IT'S CONSISTENTLY LOWER THAN BASICALLY ANY OTHER SURGERY. AND THATS JUST THE SURGERY PART NOT THE TRANSITION. BAN KNEE REPLACEMENT. Ahem Ok got that out, but it's been. Studied. So let's study it...
Exemplary
IT'S CONSISTENTLY LOWER THAN BASICALLY ANY OTHER SURGERY. AND THATS JUST THE SURGERY PART NOT THE TRANSITION. BAN KNEE REPLACEMENT.
Ahem
Ok got that out, but it's been. Studied.
So let's study it again until we get the results we want, I guess. (┛◉Д◉)┛彡┻━┻
Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence.) The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and...
Some studies suggest that rates of regret have declined over the years as patient selection and treatment methods have improved. In a review of 27 studies involving almost 8,000 teens and adults who had transgender surgeries, mostly in Europe, the U.S and Canada, 1% on average expressed regret. For some, regret was temporary, but a small number went on to have detransitioning or reversal surgeries, the 2021 review said.
Detransitioning does not always include regret. The updated transgender treatment guidelines note that some teens who detransition “do not regret initiating treatment” because they felt it helped them better understand their gender-related care needs.
(Anecdotally many detransitions relate to how shitty trans people are treated even after transition and thus going back into the closet is easier. )
Research and reports from individual doctors and clinics suggest that detransitioning is rare. The few studies that exist have too many limitations or weaknesses to draw firm conclusions, said Dr. Michael Irwig, director of transgender medicine at Beth Israel Deaconess Medical Center in Boston.
Results: The average rate of patient dissatisfaction was 10%. Excluding complications, the average rate of dissatisfaction was 7.3%.
The claimed high regret rates - and much of the NYT reporting on the topic and the MAGA discourse (and the Cass report ) is motivated by mumsnet and similar sites literally sharing outlier, old, or dishonest data. They also either coined or popularized the "rapid onset gender dysphoria" term (that has fallen more out of favor in recent months) which is code for "my child never told me they were trans until suddenly they wanted treatment.... It must be that they were influenced and not that they didn't trust me because I'm a raging transphobe."
Anyway, it's consistent. Every site I've ever found that said anything else is a known transphobic site or organization.
I don't have a source other than vague recollections from "If Books Could Kill" but I believe most of the evidence for "regret" is from social pressure and abandonment by family, not the surgery...
I don't have a source other than vague recollections from "If Books Could Kill" but I believe most of the evidence for "regret" is from social pressure and abandonment by family, not the surgery itself. Similar to how people who leave a strict religious community only to return probably haven't had a sudden revelation, but miss their family and social connections that they've been cut off from.
I think it was on Maintenance Phase, but Michael Hobbes might have covered it on IBCK too. I've mentioned it elsewhere in the thread but yeah, even the low amounts of regret and de-transition do...
I think it was on Maintenance Phase, but Michael Hobbes might have covered it on IBCK too.
I've mentioned it elsewhere in the thread but yeah, even the low amounts of regret and de-transition do seem mostly related to social issues particularly stigma. (I'd guess people who have complications are the next largest group, that's the thing that would make most people regret any surgery)
Interesting, vaguely wondered about this. Not something I think about much, but basically my whole thought process was "man, they better be reallllllllllllllllllly sure about their decision"....
Interesting, vaguely wondered about this. Not something I think about much, but basically my whole thought process was "man, they better be reallllllllllllllllllly sure about their decision".
Seems ok if there are pretty strict psych evals ahead of time.
I'm going to point out that you took a process with incredibly low regret rates and a procedure with ten percent regret rates and decided the former needs a strict psych eval. Please consider why...
I'm going to point out that you took a process with incredibly low regret rates and a procedure with ten percent regret rates and decided the former needs a strict psych eval. Please consider why
To be clear clearance by a therapist is part of the former process it's part of why rates are incredibly low but so is the fact that it's a process. That process has a lot of hoops. Some unnecessary, some legally imposed, some helpful to a subset of people and some frustrating.
But to me it's very strange to look at this and to say that it's trans people who need a stricter process, not knee replacements.
It's an interesting one to think about it terms of giving people agency over their own medical choices whilst also trying to ensure people are given the whole picture and can be informed enough to...
It's an interesting one to think about it terms of giving people agency over their own medical choices whilst also trying to ensure people are given the whole picture and can be informed enough to make the choice that is best for them. To be clear I don't think the current hurdles involved in trans healthcare are fair particularly the rigidity with which you have to perform gender disphoria. But, should there be requirements about informing people more clearly the downsides of surgerys such as knee replacements? Or would it actually not change anything because a knee replacement seems like the sensible thing to do when walking hurts and you can no longer do the hobbies you had due to the issues with it?
I think there should be greater parity. I have seen allegations that knee replacement is pushed at higher rates because of increased compensation. But I have no sense for the accuracy of that....
I think there should be greater parity. I have seen allegations that knee replacement is pushed at higher rates because of increased compensation. But I have no sense for the accuracy of that.
There are even worse outcomes with surgery and regret and even with other life choices. There may be a baseline amount of regret with most things.
You can only control, and only somewhat, what doctors do though, and patients get information from tons of places online. I'd suspect most doctors do believe they're giving a good informed consent. All of which to say, I'm not a medical ethicist. So maybe. But I'll leave that to experts and people with a passion
What are you talking about? I didn't compare it to anything, and I said it seemed ok if there were strict psych evals... as in it seems ok because the regret level is low from said evals. You...
What are you talking about? I didn't compare it to anything, and I said it seemed ok if there were strict psych evals... as in it seems ok because the regret level is low from said evals.
You really gotta stop attacking people because you think they're coming after you when they aren't. This isn't the first time I've seen you mis-interpret a comment and get offended at someone. It's starting to seem like it's on purpose.
If multiple people misunderstand your point does it make sense to call a response that starts "I'm going to point out..." And contains "it's strange to me" as an "attack"? Because I neither...
If multiple people misunderstand your point does it make sense to call a response that starts "I'm going to point out..." And contains "it's strange to me" as an "attack"? Because I neither attacked you nor am offended by you. So I don't really know what you're talking about about. I disagreed with you and still do because your explanation doesn't address my response.
You said it seemed ok if ... Which implies your approval is contingent upon that if. You stated that "man, they (trans people) need to be really sure. Which, they are, but the strict psych evals are one of those extra hoops I was mentioning.
Once again I think it's an odd response to express approval contingent upon those psych evals, but look at the significantly higher regret rates of knee surgery with no comment.
Please feel free to elaborate on the "on purpose" part of your comment though. My posts are intentional, but again, I'm not attacking you, just disagreeing.
Yes sure. I don't really fucking care. I am amused at you and the other person taking my comment so far out of context. It was a closer to a fucking compliment because I was surprised at how low...
Yes sure. I don't really fucking care. I am amused at you and the other person taking my comment so far out of context.
It was a closer to a fucking compliment because I was surprised at how low the regret % was.
But please keep attacking me because you think I'm some kind of hater.
The trump order is stupid and unnecessary. That said, I don’t know if we can equate and compare “dissatisfaction” with “regret”. I can, and have, been dissatisfied with the outcome of some choice...
The trump order is stupid and unnecessary.
That said, I don’t know if we can equate and compare “dissatisfaction” with “regret”. I can, and have, been dissatisfied with the outcome of some choice without regretting them. Maybe it’s the best of all bad options, maybe it’s better but not up to expectations, etc.
Unfortunately researchers use the term dissatisfaction with most surgeries or other interventions. It's referred to as the regret rates however. We could ask why then interventions for trans folks...
Unfortunately researchers use the term dissatisfaction with most surgeries or other interventions. It's referred to as the regret rates however. We could ask why then interventions for trans folks get one term more than the other 🤔 but IMO the answer is obvious
Regret after gender-affirming surgery (GAS) is a complex issue. Comparing regret after GAS to regret after plastic surgery operations and other major life decisions is a novel approach that can provide insight into the magnitude of this issue.
A systematic review of three databases was conducted to investigate regret after common plastic surgery operations. Three separate literature reviews on regret after GAS, regret after elective operations, and regret after major life decisions were performed.
A total of 55 articles examining regret after plastic surgery were included. The percentage of patients reporting regret ranged from 0 to 47.1 % in breast reconstruction, 5.1–9.1 % in breast augmentation, and 10.82–33.3 % in body contouring. In other surgical subspecialties, 30 % of patients experience regret following prostatectomy and up to 19.5 % following bariatric surgery. Rate of regret after GAS is approximately 1 %. Other life decisions, such as having children and getting a tattoo have regret rates of 7 % and 16.2 %, respectively.
When comparing regret after GAS to regret after other surgeries and major life decisions, the percentage of patients experiencing regret is extremely low.
So if you don't like their methodology either, I mean, blame the people assuming trans people uniquely regret their care.
and also i wonder if they factor in dissatisfaction that trans people also very often (i believe that this will be way more than any official statistics show) have to seek and pay for for...
and also i wonder if they factor in dissatisfaction that trans people also very often (i believe that this will be way more than any official statistics show) have to seek and pay for for treatments and procedures outside the bounds of their host medical system. for example, purchase medications from abroad at great expense, that have been shown to contain high levels of contaminants including lead. and/or, seek surgeries from dodgy practitioners in dodgy markets at massive costs, who are not regulated, and for which there is no recourse if they screw up those complex procedures. this vs your knee replacement or w/e that would be covered by the nhs or your insurance, and the practitioner would be on the hook to correct problems and er, not put lead in stuff
I'm not sure how much the stats account for this, mostly due to them being tracked as part of studies so if people went abroad for surgery or were DIYing their HRT they probably wouldn't flag for...
I'm not sure how much the stats account for this, mostly due to them being tracked as part of studies so if people went abroad for surgery or were DIYing their HRT they probably wouldn't flag for the purposes of this study.
But it's worth digging into the (good) literature on it. Michael Hobbes is a journalist who has done a lot of debunking of Jesse Singal and the SEGM/Cass report/mumsnet data.
While there are Americans who DIY hormone therapy, I don't think it's actually as common as it is in the UK (and Europe more generally). Americans are unfortunately used to paying for their...
for example, purchase medications from abroad at great expense, that have been shown to contain high levels of contaminants including lead. and/or, seek surgeries from dodgy practitioners in dodgy markets at massive costs, who are not regulated, and for which there is no recourse if they screw up those complex procedures. this vs your knee replacement or w/e that would be covered by the nhs or your insurance, and the practitioner would be on the hook to correct problems and er, not put lead in stuff
While there are Americans who DIY hormone therapy, I don't think it's actually as common as it is in the UK (and Europe more generally). Americans are unfortunately used to paying for their healthcare, even for things like knee surgery, as there are things like deductibles which mean you still need to pay quite a lot up front even with insurance. Moreover, it's much easier to get HRT prescribed by a doctor in the US (at least for now), as there are hundreds of informed consent clinics throughout the US that do not require therapy in advance, including in red states. This essentially makes cost the only hurdle, and for Americans it's unfortunately a hurdle they regularly encounter for all types of healthcare. The UK, by comparison, famously makes it extraordinarily difficult to get gender-affirming care through the NHS, and even those who pursue private healthcare typically need a diagnosis of gender dysphoria from a psychiatrist first. This makes the comparison between gender-affirming care and other healthcare much starker in the UK than in the US.
I also think you're overstating both the costs and risks of DIY HRT. I know that your point is that these risks may contribute to regret for some people, but I think it's still contributing to a harmfully exaggerated narrative when it comes to the pros and cons of DIY HRT. While it's certainly not risk-free, the risk is lower than you're making it out to be, especially if you're able to get regular blood tests to monitor things, as not keeping a close enough eye on your levels is actually the much bigger risk than contamination for most people. Yes, it would be preferable if no one had to DIY and had easy access to free HRT without gatekeeping instead. But overstating the harms of DIY HRT is something that's often done to dissuade people from transitioning, and especially in places that really suck when it comes to access to trans healthcare, like the UK and the Nordics, it's often by far the best option.
Also, as for surgeries, I think you're far overstating how often people get them from "dodgy practitioners" with no legal recourse. I've never encountered even a secondhand story of someone getting gender-affirming surgery from anything but a normal, licensed doctor at a hospital, and while I'm sure it does happen sometimes, it's certainly not all that common -- certainly orders of magnitude less common than DIY hormone therapy. The closest thing I've actually heard of people doing is trans women going to Thailand for bottom surgery, but calling Thailand a "dodgy market" in that respect would be extremely inaccurate. My understanding is that the people who travel there for gender-affirming surgery these days do so because their doctors and hospitals have pretty stellar reputations when it comes to the surgical results, as it's actually not much cheaper than in the US once the cost of traveling and staying there is included.
With regards to DIY hormones it's more common than you'd think, even more so than I thought. Caveat - I don't take HRT, this is not personal experience. wiki There's a long oral history of trans...
With regards to DIY hormones it's more common than you'd think, even more so than I thought. Caveat - I don't take HRT, this is not personal experience.
Estimates of the prevalence of DIY hormone therapy in the trans community vary significantly. One survey in Ontario found that 25% currently or formerly obtained DIY hormones, whereas for trans people of color living in San Francisco a different survey found that 63% had relied on DIY.[3][5] According to a 2022 review, at the low end, 11% of Ontarian transgender people report having used DIY HRT; at the other extreme, 79% of trans women from Rio de Janeiro have done the same. In between lie London at 31% of transgender people, and 49% of trans women in San Francisco.[3] The use of DIY increased during the COVID-19 pandemic although it had been common before.[6] The prevalence of DIY hormone usage has been estimated to be higher among trans women than trans men.[8]
There's a long oral history of trans men and women swapping their hormones in the same way that gay and lesbian people would exist in lavender marriages. It works out for both parties and protects them from more harassment.
The low end was in Ontario and the highest numbers from Rio de Janeiro and San Francisco. To me that tracks. These numbers aren't solid. I found a number citing that by the time many British trans people made it to their first gender care appointment (with long waits) 17% we're on hormones. This article also points out the poverty many trans Americans live in. Plus gender affirming care is not always covered by Medicaid, depending on your state. And not all insurance plans make any drugs affordable.
Like I said these numbers are higher than I expected but it makes sense, especially in Trans POC communities where medical racism and transphobia impact them more.
I’ll have to defer on any US matters. I agree it’s way different, and that differential dissatisfaction from cost for gender transition sounds less likely there. I am definitely only speaking from...
I’ll have to defer on any US matters. I agree it’s way different, and that differential dissatisfaction from cost for gender transition sounds less likely there. I am definitely only speaking from my knowledge of the UK experience.
But DIY hrt is very expensive! I know because I have had to use it. It ran around 120 pounds per month privately (with other massive up front costs for diagnosis, maybe just under 500 if you use the cheapest but can be way more, and then ongoing costs for any monitoring and changes. Many of these are basically scams and will not properly monitor you cough gendergp cough, they are a tragedy waiting to happen - there ARE risks from these drugs if you are not managed properly, eg people die from hepatoxic response to bicalutamide), then about 150 per month via questionably legal routes (and that’s taking the rubbish blockers, gnrh blockers are hundreds a month alone). It is also way more if it were testosterone you were after (and more legal risk), and I know people who pay this and more per month. You will also have to pay for your own blood tests which at absolute minimum from randox or so will be 100ish for both hormone levels and liver/kidney etc every three months - you will have to figure out how to interpret these yourselves. hair removal will be thousands and many of the practitioners are scammy. Thousands for voice. Private surgeries tens of thousands. I’m sure there are other costs I’m forgetting. the meds themselves are getting cheaper on account of clandestine formulations though. You have to understand that there’s no other healthcare in the uk you have to seek this way and it’s both humiliating and makes a serious material difference. It’s not enough to not make you do it, as you say it’s the only option, and I’m clearly not trying to dissuade anyone. But again we reach the question of dissatisfaction vs regret.
The risks of medical tourism and buying drugs from online websites are well documented. These are openly discussed by resources that support trans people. I’m not sure how im contributing to a harmful narrative, I was mostly suggesting that there are many hidden features of trans healthcare and treatment that would likely not be accounted for in studies of dissatisfaction. I guess I gave the wrong impression
My ex-wife was briefly on DIY hormone therapy from GenderGP and was able to get bloodwork done at her normal GP here in Germany (though the GP urged her to find an endo). It was also much easier...
You will also have to pay for your own blood tests which at absolute minimum from randox or so will be 100ish for both hormone levels and liver/kidney etc every three months - you will have to figure out how to interpret these yourselves.
My ex-wife was briefly on DIY hormone therapy from GenderGP and was able to get bloodwork done at her normal GP here in Germany (though the GP urged her to find an endo). It was also much easier for her to get an appointment with an endocrinologist and switch to getting it prescribed legally and paid for by public health insurance, because she could say that she was already on HRT and just needed a new doctor to prescribe it.
I definitely agree that trans healthcare is too expensive and inaccessible, especially in the UK. But if studies on the regret rate include the US, it's unlikely that the cost is a major factor influencing it, because the costs are not significantly different than for other medical treatments of the same type. Trans healthcare is simply much easier to access in the US than in the UK at present, and in the US DIY is often done as the cheaper option compared to normal prescriptions. It's possible that there would be a lower regret rate in both countries if gender-affirming care were both free and available with informed consent, but I'm not really sure that's necessarily the case, and it's so low already that it's not really a major issue to consider when trying to improve access to gender-affirming care.
There are risks to going DIY, even without considering the expense. But over-exaggerating the risks is very common from people who want to stifle trans healthcare more generally, and it can discourage vulnerable trans people who have no better options. It's especially harmful to lump together risks like "you need to get bloodwork done bc otherwise you could miss dangerous levels," which is very much something someone DIY-ing should know, with "the HRT is contaminated with lead," which is technically possible but much rarer and not a risk for common methods of DIY-ing that get their HRT from the same pharmaceutical sources as people getting normal prescriptions. My ex-wife got the same stuff at the same local pharmacies when she DIY-ed as with a prescription from a local German doctor. Imo focusing on the risks and costs of medical tourism and DIY hormone therapy is simply focusing on the wrong thing when it comes to discussions of trans healthcare -- the barriers to care that lead trans people to pursue these things are the bigger impact on how it feels to navigate trans healthcare in a given place.
People should not over-play the risks. Conversely, down-playing or dismissing discussion of risks as dangerous is especially unhelpful exactly when there are many vulnerable people who have no...
People should not over-play the risks. Conversely, down-playing or dismissing discussion of risks as dangerous is especially unhelpful exactly when there are many vulnerable people who have no other choice. It is possible to discuss for days about what is over or under exaggerating, but I reject the notion that I’m partaking in dangerous discourse by mentioning it. The reason concern trolling and the like is so successful is because there are grains of truth which, if mentioned even in the context of discussing research design by friendly parties (that is also to say, not a discussion concerning whether or not people should transition), one frequently finds their throat jumped into.
If I may don my “what aboutism” attire as well, back surgery ?. I believe another recent article stated that you’re basically better off taking NSAIDs…
If I may don my “what aboutism” attire as well, back surgery ?.
surgery often does not relieve the pain; research suggests that 20 to 40 percent of back surgeries are not successful. This lack of success is so common that there is a medical term for it: failed back surgery syndrome.
I believe another recent article stated that you’re basically better off taking NSAIDs…
It’s requires doing extremely painful physical therapy afterwards on a regular basis to get the tendons to adjust. So for the short term afterwards you’ll have more pain than before. And it isn’t...
It’s requires doing extremely painful physical therapy afterwards on a regular basis to get the tendons to adjust. So for the short term afterwards you’ll have more pain than before. And it isn’t a permanent solution for all patients.
I had a gingival graft done in my mouth. I have bone loss under my gums, which pulls them down. One area was particularly low, and it was exposing the root of one of my teeth. So, a periodontist...
I had a gingival graft done in my mouth.
I have bone loss under my gums, which pulls them down. One area was particularly low, and it was exposing the root of one of my teeth. So, a periodontist literally sewed some pig tissue into my gums to graft it on there and cover it up.
Unfortunately, gum grafts fail sometimes. Success rates differ depending on who you consult for data and depending on the underlying condition that caused the need for a graft in the first place.
Mine looks like it might be failing.
Do I regret getting the surgery done?
Kind of.
It was painful, stressful, and expensive. The recovery was rough. I was on a liquid diet for days, and soft foods for weeks. For a while I never wanted to even look at a protein shake or mashed potatoes.
I had a legitimate psychological hurdle that I had to get over regarding the grafting of foreign tissue in my mouth. It looked gray and cadaverous initially. It was in my mouth. Imagine having something disgusting in your mouth that you can’t spit out. Imagine knowing that it’s living in there. Connected to you. Your blood is flowing through it.
I’m bothered that I went through all that just to end up in the same place that I started. I’m worried that I might need to have it done again. I’m worried that I might potentially have to have something even worse done to counteract my gum loss.
I bring this up because if someone were to say they were studying regrets related to gingival grafts, I would want to be a part of that study. I would have a lot to say.
I’d want to participate because if anyone heard that there was such a study happening, they would automatically assume it was happening as a way of improving the quality of gingival grafts or care for gum recession. If I had been better prepped about the psychological aspects going in, for example, I think I would have had an easier time. That kind of thing could lead to fewer regrets for others.
If such a study were happening, no one would assume that it was because they were wanting to prove that gum recession doesn’t exist. That the root of my tooth wasn’t actually exposed.
It’s obvious where I’m going with this analogy, but I want to point it out just to highlight what a distorted funhouse-mirror-reflection of science a study like the one proposed in the article is. They’re not wanting actual science: they’re wanting to give prejudice the authority and nominally neutral cover of a scientific backing.
Anyone would want a study done on regrets after medical procedures to help people. It’s basic human empathy.
If we lived in a world where trans identities weren’t weaponized, a study like that could be genuinely valuable. Research into regret after transition would be conducted as a way of improving outcomes for trans people. They get to voice their concerns and experiences, noting ways in which procedures could be improved to minimize social and psychological harms for them. Longitudinal studies would determine best practices; identify and alleviate pain points. “Regret” as a measure would be a driver of positive change aimed at ensuring that trans people get the best quality care they can get.
We, of course, know that these studies won’t do that.
They’ll instead be used for harm — to invalidate trans people wholesale.
“Scientific” support for cold, callous inhumanity.
Your post made me think of an old friend of mine. I met her pre-FtM surgery, got her groceries while she recovered from her surgeries, and had a lot of long, deep conversations about the nature of...
Your post made me think of an old friend of mine. I met her pre-FtM surgery, got her groceries while she recovered from her surgeries, and had a lot of long, deep conversations about the nature of life during and after. We really clicked. I will always appreciate how she stood up for me (the sole cis/het man working at that coffee shop at the time) and told the bullies to go pound sand, despite the fact that she was half their size. She had a great sense of fair play.
She ultimately regretted getting some (not all) of her work done, and was in the process of figuring out what to do next when her mental health just couldn't bear the burden any longer. She is no longer with us.
It wasn't a case of 'trans regret'. It was a complex, thorny problem of self-acceptance, dealing with abusive parents, abusive partners, and, frankly, poor quality surgery from a doctor who probably should have had his license pulled. She would have had a lot to say to people conducting a real study of the type you describe. Which could have been used to help others that came after her. We all know whatever bullshit this study is going to be will only be used to harm. It makes me sick.
Just an FYI but your wording is confusing. If she was a trans woman, you don't need to incorrectly specify the surgery (frankly you shouldn't specify surgery at all, that's weird). If he was a...
Just an FYI but your wording is confusing. If she was a trans woman, you don't need to incorrectly specify the surgery (frankly you shouldn't specify surgery at all, that's weird). If he was a trans man, you misgendered him throughout your post.
Respectfully, you did not know my friend. This was decades ago, she had different preferences than modern usages, and I did not make any mistakes in what I wrote.
Respectfully, you did not know my friend. This was decades ago, she had different preferences than modern usages, and I did not make any mistakes in what I wrote.
Seems to me that if anything’s going to make trans people regret transitioning, it’s the right wing’s deliberate efforts to make the world more inhospitable to them. Basically, “if you transition,...
Seems to me that if anything’s going to make trans people regret transitioning, it’s the right wing’s deliberate efforts to make the world more inhospitable to them. Basically, “if you transition, you’re going to regret it— precisely because we will do everything in our power to make your life miserable.” They frame this as a friendly warning, but it’s really a threat.
Fairly consistently that is (anecdotally) what most "detransitioned" people say. It's not that their understanding of their gender changed (though that can happen) it's that society treated them...
Fairly consistently that is (anecdotally) what most "detransitioned" people say. It's not that their understanding of their gender changed (though that can happen) it's that society treated them like shit.
This seems most logical and also if they have botched care, because we don’t fund or research patient based care for trans health, specifically. No shit you’re gonna have regrets if you: get...
This seems most logical and also if they have botched care, because we don’t fund or research patient based care for trans health, specifically.
No shit you’re gonna have regrets if you: get fired, lose your partner, get harassed in public, get harassed online, cannot ever find clothing or other normal affirming things that we all take for granted, can’t join a gym, can’t play sports, all that on top of being butchered or otherwise not taken care of by your doctor.
i'm sure this will be a fair study, they can take notes on how to run it from Cass, and the other various pocket academics they are now commissioning to run service reviews in the UK. my only...
i'm sure this will be a fair study, they can take notes on how to run it from Cass, and the other various pocket academics they are now commissioning to run service reviews in the UK. my only post-transition regret is that i have to continue to live in the same world as these fuck-heads. i don't think i have anything more substantive to say, but needed to express myself.
ps: perhaps they will accidentally defund it because the title includes the word 'trans'?
Defunding it would be hilarious. It does suck we have to live in a world with Cass, Trump and their ilk, but please, in case the inclination strikes you not to, remember it's worth continuing.
Defunding it would be hilarious.
It does suck we have to live in a world with Cass, Trump and their ilk, but please, in case the inclination strikes you not to, remember it's worth continuing.
And just to say it out loud, this goes for you too: I've always considered you a positive contribution to Tildes at least, and I have no doubt that that extends to the real world as well. Please,...
remember it's worth continuing.
And just to say it out loud, this goes for you too: I've always considered you a positive contribution to Tildes at least, and I have no doubt that that extends to the real world as well. Please, keep being you. And thank you for all you do, especially given how difficult it must during these times.
Not going anywhere. Amidst all my stress that's not where my mind goes I also have several lovely keychains that say "I will not beat _____ to the grave" for my students. (Got Trump, Vance, Musk...
Not going anywhere. Amidst all my stress that's not where my mind goes
I also have several lovely keychains that say "I will not beat _____ to the grave" for my students.
(Got Trump, Vance, Musk and JKR)
We've lost far too many queer elders before now. We'll make it.
IT'S CONSISTENTLY LOWER THAN BASICALLY ANY OTHER SURGERY. AND THATS JUST THE SURGERY PART NOT THE TRANSITION. BAN KNEE REPLACEMENT.
Ahem
Ok got that out, but it's been. Studied.
So let's study it again until we get the results we want, I guess. (┛◉Д◉)┛彡┻━┻
Do you know of a good article summarizing the research?
Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence.)
The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets
How common is transgender treatment regret, detransitioning?
(Anecdotally many detransitions relate to how shitty trans people are treated even after transition and thus going back into the closet is easier. )
What We Know Project, Cornell University, “What Does the Scholarly Research Say about the Effect of Gender Transition on Transgender Well-Being?” (online literature review), 2018.
Meanwhile knee surgery:
Are 20% of Patients Actually Dissatisfied Following Total Knee Arthroplasty? A Systematic Review of the Literature
The claimed high regret rates - and much of the NYT reporting on the topic and the MAGA discourse (and the Cass report ) is motivated by mumsnet and similar sites literally sharing outlier, old, or dishonest data. They also either coined or popularized the "rapid onset gender dysphoria" term (that has fallen more out of favor in recent months) which is code for "my child never told me they were trans until suddenly they wanted treatment.... It must be that they were influenced and not that they didn't trust me because I'm a raging transphobe."
Anyway, it's consistent. Every site I've ever found that said anything else is a known transphobic site or organization.
I don't have a source other than vague recollections from "If Books Could Kill" but I believe most of the evidence for "regret" is from social pressure and abandonment by family, not the surgery itself. Similar to how people who leave a strict religious community only to return probably haven't had a sudden revelation, but miss their family and social connections that they've been cut off from.
I think it was on Maintenance Phase, but Michael Hobbes might have covered it on IBCK too.
I've mentioned it elsewhere in the thread but yeah, even the low amounts of regret and de-transition do seem mostly related to social issues particularly stigma. (I'd guess people who have complications are the next largest group, that's the thing that would make most people regret any surgery)
Interesting, vaguely wondered about this. Not something I think about much, but basically my whole thought process was "man, they better be reallllllllllllllllllly sure about their decision".
Seems ok if there are pretty strict psych evals ahead of time.
I'm going to point out that you took a process with incredibly low regret rates and a procedure with ten percent regret rates and decided the former needs a strict psych eval. Please consider why
To be clear clearance by a therapist is part of the former process it's part of why rates are incredibly low but so is the fact that it's a process. That process has a lot of hoops. Some unnecessary, some legally imposed, some helpful to a subset of people and some frustrating.
But to me it's very strange to look at this and to say that it's trans people who need a stricter process, not knee replacements.
It's an interesting one to think about it terms of giving people agency over their own medical choices whilst also trying to ensure people are given the whole picture and can be informed enough to make the choice that is best for them. To be clear I don't think the current hurdles involved in trans healthcare are fair particularly the rigidity with which you have to perform gender disphoria. But, should there be requirements about informing people more clearly the downsides of surgerys such as knee replacements? Or would it actually not change anything because a knee replacement seems like the sensible thing to do when walking hurts and you can no longer do the hobbies you had due to the issues with it?
I think there should be greater parity. I have seen allegations that knee replacement is pushed at higher rates because of increased compensation. But I have no sense for the accuracy of that.
There are even worse outcomes with surgery and regret and even with other life choices. There may be a baseline amount of regret with most things.
You can only control, and only somewhat, what doctors do though, and patients get information from tons of places online. I'd suspect most doctors do believe they're giving a good informed consent. All of which to say, I'm not a medical ethicist. So maybe. But I'll leave that to experts and people with a passion
What are you talking about? I didn't compare it to anything, and I said it seemed ok if there were strict psych evals... as in it seems ok because the regret level is low from said evals.
You really gotta stop attacking people because you think they're coming after you when they aren't. This isn't the first time I've seen you mis-interpret a comment and get offended at someone. It's starting to seem like it's on purpose.
If multiple people misunderstand your point does it make sense to call a response that starts "I'm going to point out..." And contains "it's strange to me" as an "attack"? Because I neither attacked you nor am offended by you. So I don't really know what you're talking about about. I disagreed with you and still do because your explanation doesn't address my response.
You said it seemed ok if ... Which implies your approval is contingent upon that if. You stated that "man, they (trans people) need to be really sure. Which, they are, but the strict psych evals are one of those extra hoops I was mentioning.
Once again I think it's an odd response to express approval contingent upon those psych evals, but look at the significantly higher regret rates of knee surgery with no comment.
Please feel free to elaborate on the "on purpose" part of your comment though. My posts are intentional, but again, I'm not attacking you, just disagreeing.
So basically every other surgery should have stricter psych evals? Because they all have higher rates of regret.
Yes sure. I don't really fucking care. I am amused at you and the other person taking my comment so far out of context.
It was a closer to a fucking compliment because I was surprised at how low the regret % was.
But please keep attacking me because you think I'm some kind of hater.
I'm not attacking you? I was asking a question. But it seems I struck a nerve, so have a nice day!
The trump order is stupid and unnecessary.
That said, I don’t know if we can equate and compare “dissatisfaction” with “regret”. I can, and have, been dissatisfied with the outcome of some choice without regretting them. Maybe it’s the best of all bad options, maybe it’s better but not up to expectations, etc.
Unfortunately researchers use the term dissatisfaction with most surgeries or other interventions. It's referred to as the regret rates however. We could ask why then interventions for trans folks get one term more than the other 🤔 but IMO the answer is obvious
Here's a review that directly compares regret across surgery types and other life decisions
A systematic review of patient regret after surgery- A common phenomenon in many specialties but rare within gender-affirmation surgery
Abstract
So if you don't like their methodology either, I mean, blame the people assuming trans people uniquely regret their care.
and also i wonder if they factor in dissatisfaction that trans people also very often (i believe that this will be way more than any official statistics show) have to seek and pay for for treatments and procedures outside the bounds of their host medical system. for example, purchase medications from abroad at great expense, that have been shown to contain high levels of contaminants including lead. and/or, seek surgeries from dodgy practitioners in dodgy markets at massive costs, who are not regulated, and for which there is no recourse if they screw up those complex procedures. this vs your knee replacement or w/e that would be covered by the nhs or your insurance, and the practitioner would be on the hook to correct problems and er, not put lead in stuff
I'm not sure how much the stats account for this, mostly due to them being tracked as part of studies so if people went abroad for surgery or were DIYing their HRT they probably wouldn't flag for the purposes of this study.
But it's worth digging into the (good) literature on it. Michael Hobbes is a journalist who has done a lot of debunking of Jesse Singal and the SEGM/Cass report/mumsnet data.
While there are Americans who DIY hormone therapy, I don't think it's actually as common as it is in the UK (and Europe more generally). Americans are unfortunately used to paying for their healthcare, even for things like knee surgery, as there are things like deductibles which mean you still need to pay quite a lot up front even with insurance. Moreover, it's much easier to get HRT prescribed by a doctor in the US (at least for now), as there are hundreds of informed consent clinics throughout the US that do not require therapy in advance, including in red states. This essentially makes cost the only hurdle, and for Americans it's unfortunately a hurdle they regularly encounter for all types of healthcare. The UK, by comparison, famously makes it extraordinarily difficult to get gender-affirming care through the NHS, and even those who pursue private healthcare typically need a diagnosis of gender dysphoria from a psychiatrist first. This makes the comparison between gender-affirming care and other healthcare much starker in the UK than in the US.
I also think you're overstating both the costs and risks of DIY HRT. I know that your point is that these risks may contribute to regret for some people, but I think it's still contributing to a harmfully exaggerated narrative when it comes to the pros and cons of DIY HRT. While it's certainly not risk-free, the risk is lower than you're making it out to be, especially if you're able to get regular blood tests to monitor things, as not keeping a close enough eye on your levels is actually the much bigger risk than contamination for most people. Yes, it would be preferable if no one had to DIY and had easy access to free HRT without gatekeeping instead. But overstating the harms of DIY HRT is something that's often done to dissuade people from transitioning, and especially in places that really suck when it comes to access to trans healthcare, like the UK and the Nordics, it's often by far the best option.
Also, as for surgeries, I think you're far overstating how often people get them from "dodgy practitioners" with no legal recourse. I've never encountered even a secondhand story of someone getting gender-affirming surgery from anything but a normal, licensed doctor at a hospital, and while I'm sure it does happen sometimes, it's certainly not all that common -- certainly orders of magnitude less common than DIY hormone therapy. The closest thing I've actually heard of people doing is trans women going to Thailand for bottom surgery, but calling Thailand a "dodgy market" in that respect would be extremely inaccurate. My understanding is that the people who travel there for gender-affirming surgery these days do so because their doctors and hospitals have pretty stellar reputations when it comes to the surgical results, as it's actually not much cheaper than in the US once the cost of traveling and staying there is included.
With regards to DIY hormones it's more common than you'd think, even more so than I thought. Caveat - I don't take HRT, this is not personal experience.
wiki
There's a long oral history of trans men and women swapping their hormones in the same way that gay and lesbian people would exist in lavender marriages. It works out for both parties and protects them from more harassment.
The low end was in Ontario and the highest numbers from Rio de Janeiro and San Francisco. To me that tracks. These numbers aren't solid. I found a number citing that by the time many British trans people made it to their first gender care appointment (with long waits) 17% we're on hormones. This article also points out the poverty many trans Americans live in. Plus gender affirming care is not always covered by Medicaid, depending on your state. And not all insurance plans make any drugs affordable.
Like I said these numbers are higher than I expected but it makes sense, especially in Trans POC communities where medical racism and transphobia impact them more.
I’ll have to defer on any US matters. I agree it’s way different, and that differential dissatisfaction from cost for gender transition sounds less likely there. I am definitely only speaking from my knowledge of the UK experience.
But DIY hrt is very expensive! I know because I have had to use it. It ran around 120 pounds per month privately (with other massive up front costs for diagnosis, maybe just under 500 if you use the cheapest but can be way more, and then ongoing costs for any monitoring and changes. Many of these are basically scams and will not properly monitor you cough gendergp cough, they are a tragedy waiting to happen - there ARE risks from these drugs if you are not managed properly, eg people die from hepatoxic response to bicalutamide), then about 150 per month via questionably legal routes (and that’s taking the rubbish blockers, gnrh blockers are hundreds a month alone). It is also way more if it were testosterone you were after (and more legal risk), and I know people who pay this and more per month. You will also have to pay for your own blood tests which at absolute minimum from randox or so will be 100ish for both hormone levels and liver/kidney etc every three months - you will have to figure out how to interpret these yourselves. hair removal will be thousands and many of the practitioners are scammy. Thousands for voice. Private surgeries tens of thousands. I’m sure there are other costs I’m forgetting. the meds themselves are getting cheaper on account of clandestine formulations though. You have to understand that there’s no other healthcare in the uk you have to seek this way and it’s both humiliating and makes a serious material difference. It’s not enough to not make you do it, as you say it’s the only option, and I’m clearly not trying to dissuade anyone. But again we reach the question of dissatisfaction vs regret.
The risks of medical tourism and buying drugs from online websites are well documented. These are openly discussed by resources that support trans people. I’m not sure how im contributing to a harmful narrative, I was mostly suggesting that there are many hidden features of trans healthcare and treatment that would likely not be accounted for in studies of dissatisfaction. I guess I gave the wrong impression
My ex-wife was briefly on DIY hormone therapy from GenderGP and was able to get bloodwork done at her normal GP here in Germany (though the GP urged her to find an endo). It was also much easier for her to get an appointment with an endocrinologist and switch to getting it prescribed legally and paid for by public health insurance, because she could say that she was already on HRT and just needed a new doctor to prescribe it.
I definitely agree that trans healthcare is too expensive and inaccessible, especially in the UK. But if studies on the regret rate include the US, it's unlikely that the cost is a major factor influencing it, because the costs are not significantly different than for other medical treatments of the same type. Trans healthcare is simply much easier to access in the US than in the UK at present, and in the US DIY is often done as the cheaper option compared to normal prescriptions. It's possible that there would be a lower regret rate in both countries if gender-affirming care were both free and available with informed consent, but I'm not really sure that's necessarily the case, and it's so low already that it's not really a major issue to consider when trying to improve access to gender-affirming care.
There are risks to going DIY, even without considering the expense. But over-exaggerating the risks is very common from people who want to stifle trans healthcare more generally, and it can discourage vulnerable trans people who have no better options. It's especially harmful to lump together risks like "you need to get bloodwork done bc otherwise you could miss dangerous levels," which is very much something someone DIY-ing should know, with "the HRT is contaminated with lead," which is technically possible but much rarer and not a risk for common methods of DIY-ing that get their HRT from the same pharmaceutical sources as people getting normal prescriptions. My ex-wife got the same stuff at the same local pharmacies when she DIY-ed as with a prescription from a local German doctor. Imo focusing on the risks and costs of medical tourism and DIY hormone therapy is simply focusing on the wrong thing when it comes to discussions of trans healthcare -- the barriers to care that lead trans people to pursue these things are the bigger impact on how it feels to navigate trans healthcare in a given place.
People should not over-play the risks. Conversely, down-playing or dismissing discussion of risks as dangerous is especially unhelpful exactly when there are many vulnerable people who have no other choice. It is possible to discuss for days about what is over or under exaggerating, but I reject the notion that I’m partaking in dangerous discourse by mentioning it. The reason concern trolling and the like is so successful is because there are grains of truth which, if mentioned even in the context of discussing research design by friendly parties (that is also to say, not a discussion concerning whether or not people should transition), one frequently finds their throat jumped into.
If I may don my “what aboutism” attire as well, back surgery ?.
I believe another recent article stated that you’re basically better off taking NSAIDs…
I believe the regret rates for spinal fusion is 10-15%
My partner has had 17 or 18 spine surgeries and has been diagnosed with FBSS
I know nothing on the topic, was the knee replacement statement just a joke, or does knee replacement surgery actually just suck?
It’s requires doing extremely painful physical therapy afterwards on a regular basis to get the tendons to adjust. So for the short term afterwards you’ll have more pain than before. And it isn’t a permanent solution for all patients.
Knee replacement surgery has 10% regret rates. I linked a study in a comment above
I had a gingival graft done in my mouth.
I have bone loss under my gums, which pulls them down. One area was particularly low, and it was exposing the root of one of my teeth. So, a periodontist literally sewed some pig tissue into my gums to graft it on there and cover it up.
Unfortunately, gum grafts fail sometimes. Success rates differ depending on who you consult for data and depending on the underlying condition that caused the need for a graft in the first place.
Mine looks like it might be failing.
Do I regret getting the surgery done?
Kind of.
It was painful, stressful, and expensive. The recovery was rough. I was on a liquid diet for days, and soft foods for weeks. For a while I never wanted to even look at a protein shake or mashed potatoes.
I had a legitimate psychological hurdle that I had to get over regarding the grafting of foreign tissue in my mouth. It looked gray and cadaverous initially. It was in my mouth. Imagine having something disgusting in your mouth that you can’t spit out. Imagine knowing that it’s living in there. Connected to you. Your blood is flowing through it.
I’m bothered that I went through all that just to end up in the same place that I started. I’m worried that I might need to have it done again. I’m worried that I might potentially have to have something even worse done to counteract my gum loss.
I bring this up because if someone were to say they were studying regrets related to gingival grafts, I would want to be a part of that study. I would have a lot to say.
I’d want to participate because if anyone heard that there was such a study happening, they would automatically assume it was happening as a way of improving the quality of gingival grafts or care for gum recession. If I had been better prepped about the psychological aspects going in, for example, I think I would have had an easier time. That kind of thing could lead to fewer regrets for others.
If such a study were happening, no one would assume that it was because they were wanting to prove that gum recession doesn’t exist. That the root of my tooth wasn’t actually exposed.
It’s obvious where I’m going with this analogy, but I want to point it out just to highlight what a distorted funhouse-mirror-reflection of science a study like the one proposed in the article is. They’re not wanting actual science: they’re wanting to give prejudice the authority and nominally neutral cover of a scientific backing.
Anyone would want a study done on regrets after medical procedures to help people. It’s basic human empathy.
If we lived in a world where trans identities weren’t weaponized, a study like that could be genuinely valuable. Research into regret after transition would be conducted as a way of improving outcomes for trans people. They get to voice their concerns and experiences, noting ways in which procedures could be improved to minimize social and psychological harms for them. Longitudinal studies would determine best practices; identify and alleviate pain points. “Regret” as a measure would be a driver of positive change aimed at ensuring that trans people get the best quality care they can get.
We, of course, know that these studies won’t do that.
They’ll instead be used for harm — to invalidate trans people wholesale.
“Scientific” support for cold, callous inhumanity.
Your post made me think of an old friend of mine. I met her pre-FtM surgery, got her groceries while she recovered from her surgeries, and had a lot of long, deep conversations about the nature of life during and after. We really clicked. I will always appreciate how she stood up for me (the sole cis/het man working at that coffee shop at the time) and told the bullies to go pound sand, despite the fact that she was half their size. She had a great sense of fair play.
She ultimately regretted getting some (not all) of her work done, and was in the process of figuring out what to do next when her mental health just couldn't bear the burden any longer. She is no longer with us.
It wasn't a case of 'trans regret'. It was a complex, thorny problem of self-acceptance, dealing with abusive parents, abusive partners, and, frankly, poor quality surgery from a doctor who probably should have had his license pulled. She would have had a lot to say to people conducting a real study of the type you describe. Which could have been used to help others that came after her. We all know whatever bullshit this study is going to be will only be used to harm. It makes me sick.
Just an FYI but your wording is confusing. If she was a trans woman, you don't need to incorrectly specify the surgery (frankly you shouldn't specify surgery at all, that's weird). If he was a trans man, you misgendered him throughout your post.
Respectfully, you did not know my friend. This was decades ago, she had different preferences than modern usages, and I did not make any mistakes in what I wrote.
Fair enough, I apologize for making an assumption
No worries, and I appreciate it.
Seems to me that if anything’s going to make trans people regret transitioning, it’s the right wing’s deliberate efforts to make the world more inhospitable to them. Basically, “if you transition, you’re going to regret it— precisely because we will do everything in our power to make your life miserable.” They frame this as a friendly warning, but it’s really a threat.
Fairly consistently that is (anecdotally) what most "detransitioned" people say. It's not that their understanding of their gender changed (though that can happen) it's that society treated them like shit.
This seems most logical and also if they have botched care, because we don’t fund or research patient based care for trans health, specifically.
No shit you’re gonna have regrets if you: get fired, lose your partner, get harassed in public, get harassed online, cannot ever find clothing or other normal affirming things that we all take for granted, can’t join a gym, can’t play sports, all that on top of being butchered or otherwise not taken care of by your doctor.
i'm sure this will be a fair study, they can take notes on how to run it from Cass, and the other various pocket academics they are now commissioning to run service reviews in the UK. my only post-transition regret is that i have to continue to live in the same world as these fuck-heads. i don't think i have anything more substantive to say, but needed to express myself.
ps: perhaps they will accidentally defund it because the title includes the word 'trans'?
Defunding it would be hilarious.
It does suck we have to live in a world with Cass, Trump and their ilk, but please, in case the inclination strikes you not to, remember it's worth continuing.
And just to say it out loud, this goes for you too: I've always considered you a positive contribution to Tildes at least, and I have no doubt that that extends to the real world as well. Please, keep being you. And thank you for all you do, especially given how difficult it must during these times.
Not going anywhere. Amidst all my stress that's not where my mind goes
I also have several lovely keychains that say "I will not beat _____ to the grave" for my students.
(Got Trump, Vance, Musk and JKR)
We've lost far too many queer elders before now. We'll make it.
i really appreciate the check-in. to be clear, i very much feel that my life is worth continuing. also, i have transition to thank for this (!!!)