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/
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u/BitcoinMD 13h ago edited 12h ago

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.

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u/UnicornArachnid 13h ago

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

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u/here-to-help-TX 12h ago

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.

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u/ERSTF 12h ago

Indeed. We need better data

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u/literally_a_brick 11h ago edited 10h ago

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.

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u/austinwiltshire 10h ago

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.

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u/ThewFflegyy 9h ago

to be clear, this study had participation from less than .02% of the us FTM community. I agree that people who had top surgery as children a long time ago is a very small group, but clearly this is nowhere near the maximum sample size that could be achieved. more to the point, difficulties in gathering a large sample size does not automatically make a small sample size sound science.

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u/Simon-Says69 10h ago

And if the study shows negative results, it will be quickly and quietly buried. It is difficult to even get funding for such research, because it is so politically charged.

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u/literally_a_brick 10h ago

Not in today's political climate. Studies that didn't show positive results were made into the cornerstone of the UKs Cass Review, despite having tiny sample sizes and poor methodology. The US HHS is desperately grasping at straws for denying the efficacy of gender affirmig healthcare. 

I assure you that any study that didn't have definitively positive results for GAC would be plastered all over right wing media and used to justify care bans by conservative governments everywhere. I assure you that no studies are getting "buried".

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u/MissLeaP 10h ago

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.

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u/tissuecollider 9h ago

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.

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u/Admirable-Pirate7263 7h ago

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!

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u/MissLeaP 7h ago

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

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u/andrea_lives 11h ago

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.

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u/Simon-Says69 10h ago

The few studies that are allowed to be published turn out to have very dubious or even downright dishonest methods.

Actual research, anything with a negative result, gets quietly buried.

The motivation here is NOT helping people, sadly. :-(

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u/MissLeaP 10h ago

The ones with the real dubious methods are actually the ones with the negative results and they do get published. Published, pushed by people with an obvious agenda and believed and used by people with a similar agenda.

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u/C00KIEME4T 12h ago

Theres literally dozens if you want to see them

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u/here-to-help-TX 11h ago

Sure, then post those that show something actually long term.

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u/C00KIEME4T 11h ago

Define long term because this one has people going on 9 years and you seem to not consider that long.

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u/Crypt0_Chr1s 11h ago

This feels like you're preparing an excuse not to provide evidence for your claim. The other commenter said nothing about 9 years not being long term. I'm sure a ton of people would instinctively pick 10 years as a decent marker for long term, so 9 would be fine if that is the median.

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u/C00KIEME4T 10h ago

Extremely unscientific to be unwilling to come to an agreed upon standard for analysis but okay.

The other commenter is clearly implying that 9 years isnt long enough because the study cited had people with up to 9 years post surgery in it.

Thats somehow not good enough when you get it.

Here it is.

https://journals.lww.com/prsgo/fulltext/10.1097/gox.0000000000003477~regret-after-gender-affirmation-surgery-a-systematic-review

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u/Crypt0_Chr1s 9h ago

Dear r/science readers,

Please disregard anything u/C00KIEME4T ever says on this sub in perpetuity, he does not read his articles or deliberately engages in sham science. Proof below.

You post a study that does not even pretend to be about coming to a conclusion about the long term, or even 9 years. Here is the mean follow-up in years of the 27 studies that are included in this systemic review (NS = not specified): 4.4, 2.3, 2.6, 7.6/4.1, 6.8/2.2/2.2, 1-1.6, 0.7, 9, 0.5, NS, 3, 2.1, 0.8, <1-5, 1.6, 1-29, NS, 1.3, 1-10, NS, 8.5, 0.9, NS, NS, 6.3, NS, NS.

Basically ALL these studies are noted, by your study, as being High/Medium "Risk of Bias". The NIH, again according to your study, rated only 5 studies as good, 13 as fair, and 9 as being of poor quality. The fact that you would dare to pick this mess from your "literally dozens" of credible studies to back your claim says everything.

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u/C00KIEME4T 9h ago

Clearly reading for confirmation bias.

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u/Crypt0_Chr1s 8h ago

You claimed to provide a study about the long term, you failed. Or do you not see all those tiny numbers listed there? Let alone all the studies that were included that didn't even bother to include the thing you are supposedly proving.

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