Long Term Follow up: Transsexuals

I have quoted this study often but never actually featured it on my blog. Time to remedy this deficit. Study linked below:

Long Term Follow up TS

This study is from 2011. It followed 341 ”transsexual” persons for a median period of 11 years. They had ”transitioned” between 1973 and 2003. 191 were male and 133 were female.

The author’s explain there is a dearth of long term follow up and this remains the case, nearly 20 years later, measured against the end point of those surveyed. This despite sky rocketing numbers of children and young people, in particular, claiming a ”transgender” identity. In the UK there has been a 4000% + spike in females referred to the Tavistock Gender Identity Development Service (GIDS). Last time I looked the increase for males was 1152%. There are also rising rates of detransitioners. I cover this on my series on detransition.

Detransition

This study sought to remedy the deficit in research by following up a cohort and evaluating patterns of morbidity, mortality and also criminality. Median length of follow up was 11 years. They looked at people who had undergone “sexual reassignment” from 1973 to 2003. The researchers also matched each group to compare outcomes measured against their biological sex and the sex the participants wished they were.

Abstract

The study looks at mortality and morbidity rates as well as patterns of criminality.

Results

As you can see mortality was higher, particularly due to suicide, psychiatric inpatient care remained higher for this demographic, females also had a higher propensity for criminality than the rest of their sex. (“Transsexual” males matched the pattern for their sex).

Despite the less than optimal outcome, hormonal /surgical treatments remain the recommended treatment for “Gender Dysphoria”. These are the treatments listed in the study which seem to assume patients are male. (I am basing this on the fact that females would not require body hair removal). However, from 1973 to 2003 the majority of patients would have been male.

This research followed patients from 1973 to 2003. Even then they point out that outcome data is scant. (Despite protestations to the contrary, the data still remains scant, in terms of long term follow-up). All the other studies quoted are referenced so can be looked at in more detail. (I will post on any that are open access). The rate of suicides does look high to me and later the authors compare these rates to the rate for their actual sex and the sex to which they aspire. ( Until I read this paper I also had no idea that people can actually die from complications following “sexual reassignment surgery”).

Other referenced studies. 👇

This is the one that followed up 24 “transsexuals” :

The same names appear on this study which looks like another worthwhile piece to follow up.

These were the other two referenced studies.

You can access the second one (7) here:

5 year follow up

Here are a few more studies:

References to the quoted studies:

I could only find links to a full copy for this one.

11. Gooren, Giltay et al

Back to this study.

The data is inconsistent but overall the authors concluded the “evidence base for sexual reassignment surgery is of very low quality” .

This is a very good summary of the limitations of the research that does exist. Some of the reasons seem insurmountable (double blind, randomised trials, for example) but for others it is baffling why there has not been sufficient will to overcome them. I am thinking about the surgeries that were funded by the NHS, in the U.K. These should have made it possible to do long term follow up.

There follows a thorough outline of the methodology. For those of you interested in this it is a very comprehensive section. One thing to note is that accurate follow up needs to record biological sex and a way of coding “sexual reassignment surgery”; such that outcomes can be tracked. Those people arguing for the end to recoding biological sex in any formal documents are going to undermine this kind of follow up.

Of the “transsexuals” in this study their hospitalisation rates for psychiatric issues, other than gender identity issues, were four times the rate for the control group. This was prior to “transition”. As I have said before there are victims in this cohort; notwithstanding their plight has been weaponised against the female population.

There was an increased rate of criminal convictions after sexual reassignment.

More details on co-morbidities, substance use and accidents paints a picture of a vulnerable population both pre and post “transition”.

For this of you who like a graph what is buried in this one is that the suicide rate for this demographic is 19 times higher for this demographic.

The authors make a distinction in patterns for criminality based on the dates of their surgeries.

Notice that the differences in patterns of suicidality conform to birth sex not “gender identity”.

While the surgeries are deemed to alleviate “gender dysphoria” psychiatric co-morbidities remain. The authors may see this as a success because once post-operative there is nothing, material, that can be done to address the felling of a mismatch between their biology and their outward appearance. However, what if the psychiatric co-morbidities remain because they surgeons were treating the wrong problem?

The retention of a male pattern of criminality also suggests our politicians are wrong to place men in female prisons, regardless of any “identity”. To be clear there are more issues than male patterns of criminality to exclude males from female spaces. Women should be allowed single sex spaces for privacy and dignity, irrespective of safety. The increased rate among females warrants some research into the impact of testosterone on a female body.

More detail on those patterns of criminality. 👇

Strengths of this Study.

The period of time followed, low drop out rates and surveying a clear population of post operative “transsexuals” are all strengths. Also important was that the group surveyed are compared to both their biological sex and the sex they aspired to. This is important because, for example, the higher rates of criminality in females would have been masked if only measured against males.

There is a detailed sections on the limitations of the study. Among the arguments are that “transsexualism” was still only a low number of people, in Sweden; during the period covered by the survey. They argue psychiatric treatments have improved over this period. Furthermore people treated for other psychiatric conditions continued to have high rates of referrals for mental illness which, they argue, cannot be assumed to be because of the treatment they received.

Wherever you stand on the wisdom of medical responses to “gender dysphoria” it is clear that this patient group are poorly served in terms of follow up and long term, evidenced based, research. Even if you were to find a group willing to opt for solely therapeutic care to deal with their “gender dysphoria” ; to compare to those given hormones /surgeries, I suspect the results would be dismissed. The group willing to try therapy only, would automatically be assumed to be less “dysphoric”.

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