Debunked: No, New Study Does Not Show Transgender Surgeries Double Depression

The study, which has been paraded around right-wing media sources, does not evaluate the impact of surgery on transgender depression rates.

Ted Eytan via Flickr - Creative Commons

Over the weekend, several far-right accounts falsely claimed that a new study showed gender reassignment surgery significantly increases depression, anxiety, and suicidality among transgender people. The study in question, conducted by researchers at Texas A&M University, does not support these claims in any way. Instead, it examines differences between transgender people who desire and obtain surgery versus those who do not obtain surgery, regardless of if they desire it. Crucially, the study does not measure the impact of surgery on an individual's mental health—there is no pre- and post-surgery comparison. Any assertion that the study links surgery to worsened mental health contradicts both its actual methods and the broader body of research demonstrating the positive effects of gender-affirming surgery for those who need it.

The study went viral after the far-right Twitter account AFPost (America First Post) falsely claimed, "A recent study published in Oxford’s Journal of Sexual Medicine sampling 107,583 patients found that sex-change surgery doubles depression rates among gender dysphoric individuals rather than reducing them." While the study does show that transgender people who have undergone surgery report higher rates of depression than those who have not, AFPost and its followers misrepresent its findings. The study itself explicitly states that it does not compare transgender people who desire but cannot access surgery to those who have received it. Instead, it examines two groups with vastly different characteristics—a fundamental flaw known as selection bias.

It is possible—and likely—that transgender people who desire surgery experience higher levels of gender dysphoria to begin with, which itself is strongly linked to depression and anxiety. It is also possible—and likely, given other studies— that surgery alleviates depression for those who need it, yet the study’s findings would remain the same. Crucially, the study does not analyze causation; it does not measure the impact of surgery on an individual’s mental health over time. In contrast, studies that do evaluate this impact consistently show that gender-affirming surgery improves mental health outcomes for those who seek it.

Think of two groups of students preparing for a major math exam. One group obtains tutoring sessions, while the other does not. The students who choose tutoring are often those who already feel behind or find certain topics more challenging. By test day, these “tutored” students might still score lower on average—just because they started at a greater disadvantage. This doesn’t mean the tutoring caused them to do worse; rather, it’s a classic example of selection bias: the group that seeks out additional help is already different from the group that doesn’t need it.

The study itself acknowledges another significant selection bias in its data: transgender people who seek surgery are far more likely to have extensive exposure to medical and mental healthcare systems. The financial and logistical hurdles of obtaining surgery, along with the mandatory mental health evaluations, mean that these individuals are much more likely to receive a formal diagnosis both before and after surgery. If this is the case, the difference in reported rates of depression and anxiety may reflect increased access to medical care rather than an actual disparity in mental health outcomes.

Extensive research has examined the impact of gender-affirming care on transgender people’s mental health, consistently showing that it leads to improvement, as expected. One study of 3,134 patients found that SSRI and SNRI use declined after surgery, alongside reductions in depression, anxiety, and suicidal ideation. Another study comparing transgender people who obtained surgery to those who desired it but were unable to access it found that those who underwent surgery experienced lower psychological distress, reduced smoking rates, and decreased suicidal ideation. Studies that focus specifically on the mental health outcomes of transgender people who seek surgery—rather than lumping together all transgender individuals, many of whom do not want surgery—consistently show significant improvements in mental health.

Despite the glaring issue of selection bias, right-wing figures are already weaponizing this study to justify attacks on transgender people. Within days of its publication, it was cited in the Montana House Judiciary Committee to promote anti-trans legislation. Those pushing this narrative consistently ignore the overwhelming body of research demonstrating the benefits of gender-affirming care and gender-affirming surgery on those who desire it. They do not engage with science in good faith—instead, they cherry-pick and distort data to fit their ideological agenda, using the very research they otherwise dismiss to manufacture justifications for further discrimination.