Landmark Systematic Review Of Trans Surgery: Regret Rate "Remarkably Low"
A landmark systematic review has concluded that regret rate for transgender surgeries is "remarkably low," comparing it to many other surgeries and major life decisions.
In recent years, anti-transgender activists have used fear of "regret" as justification to ban gender-affirming care for transgender youth and restrict it for many adults. Now, a new systematic review published in The American Journal of Surgery has concluded that the rate of regret for transgender surgeries is "remarkably low." The review encompasses more than 55 individual studies on regret to support its conclusions and will likely be a powerful tool in challenging transgender bans in the coming weeks.
The study, conducted by experts from the University of Wisconsin School of Medicine and Public Health, examines reported regret rates for dozens of surgeries as well as major life decisions and compares them to the regret rates for transgender surgeries. It finds that "there is lower regret after [gender-affirming surgery], which is less than 1%, than after many other decisions, both surgical and otherwise." It notes that surgeries such as tubal sterilization, assisted prostatectomy, body contouring, facial rejuvenation, and more all have regret rates more than 10 times as high as gender-affirming surgery.
You can see regret rates for many of the surgeries they examined in the review here:
The review also finds that regret rates for gender-affirming surgeries are lower than those for many life decisions. For instance, the survey found that marriage has a regret rate of 31%, having children has a regret rate of 13%, and at least 72% of sexually active students report regret after engaging in sexual activity at least once. All of these are notably magnitudes higher than gender affirming surgery.
Regret is commonly weaponized against transgender care. The recently released Cass Review, currently being used in an attempt to ban transgender care in England, mentions "regret" 20 times in the document. Pamela Paul's story in The New York Times features stories of regret heavily and objects to reports of low regret rates. Legislators use the myth of high levels of regret to justify harsh crackdowns on transgender care.
Recently, though, anti-trans activists who have pushed the idea that regret may be high appear to be retreating from their claims. In the WPATH Files, a highly editorialized and error-filled document targeting the World Professional Association for Transgender Health, the authors state that the low levels of regret for transgender people obtaining surgery are actually cause for alarm, and that transgender people are "suspiciously" happy. The idea that transgender people cannot be trusted to report their own happiness and regret has also been echoed by anti-transgender activists and influencers like Matt Walsh and Jesse Singal.
The review has sharp critiques for those who use claims of “regret” to justify bans on gender affirming care: "Unfortunately, some people seek to limit access to gender-affirming services, most vehemently gender-affirming surgery, and use postoperative regret as reason that care should be denied to all patients. This over-reaching approach erases patient autonomy and does not honor the careful consideration and multidisciplinary approach that goes into making the decision to pursue gender-affirming surgery… [other] operations, while associated with higher rates of post-operative regret, are not as restricted and policed like gender-affirming surgery.”
The review is in line with recent data supporting very low regret rates for transgender people. The 2022 U.S. Transgender Survey, the world’s largest survey of transgender individuals, which surveyed over 90,000 transgender people, found that for those receiving hormone therapy, regret rates are incredibly low: less than 1% report being a little or a lot less satisfied after beginning hormone therapy.
You can view a chart from the 2022 US Transgender Survey showing low rates of regret for hormone therapy here:
There is no evidence that transgender people experience high rates of regret for any transgender care, including transgender surgery. On the contrary, gender-affirming care saves lives. A Cornell review of more than 51 studies found that gender-affirming care significantly improves the well-being of transgender individuals and also concluded that regret is rare. Low rates of regret for transgender people are not "suspicious." Rather, they are evidence that the care transgender people seek is important, carefully provided, and helps them live more fulfilled lives.
Correction: A previous version of the story hyperlinked to a 2021 review. The link has been corrected to point to the 2024 study.
Update: I incorrectly linked to a 2021 study instead of the 2024 review in an earlier version of this article. The new link is correct.
https://www.americanjournalofsurgery.com/article/S0002-9610(24)00238-1/abstract
"Trans people are too damn happy, it's suspicious!"... like really?
Sometimes I think people hate us because we figured out how to live our lives, honestly be ourselves, and still manage to be happy even when large pockets of society are against us.