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.
"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.
If I had listened to "society" I would've never transitioned. It was a huge concern of mine, and even though I didn't know what would happen, the benefits to my psyche far outweigh what anybody thinks. What a mistake to politicize who we are and make people scramble to prove something to the world. I couldn't give a shit and have nothing to prove to nobody.
Of course, this finding will not be surprising to anyone on this readership. GAC is evidence-based, and has the solid backing of major medical organizations. It’s also similar to many other life decisions in that people based their subsequent life paths on those decisions, and as such, aren’t inclined toward regret.
But that won’t stop the anti-trans zealots. No reasoning or medical evidence will. That’s because their motive isn’t to weigh the medical evidence, it’s to eliminate trans people from participating in society and living their lives humanely. In a way, I wish we could eliminate the term “transphobic” and replace it with “trans hatred”. The suffix “phobia” suggests fear, and there is no fear here really, just bigotry and hatred - a desire to demean and savage trans people in any way they can. It is remarkable and sickening how intensely politicized this has become.
Spot on Sandra. Evidence has become meaningless to huge numbers of haters (i.e. Politicians) As you say, it's not phobia... it's much worse. Let's stop using the word transpobia. Phobia has a way of softening the terrible situation that we experience.
"Rate of regret after GAS is approximately 1%. ...having children ... ha(s) a regret rate of 7%!!!!
And the people restricting affirming care for trans people are the same people banning abortions. Nothing like trying to make the rest of the country as miserable as yourself ("if I'm going to make myself miserable miming all of this pathetic christo-fascist BS, I'll be damned if I'm going to leave other people to simply enjoy their lives!")?
I really give a lot of effort to confronting misinformation. I see if I can get the contact information of the publications that printed it. It is especially nice when I read lies about regret, and there is an opportunity to give comments.
I'm glad this exists, and it's definitely going in my "well, 𝘢𝘤𝘵𝘶𝘢𝘭𝘭𝘺" arsenal; it's sure to be of help with people who actually want to understand and simply lack good information... but unfortunately there is no evidence, of any level of quality, no matter how reputable the source, that devout transphobes won't dismiss out of hand then turn right back around and try to legislate us out of existence anyway.
FYI - for those who care about this sort of thing, the American Journal of Surgery has a respectable impact factor of approx. 3.0. Not JAMA level but right along side most similar specialized journals.
What other surgeries involve the careful consideration and consultation with at least three doctors of different specialties. Why not give the cosmetic surgery industry as much scrutiny.
This review doesn't just provide evidence, it provides a narrative. It re-takes the term regret - humanizes it and places it in context as a normal element of life. Situating regret after trans-affirming surgery within this broad empirical frame is powerful and empowering. Narrative power coupled with evidence. Yes - this builds solidarity.
Empirically driven narrative power, ethically responsible solidarity power, these things together are critical ingredients to building responsible political power. This is a good morning, thank you, Erin.
Would it be considered 'regret' if I really wish that I'd had a full depth vaginoplasty for my bottom surgery instead of a (shallow depth) vulvoplasty?
No. That's between you and your surgeon and can be fixed. Painful as it is, I knew a t-woman who had it done after years of having a shallow one. She suffered for a while then was happy as a lark.
How come the beginning read like only trans women were considered? Never ceases to amaze me how people treat trans men like they're invisible. Because of that, I didn't read everything I could've. But, I did see in the references that somebody talked about us. Perhaps we were part of the study.
The abstract, and unless terminology changed, yet again, everything said in the following didn't pertain to trans men:
"A total of 55 articles examining regret after plastic surgery were included. The percentage of patients reporting regret ranged from 0-47.1% 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."
Bariatric surgery can apply to men, trans or not. But in any case these are the comparison surgeries, not the gender-affirming surgeries. It happens that most (not all) of the comparison surgeries are more commonly performed on women, because elective cosmetic surgery and surgery in response to breast cancer (among cis people) are more common in women. But the gender-affirming surgeries considered are for both trans men and trans women, as clearly shown on the graph. (It's unclear how/whether non-binary people were counted.)
In any case, nothing in what you quoted is gender-specific, strictly speaking. (Cis men can, rarely, have mastectomy in response to gynaecomastia or breast cancer. Prostatectomy is specific to people with a prostate. Body contouring isn't dependent on gender even though it's done more commonly for women.)
You're playing games with terminology and none of that is what we call our surgeries. We are more prone to breast cancer than trans women anyway, because we went through puberty #1 with those things on our chest. Between cis women & trans men, together we far outnumber you all.
Listen, it's no secret in our circles that everything going on is more about trans women than trans men. And since it is, it would be nice to get some representation from you all to set the record straight. It's like being Black and trying to get through to white people. Since you're out there in front, you have more of a chance at correcting those folks than we do.
Don't get me talking about how divisive the LGBQ+ is towards us. The same kind of divisiveness is going on in the trans community. Yup. Just makes me want to stop sticking up for you ladies. That's all. Stick up for us too!
To start with your last point, I do stand up for trans men. Always.
I know perfectly well that trans women get more attention and visibility (for better *and* worse), and that trans men often have difficulty getting issues that apply to them heard. I support you in that.
But this particular article and paper is objectively not an example of that problem. When you say "none of that is what we call our surgeries": of course not, because *these are the comparison surgeries, in cis people*. Not trans men, not trans women. Cis people. The breast augmentations they're referring to here are elective cosmetic surgery in cis women, not gender-affirming surgery for trans women. (Trans people can of course get some of these surgeries for reasons other than gender-affirming care, but they wouldn't be included in the comparison groups for surgeries that are also used for gender affirmation.)
Neither Erin's article, nor the abstract, nor the quoted graph, are specific about what gender-affirming surgeries they're referring to. The article and the abstract don't need to be. The graph probably should be, but that's just as much of a mistake for trans people of all genders; it is in no way specific to trans men that more than one kind of surgery is available and they could have different regret rates.
As an aside, you are incorrect about the relative incidence of breast cancer in trans men relative to trans women, at least when both are taking gender-affirming hormones at the age range when breast cancer is most likely to develop. That is because breast cancer is highly estrogen-sensitive, and trans women on GAH have higher estrogen levels than trans men on GAH. In https://www.bmj.com/content/365/bmj.l1652 the incidence was very roughly 50% higher in trans women (0.2-0.4 times the rate for cis women, average 0.3) than in trans men (0.2 times the rate for cis women). Note that although testosterone can aromatize to estradiol and there are some papers assuming that this will increase overall estradiol levels for trans men on testosterone therapy, https://pubmed.ncbi.nlm.nih.gov/29561193/ shows that this is incorrect. Testosterone therapy actually significantly reduces estradiol levels, which may explain the lower incidence of breast cancer. (There is also in-vitro evidence of potentially cancerous changes in breast tissue being reduced in hormonal environments that are typical for trans men on testosterone.)
While we are on this subject, it's important to point out that trans people, but especially trans men in the case of breast cancer, often encounter horrifically discriminatory treatment in cancer care. For instance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520739/ describes a particularly horrible case of a trans man with breast cancer being repeatedly misgendered. We should all want to improve cancer care and every other area of healthcare for trans people, not just gender-affirming care.
> Just makes me want to stop sticking up for you ladies.
Then, I don't understand the point of that article or our place in it. Has to have a connection, and if they're talking about cis people, where do we fit in? So many surgeries that can be done on human bodies. Why would we even mention these without mentioning the comparisons of ours to theirs? Of course we know some are happy with, or regret their cosmetic surgeries, but they're less medically necessary than ours. Could be argued about weight loss, but again, why compare apples to oranges?
So, I'm a bit confused. Forgive my not understanding the point of this. I'm 66 years old and didn't start my transition until 58. I had to fight against breast cancer & something awful that happened when menopause arrived. Don't believe what you're saying about the numbers of trans men & trans women with that unless you're assuming there's a lot of minors taking our hormones.
However many trans people there are in the U.S., you can virtually cut that in half for the # of women, and then cut it in half depending on the generation. God knows you ladies try to be right about your tone & efforts on our behalf, but you're not always right. I sensed a certain microaggression about what I said to begin with. Why would you jump out here when my original thoughts about what I read were just my thoughts about what I read (and experience). Not what you said. You're gas-lighting, hun. Hmmmmm...
Question. Is calling out racism being racist? If not, then calling out what I see & experience isn't any more divisive than the previous sentence. I said what I said. Later, later.
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.
If I had listened to "society" I would've never transitioned. It was a huge concern of mine, and even though I didn't know what would happen, the benefits to my psyche far outweigh what anybody thinks. What a mistake to politicize who we are and make people scramble to prove something to the world. I couldn't give a shit and have nothing to prove to nobody.
Of course, this finding will not be surprising to anyone on this readership. GAC is evidence-based, and has the solid backing of major medical organizations. It’s also similar to many other life decisions in that people based their subsequent life paths on those decisions, and as such, aren’t inclined toward regret.
But that won’t stop the anti-trans zealots. No reasoning or medical evidence will. That’s because their motive isn’t to weigh the medical evidence, it’s to eliminate trans people from participating in society and living their lives humanely. In a way, I wish we could eliminate the term “transphobic” and replace it with “trans hatred”. The suffix “phobia” suggests fear, and there is no fear here really, just bigotry and hatred - a desire to demean and savage trans people in any way they can. It is remarkable and sickening how intensely politicized this has become.
Spot on Sandra. Evidence has become meaningless to huge numbers of haters (i.e. Politicians) As you say, it's not phobia... it's much worse. Let's stop using the word transpobia. Phobia has a way of softening the terrible situation that we experience.
"Rate of regret after GAS is approximately 1%. ...having children ... ha(s) a regret rate of 7%!!!!
And the people restricting affirming care for trans people are the same people banning abortions. Nothing like trying to make the rest of the country as miserable as yourself ("if I'm going to make myself miserable miming all of this pathetic christo-fascist BS, I'll be damned if I'm going to leave other people to simply enjoy their lives!")?
This paper "GAC isn't wrong, it's literally the approach to everything else that's wrong."
Transphobes be like "no regret can't be that low, impossible, regret is so high for everything else and it's the only experience I've ever had"
Us "have you considered maybe this can be better for everyone?"
Them "No if it's not shit we need to ban it, you must suffer like us"
I really give a lot of effort to confronting misinformation. I see if I can get the contact information of the publications that printed it. It is especially nice when I read lies about regret, and there is an opportunity to give comments.
I did not mean to imply this was misinformation
I'm glad this exists, and it's definitely going in my "well, 𝘢𝘤𝘵𝘶𝘢𝘭𝘭𝘺" arsenal; it's sure to be of help with people who actually want to understand and simply lack good information... but unfortunately there is no evidence, of any level of quality, no matter how reputable the source, that devout transphobes won't dismiss out of hand then turn right back around and try to legislate us out of existence anyway.
FYI - for those who care about this sort of thing, the American Journal of Surgery has a respectable impact factor of approx. 3.0. Not JAMA level but right along side most similar specialized journals.
What other surgeries involve the careful consideration and consultation with at least three doctors of different specialties. Why not give the cosmetic surgery industry as much scrutiny.
This review doesn't just provide evidence, it provides a narrative. It re-takes the term regret - humanizes it and places it in context as a normal element of life. Situating regret after trans-affirming surgery within this broad empirical frame is powerful and empowering. Narrative power coupled with evidence. Yes - this builds solidarity.
Empirically driven narrative power, ethically responsible solidarity power, these things together are critical ingredients to building responsible political power. This is a good morning, thank you, Erin.
Would it be considered 'regret' if I really wish that I'd had a full depth vaginoplasty for my bottom surgery instead of a (shallow depth) vulvoplasty?
No. That's between you and your surgeon and can be fixed. Painful as it is, I knew a t-woman who had it done after years of having a shallow one. She suffered for a while then was happy as a lark.
My biggest regret is that I didn't transition as a teen.
I hear ya, girl. I wish we'd had the language so that I could have figured myself out in the 90s, when I was in my 20s....
How come the beginning read like only trans women were considered? Never ceases to amaze me how people treat trans men like they're invisible. Because of that, I didn't read everything I could've. But, I did see in the references that somebody talked about us. Perhaps we were part of the study.
I don't see anything gender-specific in either Erin's article or the abstract of the paper. Did I miss something?
The abstract, and unless terminology changed, yet again, everything said in the following didn't pertain to trans men:
"A total of 55 articles examining regret after plastic surgery were included. The percentage of patients reporting regret ranged from 0-47.1% 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."
Bariatric surgery can apply to men, trans or not. But in any case these are the comparison surgeries, not the gender-affirming surgeries. It happens that most (not all) of the comparison surgeries are more commonly performed on women, because elective cosmetic surgery and surgery in response to breast cancer (among cis people) are more common in women. But the gender-affirming surgeries considered are for both trans men and trans women, as clearly shown on the graph. (It's unclear how/whether non-binary people were counted.)
In any case, nothing in what you quoted is gender-specific, strictly speaking. (Cis men can, rarely, have mastectomy in response to gynaecomastia or breast cancer. Prostatectomy is specific to people with a prostate. Body contouring isn't dependent on gender even though it's done more commonly for women.)
You're playing games with terminology and none of that is what we call our surgeries. We are more prone to breast cancer than trans women anyway, because we went through puberty #1 with those things on our chest. Between cis women & trans men, together we far outnumber you all.
Listen, it's no secret in our circles that everything going on is more about trans women than trans men. And since it is, it would be nice to get some representation from you all to set the record straight. It's like being Black and trying to get through to white people. Since you're out there in front, you have more of a chance at correcting those folks than we do.
Don't get me talking about how divisive the LGBQ+ is towards us. The same kind of divisiveness is going on in the trans community. Yup. Just makes me want to stop sticking up for you ladies. That's all. Stick up for us too!
To start with your last point, I do stand up for trans men. Always.
I know perfectly well that trans women get more attention and visibility (for better *and* worse), and that trans men often have difficulty getting issues that apply to them heard. I support you in that.
But this particular article and paper is objectively not an example of that problem. When you say "none of that is what we call our surgeries": of course not, because *these are the comparison surgeries, in cis people*. Not trans men, not trans women. Cis people. The breast augmentations they're referring to here are elective cosmetic surgery in cis women, not gender-affirming surgery for trans women. (Trans people can of course get some of these surgeries for reasons other than gender-affirming care, but they wouldn't be included in the comparison groups for surgeries that are also used for gender affirmation.)
Neither Erin's article, nor the abstract, nor the quoted graph, are specific about what gender-affirming surgeries they're referring to. The article and the abstract don't need to be. The graph probably should be, but that's just as much of a mistake for trans people of all genders; it is in no way specific to trans men that more than one kind of surgery is available and they could have different regret rates.
As an aside, you are incorrect about the relative incidence of breast cancer in trans men relative to trans women, at least when both are taking gender-affirming hormones at the age range when breast cancer is most likely to develop. That is because breast cancer is highly estrogen-sensitive, and trans women on GAH have higher estrogen levels than trans men on GAH. In https://www.bmj.com/content/365/bmj.l1652 the incidence was very roughly 50% higher in trans women (0.2-0.4 times the rate for cis women, average 0.3) than in trans men (0.2 times the rate for cis women). Note that although testosterone can aromatize to estradiol and there are some papers assuming that this will increase overall estradiol levels for trans men on testosterone therapy, https://pubmed.ncbi.nlm.nih.gov/29561193/ shows that this is incorrect. Testosterone therapy actually significantly reduces estradiol levels, which may explain the lower incidence of breast cancer. (There is also in-vitro evidence of potentially cancerous changes in breast tissue being reduced in hormonal environments that are typical for trans men on testosterone.)
While we are on this subject, it's important to point out that trans people, but especially trans men in the case of breast cancer, often encounter horrifically discriminatory treatment in cancer care. For instance, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520739/ describes a particularly horrible case of a trans man with breast cancer being repeatedly misgendered. We should all want to improve cancer care and every other area of healthcare for trans people, not just gender-affirming care.
> Just makes me want to stop sticking up for you ladies.
Eyeroll. Who's being "divisive" here?
Does this sound divisive to you? BIGGER EYE ROLL! SMFH
https://youtu.be/yLgadKi61OY?feature=shared
Yes, that is me and you're out-of-line. Where's your evidence, ma'am?
Then, I don't understand the point of that article or our place in it. Has to have a connection, and if they're talking about cis people, where do we fit in? So many surgeries that can be done on human bodies. Why would we even mention these without mentioning the comparisons of ours to theirs? Of course we know some are happy with, or regret their cosmetic surgeries, but they're less medically necessary than ours. Could be argued about weight loss, but again, why compare apples to oranges?
So, I'm a bit confused. Forgive my not understanding the point of this. I'm 66 years old and didn't start my transition until 58. I had to fight against breast cancer & something awful that happened when menopause arrived. Don't believe what you're saying about the numbers of trans men & trans women with that unless you're assuming there's a lot of minors taking our hormones.
However many trans people there are in the U.S., you can virtually cut that in half for the # of women, and then cut it in half depending on the generation. God knows you ladies try to be right about your tone & efforts on our behalf, but you're not always right. I sensed a certain microaggression about what I said to begin with. Why would you jump out here when my original thoughts about what I read were just my thoughts about what I read (and experience). Not what you said. You're gas-lighting, hun. Hmmmmm...
Question. Is calling out racism being racist? If not, then calling out what I see & experience isn't any more divisive than the previous sentence. I said what I said. Later, later.