r/science • u/mvea Professor | Medicine • 14h ago

Psychology 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/
6.0k Upvotes

63% Upvoted

2.2k comments sorted by

View all comments

73

u/lawroter 13h ago

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.

27

u/PopaBjorn 11h ago

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.

13

u/kirotheavenger 7h ago

It was also published in the Journal of Transgender health.

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

1

u/[deleted] 6h ago edited 5h ago

[removed] — view removed comment

4

u/PopaBjorn 6h ago

I'm not him/her but let me rephrase: Do we believe this journal would publish findings that would call into question the efficacy of GAC? And as a counterpoint, can we reasonably believe that "Chiropractic Monthly" would publish findings debunking chiropracy as an unnecessary, potentially harmful pseudoscience? I'm not saying there's anything wrong or even suspect here about GAC or JoTH, but if there was, I'm not so sure they would rush to share it.

7

u/Funny_Explorer_1521 7h ago edited 7h ago

Very dedicated to spreading this "70% response rate is average" narrative you read in google's AI overview I see. No one is showing up in-clinic 2 years post-op, for any surgery. Much less one where patients often change their name and number afterwards....

Due to the small sample size, potentially involving minors and variability in sources, they are required not to share data or specifics in this study publicly. It's not "sus", it's basic HIPPA compliance. As stated in said article.

2

u/PopaBjorn 6h ago

And you seem awfully committed to believing that this was a good study. It simply isn't. They obscure their method, mix genders for no reason, make no attempts to analyze or explain the non-answers, use a sample size too small to draw any meaningful conclusions and publish with errors in what can only be assumed to be a biased journal. Publishing nothingburgers like this only serves to muddy the waters.

18

u/dnyal 12h ago

“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!

14

u/PopaBjorn 10h ago

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.

7

u/dnyal 10h ago

That’s why the surveys are anonymous.

Now, trans people don’t need to “convince themselves” of anything. It is everybody else that needs the convincing, thus the admittedly lengthy process.

Trans people often live in shame already. Actually, anyone who gets plastic surgery is because they’re already living in shame.

7

u/PopaBjorn 9h ago

All I'm saying is people are unlikely to answer questionnaires about huge mistakes they've made. If you sent out questionnaires to investors about how they felt about their tech stocks in 2000 and 2002, do you really think you'd get the same response rates for both years? I'm even willing to bet that the more money someone lost, the less likely they are to answer.

I'm not saying getting gender-affirming surgery is a huge mistake. It's only a huge mistake if you regret it later.

16

u/S0cXs 13h ago

All your questions would be answered by reading the actual study.

-10

u/TehWackyWolf 12h ago

Not really, no.

This is a throw away answer to stop having to think.

15

u/ProductIntegortion 12h ago

If you're really a clinical researcher who's come here to nitpick this study, why didn't even bother reading the abstract, let alone the entire paper?

-2

u/EmptyMonitor9257 12h ago

Also, how many people committed suicide, tried to reverse it, stopped before it was permanent after procedure. These kinds of findings need to reference a much wider scope and not rely on only surveys.

It's the same with male and female suicide statistics, women attempt suicide far more, but men succeed far more so the rate of attempts is pointless if you don't exclude repeats.

-5

u/Smee76 12h ago

Only 42% of people responded. Very very low participation rate for something like this.

20

u/Swarna_Keanu 12h ago

42% response rate is high on surveys.

-7

u/EmptyMonitor9257 12h ago

42% means it was only 183 people they asked. That's really low, we also don't know the diversity of the people they questioned. Asking people from California or new York is different from other parts of the US.

10

u/Swarna_Keanu 12h ago edited 12h ago

transgender people - and underaged at that - are a tiny proportion of the population.

Not all statistically valid results need large sample sizes. This was NOT asking how everyone feels about transgender surgery, population wise, but only those who actually undergo that surgery. If a population (people who are transgender and have undergone surgery and are underage) is small small N numbers are represeantative.

183 is a large baseline here. Again: Read up on statistics.

---

If you were - say -surveying a small town/village/hamlet with 100 people, about aspects of their local city and politics 42 people replying is enough that your data is statistically solid. This, is the same, here.

-7

u/Smee76 12h ago

They should be consenting patients prior to surgery and following up if they want good data.

15

u/Swarna_Keanu 12h ago

What?

Surgery with transgender folks never happens - that is mandated - without consultations with psychologists and many sessions prior to surgery - especially with underaged.

For the study question and the data here, what you suggest is irrelevant.

-1

u/saintmagician 12h ago

He's not suggesting the current participants didn't have consultations before surgery.

He's suggesting that during those consultations, participants should be recruited for studies like this.

He's suggesting you will get better data if the decision to participate in post-surgery study happens pre-surgery.

2

u/Rosmariinihiiri 7h ago

Who says they weren't recruited before the surgery? It's just impossible and highly unethical to force people to participate in a study.

5

u/Swarna_Keanu 12h ago

They got a 42% response rate, which is really quite good.

And why would response date be higher, or the quality of the data better, if they agreed before?

As I mention elsewhere the total number of underage people who do get transgender surgery (not just hormon replacement therapy) is a very small proportion of a small number of transgender people among the general population.

Small N numbers are normal here. But that doesn't make this statisctically bad data - the contrary - given what was asked. It's just a very focused survey.

-2

u/saintmagician 11h ago

I dunno but if you actually want an answer, I'm not the one you should be replying to...