Study on Gender-Affirming Surgery Shows Positive Mental Outcomes

A new study published on Wednesday by JAMA Surgery found gender-affirming surgery is associated with improved mental health outcomes among transgender people.

The published resaerch is the first large-scale, controlled study to show an association between gender-affirming surgery and improved mental health outcomes, overall adding crucial new knowledge in a field where there is often little, high-quality evidence regarding the mental health effects after trans individuals undergo gender-affirming surgeries.

“There is great demand among transgender and gender-diverse people for gender-affirming surgery, and thanks to recommendations by professional associations and clinical support for gender-affirming surgical care, these treatments are much more common today than they were even just 10 years ago,” says study lead author Anthony N. Almazan, a fourth-year medical student at Harvard Medical School. “But until now, there has been limited evidence that these surgeries result in better mental health outcomes.”

To come to this conclusion, the study, titled “Association Between Gender-Affirming Surgeries and Mental Health Outcomes,” compared psychological distress, substance use, and suicide risk of 3,559 trans people who had undergone gender-affirming surgery with those of an additional 16,401 trans people who wanted gender-affirming surgery but had not yet undergone any procedures.

It found trans people who had received one or more gender-affirming, surgical procedures had a 42 percent decrease in odds of experiencing past-month psychological distress, a 35 percent reduction in the odds of past-year tobacco smoking, and a 44 percent reduction in the offs of past-year suicidal ideation.

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Overall, the study found that people who received all of the gender-affirming surgeries they desired had significant reductions to odds of experiencing adverse mental health outcomes across the board.

Recent attempts to find this same association had mixed results. A 2010 analysis of 1,833 trans and gender-diverse people concluded there was “low-quality evidence” that gender-affirming surgery would lead to better mental health outcomes. A 2019 study of 2,679 trans people demonstrated an associated between gender-affirming surgery and reduced utilization of mental health treatments, though a 2020 correct to the study reported no mental health benefits after comparison with the control group of trans people who had not yet undergone wanted surgeries.

“These results are incredibly important for the evolving field of transgender healthcare,” says study senior author Dr. Alex S. Keuroghlian. “Although clinicians have long supported the provision of gender-affirming medical and surgical care, the practice has been challenged by health insurers asking for more evidence showing its efficacy. In light of this study’s results, gender-affirming surgeries should be made available for transgender and gender diverse people who seek them, and we should work to remove barriers to gender-affirming surgery such as insurance exclusions for such care.”