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Psychiatry journal issues major correction to study on trans surgeries effect on mental health

Hand holding a paper sheet with transgender symbol and equal sign inside.
Hand holding a paper sheet with transgender symbol and equal sign inside. | Getty

The conclusion of a study hailing the mental health benefits of “gender-affirming” surgeries on transgender-identifying people has been corrected, asserting that its core claim was too strong.

Originally published in October 2019 in the American Journal of Psychiatry, the researchers analyzed the records of 9.7 million Swedes in the national population registry. Of the 2,679 individuals who had been diagnosed with "gender incongruence" between 2005 and 2015, 1,018 underwent surgeries that either removed their genitals or permanently altered their bodies.

A key finding that led the authors to conclude that public policy ought to support what are euphemistically called "gender-affirming" surgeries was that postoperative patients suffer from mood and anxiety disorders less, showing an 8% decrease each year following the surgical procedures. 

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The study was widely disseminated in many major media outlets.

Yet authors Richard Bränström, an associate professor at Sweden’s Karolinska Institute, and John Pachankis, an associate professor at the Yale School of Public Health, are now saying their previous claim was worded too strongly.

The authors posted a correction in the journal Saturday, stating that their data “demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts.”

The correction comes following the recent publication of several letters to the editor, which challenged the methodology of the study published by the journal.

"Upon request, the authors reanalyzed the data to compare outcomes between individuals diagnosed with gender incongruence who had received gender-affirming surgical treatments and those diagnosed with gender incongruence who had not,” the correction reads. 

“While this comparison was performed retrospectively and was not part of the original research question given that several other factors may differ between the groups, the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison.”

In November, University of Texas sociologist Mark Regnerus noted that the results of the study, particularly the statistically significant effect of time since the last gender-affirming surgery on reduced mental health treatment, were misleading because they were inflated and relied on a tiny group of people.

Only 19 respondents in the research who underwent gender surgeries reported their final surgery as having occurred 10 or more years ago, according to the data. More than half of those sampled, 574 out of 1,018, indicated their last operation occurred within the past two years. 

Out of those 574, 42% reportedly sought therapy in 2015.

"[I]f a mere three additional cases among these 19 had sought mental health treatment in 2015, there would appear to be no discernible overall effect of surgery on subsequent mental health," Regnerus noted in an essay in the Public Discourse.

Ryan Anderson, a scholar at the Heritage Foundation and author of the 2018 book, When Harry Became Sally: Responding to the Transgender Moment, welcomed the correction.

“Gender dysphoria is a serious condition. People who experience a gender identity conflict should be treated with respect and compassion. And they deserve to know the truth,” Anderson wrote in a Daily Signal column Monday.

“Now the world’s largest relevant dataset reveals hormones and surgeries don’t bring wholeness and happiness. We need to find better, more humane, and effective responses to those who experience dysphoria.”

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