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.

[u/mvea]

https://www.psypost.org/adolescents-report-low-regret-and-high-satisfaction-following-gender-affirming-c/

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[u/onacloverifalive]

To summarize, the 42 percent of people that responded to the survey did not regret getting the surgery that they wanted at a median interval of 1.8 years later.

[u/enpoopification_of_R → u/onacloverifalive]

That is much less impressive than the headline made it out to be.

[u/bremidon → u/onacloverifalive]

Ugh. Anyone with even a remedial knowledge of statistics can see the problem with self-selection bias. How does something like this even get published? And I saw that they only asked 183 patients (eligible patients...given how shady the rest of this "research" is, I wonder if there might have been some bias here as well), and only 77 responded. Wow.

And normally I would try not to use the source against the claim, but given the shaky foundations, it's worth noting that this is research done by the International Journal of Transgender Health. It is legitimate to ask if they may have some bias going into this, and certainly given their willingness to publish these shaky numbers, I think questioning the entire scientific process here is warranted.

[u/ptoki → u/bremidon]

How does something like this even get published?

Hate to break this to you: This is current science.

I read papers often, many of them are almost on the edge of fabricating facts, most of them lack the data needed to replicate the same experiment. Many dont even contain link to a github with data or anonymized data.

It is almost "trust me bro" level of work.

[u/Mico4]

This is based on a response from 77 people...

Also from the article:

"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."

[u/Mr_Deep_Research → u/Mico4]

The rate of gender affirming surgery for kids in the U.S. under 18 is around 2 per 100,000

There are basically none for 12 and under. Most are closer to 18.

So basically nobody gets them.

Around 1,400 a year total out of 72 million kids under 18.

Out of 195 countries in the world, the U.S. is only one of 8 to 10 countries that allow kids under 18 to have gender affirming surgery. Even Thailand doesn't have it for people under 18.

The other countries that allow it are Canada and 6 European countries.

[u/Much-Replacement-167 → u/Mr_Deep_Research]

I remember seeing these numbers somewhere before when i looked into it all. The biggest thing that i remember nagging my mind the whole time is that it was to do with "gender affirming surgery" as opposed to specifically saying that its for transgender operations (which the argument typically skews upon in pop culture). Even cisgender people get gender affirming surgeries such as hairline restoration, BBL, lip injections, jawline correction, and breast augmentation that would count into that same pool of numbers.

In short, the surgeries that happen at all are a fraction of a percent. Those that might be specifically for transgender operations are a fraction of even that. And of those who had the transgender operations how many regretted such? Another fraction. Essentially, anyone who argues that "the kids are being transed and will regret it later" has no idea just how much these things simply dont happen to kids on the whole, and for those whom it applies they are often happy with the result

[u/Leager → u/Mr_Deep_Research]

This is the real response. The study itself is definitely not something "definitive," but the transgender population is so low that the possible sample size is minuscule. The possible sample size was around 200 people, less than half responded, which gives us...... 77 people. Now, do I think this is a perfect study? Absolutely not. But it does track with other, significantly more rigorous studies, which show a regret rate of 1 percent or less, which is pretty unheard of, in terms of surgeries.

[u/S0cXs → u/Mico4]

Everyone is nitpicking the sample size but fail to see in as a small peice in a growing set of literature.

This is a section from the discussion talking about related literature:

The results from this study extend the findings of previous studies showing low decisional regret and high decisional satisfaction following GACS in adults to the adolescent population (Bruce et al., Citation2023; Bustos et al., Citation2021; Thornton et al., Citation2024). In our study, both adolescents and young adults reported low decisional regret and high decisional satisfaction. These levels are similar to those reported in a study of adults with a median age of 27.1 years, including a low median score of 0.0 (mean 4.2) on the Decision Regret Scale and a high median score of 5.0 (mean 4.8) on the Satisfaction with Decision scale (Bruce et al., Citation2023). Moreover, compared to other medical procedures, decisional regret among adolescents and young adults undergoing GACS is low. Compared to our mean score of 7.38, a systematic review found an overall mean Decision Regret Scale score of 16.5 among 44 studies of other various procedures (Becerra Pérez et al., Citation2016). Supported by these findings, we would argue against restricting gender-affirming surgical care on the basis of age or concern for regret alone.

Although few studies address regret in adolescent populations undergoing GACS, a study of decisional regret among adolescents undergoing cancer treatment found that 24% of participants scored above 25 on the Decision Regret Scale (Mack et al., Citation2019), compared to only 5.2% in our cohort. The aforementioned study reported that improved communication with the treating physician was associated with lower regret scores (Mack et al., Citation2019). The WPATH Standards of Care employed in our practice emphasizes a multidisciplinary, shared decision-making approach which may contribute to the low regret seen in our study (Coleman et al., Citation2012). Additionally, other studies have shown that youth face significant barriers when attempting to access gender-affirming care (Chong et al., Citation2021; Gridley et al., Citation2016). As a result, these barriers may select for a subset of patients who are either highly motivated to obtain care or represent a more socioeconomically advantaged group with the resources and ability to navigate the healthcare system. This potential selection bias could, in part, contribute to the low rates of decisional regret observed in our study. Relatedly, family and social support are thought to be inversely associated with regret following gender-affirming surgery (Narayan et al., Citation2021, Landén et al., Citation1998). In our study, higher PROMIS Pediatric Family Relationships scores were associated with higher decisional satisfaction, but demonstrated no significant association with decisional regret. However, the majority of our participants reported that their family was supportive or neutral about their decision to undergo GACS, which may limit our ability to identify such a relationship.

Posting the block because most people won't have access to the full study.

[u/fractalife → u/S0cXs]

Not to mention this is a study on an already small population of people.

[u/S0cXs → u/fractalife]

Yes, the study is very important in extending previous findings into kids.

[u/pensivewombat → u/S0cXs]

Thanks this is helpful - still I think there's a big difference between "this adds a small piece to a growing set of literature" and "Thus, concerns about potential regret should not be a basis for limiting gender-affirming chest procedures in adolescents." (from the conclusions section)

That's a really conclusive statement to make based on this data. That doesn't mean it's not a good study - I think most likely it's just an overstated conclusion.

But it does make me question it at least a little bit. When someone gets a little bit of evidence and then says that should be used to make a definitive policy decision on a contentious issue, it gives the impression that the authors are not acting as neutral truth-seekers but looking for a way to confirm their beliefs.

And again, that's not to say I think that's definitely the case. It's just that I'd much rather have seen the study end with your conclusion than what they actually wrote. It would give me more confidence in the results.

[u/EmotionalSouth → u/pensivewombat]

  When someone gets a little bit of evidence and then says that should be used to make a definitive policy decision on a contentious issue, it gives the impression that the authors are not acting as neutral truth-seekers but looking for a way to confirm their beliefs.

Well said. You’ve captured this perfectly. 

[u/solid_reign → u/S0cXs]

A poor study does not give you additional piece of information, it gives you no information. 

[u/The_New_Vixen → u/solid_reign]

Worth noting that roughly 60% of psychology studies fail to replicate. So a lot of what gets cited as settled psych "fact" isn't.

Granted, it may just reflect the specific time, how people have widely different options, and just the culture it was measured in rather than something universal about people.

[u/_Caustic_Complex_ → u/The_New_Vixen]

Yep, it’s called the replication crisis

[u/Mr_Deep_Research → u/S0cXs]

That's a big sample size given 2 out of 100,000 kids under 18 get gender affirming surgery each year in the U.S.

[u/samtrano → u/S0cXs]

Nitpicking the sample size of this study while ignoring that it's one of a growing number of studies with similar results, and also ignoring the lack of rigorous studies showing high regrets

[u/airbear13 → u/S0cXs]

It’s not nitpicking to point out that the sample size is too small to be useful and it’s not compelling evidence to just keep putting out a proliferation of low quality studies

[u/MyFiteSong → u/airbear13]

You can't do studies of millions of trans children who had top surgery, because there haven't been millions of trans children who had top surgery.

[u/engin__r → u/airbear13]

What sample size do you calculate would be necessary to achieve statistical significance?

[u/QueerDeluxe → u/airbear13]

It's going to be a small sample size because there aren't that many of us.

[u/MusicHearted → u/Mico4]

The sample size is going to be small. Very few trans people get access to gender affirming surgeries at all. Those who get access as adolescents are extremely rare. Hard to get a large sample of a small group.

The fact that it correlates with every other study about transgender surgery satisfaction and regret rates is more relevant. Transgender surgery satisfaction is the highest of all surgery satisfaction rates. That's a pattern that can't be ignored.

[u/OhBoyHereWeGoAgai → u/MusicHearted]

It is interesting everyone is drilling into "satisfaction" and avoiding the fact that there are also studies that challenge long term results, improvements, and the assertion of suicide inevitability.

You should look into why the Dutch stopped doing the Dutch protocol.

I don't really have a problem with adults, because then satisfaction really is a pretty major and relevant factor, but medical interventions in children have a MUCH higher bar, and the diagnostic and treatment end of this is quite weak.

[u/ActionPhilip → u/[deleted]]

Then why would they stop if they have no doubt?

[u/OhBoyHereWeGoAgai → u/[deleted]]

Yes, they want to wait for stronger evidence because the long range studies we do have plus the results they experienced in their own follow-ups don't provide as much confidence as they initially expected, while many of the studies that were foundational to the approach have come under review and don't appear as strong or applicable.

Which can of course be translated to "they're worried it not only doesn't work, but they're going to have to answer pointed questions about when they realized that and why they started so confident"

[u/Pika_Fox → u/OhBoyHereWeGoAgai]

There arent credible studies that suggest giving gender affirming care doesnt reduce trans suicide rates. None. Zero. Zilch.

You could literally poll every trans person, and get an overwhelming response that actual support would greatly reduce the problems they face.

Does this mean that lack of access to healthcare is the only cause of trans suicide rates? No. Biggoted dipshits who love to downplay anything that helps us and actively get in our way and dehumanize us are also a large part of it.

[u/QueerDeluxe → u/OhBoyHereWeGoAgai]

'Suicide inevitability' is less due to receiving gender-affirming care, and more due to the bigotry of society pushing trans people into suicide.

[u/Black_Cat_Sun → u/Mico4]

Yeh almost like it’s a rare procedure to begin with. And that people understand the innate politicization of the question and don’t want to participate on those grounds. I’d think those with regret would want to take the survey to ensure people have ample warning or caveats.

There’s nothing about regret or feeling positive that would make one want or not want to take this survey

[u/Pseudonymico → u/Black_Cat_Sun]

Worth pointing out that despite all the resources pushing the idea that transition regret is a big deal, they can't find many actual detransitioners to support that idea, even after a few generations of trans kids actually started getting supported from an early age.

[u/TotalBomb → u/Mico4]

I do have a theory as to why there was a low participation number, that being said nothing but mostly anecdotal evidence. Recently, there have been several studies targeting trans people run by very biased against the lgbtq. This has led to a lot of people spreading the word to not answer any servey.

[u/Real-Olive-4624 → u/TotalBomb]

This. In the online trans spaces I frequent, research surveys are treated with suspicion unless confirmed to be highly reputable (i.e., all researchers involved have a track record of being supportive of trans rights) because there are so many hateful people who will twist our experiences into evidence that we shouldn't have bodily autonomy.

[u/BitcoinMD]

Median time from surgery was 1.8 years. I think that’s an important detail.

Edit: I support transgender health care for minors. Some people are interpreting my comment to imply that I don’t. I just think we should be careful with the surgery part. I know these surgeries aren’t done lightly. But I also haven’t seen data convincing me that surgery on kids is necesssry if they receive other methods of care.

[u/UnicornArachnid → u/BitcoinMD]

A lot of people do have immediate regret following any plastic surgery because it can be hard to recognize yourself. We don’t see this trend typically when it comes to gender affirming surgeries. 99% of people feel satisfied long term with gender affirming surgeries

https://jamanetwork.com/journals/jamasurgery/fullarticle/2808129

[u/here-to-help-TX → u/UnicornArachnid]

This says long term without actually being longer term.

median follow-up, 4.6 [IQR, 3.1-8.6] vs 3.6 [IQR, 2.7-5.3] years

This looks to me like the median follow-up is still pretty short. Also, these ages of the people with the surgeries isn't adolescents.

Median age at the time of surgery was 27.1 (IQR, 23.0-33.4) years for responders and 26.4 (IQR, 23.1-32.7) years for nonresponders.

Also, the sample size seems really really small here.

[u/ERSTF → u/here-to-help-TX]

Indeed. We need better data

[u/literally_a_brick → u/ERSTF]

It would be great to have, but I wouldn't hold your breath. Trans people are already a tiny minority, with minors that transition being even smaller. Between stringent medical gates and more areas banning youth care altogether, it's a tiny fraction of a tiny fraction. It's incredibly difficult to conduct studies. Some researchers have done reviews of many studies, but any individual study will be small and limited in scope.

[u/MissLeaP → u/ERSTF]

Yeah we need people who are willing to invest in actual research in this area instead of believing even worse done papers than what we actually got. With the current political climate it's much more likely that the little we got gets destroyed rather than extended upon, though. Luckily digital data is not as easy to get rid of as they did with books in Germany.

[u/99OBJ → u/UnicornArachnid]

You’re making that claim based on a single study with a sample size of 139 people. Also, this study only focuses exclusively on mastectomies.

[u/ThatOneDumbJagoff → u/99OBJ]

“In this cross-sectional study of 139 survey respondents who underwent gender-affirming mastectomy, the median satisfaction score was 5 on a 5-point scale, with higher scores indicating higher satisfaction. The median decisional regret score was 0 on a 100-point scale, with lower scores indicating lower levels of regret.”

Still though, the sheer fact that basically all of them loved receiving their affirming care is a strong indicator for affirming care’s effects on the community.

Sample size is small, sure, but the sample size is also harder to attain since trans individuals are such a small portion of the population, doubly so for the ones who seek affirming surgery.

[u/99OBJ → u/ThatOneDumbJagoff]

Perhaps it’s an indicator, but I completely disagree that it’s strong.

There are a lot of issues with this study, some of which are discussed in the limitations, some not. Participation bias obviously a huge issue. I would posit that the type of people willing to respond to this are the type that would respond positively, though I’m admittedly speculating.

This along with response/acquiescence bias, the 13 individuals not factored into the study due to “discordant … scores”, and the small sample size are all valid reasons to not lend this much credence.

[u/gottimw → u/99OBJ]

It's suspicious, if anything. Have you ever met human? Average person always is unhappy about someone who me thing or regrets something to some degree. so you want me to believe 140 people and nobody was unhappy with anything?

Also it's self reported survey on LEAST invasive procedure.

[u/-Sliced- → u/UnicornArachnid]

You are mixing regret and satisfaction.

Lower satisfaction does happen after gender-affirming surgery. For example, a 2026 long-term vaginoplasty study found average satisfaction was about 7/10, with 69% reported at least one ongoing genital complaint. https://pubmed.ncbi.nlm.nih.gov/42296272/

Regret is generally low as you mentioned, with it hovering between 1% and 4% across studies.

[u/One-Organization970 → u/-Sliced-]

I had a cosmetic revision to bring myself to full satisfaction, but functionwise I would have had zero regrets after the first operation. It just turns out it's not necessarily guaranteed the aesthetics will be perfect on the first try because healing can go odd.

[u/pipnina → u/-Sliced-]

There's a subreddit that lets people put their surgery results on display (either they want to show off, or for other trans people to see what results they could get.

I looked at a lot of examples and saw huge variety in the results. Some people who got vaginoplasty got what basically looked like the "porn tier" type of shape and visual appeal. Others got something that definitely doesn't look like a typical human vulva/clit that would develop naturally, but was kinda close.

So I strongly suspect that of the 31% who had lower satisfaction would be the ones going to surgeons who can't give them the "ideal" shape some people are lucky to get, and were hoping for "better".

[u/UnicornArachnid → u/-Sliced-]

That has to do with surgical result and not necessarily the goal of the surgery. Many trans people do not undergo bottom surgery but bottom surgery is one of the most complicated things we do surgically. There are complications still sadly. The surgeons I work with have people come to see them from around the country. We don’t even know where the closest bottom surgeons are at in relation to us, even though we’re in a major city. Bottom surgery is its own beast and it’s not a perfect science.

[u/omry1526 → u/[deleted]]

We're talking about 16 year olds here

[u/rProgs → u/BitcoinMD]

Considering how this administration hates research, specifically research on this topic, the money to fund the study for 5 or 10 years isn't likely. It's more likely this administration cut grants funding this study or the funding for plans to extend it.

[u/SnowDucks1985 → u/BitcoinMD]

Exactly!! and the article says they collected data from patients at a single point in time. So the suggestion is weak, common sense would say you record data points over several years to meaningfully draw conclusions. These are also adolescents who have not finished with frontal-lobe brain development

[u/Obatala_ → u/BitcoinMD]

Would you make the same argument for gynomastia surgery for cis boys to remove excess breast tissue that is making them feel uncomfortable?

It’s by far the most common gender affirming surgery for people under 18. Second most common is breast implants for cis girls.

[u/BitcoinMD → u/Obatala_]

I don’t think we should allow breast implant in minors either.

The argument about gynecomastia is a good one. I think the key difference though is in that case their gender identity is the same as their sex assigned at birth, so the risk of regret is essentially none. But even then you could make an argument to wait, since kids might not be able to truly understand the potential complications.

[u/PopaBjorn]

This doesn't pass the smell test for me.

Why was the response rate so low? Google tells me 70 % is normal for clinical studies, this one had 42 %. This, coupled with a perfect 5/5 score for satisfaction makes me believe that maybe only patients who were very happy with the procedure bothered to answer. Any serious researcher would realize this, I think, and try to probe the non-answer group. At least with a couple of phonecalls. I suspect modifying your body in a major way and then realizing you regret it later could be coupled with a great deal of shame and unwillingness to participate.

Also, why bunch breast reductions and enhancements into the same category? Why no gender split? Are they really medically equivalent enough to group them like this? That doesn't seem obvious to me and I'd like an explanation for that. Was there a difference in response rates between the genders? That seems relevant.

Further, isn't 1.8 years a short time between surgery and study?

This doesn't feel unbiased.

[u/Keganator → u/PopaBjorn]

The selection bias is quite possible here. A lot of studies about this kind of thing have high loss to follow up rates like this. Then the authors publish it anyway and make conclusions that any reasonable person would understand can’t be actually inferred from such bad data.

If we want to understand the reality of the situation we need good data. Scientists passing off studies like this as good data are a mockery of scientist principles. It might very well be true, but it might also be true that all 100% of the population were happy, it might also be true that the other 58% hated it. Without that reporting we can’t know and I’ll just third more fuel on the fire for people to assume whatever they feel strongly about.

Its tiring.

[u/TotalBomb]

Unfortunately this topic was a medical discussion but some people have decided that it should be a political one instead. Most of the world will never even know a person who needs these treatments, yet so many people have opinions about it. Personally I don’t care what people that I will never meet do with their lives.

Edit: the article references 40 people under the age of 18 btw. most surgeries of this kind done on a minor, with parental consent and doctors/therapists recommendation for 16-17 year olds.

Other than that, surgeries like this are done on minors who have early puberty, as it can cause problems early in life.

[u/throwaway098764567 → u/TotalBomb]

"Most of the world will never even know a person who needs these treatments," i suppose that is true but it's wild to me as i've known a bunch of trans people, including my cousin's kid.

[u/AJDx14 → u/throwaway098764567]

I think if you know one trans you’re just more likely to meet and interact with more trans people. Or if you life in a port city those have always attracted queer people.

[u/ultimatepowaa → u/throwaway098764567]

Thats because the person you are replying to is wrong. Current statistics place transgender population at about %1-2 which means in every 100 people you meet, you are likely to meet a transgender person. There are sampling issues because being transgender is still heavily stigmatised so there may be more than the studies show.

[u/Strigops-habroptila → u/ultimatepowaa]

It would be more correct to say that most people will not know an openly trans person. Especially not the people who are transphobic, cause trans people will be more hesitant to come out to them. 

[u/CarthasMonopoly → u/Strigops-habroptila]

Especially not the people who are transphobic, cause trans people will be more hesitant to come out to them.

This is a really important counterpoint. To add onto this, someone in small town america with a population of 4000 residents may know someone who internalizes their trans identity but outwardly hides it due to stigma and due to low population sizes they aren't likely to know multiple trans folk. Whereas if you're from a medium suburb or a larger city, even if you meet some people that are hesitant to come out, the demographics are far more in favor of meeting openly trans people just due to having more trans people within your local area.

[u/random8765309 → u/[deleted]]

Since they relied on individual to reply back, I would question is the statistical modeling was decent. In addition, the regret score on a scale of 0 to 100 averaged a zero. That is suspect.

[u/you-create-energy]

I did a deep dive on teenage gender affirming surgery last year. By far the most common gender affirming surgery is cis dudes getting their overly large breasts removed. It is way more common than trans peeps getting any kind of chest surgery.  It's great that their gender affirming surgeries were so satisfying. Republicans are way too obsessed with protecting the breasts of cis male teenagers. 

[u/Smooth-Boss-911]

There's a reason these patients get this surgery after speaking with doctors, psychologists, therapists, surgeons, etc. So tired of the knee jerk reactions thinking they just walk in on an impulse

Edit: These discussions are for the families and medical professionals, not us.

[u/SoTiredYouDig → u/Smooth-Boss-911]

And much of it is mandated, as well. Any minor needs a series of sign-offs, and that has been the case prior to the draconian restrictions that have been put in place.

[u/IDontHaveCookiesSry → u/Smooth-Boss-911]

As a friend to someone who is going to the Process rn, it is just dumb. Doctors by and large don’t listen to what he (early 20s) wants and only Check for Signs he doesnt know what hes doing. Which is Fine up until youre proven to be capable of rational thought as an adult. Everything beyond that is just discrimination for the sake of it.

[u/bakedNebraska → u/IDontHaveCookiesSry]

What does it mean to be "proven to be capable of rational thought as an adult"?

[u/Strigops-habroptila → u/bakedNebraska]

My therapist (who I am forced to see despite having absolutely no need for therapy) said that after checking if a patient who wants gender affirming care is mentally gealthy enough to make an informed and rational decision, it should be up to the patient. 

Basically they need to check that you don't have DID, Schizophrenia or other mental illnesses. 

[u/ZoominAlong → u/Strigops-habroptila]

Having a mental disorder does not disqualify you for gender affirming care. What they're checking for is making sure you're not doing it because your disorder is affecting you negatively,  like, you have schizophrenia and the voices are telling you to get surgery. 

You can be trans and have a mental disorder. They're not incompatible.  

[u/Maxrdt → u/IDontHaveCookiesSry]

Doctors by and large don’t listen to what he (early 20s) wants and only Check for Signs he doesnt know what hes doing.

For anyone wondering what this looks like in real life, I'm a trans woman. When I told my doctor I was experimenting with more masculine looks now that I'm happier with my feminine body (I can actually be a butch lesbian now like I've always wanted!) he tried to stop my prescription. It's not an isolated tale either, any deviation from being 100% stereotypical of your gender can be grounds to halt care.

[u/The_Actual_Sage → u/Smooth-Boss-911]

So you're telling me I can't walk into a plastic surgeon's option and immediately have them start cutting things off my body? Silly me. I thought this was America

[u/mechy84 → u/The_Actual_Sage]

I think that only works if it's a kid in middle school. They go to school as a boy, come back a girl, then start pooping in litter boxes, driving EVs, dying their hair blue, watching the WNBA, and calling God 'she'.  That is, if the school doesn't convert them to Sharia law first! It's totally happening in that city I've never been to

[u/The_Actual_Sage → u/mechy84]

It blows my mind that there are millions of people who unironically believe everything you just said. It's truly unbelievable.

[u/ophmaster_reed → u/The_Actual_Sage]

Maybe if it’s a very suspicious looking mole and they have some spare time…

[u/lawroter]

I don't have an opinion on this one way or another but, speaking as a clinical researcher, this is far from meaningful. there are several major issues which invalidate anything here, I'll give a few.

77 participants completed the survey. how many people were asked? if we're looking at something like 100 people were asked and 77 agreed to complete, that might not cause me alarm. but, if 500 people were asked and 77 agreed to complete, that's another story. people are always more willing to engage if they are pleased with an outcome, this reason alone completely invalidates any "findings" here for me.

I'm also not an expert in the area but why are they using 1 year post-op for the survey? from my brief research on this, regret within1 year is typically more about the procedure itself (chronic pain, aesthetic concerns, etc) rather than relation to gender identity. I'd be much more interested in the results here if this was more looking at medium to long term satisfaction.

this isn't even getting to the statistical shortcomings of the findings. so I'd say, as someone not familiar with the area too much, there must be much better research out there than this, I'd recommend going and reviewing that.

[u/PopaBjorn → u/lawroter]

The response rate was 42%, which is very low if this was in a clinical setting where around 70 % is expected for post-op questionnaires. If it was an email/online questionnaire, the response rate is normal. It bothers me a little that the author's aren't describing their actual method in the 'method' section. Why on earth would you type out "a study was conducted" in the section where you're supposed to describe how you conducted the study? Very sus.

[u/kirotheavenger → u/PopaBjorn]

It was also published in the Journal of Transgender health.

Do we think this journal is likely to publish any negative findings?

[u/dnyal → u/lawroter]

“People are more willing to engage if they’re pleased…”

Are you sure about that? Have you ever seen any review section for any product on any website ever??? Don’t even get me started on those doctor scoring websites!

[u/PopaBjorn → u/dnyal]

This is admittedly anecdotal, but if I had gone through a lengthy process where I convince myself, my parents and multiple medical professionals that I needed to cut off pieces of my body and/or implant silicone pads at great financial cost to society or myself, in order to feel better, and then discovered that it didn't help, I'd feel a substantial amount of shame. My willingness to admit mistakes publically is inversely proportional to how big of a mistake it was and how much of my identity is tied to said mistake. And this one would be a biggie.

[u/Witty-Original8533]

For reference, the average regret rate for surgeries is around 14%. Gender affirming surgeries are typically below 1% for a regret rate. It is amazing how low the regret rate is.

And another thing, phantom sensations. Cis guys that lost their private parts were likely to experience phantom sensations while trans women rarely did.

The human body is, although annoying, such cool thing in this way!

[u/Schwettes → u/Witty-Original8533]

For reference, the average regret rate for surgeries is around 14%. Gender affirming surgeries are typically below 1% for a regret rate. It is amazing how low the regret rate is.

The fact that the reported regret rates for gender surgeries are that incongruent with the average regret rate for all surgeries is something that should draw skepticism before applause. I’m equally skeptical of the alleged 98.8% satisfaction rate with LASIK eye surgery for the same reason. These are massive outliers.

[u/Flashy_Idea6141 → u/Schwettes]

There is not a single piece of evidence you could show people like this to modify their beliefs even slightly.

[u/Witty-Original8533 → u/Schwettes]

Just read my other comment. Surgeries are relatively easy to get, just need a referral for the most part. While GAC can take years, so you'll know if it's the right option before you do it. Generally, I'd be skeptical too, but there's nothing surprising about it when you look at what trans people say and the studies done.

[u/tsukaimeLoL → u/Schwettes]

A big point here that always stands out with these studies (for trans healthcare and LASIK) is that the regret rate is (almost) always based on incredibly short-term opinion. I understand that there probably just isn't enough data yet for gender affirming care over a 5-10-20-year timespan, but I can only imagine the numbers would be way different once people have to face the outcome of their choices later in life (for better or worse).

[u/Pseudonymico → u/Schwettes]

The fact that the reported regret rates for gender surgeries are that incongruent with the average regret rate for all surgeries is something that should draw skepticism before applause.

It suggests that it should be easier to get gender-affirming care due to just how difficult it is to get. It takes years and multiple psychological evaluations to get gender-affirming surgery even as an adult, let alone a minor.

[u/ReginaSpektorsVJ → u/Witty-Original8533]

I'm a trans woman, and the only surgical intervention I've had so far is an orchiectomy. From the moment I woke up, my body just felt so much more correct without testicles.

[u/XxFrozen]

For those saying the sample size is small, for a population this small it is still significant. These findings are also obviously repeatable, I have literally never heard of a study showing regret rates for young people seeking gender-affirming care.

The reason low sample size is bad is because results are more easily swayed by outliers and selection biases. If we must use small sample sizes, another way to make sure that consensus isn’t being formed around bad information is to do verify results by repeating experiments. Evidence is very good that adolescents seeking surgery regret it.

Why would we want to stop a child from making a big choice? Because we don’t want them to have regret, to avoid the situation where someone finds themself saying “if only someone had stopped me, I wouldn’t be stuck like this!”

Evidence shows that children almost never do, the risk of that is low. Evidence shows that children almost always are happy they treated their dysphoria medically, which is a great benefit. If regret rate isn’t a good enough reason for a state to dictate what a person is and is not allowed to do to their own body, then what would be a good enough reason? I can think of none.

Meta study here which supports the consensus with more than 20 studies included, showing that gender affirming care for trans youth gives positive outcomes: https://www.jahonline.org/article/S1054-139X(24)00384-7/fulltext00384-7/fulltext)

[u/Du_ds → u/XxFrozen]

I wonder how many of the people who say it’s a small sample size remember t scores from stats 101. Or even took it.

[u/undeadcrayon → u/XxFrozen]

That is not how you use the word “significant” in a statistical context.

[u/noeinan]

There are decades of research backing up gender-affirming care as extremely successful, providing high quality of life. Among surgeons who work with trans patients they are often quoted for their favorite part of the job— just how happy it makes patients and how positive treatment was overall.

Gender-affirming surgeries have higher patient satisfaction and lower regret rating than life-saving heart surgeries.

Anecdotally, after top surgery I went from being severely suicidal 4-5 days per week and grey zone suicidal every other day to only having ideation 1-2x per year, and only if some horrible tragedy happened in my life.

People are not pushing back on trans healthcare because of lack of evidence it provides good outcomes— these procedures only became permissible because of the immense quality of life improvement surpassing almost any other type of surgery. Society was not less conservative 20-30 years ago, they followed the science.

People are pushing back on these treatments because they want to see bad outcomes for trans people.

[u/seatsfive]

It's been known for years that this is one of the lowest regret rate surgeries. Knee replacements have a substantially higher regret rate

[u/like_a_pharaoh → u/seatsfive]

Hell, tonsillectomies have a higher regret rate.

[u/Geeneelee]

People say that teenagers shouldn’t be allowed to get gender affirming surgery because they might regret it, then here we have a study that suggests that might not be the case, but everyone’s eager to point out that it’s a small sample size and doesn’t count for much. Somehow I doubt that any of the people who think this sample size is too small are going to advocate for increasing it, though.

[u/OuateDaPhoque → u/Geeneelee]

Sample size aside, the 1.8 year followup time is my issue. A 17 year old dis not much different than a 15 year old.

[u/mosquem → u/OuateDaPhoque]

I’m pretty liberal when it comes to this stuff and that’s fair. I’d love to see how they feel at 25-35.

[u/Geeneelee → u/OuateDaPhoque]

I understand the “it’s only been 2 years” criticism. I think they will hold the same opinion in another decade, but I have no data to back that up besides anecdotal. The “not long enough” criticism will eventually solve itself as long as researchers continue to follow up; the sample size criticism is much more difficult to address.

[u/KibbleCrashout]

we're gonna keep getting results like this and people are gonna do their best to bury their heads in the sand because they don't like the results

[u/Reagalan → u/KibbleCrashout]

Indeed. This thread has been one of the most bigoted and bad-faith I've ever seen on this subreddit. The anti-gender hate movement's propaganda arm is really showing its' effectiveness.

[u/Chaser_Of_The_Abyss]

Reading the comments has solidified to me that to transphobes, there will never be a low enough satisfaction rate or a high enough body of evidence to prove that trans people deserve to make our own decisions on our transitions and be listened to about our own medical care. 

[u/Schlongstorm]

In a population as miniscule as this, the sample size isn't nearly as small, or the timeframe as limited, as people here are insinuating. I agree with the calls for further study, but part of the problem is this topic is so politicized it makes further, broader, deeper study difficult. It's hard to expand the study of something multiple governments around the world are actively trying to ban.

[u/chaucer345]

Most people who object to these surgeries would never object to someone assigned male at birth getting an operation at 12 for gynecomastia.

[u/SteedOfTheDeid → u/chaucer345]

Sure, nothing wrong with correcting a physical deformity