New Study Once Again Finds That Transsexuals Are Far More Likely to Attempt Suicide After Getting "Gender-Affirmation Surgery" Than Before

The study looked at American hospital ER visits over a 20-year period (2003-2023) and compared the rates of suicide, suicide attempts, self-harm, and PTSD of ER patients aged 18-60 who'd had "s*x reassignment surgery" in the past five years to three other groups of ER patients seen in the same time period: female ER patients aged 18-60 who'd previously had a tubal ligation; male ER patients aged 18-60 who'd previously had vasectomy; and all adult patients aged 18-60 presenting with acute pharyngitis.

The paper never aimed to investigate the relationship between having, or claiming to have, a transgender identity and suicide and self-harm rates. It was solely interested in looking at people who'd undergone so-called "s*x reassignment surgery" to find out if there was a connection between having had this kind of surgery and the likelihood of showing up in a hospital ER due to suicide attempts, death, suicide/self-harm, and PTSD in the five years following the "s*x reassignment surgery."

None of the people in the study appear to have been categorized as "trans" on the basis of how they claimed to "identify" or how others assumed they "identified" at the time they showed up in ERs. All that seems to have mattered was if they had undergone "s*x reassignment surgery" in the previous five years.

This study utilized TriNetX to identify patients who had a “personal history of s*x reassignment” and evaluate their relative risk for suicide attempt, death, suicide/self-harm, and PTSD. The term “s*x reassignment” was based on the International Classification of Diseases, 10th Revision (ICD-10) code in the database but will be referred to as the current term “gender-affirmation surgery” for the remaining article. All outcomes were evaluated during the five years after gender-affirmation surgery.

Data from February 4, 2003, to February 4, 2023, were analyzed to examine suicide attempts, death, self-harm, and post-traumatic stress disorder (PTSD) within five years of the index event.

The study involved four cohorts:

cohort A, adults aged 18-60 who had gender-affirming surgery and an emergency visit (N = 1,501);

cohort B, control group of adults with emergency visits but no gender-affirming surgery (N = 15,608,363);

cohort C, control group of adults with emergency visits, tubal ligation or vasectomy, but no gender-affirming surgery (N = 142,093).

A secondary sub-group analysis, cohort D, was performed utilizing acute pharyngitis (ICD10CM:J02) as a control group for patients aged 18-60 that was run on June 2, 2023. This was performed to ensure that the vasectomy or bilateral tubal ligation (BTL) group acted as an appropriate control [for cohort A].

Cohort A was used again and compared with cohort D, which included patients presenting to the emergency room after diagnosis of acute pharyngitis.

Chances are, some of the people who had undergone this surgery no longer "identified as" trans when they had reason to go to ERs. Then again, maybe not. It's hard to tell because of clear-as-mud statements like this:

Patients who have undergone gender-affirmation surgery are identified by their affirmed gender.

The hypothesis the researchers set out to test and their findings:

At the start of this study, the hypothesis that was proposed predicted individuals who had undergone gender-affirmation surgery would have a greater risk of suicide, death, and self-harm compared to the two controls. This was confirmed by comparing the two control groups.

In the second analysis, it was determined that patients who had undergone gender affirmation had a statistically significant increase in suicide attempts, death, self-harm, and PTSD after completion of gender affirmation in comparison with those who had undergone BTL [bilateral tubal ligation] or vasectomy and had not undergone gender-affirmation before propensity matching.

After propensity matching our cohorts for age at index, race, and ethnicity, we also found a statistically significant increased risk of suicide attempts, death, self-harm/suicide, and PTSD [in the group who had undergone "s*x reassignment surgery" in the previous five years]. These outcomes confirmed the hypothesis. The secondary sub-group analysis utilizing pharyngitis as a control showed results that were comparable to the BTL/vasectomy control group, validating cohort C as an appropriate control group for propensity matching.

The results of this study show that gender-affirmation surgery is associated with a significantly higher risk of suicide, death, suicide/self-harm, and PTSD compared to control groups in this real-world database.

One of the most significant aspects of this study, in my view, is that it compared adults who became permanently and irreversibly sterile due to "s*x reassignment surgery" to adults who'd undergone other medical procedures that are usually done for the express purpose of making it nearly impossible for them to have children. Apparently, this was to try to get a sense of the extent to which the rates of suicide attempts, suicides, self-harm, and PTSD amongst the groups compared might be - or might not be - tied to their loss of fertility. Though obviously, to figure that out, the researchers would need to have looked at the reproductive histories of the patients compared.