Study links transgender surgery to greater mental health risks

Transgender Americans who undergo surgical interventions are more likely to experience depression, anxiety, suicidal ideation, and substance abuse than those who do not, researchers in Texas report. A retrospective study published last week in the Oxford Academic Journal of Sexual Medicine analyzed individuals who struggle with gender dysphoria, comparing those who received surgical interventions with those who did not. Scientists from the Baylor College of Medicine, the University of Texas Medical Branch, and the University of Texas Health Houston analyzed data collected by the TriNetX database from 2014-24. The dataset included more than 107,500 American patients aged 18 or older and researchers examined mental health reports over two years post-surgery. The study concluded that surgeries for so-called gender-affirming care are associated with an increased risk of mental health issues.

What did the study find? Men who underwent surgical interventions were more than twice as likely to suffer depression and nearly four times as likely to have anxiety than men with gender dysphoria who did not have surgery. People who underwent feminization surgery were particularly at risk for depression and substance use disorders. Meanwhile, women who received surgery were also more likely to be depressed or have anxiety than those who did not have the interventions.

Are the findings consistent with other studies? A study from the National Institutes of Health published last April found that people who went through gender transition surgeries had elevated rates of PTSD, suicide attempts, and suicide. However, another study from the NIH published in November found that such surgery was effective in improving mental health outcomes as evidenced by decreased antidepressant use in patients. A 2021 Harvard study also found a correlation between surgery and improved mental health. Meanwhile, the Society for Evidence Based Gender Medicine debunked the same claims made by a 2019 study conducted in Sweden. Opponents of each study have disputed the findings based on data limitations, analysis issues, and biases.

Are there any limitations to the recent Texas study? As a retrospective study, the researchers did not evaluate the patients’ mental health before surgery or measure the rate of change in mental health. Opponents of the study also said that those who opt for surgery may have more severe mental health issues than other people diagnosed with gender dysphoria who do not. The researchers themselves noted that they were unable to measure possible factors such as the patients’ social support.

Dig deeper: Read Nathanael Blake’s opinion piece about how a report that identified issues with gender ideology has withstood scrutiny.