Does Transition "Work" For Trans People?

Does transition improve quality of life for transgender people?

There’s a pretty big body of research that indicates that transition reduces anxious and depressive thoughts and feelings among transgender people.

A typical study on the subject found that: “Participants reported high degrees of well-being and a good social integration. Very few participants were unemployed, most of them had a steady relationship, and they were also satisfied with their relationships with family and friends. Their overall evaluation of the treatment process for sex reassignment and its effectiveness in reducing gender dysphoria was positive. Regarding the results of the standardized questionnaires, participants showed significantly fewer psychological problems and interpersonal difficulties as well as a strongly increased life satisfaction at follow-up than at the time of the initial consultation.” (Source: Archives of Sexual Behavior.)

Does transition cause regret among trans people?

There are two issues here. First, do a high percentage of transgender people regret their transition, and second, what does such regret mean?

Let’s address the incidence of regret. Trans people do sometimes regret gender reassignment surgery or other aspects of medical transition. That happens in less than four percent of patients — by comparison, elective plastic surgery in the general population has a regret rate of 65 percent. By those standards, either elective plastic surgery should be banned or GCS (Gender Confirmation Surgery) should be elective.

However, GCS isn’t elective (in the West) and is carried out as part of a supervised medical transition. The current rate of regret among male to female transgender gender confirmation surgery patients is between one percent and two percent, among the lowest for any surgical procedure. (Source: Psychological Medicine.)

Why do people regret transition? If the majority of those who regret transition do so because they feel they were mistaken to seek it in the first place (because they were not transgender after all), that would be a strong indictment of the current system at least and possibly of the very idea of transition as a solution to trans problems.

In fact, though, the evidence shows that trans people tend to regret transition for the following reasons that are unrelated to their gender identity:

• Lack of support from the patient’s family
• Poor social support
• Late-life transitions (which frequently show a reduced response to hormone therapy)
• Severe psychopathology
• Unfavorable physical appearance
• Poor surgical result

(Sources: Acta Psychiatrica Scandinavica, Archives of Sexual Behavior.) 

One of the biggest trends in the last fifteen years has been the fall in dissatisfaction rates in post-transition transgender individuals — in spite of the increase in their number — as surgical techniques improve, leading to more functional and esthetic outcomes. This is the opposite of what you’d expect if transition was ineffective as a therapy for the issues trans people face.

READ Is Binary Transgender Acceptance Another Trap For Non-Binary Trans People?

Does transition reduce suicidal thoughts or suicide?

The Wall Street Journal’s Paul McHugh ran a story in which he observed that post-transition trans people had a suicide rate that was higher than the background population. This is true — but it’s a non sequiteur for our purposes. 

While the numbers shouldn’t be trusted absolutely because several social and medical factors conspire to muddy them, they do point toward a sharp reduction in suicide risk after transition. Among those trans people who had undergone a medical transition in the Ottowa study, for instance, suicidal ideation was halved — a dramatic improvement.

If I've left out something important or you feel I've misrepresented the facts, or you have something to add to the discussion, get in touch in the comments section below.