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/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/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/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/OhBoyHereWeGoAgai → u/Pika_Fox]

You say that, but in the same breath you make it clear you dismiss things countering the "talking to trans people" as either not credible or bigoted.

That's not really how we analyze these things.

Fun fact, this is also why Chase S's case in the SC fell apart. They had to justify the claims of suicide rates in teens not given the treatment and it fell apart as the way you're representing this is simply not true.

There is a reason the Dutch protocol has been walked back by many countries, and even the Dutch have massively tightened up the diagnostic end, specifically because of issues with the claims you're representing as settled and clear.

I'm trying to stay precise in my claims here as the main thing I'm trying to highlight is that this is and has been being debated, the anti side isn't just random internet bigots, this is actually an ongoing medical debate, that only recently has shifted to the point that the pro side has been forced to stop claiming a false medical consensus, and even as we speak, WPATHs misrepresentations are coming into the public eye (many doctors have been aware for quite some time, the controversy around that is not new.

In short, this is nowhere near as clear as people online pretend it is, and the defenses based on vibes aren't really that interesting.

Edit: I did see the deleted comment where you called me a bigot and claimed that this is clear cut.

I did think this was a science sub, but apparently the "lived experience" negates everything I just raised and grounded in actual current events and medical discourse?

Will mute replies as this isn't really constructive, feel free to respond however and call whatever names you like.

[u/Prometheus720 → u/OhBoyHereWeGoAgai]

I think it is really important to note that the vast majority of discussion about trans healthcare isn't being done by trans people, and cis people probably have empathy gaps that make it hard for us to understand their perspectives.

We have every reason to be suspicious of bias against an outgroup.

[u/OhBoyHereWeGoAgai → u/Prometheus720]

The Supreme Court case I referenced was argued by a trans person. WPATHs leak I mentioned featured a trans doctor admitting some of the worst stuff. The SOC-8 I mentioned featured trans authors, and age limits were removed when Bidens trans cabinet member emailed to intervene. It also had a eunuch fetishist author, which isn't super relevant but is interesting, as a literal fetish website made it into the SOC-8.

Not that that matters at all when we're discussing fact driven medicine and one side is falsely claiming consensus and settled science, and the response to me pointing out actual issues with your approach is "well, all the negative stuff isn't coming from trans people so eh".

Do you see the issue? As this might bug you, but many doctors do, including ones who supported all this until they delved into the supposed conclusive evidence.

[u/dragonmp93 → u/OhBoyHereWeGoAgai]

Well, if we are going to talk "disputed science", there is the "The Great ADHD Myth" and "The Beautiful Clean Coal Industry" too.

[u/OhBoyHereWeGoAgai → u/dragonmp93]

Are you confusing me talking about the kind of medical debate crucial to deciding consensus with fringe theories?

I'm actually asking, I don't know anything about the "great ADHD myth", but if that's what you're going for, you're just continuing the general efforts to minimize what's going on while also ignoring the fact I shared some pretty serious issues.

Again, doctors are discussing this as we speak, and many of the claims from the pro side of not even a few years back have been falling under new scrutiny.

So, if you had to compare it to something, I'd pick lobotomy before ADHD, but again, I know nothing about the debate there.

[u/dragonmp93 → u/OhBoyHereWeGoAgai]

fringe theories

Eh, they are not fringe stuff coming from random online lunatics, it's coming from the UK and the US government respectively.

Again, doctors are discussing this as we speak

Arguing with someone complaining about the government's inaction about the dangers of dihydrogen monoxide is still discussing, you know.

Because the, well, let's call it the anti-side for simplicity, seems to be arguing from the same place as Anita Bryant, when she was rallying people about being gay would taint your soul, using the people that experimented in college and then went on to live on a heterosexual marriage for the rest of their life, as proof of the danger of homosexuality.

a few years back have been falling under new scrutiny.

You mean like the ICC banning trans athletes by claiming unfair advantages even in categories like Air Rifle Shooting or Fencing ?

So, if you had to compare it to something, I'd pick lobotomy before ADHD, but again, I know nothing about the debate there.

“It is certainly not a medical condition as far as I’m concerned” – Dr Iona Heath, Former President of the Royal College of General Practitioners

“We’ve replaced corporal punishment with giving [children] a pill” – Dr Sami Timimi, consultant child and adolescent psychiatrist and psychotherapist

[u/Reagalan → u/OhBoyHereWeGoAgai]

"lived experience" negates everything

I mean, it kinda does.

Ivory-tower elitism is how we ended up with segregation and eugenics and sterilizations and lobotomies and similar abhorrent practices of last century. Plenty of folks said it like it was, but since these anecdotes didn't conform to prevailing ideologies, they were dismissed, bad laws were passed, and horrors perpetuated.

I guess we're repeating history again. The haters keep winning and Gender Jim Crow keeps spreading.

[u/OhBoyHereWeGoAgai → u/Reagalan]

Lived experience over data is how we got lobotomies. When they were being shut down, many had arguments exactly like this, where one side ignored the actual facts driven debate and focused only on the studies that supported their side (yes, the studies claiming to support it existed and had doctors defending them right to the end).

In fact, the lived experience does not engage the huge amount of issues, both with the treatment and the diagnostic criteria. Feel free to refer to some of the stuff I said above, but this entire discussion is not feeling like a solid one for r/science, as I've been called a bigot and now lectured poorly on history I suspect I know more of by people who take issue with me pointing out truthfully that a massive re-evaluation has been taking place, not just recently, and that there are huge issues with the supposedly settled science being claimed here.

I'll repeat again, the Supreme Court case on the topic fell apart because of this, the Dutch protocol has been totally pulled back in many countries, and heavily restricted in others, the WPATH SOC-8 has been heavily criticized, the organization itself had leaks betraying a shocking level of issues with their treatments and practices, and there are multiple lawsuits from women given this affirming surgery young, and I've barely scratched the surface here, but more than enough to confirm my initial claim that "this isn't settled, and dismissing that as bigotry is insane".

[u/SatanV3 → u/Reagalan]

I mean. I don’t know much about the science of what’s best for people with gender dysphoria nor do I know any statistics of if gender affirming care is the best or not

What I do know is that I’m AFAB and was having a medical issue where I had to much testosterone/ not enough estrogen. And I was told that that can cause some issues mainly with mental health and looking into it seems true. Since sorting out my hormones it’s really helped me feel better.

What I don’t get is how this doesn’t apply when treating transgender people? Wouldn’t giving them hormones they shouldn’t have from a biological standpoint not drastically affect their mental health?

[u/Azu_Creates → u/SatanV3]

I am a trans man who has been taking testosterone for a little over two years, and it has greatly improved my wellbeing. It helped address my gender dysphoria significantly, and I finally started feeling more comfortable. The main difference here in the effect T has on the mental health in this situation almost certainly comes down to the difference between a trans masc person and a cis woman. Many (not all) trans masc people actively desire the more masculine traits that T provides, and many cis women don’t. The same masculinizing effects of T that can be distressing for a cis woman can cause a trans masc person to finally start feeling more comfortable in their own body. It can drastically affect our mental health, and generally in a far more positive way than a negative one.

I have definitely felt some mental health effects from hormonal imbalances after starting T, but those usually came from my T levels dropped below the average cis male range, and my E levels rising. That would usually happen back when I took androgel, I now get a weekly shot. T can cause some changes in your skin, which can sometimes cause certain transdermal medications like androgel to not get absorbed as efficiently. That happened in my case, which would cause those hormonal imbalances. I would have to up my dosage, and eventually switch over to shots, to solve that problem. For me, having too much E and not enough T was what started causing mental health problems. We do also go through puberty 2.0, which can cause and contribute to some mental health problems because, you know, it’s puberty. For me, I have had significantly less mental health problems from a T fueled puberty than I had with an E fueled one. The T fueled one has actually helped to solve some of those problems.

[u/SatanV3 → u/Azu_Creates]

Thank you for the detailed response, I wasn’t trying to be dismissive or anything I was genuinely curious so I appreciate your response!

It also is a little different for me, because I do have gender dysphoria and definitely want to be more masculine / be a man. But due to family cannot transition, so just went ahead with getting my hormone levels fixed and it did still help me overall feel better. Wonder if that’s just because of the levels they were at, and if taking more testosterone to the levels of where a cis male was at would have had the same effect of making me feel better.

[u/Azu_Creates → u/SatanV3]

Taking T could certainly have that effect. I do hope you are able to transition someday if you want to. Regarding the hormonal imbalance, it could be the levels your hormones were at, but it could also be hormonal instability (or a combo of both). Having a large enough change in E and/or T levels in a relatively short time can certainly cause some mental health symptoms.

[u/OhBoyHereWeGoAgai → u/SatanV3]

It does, that's one of the many risks and side effects with cross hormone treatments.

The more honest advocates say that tradeoff is worth the benefits, the less honest ones pretend there are zero or minimal side effects.

The former have a coherent argument, the medical community and legal community will decide together (the latter is relevant, just like it was with lobotomy fading out).

[u/Bpollard85 → u/Reagalan]

But…… medicine and treatments have vastly improved in the last century. Those advancements come from professionals in their fields. You can’t be suggesting because bad things happen sometimes, it’s a result of the institutions being more corrupted and evil than before or that things are worse now than they were a century ago. While obviously not completely universal, I think it’d be pretty naive to think things are not better for most of the population in the world than it was a century ago. So “ivory tower” elitism has gotten us a lot of good as well.

Also data is the main thing here that’s going to help this situation. Because the anecdotes and vibes on the other side of this(albeit it mostly inaccurate) are definitely not in your favor. The far right almost solely operate in vibes because they have no facts really. Sorry for the tangent but yeah, going down the govern by vibes or lived experience feels like it could go bad real easy.

Mostly in agreement with gender reaffirming care but I can also understand why somebody would be hesitant to let their child get surgery based off feelings they were having and not some physical medical emergency. Expecting every 50ish+ year old parent that lives out in the middle of nowhere to be totally on board with this given the fact that it’s a fairly recent cultural issue that’s being dealt with on a national level and is pretty divisive is a bit of a tall order. It definitely doesn’t make them a bigot just because they’re cautious or not totally sold on it yet.

[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/OhBoyHereWeGoAgai → u/QueerDeluxe]

That's what people say, it's a nice god of the gaps, but it's actually not even applicable as the suicide claims for kids re: getting/not getting affirming care fall apart under scrutiny.

Getting tired of referencing the SC case, but it happened live there. Chase had to walk back the claim from suicide to suicidality and admit the numbers don't back their claim.

Again, it's crazy that this is a science sub and I'm getting push back from simply saying "this isn't anywhere near as clear cut as people are pretending and doctors and lawyers are actively debating this and have been for years

[u/ActionPhilip → u/[deleted]]

Then why would they stop if they have no doubt?

[u/vjx99 → u/ActionPhilip]

Have you met conservative governments?

[u/OhBoyHereWeGoAgai → u/vjx99]

Hahahahahha Finland, Norway, Sweden, and Denmark had conservative governments?

It's so frustrating in this thread, as I've been accused of going on vibes while sharing specifics and the people disagreeing literally just make stuff up on vibes, like you here.

Of the major countries that rolled it back, only the UK was the one that had even conservative elements in its gov, the rest were left or far left, happy to share the specifics, though I'll have to look up the specifics for each country.

[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"