David M. Greenwald
Editor-in-chief
The idea that some trans people experience regret after having gender-affirming surgery has generated a lot of controversy on the right. The idea of “de-transitioning,” where many have argued that there are too many “bodies and minds falling apart in the fallout of transition,” has been one of the driving forces behind the argument.
This has been used as evidence throughout the country by organizations like Moms for Liberty to argue that minors and other young people shouldn’t be allowed to receive gender-affirming medical care.
But three Johns Hopkins University researchers question that in a recent article published in the esteemed Journal of the American Medical Association.
This Wednesday, the study was released.
They point out that “policymakers across the US have been using the potential for surgical regret to support an unprecedented wave of policy that bans transgender and gender-diverse youths from accessing gender-affirming care,” which they claim is “a safe and effective form of health treatment that allows TGD individuals to align their bodies with their own inner sense of self.”
These policies are motivated by the idea that people “who undergo gender-affirming surgeries (GAS) would later regret their decision to undergo such procedures.”
According to the study, “Despite this alleged regret, evidence suggests that less than 1% of TGD patients who undergo GAS report surgical regret.”
The report summary stated, in part, that “this rate of surgical regret among (transgender and gender diverse) patients appears to be significantly lower than rates of similar procedures among the general population, including cisgender individuals.”
The summary continued, “In fact, one rigorous review found that the average prevalence of clinical regret was 14.4% among all study reports analyzed, which the authors suggested was somewhat low.”
According to the report, transgender surgery consumers’ lower level of regret may be related “to why they underwent the procedure in the first place.”
Johns Hopkins notes “that decrease in regret may also result from careful implementation of current evidence-based, multidisciplinary guidelines and standards of care for those who are (transgender or gender diverse), such as requiring a well-documented history of gender dysphoria.”
Far from being an unusual finding, this study perfectly matches the clinical community’s perspective on gender-affirming care.
Along with the World Professional Association for Transgender Health, the American Academy of Pediatrics, American Medical Association, and American Psychological Association all endorse that course of action.
The World Professional Association for Transgender Health stated evidence of later regret is minimal, but that people should be informed about the probability during psychological counseling, according to the Associated Press this spring.
They also cited a recent Dutch study that stated that transgender adults who underwent thorough psychological evaluations as children before receiving hormone therapy and puberty blockers “found no evidence of regret.”
Additionally, they point out that “some studies suggest that levels of regret have decreased over the years as individual choice and treatment techniques have improved.”
“In a review of 27 experiments involving nearly 8,000 adolescents and adults who underwent transgender surgery, primarily in Europe, the U.S., and Canada, only about 1% expressed regret on average.”
This perfectly aligns with the most recent Johns Hopkins research.
However, there has been a fierce debate over these policies.
The Associated Press reported that Mississippi Governor Tate Reeves signed a bill in February 2023 that forbade “gender-affirming treatment in the state for anyone under the age of 18” as part of an overall conservative state effort to limit trans-related sports, care, and public displays.
Reeves argued on Twitter that it is wrong to sterilize and castrate children in the name of a new identity philosophy. “In today’s world, that simple truth is, in some ways, controversial.”
The act was criticized in a statement by Jensen Luke Matar, executive director of the Mississippi-based Transgender Education and Advocacy Program.
According to Matar, Mississippi legislators are ignoring the advice of every major health organization and insisting that they know what is best for transgender children. Patients should determine which health care is in a patient’s best interest, not politicians, along with their health care providers. Years of working directly with trans children in Mississippi have taught me that they need support, love, and affirmation—not this blatant political attack that denies them access to life-saving care.
However, the national organization Heritage Action, which is connected to the Heritage Foundation in Washington, praised the bill’s passage.
According to Jessica Anderson, executive director of Heritage Action, “Dangerous cross-sex hormones and experimental therapies are not a compassionate option for kids struggling with gender dysphoria.” These risky techniques cause irreparable psychological and physical harm for the rest of their lives and also fail to address underlying mental health issues.
The vast majority of studies show that this is once again an ideological criticism rather than a scientific one.
Despite the extraordinarily high levels of suicidal ideation among trans-identifying children and their general satisfaction with current methods, these reports are probably not going to dispel the condemnation of such methods.
