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.


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.


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


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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Researching the impact of Gender Identity Ideology on women’s rights, child safeguarding, freedom of speech and the truth. Speaking up in the hope that people wake up to the harm we are doing to our gay, autistic and other vulnerable groups.


The destruction of Nancy: The girl nobody wanted.


I have covered this in passing but I feel it warrants a post all of its own. Nancy was born a girl and her parents wanted another boy; their other two children were boys. There does not appear to have been any attempt to hide this from Nancy who says her brothers were celebrated whilst she was relegated to a space above the garage.

I cannot find any account that explores what the process was for assessing Nancy before she was put on testosterone. Clearly she needed therapy not drugs and surgeries. Drugs and surgeries were what were delivered.

I have no idea what assessment process was used at the Gender Clinic, maybe Nancy didn’t open up about the motivation for becoming ”Nathan”. What I do know is that the current ”affirmative“ model would not screen out a ”Nancy” in much the way it has not explored the homophobic bullying that has led my son (gay & male) down the same path. Nancy was also a Lesbian.

The testosterone and surgeries left Nathan feeling like (in her own words) a ”monster”. She had a double mastectomy and a phalloplasty. The latter surgery has high rates of complications and it appears Nancy was out of luck there too.

Finally Nathan applied to be voluntarily euthanised. For this we were told Nathan had six months of psychological investigation. This was taken the night before which was spent dancing with friends.

It turns out somebody made a documentary about her. You can watch the trailer here :

Nathan: Free as a Bird

These were the words of Nathan’s mother after learning of her daughter’s death.

In the trailer there is footage of Nancy laughing with friends an lighting a big fat cigar. Shown dancing with friends as part of a last goodbye. I will leave you with Nathan’s own, heartbreaking, words.

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Researching the destructive impact of Gender Identity Ideology on women’s , sex based, rights, gay rights and the funnelling of vulnerable kids to Gender Clinics. No body is born in the wrong body.


Suicide in trans youth:

Paper by Michael Biggs.

This paper was published in January 2022. Michael has done excellent work in this field and I covered his work on puberty blockers in the series on the Tavistock. Below is a paper examining claims about suicidality in trans-identified youth. This paper, by Biggs is forensic in it’s analysis and measured in the conclusions drawn.


Here is the introduction. 4 patients under the care of the U.K Gender Identity Development Service (G.I.Ds) also known simply as the Tavistock.

By now, we are all familiar with the casual deployment, as a debating tactic, of suicide in the trans-identified community. Most of the “research” used to advance this claim is suspect for a number of reasons. The main flaws are the small sample sizes and taking, self-reported, suicide attempts on trust. The latter is dangerous because the “trans” subculture fosters a victim narrative and has created a climate where activists recommend threatening suicide; especially to blackmail parents into medicalising.

However, whilst generally the suicide statistics bandied about by activists should be taken with a pinch of salt, Biggs’ work merits serious consideration. Here Michael estimates the suicide rate at GIDs to be 5.5 times higher than similar demographics but, crucially, far lower than the only other paediatric gender clinic with published data.

Biggs begins by detailing the many times the media /politicians leverage the suicide card to advance the issue of ”Transgender” rights. The more blatant would tell me to my (twitter) face that my “daughter” would kill herself if I did not affirm him as the opposite sex. Having done some investigation into the suicide statistics I had got into the habit of routinely dismissing them as transperbole, but I did become increasingly concerned about suicide rates post transition.

Biggs then takes some time looking at how these statistics gain a life of their own embedding themselves in the trans-narrative. In the UK this tended to be the figure of 48% which I covered in this 👇piece. (That study was based on 13, out of 27 trans-identified people under the age of 24). Biggs quotes a few studies using suicide statistics that look quite alarming. One of them (41%) was widely repeated and played a role in how transgender narratives were discussed and terrified family members.

Suicide in the Trans Community

The 41% figure was covered in an article.

He then references some research which suggests those self-reports were more complex in their origins. Some clarified they had only got to the ”planning” stage or were an attempt to signal they were in need of help, others were signalling their identification with the gay community.

Norman Spack who is a leading proponent of medicating ”trans-children” had this to say: ”The majority of self harmful actions that I see in my clinic are not real suicide attempts

Statistics on suicide rates after referral to gender clinics are covered by a few studies. As you can see rates are quadruple the rates for their sex. For those who have genital surgeries rates are even more significantly elevated, especially for males.

Looking at adolescent referrals the only comparative study showed 5 suicides, or 2.8% and was the highest suicide rate for the transgender population.

Legally assisted suicide.

Belgium allows legally assisted suicide and one of the people who ended her life was a trans-identified female. You can read about this case here:

Assisted suicide case

This coverage is short on detail. Nathan Verhelst had been born into a family who did not want a girl and had been rejected by her parents. The Gender Industry obliged by giving Nathan a double mastectomy and a phalloplasty. The surgeries left Nathan suicidal. She died by lethal injection at the age of 44. Supporters of voluntary euthanasia were keen to justify how diligent they were screening Nathan for assisted suicide. If only the Gender Clinic had been as diligent screening Nathan for ”transition”.

Co-morbidities in referrals to Gender Clinics

There is a pattern of self-harm and suicidal ideation in referrals to GIDs.

So, it is a confusing picture but we do, fortunately, have mandatory reporting for all serious incidents in the NHS and suicides have to be reported for all referrals to the Tavistock, including those on the waiting lists. Thus we have concrete data which reveals 4 suicides between 2007 and 2020.

Biggs conclusions looked at high rates of autism spectrum disorder in referrals and this group, especially females, have higher rates of suicide. Many of the referrals have competing mental health diagnoses, it could also be the case that the population is skewed in favour of those who had parents motivated to refer because their children exhibited self-harm or suicidal behaviour. This was Biggs, tentative conclusion:

It is crucial to bear in mind the level of completed suicides is 0.03% and reiterate this when politicians bandy about the statistics which claim suicide rates are at epidemic rates. It is also important not to dismiss the reasons people find themselves on this path. Autism, a history of homophobic bullying, eating disorders and experiences of child sexual abuse can all result in a rejection of your sexed body. Children in care are also over-represented at Gender Clinics and at a higher risk of self-harm and suicide. (Article and clip below) 👇

Suicide and Looked after children

Saddest of all is suicide after parental rejection as with the case of Nathan Verhelst who was taught to reject her female body. Rest In Peace.

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Researching Gender Identity Ideology and it’s impact on society, women’s , sex based rights, and gay rights. Particularly concerned with referrals of gay, autistic and foster kids to Gender Clinics.


Suicide in the Trans Community

Better a live daughter than a dead son! 

This blog is in response to the consistent use of versions of the above phrase.   Parents are being told a failure to comply with medicalisation, for their “gender confused” offspring, will result in a significant risk of  suicide. Lobbying organisations are using suicide rates of “trans” kids to influence public policy, advocate for legislative change and dictate clinical guidelines for kids/teens with Gender Dysphoria. Despite the headline grabbing claims the data does not stand up to scrutiny.

A selection of headlines:


A more recent one from September 2019 includes a direct demand that legal change is required to mitigate against these suicides:



These are not isolated examples. This theme is used consistently by lobby groups, in particular, Mermaids. Below is a link to a taped Mermaids representative in a training session. When an audience member notes that some academics have criticised the data, on trans suicides, the trainer warns that academics can still be transphobic!    Mermaids Training.

Full statement from Mermaids on World Suicide Day here.  Note the statistic of 45% is still in use. They also then quote the general suicide rate, in under 19s, to support their case. This is not disaggregated to show any link to Trans identity.  World Suicide Day

Here is a slide presentation, used by Mermaids,  during a presentation at a conference in front of an audience of lawyers, press, NHS representatives and government officials. This was on 18th November 2016 at the Trans Equality Legal Initiative.


Two key pieces of research are used to make claims of high suicide rates/attempts in the trans community. The first one is a study commissioned by PACE RaRe and the other was commissioned by Stonewall.  These studies may not have reached a wide audience but their message informed the ITV drama  “Butterfly” : which made liberal use of the suicide narrative.


Here is a detailed debunking of the suicide stats,  authored by Associate Professor Michael Biggs, prompted by the ITV drama “Butterfly” : Suicide data. 

Here are some key excerpts:

That’s FOUR  cases over a decade. Each one a tragedy for the individual, and their parents,  but in no way supporting the ,manufactured, public perception, of a suicide epidemic in Trans youth.  These figures have been published by leading MPs who seem to be uninformed about their unreliability.

Here is Susie Green (CEO of Mermaids) claiming she is aware of 4 trans-suicides in just one year. There is no evidence to support this statement.


The PACE RaRe study is available in full here: PACE/Rare LGBT suicide

Here is a full analysis of the data in the above study, in particular questioning the way these statistics have been used by Lobby groups. Suicide Myths

Below is a brief snapshot highlighting that the central figure is based on 13 trans young people who self-report attempted suicide.


Included in the above report is correspondence with one of the authors of the study expressing concern about how the data has been used. Below is one example:


The author of the study had this to say about the way organisations, with an agenda, are using their data:


The second study under analysis is one commissioned by Stonewall, with an introduction by, former CEO, Ruth Hunt.  The full report is here

Attempts made to obtain the methodology were not forthcoming.  In Academia it is absolutely expected  that any published research is open about their methodology. This is so it can be critically evaluated and it’s robustness tested.  No peer-reviewed journal would accept research without knowing that the data set was available to scrutiny. The Stonewall research was not subject to peer review  and no dataset was forthcoming. 👇


A detailed list of criticisms is here:

547201B2-C3BB-419F-814D-B7C63BBB055EIt is well demonstrated that Lesbian and Gay youth are more likely to be bullied and have suicidal tendencies.  Research needs to disaggregate the data to include sexual orientation however a research subject identifies. This is the only way to understand what is going on.  Hence point three, above, is important.

The report ends with a link to the Samaritans Guidelines on responsible reporting of suicide.  Samaritans: Media Guidelines

Remember that the Samaritans warn, repeatedly, that irresponsible reporting can foster suicide ideation in vulnerable groups. They warn it is dangerous to over-simplify narratives about suicide cases. In addition to focus on one of the deceased characteristics can harm those who share that trait.  (Please note that this in no way negates the real experience of individuals living through genuine distress either due to sexual orientation/ Gender Dysphoria or, as is often the case, both).

For parents with children/teens with Gender Dysphoria, the way the suicide narrative is presented can generate understandable anxiety. By way of reassurance I  repeat the guidance from the Gender Identity Services (GIDs) own FAQ page.


Here are also Polly Carmichael (Director of The Tavistock, Gender Identity Clinic)  on the suicide statistics and how they are used: 5F578DED-E5FC-4BD8-A5B0-1FE4660E7A7E

The aim of this blog is to inform enough people to  rebut this narrative when we hear it. Whether that is in real life, diversity training, or on social media.  Please do also let Samaritans know when you see this irresponsible coverage. I live  in hope they are moved to make a public statement, or at least, a private overture to those peddling this dangerous narrative.

Acknowledgement: Thanks to Professor Michael Biggs and Transgender Trend for all the work they do.