New research from Harvard Medical School suggests that gender-affirming surgery for transgender people is linked with various mental health benefits.
The study analysed the results of the 2015 US Transgender Survey of almost 28,000 transgender or gender-diverse (TGD) people and found that those with a history of gender-affirming surgery showed far lower rates of mental health issues than those who had not received surgery.
Comparing participants who had received gender-affirming surgery at least two years prior to the study to those who had not received any surgery but wanted to, the team found that surgery recipients saw a 42% reduction in psychological distress, a 44% reduction in suicidal ideation, and a 35% reduction in tobacco smoking.
The results suggest that the surgery, which some US states are moving to ban or even criminalise for minors, can be a positive change for young people and benefit their quality of life.
"Going into this study, we certainly did believe that the gender-affirming surgeries would be protective against adverse mental health outcomes," says Anthony Almazan, lead study author.
"I think we were pleasantly surprised by the strength of the magnitudes of these associations, which really are very impressive and, in our opinion, speaks to the importance of gender-affirming surgery as medically necessary treatment for transgender and gender diverse people who are seeking out this kind of affirmation."
With these new findings to-hand, US policies surrounding gender-affirming surgery can be better informed, says Almazan, which could improve access for TGD people to undergo the surgery they want.
"We've seen, for example, that it's still quite common for health insurers to routinely deny coverage for certain types of gender-affirming surgery, and that's partly due to limited evidence for their health benefits," adds Almazan.
"We conducted this study to fill these really crucial evidence gaps in hopes that it will help us both improve clinical care and work toward policies that ensure more expansive, equitable and affirming care for transgender and gender diverse populations."
In the UK, research has shown that mental health issues are far more common among transgender people than the general population, with one study showing that 88% of TGD respondents had symptoms of depression and 75% of anxiety compared with 20% of non-TGD people.
The same dataset also showed that 66% of trans people had used mental health services – a much higher rate than the general population.
Treatment for TGD people with so-called 'gender dysphoria' can be accessed via the NHS, although the finality of the treatment given depends on the person's age.
Children and young people under the age of 18 are usually referred to the Gender Identity Development Service (GIDS) for assessment by various psychological therapists and a social worker.
Depending on the assessment findings, young people can be referred to several different types of psychotherapy service as well as to a hormone clinic for which they need to meet strict criteria.
Surgery tends to only be considered once a young person reaches 18 years of age.
Once a young person receives gender-affirming surgery, research shows improvements in confidence and relationships, says senior study author Alex Keuroghlian.
He states: "If we align people's bodies and gender expression with their gender identity, that is a way in which they can most authentically live their true lives and be their true selves, and also navigate society in a way where they are presenting as the gender they identify with. We think that that reduces distress significantly."
To read the full study from Harvard Medical School, click here.
Written by Alice Lynes
News reporter for Talking Mental Health
Twitter & Instagram: @alicelynes