A recent study by Johns Hopkins researchers, published in JAMA Surgery, has made an important observation regarding gender-affirming surgery (GAS) among transgender and gender-diverse people. The research shows that less than 1% of individuals who have undergone GAS experience regret after their procedures. This surprisingly low regret rate is much less than what’s observed in surgeries among cisgender individuals.
The study suggests that this low rate of regret is likely a result of the thorough and careful application of existing evidence-based, multidisciplinary guidelines and standards of care designed specifically for these patients. This finding is in line with the views of the broader medical community including the American Academy of Pediatrics, among other medical organizations, which support gender-affirming care.
Notably, this study counters the widely held misconception, often perpetuated by anti-transgender activists and some politicians, that a significant number of transgender and gender-diverse people regret their decision to undergo gender-affirming surgery.
The findings from this study provide evidence that the regret rate among transgender and gender-diverse individuals who undergo GAS is much lower than previously thought, and that the surgery can have a positive impact on their well-being
Key findings:
- Exceptionally low regret: Less than 1% of TGD individuals reported regret after GAS, significantly lower than surgical regret rates among cisgender people.
- Distinct motivations: Differences in regret may stem from the underlying reasons for surgery. TGD individuals typically seek GAS for gender alignment, while cisgender individuals often undergo surgery for medical reasons like cancer treatment.
- Standardized care matters: Careful implementation of established guidelines and standards of care, including thorough assessments of gender dysphoria, appears to contribute to lower regret rates.
- Accurate evaluation remains a challenge: Assessing post-surgical satisfaction and regret effectively requires specialized tools and methodologies.
To address these challenges, the researchers propose:
- Utilizing Gender-Q: This validated patient-reported outcome measure specifically assesses TGD experiences and holds promise for accurate regret assessment.
- **Delayed ** Evaluating regret at least one year after surgery allows for biases from the immediate post-operative period to fade.
- Holistic assessments: Considering factors like age, race, education, and quality of life before surgery can provide a more complete picture of potential regret risks.
- Nuanced research: Further research exploring diverse TGD experiences and contexts can inform improved public policy and ultimately enhance the long-term health and well-being of TGD individuals.
This research offers strong evidence against the unsubstantiated claims of widespread regret after GAS. By prioritizing careful patient assessment, evidence-based care, and accurate regret measurement, healthcare professionals can ensure positive outcomes for TGD individuals seeking gender-affirming surgery.
The researchers are:
- Harry Barbee, Ph.D., assistant professor and interdisciplinary social scientist at the Johns Hopkins Bloomberg School of Public Health
- Bashar Hassan, M.D., a postdoctoral research fellow in plastic and reconstructive surgery at the Johns Hopkins Center for Transgender and Gender Expansive Health (CTH) and the University of Maryland Medical Center’s R Adams Cowley Shock Trauma Center
- Fan Liang, M.D., medical director at the CTH and assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine
In their article, the three report findings from a retrospective look at the limited amount of evidence-based studies addressing post-GAS regret. They also describe how research, health care and public policy can be guided by using scientific data to properly define post-surgical regret -; currently believed to be very low -; to address health needs across diverse populations. [Study source]
Frequently Asked Questions (FAQs)
What is Gender Affirming Surgery?
Gender Affirming Surgery refers to medical procedures that aim to alter a person’s physical appearance and biological sex characteristics to better match their gender identity. These surgeries can include various types of procedures, such as breast augmentation, chest reconstruction, genital surgeries, and facial modifications, among others.
What did the Johns Hopkins Study find about Gender Affirming Surgery?
The Johns Hopkins Study found that individuals who underwent gender affirming surgery reported high levels of satisfaction with the outcomes of their procedures. Furthermore, the study highlighted that rates of regret following these surgeries are significantly low, emphasizing the positive impact of these surgeries on individuals’ mental health and overall well-being.
Why is the Johns Hopkins Study important?
- Validation of experiences: The study provides empirical evidence supporting the positive outcomes of gender affirming surgeries for transgender and non-binary individuals, validating their experiences and decisions.
- Healthcare implications: With its findings, the study has the potential to influence healthcare policies and insurance coverage, making these necessary procedures more accessible.
- Educational value: It serves as an educational resource for medical professionals, policymakers, and the general public, increasing awareness and understanding of the needs and experiences of transgender individuals.
How common is regret after Gender Affirming Surgery according to the study?
According to the study, regret after Gender Affirming Surgery is quite rare. The research indicates that when individuals have access to proper counseling and support throughout their transition process, including before and after surgery, the levels of satisfaction are overwhelmingly positive, thereby minimizing cases of regret.
How can someone interested in Gender Affirming Surgery get started?
- Consult a healthcare provider: Initially, consult with a healthcare provider who is knowledgeable about gender identity issues and can provide guidance on the transition process and surgical options.
- Seek mental health support: It’s important to have support for your mental health, both for navigating personal feelings about your gender identity and for coping with societal pressures.
- Research qualified surgeons: Look for surgeons with experience in gender affirming surgeries. Many organizations and online communities can provide recommendations.
- Understand the requirements: Be aware of the prerequisites for undergoing gender affirming surgery, which typically include letters of recommendation from mental health professionals and sometimes living as your true gender for a certain period.
Can Gender Affirming Surgery be covered by insurance?
Insurance coverage for Gender Affirming Surgery varies by location and insurance provider. However, there has been a positive trend towards recognizing these procedures as medically necessary for many individuals. It is recommended to consult directly with your insurance company to understand your coverage. Additionally, some countries and regions have policies in place that mandate coverage for these surgeries, so it’s worth researching local laws and regulations.
