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Correction of a Key Study: No Evidence of “Gender-Affirming” Surgeries Improving Mental Health | SEGM
Allowing scientific debate in transgender medicine improves evidence basisIn October 2019, the American Journal of Psychiatry NAJPO published a study from the Karolinska Institute in Sweden, and the Yale School of Public Health which reported that “gender-affirming" surgeries for gender dysphoric patients are associated with improved mental health outcomes (1). Looking at mental health utilization in the year 2015, a retrospective analysis showed that the more time passed since surgery, the fewer mental services were utilized by patients, with an average 8% reduction in mental health utilization for each year following surgery. From this, the study concluded that surgery has a beneficial effect on mental health, and that benefits continue to accrue over time. However, following a reanalysis of the data, this conclusion has now been officially corrected to indicate that there is “no advantage of surgery.”
Original Study by Bränström & Pachankis N2019O
The study (1) 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. To approximate mental health outcomes, the authors relied on the count of mental health visits, psychiatric medication prescriptions, and hospitalizations following suicide attempts. It was presumed that the fewer “mental health events” a person experienced, the better their mental health.
While the authors found no evidence of benefits of hormonal treatments (adjusted odds ratio=1.01, 95% CIh0.98 i 1.03O, they noted a statistically significant relationship between time since surgery and mental health status (adjusted odds ratio=0.92, 95% CIh0.87 i 0.98O. Specifically, the researchers observed that as of 2015, patients who had surgeries further in the past had better mental health than patients whose surgeries were more recent.
This “longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment” was interpreted by the authors as the evidence of a positive, time-release-like effect of “gender- affirming” surgery. The authors opined that this finding should “lend support to the decision to provider gender- affirming surgeries to transgender individuals who seek them.” The conclusions of the study were widely publicized by mass media outlets. The study also made a rapid and significant impact on clinical and public health education.
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Correction of a Key Study: No Evidence of “Gender-Affirming” Surgeries Improving Mental Health
In October 2019, the American Journal of Psychiatry (AJP) published a study from the Karolinska Institute in Sweden, and the Yale School of Public Health which reported that “gender-affirming" surgeries for gender dysphoric patients are associated with improved mental health outcomes (1)...
segm.org
