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Gender-affirming surgeries linked to ‘significant reduction’ in odds of suicide risk, substance abuse: study

The New York Daily News - 4/28/2021

Gender-reaffirming surgeries are associated with improved mental health outcomes among transgender people, a new study has found.

The study, titled “Association Between Gender — Affirming Surgeries and Mental Health Outcomes,” was authored by a team of researchers at Harvard Medical School, Harvard T.H. Chan School of Public Health, The Fenway Institute at Fenway Health, and the Department of Psychiatry, Massachusetts General Hospital.

They sought out to demonstrate an association between gender-affirming surgery and improved mental health outcomes among transgender and gender diverse (TGD) people

“There is great demand among transgender and gender diverse people for gender-affirming surgery, and thanks to recommendations by professional associations and clinical support for gender-affirming surgical care, these treatments are much more common today than they were even just 10 years ago,” study lead author Anthony N. Almazan, a fourth-year medical student at Harvard Medical School, said in a statement.

“But until now there has been limited evidence that these surgeries result in better mental health outcomes,” he added.

The study, which was published Wednesday in JAMA Surgery, is the first large-scale study to demonstrate that gender-affirming surgery is associated with lower odds of suicidal ideation and psychological distress among TGD people.

Researchers compared the psychological distress, substance use, and suicide risk of 3,559 transgender people who’ve had at least one gender-affirming surgical procedure with those of 16,401 people who wanted to undergo surgery, but haven’t had any.

They found that those who received one or more gender-affirming surgical procedures had a 42% reduction in the odds of having experienced psychological distress in the previous month.

The study also showed a 44% reduction in the odds of suicidal ideation, as well as a 35% reduction in the odds of tobacco smoking, over the past year.

Study senior author Dr. Alex S. Keuroghlian welcomed the results as “incredibly important for the evolving field of transgender health care.”

Keuroghlian — the director of the National LGBTQIA+ Health Education Center at The Fenway Institute and the Massachusetts General Hospital Psychiatry Gender Identity Program — noted that even though health professionals have for long supported gender-affirming medical and surgical care, “the practice has been challenged by health insurers asking for more evidence showing its efficacy.”

“In light of this study’s results, gender-affirming surgeries should be made available for transgender and gender diverse people who seek them, and we should work to remove barriers to gender-affirming surgery such as insurance exclusions for such care,” he added.

For the study, researchers performed a secondary analysis of data from the 2015 U.S. Transgender Survey — the largest survey ever devoted to the lives and experiences of trans people in the country, which was conducted by the National Center for Transgender Equality.

More than 27,000 transgender adults living in all 50 U.S. states, the District of Columbia, U.S. territories, and U.S. military bases abroad took the 2015 survey. The secondary analysis took place between Nov. 1, 2020, and Jan. 3, 2021.

Adjustments were made for exposure to other types of gender-affirming care such as counseling, pubertal suppression, and hormone therapy, and also for sociodemographic factors including age, education level, employment status, household income, and race.

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