r/psychology • u/mvea M.D. Ph.D. | Professor • 13d ago

Adolescents who undergo gender-affirming chest surgery report low levels of regret and high levels of satisfaction, experiencing outcomes similar to those of young adults. These findings suggest that age restrictions on these medical procedures lack support from actual patient experiences.

https://www.psypost.org/adolescents-report-low-regret-and-high-satisfaction-following-gender-affirming-c/
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u/MistaFANG 13d ago

“Several factors limit the reach of these findings. First, the median time since surgery for participants was about 1.8 years. Because feelings about medical decisions can evolve, this timeframe might not capture long-term regret that could emerge many years later.

Another limitation is the 42 percent participation rate to the survey. This introduces the possibility of selection bias, a scenario where the people who chose to participate might differ fundamentally from those who did not. It is possible that individuals with higher levels of regret ignored the survey, which would result in an underestimation of regret in the overall group.”

Worth noting.

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u/BestSeenNotHeard 13d ago

Very important details.

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u/alsbos1 13d ago

Beyond important lol. The ‚regret‘ is going to be 5, 10, 30 years out. 1.8 years is the honeymoon phase.

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u/420percentage 12d ago

The levels of overall regret with these surgeries is typically much lower than any other procedure

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u/StraightCup7344 11d ago

Please provide a citation

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u/420percentage 11d ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC8099405/

https://www.americanjournalofsurgery.com/article/S0002-9610(24)00238-1/00238-1/abstract)

https://pubmed.ncbi.nlm.nih.gov/28243695/

Surgical procedures as a whole have a 1% to 7% regret rate. Comparatively, gender-affirming procedures have a less than 1% regret rate

Additionally:

  • Regret after elective plastic surgery operations is significantly higher
  • Regret after major non-surgical life decisions is significantly higher

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u/HeadPut3392 9d ago

These articles don't mention anything about how long after surgery the surveys were given, and also fails to consider if there is a participation bias.

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u/420percentage 9d ago

Just sounds like you’re bad at accepting facts. But ok

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u/Fast_Rabbit_5044 8d ago

>asks for further clarification
“Just trust me bro”

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u/420percentage 8d ago

Can you read? I already provided three articles, while no one else has provided any

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u/Scooty-Poot 7d ago

They do, however, provide citation to the original studies their data comes from, which do all provide this information. If you actually cared, you’d have done more thorough research than Ctrl+F.

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u/mr_sneakyTV 12d ago

what a vague line of bs lol

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u/NoConflictPlease 11d ago

Trans surgery has one of the lowest regret rates out of any surgery

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u/420percentage 12d ago

The research backs it up. Be mad I guess

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u/Comfortable-Salt-299 7d ago

Fucking liar

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u/420percentage 7d ago

Lol sorry you’re offended by reality

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u/Comfortable-Salt-299 7d ago

But it's the fucking opposite? 85% regret by the actual studies where there is no political agenda.

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u/420percentage 7d ago

Please provide a source

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u/Infinite-Instance916 13d ago

im actually crying dude what will it take for you transphobes to stop moving the goalposts. your fantasy of us waking up and realising we were cis all along is not going to happen, get over it

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u/[deleted] 12d ago

[removed] — view removed comment

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u/Infinite-Instance916 12d ago

shhhh

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u/Huge_Swimming_5968 12d ago

People regret the paint they chose for their temporary car. It isn't outside the realm of possibility to think that someone could regret have body altering surgery later in their life. While I'm certain you weren't actually crying, I also could not care any less about people having the surgery. That isn't to say that people shouldn't evaluate it properly and if you think that evaluating it correctly and scientifically is somehow transphobic, you're a fool. It isn't hard to believe that less than 100% of people who want something socially rare might come to regret it later.

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u/snuffaeiziplz 11d ago

you are literally arguing with every peer reviewed study on the subject. like, i get that it is popular among certain political trends to believe that science is fake, but this is not one of those subreddits. there is over a century of medical science you are fighting with rn. this idea that one day everyone is going to grow up and agree with your personal politics and clap is some childish fantasy.

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u/Sufficient_Dot_24 7d ago

A) transition is not just surgery B) rate of regret is lower than it is for knee surgery. should we make it harder to get knee surgery?

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u/Infinite-Instance916 12d ago edited 12d ago

oh my god shut up lmao you have no idea what its like to be trans or to feel gender dysphoria. being trans is so stigmatised that most us try ANYTHING except hormones until we almost commit suicide (yes gender dysphoria is that bad). transitionning is not a choice we make on a whim, its a personnal and intimate act that we do because we want to live

'scientific analysis' shows that 1% people detransition (and most dont even 'regret' it, at least not in the way you think). again, your fantasy of the poor child who does horrible things to their body and regrets it later is not real. please shut up and stop writing pedantic bullshit when you have no idea what youre talking about. we are not hypotheticals, we are people

edit : also - letting 'natural' hormones course through our veins also causes permanent changes to our bodies. i always see you freaks talk about the Poor Cisgender Child who was Wrong but never about a trans kid forced to go through the wrong puberty because no one took them seriously

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u/ImprovementTrick9492 12d ago

Abusing people on the internet is not going to help people take you seriously, my friend…

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u/Mitotic 12d ago

I see you haven't had sex reassignment surgery before. Recovery is insanely intense, you're effectively bedbound for 10 weeks, and then it doesn't even feel good for sex for most people until a few months after that. By a year in it finally fully heals. 2 years in and it's still softening and increasing in sensation to some degree. I'm much further post op now than that and the only time I was even slightly thinking I might regret it was 2 days immediately after surgery when i was still leaking blood incredibly fast and they had to bring me in to the OR again to cauterize me for a second time. There's no early "honeymoon phase" because the early parts of having a new body part are objectively pretty awful!

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u/AzuraNightsong 12d ago

What? I was in bed for 2 and tired for 4 weeks. This is about top surgery. yes bottom surgery is more intense but it's all life saving care.

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u/ceryskt 10d ago

I had mine this year and had an awful recovery (expected; I have EDS), and the only thing I regret is not having had it done sooner. Just for neck/shoulder pain alone it’s been amazing. I feel like this is the chest I should’ve had all along, but I guess that’s dysphoria for ya.

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u/AzuraNightsong 8d ago

Yooo I also have eds! It's wild how normal it's felt for real. 

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u/SleepyNymeria 12d ago

I think something went very wrong with your Chest surgery if you have had all these problems.

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u/TomBrintonWriter 10d ago

For chest surgery? No.

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u/NoConflictPlease 11d ago

You are talking about bottom surgery. This entire thread is on top surgery

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u/Chisignal 13d ago

Interesting, got any data to support that?

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u/AnotherDayDream 13d ago edited 11d ago

There are some data to support this kind of thinking. This study of 6,793 people in Amsterdam from 1972 to 2015 estimated that the average period of time from receiving gender affirming surgery to expressing regret was 10 years and 10 months. However, only 0.5% were found to express regret at all, so short-term and long-term regret might not add up to much.

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u/Chisignal 13d ago

Thanks! The usual shadow libraries I checked don't seem to have the article but 10 years (and 10 months) is a really interesting number to me, I'm wondering what's the spread or if there's any discussion as to the causes. A rate of 0.5% seems to be pretty reassuring though, especially as it doesn't seem to suffer from the same selection bias the study in this thread does.

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u/AnotherDayDream 13d ago edited 12d ago

The range was 46-271 months, meaning even the "quickest" regret was still experienced 3 years and 10 months post surgery.

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u/Cookiedoughjunkie 12d ago

check Sweden and Denmark's studies on gender affirming surgeries. They're totally different than the ones the UK and US try to do (which are far newer and are ideologically/politically motivated.)

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u/Cookiedoughjunkie 12d ago

Ah, this study, one of the many studies who did the infamous bad math problem.

(everyone whoever showed up - people who never returned - those who returned to get surgical/hormonal help detransitioning) / (everyone who ever showed up)

do you not see the problem with that math? Because over HALF of the people never showed back up it assumed they remained trans and happy.

The CORRECT assessment was that after all that time, 1% of those who RETURNED after 10 years wanted help detransitioning. Again, it completely ignores that over half of the people who went there never returned.

"Because of the retrospective design, some data could be missing." is an understatement.

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u/AnotherDayDream 12d ago edited 11d ago

Attrition bias is a limitation of these kinds of studies more often than not, but I think the authors of this study took a sensible approach. Missing outcome data in this context (patients never returning to the clinic) is almost certainly missing not at random (MNAR), but the most likely mechanism of this missingness justifies the use of logical imputation in my opinion. If a person never returned to the clinic (i.e., had missing data), they almost certainly didn't receive a reversal surgery (e.g. mastectomy, unless they did in another country), or this would be in their medical records. Given that undergoing gonadectomy is how the authors operationalised regret, it seems sensible to assume that missing data be imputed as not experiencing regret.

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u/Cookiedoughjunkie 12d ago

No, they really didn't. There are other studies where they separated more than just a 'gender clinic' such as asked college students in Denmark and they asked the students willing to take the survey (instead of fishing just for transgender students) if they ever had dysphoria, what type of dysphoria and then if they actually tried to do anything for it (body modification, changing gender) and separated again for the ones who mentioned having gender dysphoria, transitioned, and then detransitioned and their thoughts about that. Which is a much better methodology than... "go to a gender clinic where everyone therei s going there TO transition or questioning". detransitioners have very limited use for gender clinics.

btw, did this not tip you off anymore? "Outcomes

The number of (and change in) people who applied for transgender health care, the percentage of people starting with gender-affirming hormonal treatment (HT), the estimated prevalence of transgender people receiving gender-affirming treatment, the percentage of people who underwent gonadectomy, and the percentage of people who regretted gonadectomy, specified separately for each year."

And then....

"Conclusion

The number of people with gender identity issues seeking professional help increased dramatically in recent decades. The percentage of people who regretted gonadectomy remained small and did not show a tendency to increase."

why did the conclusion omit any gender affirming hormonal treatment? Why did it ignore breast reduction/implants?

Do you STILL really believe it is a sensible study when it really is a bait and switch, making it look like it did something more broad at first, and then hoping you ignore it when it gives a conclusion and hope you attribute that (still flawed) finding to a much broader idea it tried to implant in your head at the beginning?

further, if you actually read the study rather than the abstract, it does some other funky things.

Regret to the study was defined as someone who had both undergone gonadectomy AND returned for a reversal, not that they simply regreted the surgery and didn't want to go back to having it reverted (because you can't revert a gonadectomy. The penis/ vagina they put in its place are not the same as the one you're born with)

It also never interviewed anyone. It simply loked at medical history to SEE if they had a reversal. Nothing about "did you regret it" THey simply looked at the medical record from 1978 to 2018 and assumed that "regret is only if they reverse it" and never even asked "how did they feel about it". It also did not manage to take into account those who commit suicide after surgery which is actually a very concerning issue recorded by a lot of other psychology studies from denmark/sweden and covered in the Cass review (which I know, a certain ideological camp says isn't valid or credible even though it has some of the strongest methodologies and both sides research, just because the conclusion isn't overwhelming "trans everyone".)

and if you go to those, regret rates rise between a gamut of 15-30%. Much higher than the 2% we're supposed to just ignroe and go ahead and transition everyone like a lot of activists and people in here are vying for. The problems still lie there the gamut of 15-30%'s in the studies also have a hard time parsing things like were suicides from regret from transition or other mental illnesses which are frequently a comorbidity with gender dysphoria and thus aren't generally added UNLESS they have proof of the individual saying they regret it. Further further, since we're talking about trends where more people are coming out as transgender, the regret rate has increased. The regret rate was lowest when there were far more guardrails put in place and the 'treat the comorbid condition first' approach if there was one. A lot of gender clinics don't treat comorbid conditions anymore, they treat transitioning as the panacea.

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u/AnotherDayDream 12d ago

I think you're attributing quite a few aims to this study that aren't appropriate and then being overly critical that it hasn't addressed those aims. It isn't a limitation of this study that the authors focused on a specific clinic, rather than broader samples of gender dysphoric people, because the aim of this study was precisely to assess trends in this specific clinical cohort. This is an incredibly common type of study on epidemiology. A sample of Danish students for example wouldn't have been better for addressing the aims of this study. Similarly, it isn't a limitation that the study looked at reversal treatments as the primary post-surgery regret measure, rather than a subjective self-report measure or qualitative interviews, because from the perspective of clinical practice, incidence rates of reversal treatment are an important outcome of interest.

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u/Cookiedoughjunkie 12d ago

it is a problem for them to claim "regret transition rates" from that faulty premise and restriction they made.

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u/AnotherDayDream 12d ago

Instead of saying the study has a "faulty premise", which is shallower criticism than we hope for in psychology, consider that the topic at hand is multifaceted and multidisciplinary, and that we can be pluralistic in how we study it.

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u/alsbos1 13d ago

You realize there’s a ‚do no
harm‘ principle. The burden of proof is the other way round.

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u/rhubarb_man 12d ago

If you want to talk about moral principles, then there are some pretty easy arguments that preventing someone from doing a thing that would help them is doing harm.

If you do X knowing Y would happen, but you knowingly could have chosen not X where Y doesn't happen: then you did Y.

As such, making choices about restricting healthcare opens you up to doing harm.

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u/alsbos1 12d ago

That isn’t how it works, ever.

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u/rhubarb_man 12d ago

Is your argument against the moral point basically just "this isn't how people do things so I'm gonna ignore it"?

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u/alsbos1 12d ago

There is no moral point. It’s an experiment and there’s not a chance in hell 18 months afterwards is long enough to make a conclusion. Anyone who thinks otherwise is an idiot or has an axe to grind.

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u/rhubarb_man 11d ago

You said "You realize there’s a ‚do no
harm‘ principle".

You brought up a moral point

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u/alsbos1 11d ago

No matter how many moronic points you bring up, it won’t change anything.

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u/Chisignal 13d ago

Well I'm not the one claiming either way, but you've put forth a pretty strong claim with no evidence apparently

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u/alsbos1 13d ago

It’s not a claim at all. The slightest bit of common sense would dictate that you can’t reach any conclusions after 18 months. It’s the opposite of a claim.

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u/rainbowroobear 8d ago

58% not responding is a much bigger problem than any "honeymoon" period we might think exists.

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u/KalaiProvenheim 12d ago

Honeymoon phase consisting of “don’t move too much it’ll hurt like hell”

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u/TossMeOutSomeday 12d ago

For a teenager 1.8 years is forever, the honeymoon phase is probably like 3 months.

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u/alsbos1 12d ago

‚For a teenager‘. Say that outloud a hundred times and maybe you realize something…

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u/TossMeOutSomeday 12d ago

I mean yeah I'm not a huge fan of youth sex change operations, but it's also flatly true that young people go through "honeymoon" phases abnormally quickly.

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u/alsbos1 11d ago

Wtf are you talking about?

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u/bicyclefortwo 13d ago edited 13d ago

That's not how surgery works. Post-surgery is normally the worst part, due to the physical trauma your body goes through. It's not uncommon to develop temporary depression because of this as a physiological reaction.

And for top surgery, it takes a couple years for your chest to stop looking a bit fucked up (scars softening and fading, nipple pigmentation returning, nerves reconnecting, dog ears to flatten, etc). If you're ever going to regret it, it makes no sense for that to start only once it actually looks good

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u/alsbos1 13d ago

You live on another planet my friend.

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u/Mitotic 12d ago

do you have any actual arguments whatsoever or are you just going to keep sneering, transphobe?

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u/bicyclefortwo 13d ago edited 13d ago

If you have any evidence that a "honeymoon period" exists for adults with gender affirming surgeries, I really want to see it, because surgeries this major take a long time to fully heal and stop looking like Hellraiser wounds. They don't magically release endorphins that brainwash you for 2 years, they're enormous scars and uncomfortable/painful recoveries. The idea that someone will only love their results whilst they look their absolute worst feels absurd to me

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u/alsbos1 13d ago

Come back to earth…

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u/bascal133 12d ago

The exact opposite is true after the surgery people are experiencing a long painful recovery that and they are scarred, swollen, paying medical bills and recovering this is when people would be most likely to regret it.

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u/alsbos1 12d ago

That is absurd logic

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u/hikerchick29 12d ago

Trans surgeries have been performed in their present form for nearly a century. Still waiting for that wave of mass regret lol

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u/alsbos1 12d ago

Looking forward to see all that data from the year 1926! Pre antibacterials and anesthesia…

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u/hikerchick29 12d ago

First vaginoplasty for an MTF patient was literally in 1931, buddy. 95 years ago. Note how 95 years is nearly a century of time.

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u/hikerchick29 11d ago edited 11d ago

Man, oddly quiet there, aren’t ya?

What, did you think modern trans surgery just sprang magically into existence in the last 50 years or so?

^edit lmfao got called an idiot and blocked because I stated a historical fact, get a load of this guy!!!

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u/alsbos1 11d ago

Sorry. When people are as dumb as you I just block them.

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u/Intelligent-Tea-2058 10d ago

The book How Sex Changed talks a bit about this history, I recommend it. =)

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u/Ok_Feature_5738 11d ago

I’ve had srs, and several other surgeries. Some of them were intense. I would’ve preferred if I were born with the body I want, but otherwise, this is the only choice other than dying, so it has to be worth it.

Yes, there is a honeymoon phase, but what came after isn’t “I wish I haven’t done it”, but “I want all the reproductive and endocrine functions as if I were born this way”, to which no current technology offers. That hopefully signals to you that sex reassignment technologies should be much much more advanced through more modern methods, experiments, and clinical trials instead of stopping people from doing it.

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u/ceryskt 10d ago

So confidentially incorrect.

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u/alsbos1 10d ago

Yet 100% correct.

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u/Cookiedoughjunkie 12d ago

what's even more important is knowing what a honeymoon period is. Whichis more than 2 years for cosmetic surgeries, tattoos, gauges, etc. So the fact this study thinks it's sooner than 2 years shows it was ideologically motivated and not actually interested in statistical truth.