(Originally posted Sept 5, 2021)
Transgender activists often claim if the “affirmative care model” is not followed the mental health of those suffering from gender dysphoria will worsen and increase the likelihood of suicide.
Parents are shocked into action when told by health professionals that puberty blockers and cross sex hormones, and eventually “gender affirming surgery” may be the only way to prevent their children from committing suicide. Starting them on a medicalized pathway from their “sex assigned at birth” to the sex they now identify with is the most beneficial and humane course of action, parents are instructed.
[Please view this post which rebuts the “assigned at birth” fiction]
In 2019 one of the few major studies on this issue released its findings. The study analyzed health records of 2,679 Swedes diagnosed with gender dysphoria between 2005 and 2015 to determine whether hormonal or surgical treatments improved their mental health over time. This was one of the first longitudinal studies done about the efficacy of cross-sex hormonal therapy and sex reassignment surgery. And the largest population study to date. Plus it was done in perhaps the most Trans-friendly country on the planet, Sweden.
The original study conducted by a researcher from the Karolinska Institute in Sweden and a researcher from the Yale School of Public Health was published in the American Journal of Psychiatry in 2019. (The Karolinska Institute is the same institute that awards the Nobel Prize in Medicine and in May advised its hospital to stop hormone treatments and surgery for young people under 18!) The study concluded that “Transgender individuals who undergo gender-affirming surgery are significantly less likely to seek mental health treatment for depression and anxiety disorders or attempt suicide in the years following the procedure.”
Still from the perspective of the “affirmers” the results were decidedly mixed.
We learned two things from this study.
The main finding of the study was that hormonal transition showed no signs of mental health improvement for “gender incongruent” patients. This “no improvement” finding was largely ignored by the news media and trans-activists.
Administering cross-sex hormones to gender confused folk did not improve their mental health.
But the 2019 study did show that gender affirming surgery improved the mental health of those in the study. Patients from 2005-2015 who underwent surgical procedures to assist their transition to the opposite sex showed an overall 8 percent improvement.
This was widely reported as evidence that the “affirmative care model” works!
You may think an 8% improvement for those who underwent radical irreversible surgery is not a lot to “hang one’s hat on.” But this result was widely used to denounce Gender Critical viewpoints like mine as anti-science. (read on)
That was then. This is now. (as of August 2020)
After criticism for the study’s flawed methodology, the American Journal of Psychiatry was forced to retract those findings. What was the flawed methodology? For starters: No control group! The researchers looked at a large group of transgender patients over a 10 year period, making it a good longitudinal study. But they failed to compare those results with a control group of transgender patients who had not undergone body altering surgery. Once that was done the rather small 8 percent improvement evaporated.
“the results [of the reanalysis] demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts” - AJP correction
Surgery did not improve psychological well-being. It did not decrease suicide attempts relative to those transgender patients who went the non-surgical route. (Remember this is a study of Swedish patients in the most trans-friendly country on Earth so blaming unaccepting social factors as a cause for continued distress doesn’t work.)
Hormones & mutilating surgery did not improve outcomes for transgender patients!
Here’s a link to the correction. And here is an assessment by the Society For Evidence-Based Gender Medicine (SEGM) an international group of over 100 clinicians and researchers. Their assessment is worth your careful attention. For those of you interested in the details of the flawed methodology make sure you click on the “click here for more” link in the section labeled “Vigorous Debate Leads to Correction of Key Finding.”
So, after the retraction how did the media respond?
Journalists, like scientists can be biased too.
But sadly parents are still being pressured by pediatricians, gender clinics and Trans-activists into accepting a single medicalized pathway if they want to prevent their kids from committing suicide.
In my research this past year I’ve noticed parents and confused young people hear the following statement all the time from social media influencers and medical professionals:
That will cause any parent to sit up and take notice! But that is a bald assertion with no evidence to support it. Yes, there is a much higher incidence of suicide among this population but that is because they are psychologically troubled to begin with. Social transitioning, hormones and surgery doesn’t change that reality. My recommendation to parents is get non-affirming treatment and “hold your ground.” Your children and teens are confused.
You’ll meet some of those parents in my next post. They are distraught over the advice they and their children have been given by health care providers.
Obviously, it’s hard to know whether the flaws of the above study were just human error or whether the scientists involved desired a preferred outcome. If you read the end of my last post you’ll find one of our top Psychiatrists admitting that when it comes to questions about “Sex and sexual behavior” many scientists who view humans as infinitely malleable would rather not look too hard for empirical evidence to back up their claims. Ideology drives some of them, just like the activists.
If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend a book by Abigail Shrier.
Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School. Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]
An article titled “21 International Experts Dispute Prevailing US Gender Transition Methods” published by The Epoch Times on July 15, 2023, discusses the concerns raised by 21 clinicians and researchers from nine countries regarding the current treatment methods for gender dysphoria in the United States. These experts argue that the best available evidence does not support the use of sex-change procedures, particularly for minors. They criticize the Endocrine Society’s endorsement of hormone treatments that block puberty in minors, stating that the evidence for mental health benefits from such interventions is of low or very low certainty.
The experts’ concerns were prompted by the Endocrine Society’s criticism of an op-ed that questioned a federal court ruling which struck down an Arkansas law banning sex-change procedures for minors. The court ruling relied on the Endocrine Society’s guidelines, which are based on low-quality evidence and influenced by transgender activists.
In response to these criticisms, the Endocrine Society’s president, Dr. Stephen Hammes, defended the guidelines, stating they were developed through a rigorous process and based on extensive evidence. He argued that more than 2000 studies since 1975 show that gender-affirming care improves the well-being of transgender and gender-diverse people and reduces the risk of suicide.
However, the group of international experts disputes this claim, stating that the best available evidence does not support the assertion that sex-change procedures improve well-being. They argue that the risks of such procedures, which include sterility, lifelong dependence on medication, and regret, are significant, while the benefits are very low.
They also contradict the claim that gender transition reduces suicides, stating that there is no reliable evidence to support this, and call for medical societies to align their recommendations with the best available evidence, cautioning against exaggerating benefits and minimizing risks.