuse. After Haim provided information to Rufo, the DOJ brought charges against Haim, which have since been dropped under the new administration.

The World Professional Association for Transgender Health (WPATH) provides guidelines for treating individuals with gender dysphoria, which is considered a mental health disorder, and individuals with “gender incongruence” which is not considered a mental health disorder. Both of these conditions can be treated with “various gender-affirming treatment options,” according to WPATH.

The WPATH SOC-8 provides a long list of “medically necessary gender-affirming care interventions.” It states, “These include but are not limited to hysterectomy +/- bilateral salpingo-oophorectomy; bilateral mastectomy, chest reconstruction or feminizing mammoplasty, nipple resizing or placement of breast prostheses; genital reconstruction, for example, phalloplasty and metoidioplasty, scrotoplasty, and penile and testicular prostheses, penectomy, orchiectomy, vaginoplasty, and vulvoplasty; hair removal from the face, body, and genital areas for gender affirmation or as part of a preoperative preparation process; gender-affirming facial surgery and body contouring; voice therapy and/or surgery; as well as puberty-blocking medication and gender-affirming hormones; counseling or psychotherapeutic treatment as appropriate for the patient and based on a review of the patient’s individual circumstances and needs.”

WPATH adds, “WPATH urges health care systems to provide these medically necessary treatments and eliminate any exclusions from their policy documents and medical guidelines that preclude coverage for any medically necessary procedures or treatments for the health and well-being of TGD individuals.”

The HighWire reported last July about WPATH’s move to remove age minimums from its recommendations after receiving pressure from Admiral Rachel Levine, the assistant secretary for health at the Department of Health and Human Services in the Biden administration. WPATH made this adjustment despite concerns about “sloppy” assessments and “opportunism by inexperienced and sometimes dangerous providers.”

Chloe Cole, a female detransitioner, shared the study and confirmed that receiving a double mastectomy as a child did not improve her mental health.

The HighWire has reported multiple lawsuits against care providers for failure to provide informed consent and misdiagnosis of gender dysphoria. Dr. Johanna Olson-Kennedy, a well-known transgender care provider, is the defendant in one of those lawsuits. She was also the lead author of a study that did not show any change in mental health outcomes for children who received puberty blockers. Dr. Olson-Kennedy refused to release the study, fearing that the results would be weaponized.

Haim called the latest study a “bombshell” and said the authors have published other papers with “pseudo-intellectual jargon.” Haim wrote on X, “They never question the validity of the surgeries – only that mental health support is needed AFTER surgery. They accept the surgeries as self-evidently beneficial since they “affirm gender identity.” He added, “They explicitly endorse the transgender party line yet undercut its central premise that they improve mental health outcomes.