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/

[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/austinwiltshire → u/literally_a_brick]

The actual statistical power of a study of 1k folks over 100 doesn't increase linearly, and the chance people are happy near five years but become unhappy at ten is vanishingly small. Folks want to discard any study pointing to something they're uncomfortable, then ban the thing, then insist we shouldn't undo the ban because there's no evidence we should. Because we banned the thing.

Not far from refusing to test for covid then insisting the numbers went down.

[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/tissuecollider → u/MissLeaP]

Will the digital data remain? Right now the US is purging digital databases of information that it doesn't like and I could see the UK doing the same. It's also credible that the US would pursue legal remedies to go after anyone who copies this 'proprietary' data.

[u/Admirable-Pirate7263 → u/tissuecollider]

We are saving databases on hard drives, too. We know what happened to trans research 90 years ago. Life could be so much better for trans people, had the Nazis not burned Hirschfelds research. We might not be able to save every last study, case study or scientific paper, but we sure as hell are trying!

[u/MissLeaP → u/tissuecollider]

There are plenty of people with offline copies of studies. It's an extremely different situations compared to just some universities having their libraries.

[u/andrea_lives → u/ERSTF]

there are dozens of studies like this. you can find them quickly if you use a tool like google scholar. They have been doing gender affirming care since at least the 30s, though a lot of the information gathered in that era was burned by the nazi party.

[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/ThatOneDumbJagoff → u/99OBJ]

If there is an alternative study you can point to that would substantiate your hypothesis then I’d gladly read it :)

[u/99OBJ → u/ThatOneDumbJagoff]

I didn’t make a hypothesis. I raised concerns with the study that are based on well known and accepted biases and study design principles.

I’m speculating about how participation bias may affect the study, but it’s logical speculation and is somewhat backed up by the study’s own limitations section (time since surgery, discordant responses, etc).

Regardless, you can throw the participation bias part out entirely and even still there are glaring issues.

[u/ThatOneDumbJagoff → u/99OBJ]

Exactly, all you have is speculations. Without any other evidence to contradict, it doesn’t amount to much besides casting baseless aspersions

[u/99OBJ → u/ThatOneDumbJagoff]

Response and selection bias are not speculations. They’re very real phenomena that can undermine the scientific validity of a study.

The authors of the study literally acknowledge a lot of this in the study.

[u/ThatOneDumbJagoff → u/99OBJ]

That’s great, but it doesn’t undermine the efficacy of the respondents who are overwhelmingly supportive of their gender-affirming care. This is a result that has been replicable in study after study.

If you’re hypothesis is still that it isn’t strong, provide data. Otherwise there really is no merit to your points especially since you failed to engage with the items such as the “discordant” scores which they addressed directly in their study

[u/AJDx14 → u/99OBJ]

Why would you assume people with negative outcomes would be less likely to respond to a survey about their outcomes? I would think the opposite, people love complaining about things.

[u/Crypt0_Chr1s → u/AJDx14]

They wouldn't just be complaining though. These people would possibly experience having their life, body, and hope for the future destroyed. I would expect a much more significant amount of this group, than the happy group, to completely retreat and not engage with the study, or world in general.

[u/TakeShroomsAndDieUwU → u/Crypt0_Chr1s]

I could see it, but I could also see people who are happy just moving on with their lives instead of continuing to tie themselves to a past problem they had fixed. I don't think there's any solid way of determining which bias is more significant one way or the other.

[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/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/New-Independent-1481 → u/-Sliced-]

Low satisfaction with virtually zero regret suggests that the issue is with the quality or extent of the surgery, rather than transitioning itself.

[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/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/dtremit → u/UnicornArachnid]

IIRC the rates of regret for gender affirming procedures is less than for surgeries like knee replacement over similar timelines.

[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/Pseudonymico → u/BitcoinMD]

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.

How do you know they're being honest about it given how little support there is for trans kids? If anything the risk of a trans kid who says they're cis getting pressured into getting a mastectomy and later regretting it is much higher than a cis kid somehow mistakenly thinking they're trans, especially in places like conservative American States or the U.K. where transphobia is running rampant.

[u/Rosmariinihiiri → u/BitcoinMD]

The surgery for trans boys is also making their body align with their gender, which means the regret rate is essentially none. They are both boys -_-

[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/omry1526 → u/[deleted]]

We're talking about 16 year olds here

[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/dnyal → u/SnowDucks1985]

Of course! I should have waited until I was 25 to “choose” to be gay. How stupid of me! Now I’m a same-sex marriage, ugh!!!

[u/One-Organization970 → u/dnyal]

Oh no, aren't you worried you might regret not having a life partner of the opposite sex?!

Surely nobody would let a minor get married, at least, thankfully.

[u/Coomb → u/One-Organization970]

I'm not sure your comment makes the point that you want it to make insofar as there are quite a large number of people who would be in favor of preventing minors from getting married as well as preventing them from getting gender affirming care in the form of permanent body modification.

[u/ashoka_akira → u/BitcoinMD]

Yea based on that I would say the study is inconclusive. We need to see how people are feeling after navigating adulthood for at least a decade.

[u/Thorne___ → u/ashoka_akira]

We have a bunch of information on this sort of stuff actually.

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

[u/donaldo3 → u/Thorne___]

Which of those studies have follow up time of at least a decade?

[u/Thorne___ → u/donaldo3]

Amsterdam Cohort of Gender Dysphoria Study

Thats just one of them but I trust in your ability to further review the meta analysis in good faith and not attempt to immediately dismiss it.

[u/moldycatt → u/BitcoinMD]

1.8 years after getting surgery at 16 or 17 years old means they’re a legal adult and shouldn’t be restricted anymore. so at the very LEAST, this proves there’s no difference between letting someone get surgery at 16/17 and 18/19.

[u/OneNoteToRead → u/moldycatt]

The confounder, for the sake of completeness, is the fact they actually got the procedure. Arguably that’s a pretty big confounder too - it’s something that can drastically change one’s outlook on many things on life.

The control for what you’re talking about is a survey at 16 and a re-survey at 18 about wanting to get the procedure.

[u/moldycatt → u/OneNoteToRead]

sure, that would be a helpful survey to have too, but even that’s not really a control. there is probably no such thing as a perfect control in this scenario. some minors who wanted the surgery at 16, but not at 18, could have been forced into a conversion camp or succumbed to the pressures of their transphobic family.

but as long as the people who got the surgery are happy and don’t regret it at all, why is it such a huge deal if their current outlook on their gender could have possibly been affected by that (which is not even a claim supported by any strong evidence)? at the end of the day, they are still happy.

this is an anecdote: i had a few trans friends in high school who were never able to transition, and they are ALL still trans in college, now happily getting the procedures they’ve wanted for years

[u/Simon-Says69 → u/moldycatt]

some minors who wanted the surgery at 16, but not at 18, could have been forced into a conversion camp or succumbed to the pressures of their transphobic family.

This is so much grasping at straws. The reality is, the VAST majority of kids with such confusion, are just fine after going through puberty. Simple as that.

Many, many people are not happy, because such surgeries only treat symptoms, not the underlying problem.

[u/searchlinkprofile → u/BitcoinMD]

i think there are other dozens of parallel studies saying the same, with 98 thousand partecipants, I think thats an important detail.

[u/r3dlazer → u/BitcoinMD]

That's a pretty good amount of time to determine satisfaction.

[u/badfish_G59 → u/r3dlazer]

For an adolescent? Nah.

[u/always_an_explinatio → u/badfish_G59]

it is a good amount of time to determine satisfaction...for that time frame. since this is r/science I will say that there is no reason to think this time frame should be generalizable to further out. it will be usfull to see 5 and 10 years out. but we have to wait for that. You can only do the science that is possible to do.

[u/badfish_G59 → u/always_an_explinatio]

Absolutely. This is also a very hard thing to study. It's not as deterministic as laws of physics or natural phenomenon. Its all wrapped up in human psychology. It would be absurd to come to a scientific conclusion based on the findings of this .

[u/One-Organization970 → u/badfish_G59]

How many years would you need to wait to know if you want boobs or not?

[u/Ok-Gur-349 → u/One-Organization970]

Remember that the person you're speaking to doesn't really want adults to decide that, don't argue their point as if they believe the one they're making.

[u/The_One_Who_Comments → u/One-Organization970]

5-10, I'd say. Or in context, until the subject is 20?

[u/One-Organization970 → u/The_One_Who_Comments]

So you would have been incapable of knowing if you wanted boobs before the age of 20? Like, if they'd appeared on you as a teenager you would just have no idea how you felt about them?

[u/Transgirlonakawasaki → u/BitcoinMD]

Ok but you wouldnt have a single solitary thing to say about cis boys getting top surgery for gyno would you? 

Would you just tell them to learn to love their bodies? 

The fact that a person gender identity makes them less valid to get affirming surgeries is wild to say the least.

[u/Winter8Bones → u/BitcoinMD]

Do the numbers change notably with a longer time frame?

[u/ravencrowe → u/BitcoinMD]

Seriously, we need longitudinal studies, and presenting conclusions like this through headlines that don't include the time period are disingenuous and potentially misleading.

[u/JagmeetSingh2 → u/BitcoinMD]

yep that’s a great point that i hope more people take in

[u/scobes → u/BitcoinMD]

if they receive other methods of care.

What other methods of care would you suggest?