November 4, 2015

Nope, transitioning does not actually lead to suicide

This is story about "The Science Proves What I Believe Complex", and how a Swedish study of post-op trans people  is misrepresented in order to "prove" that gender reassignment surgery is harmful.

I have now been blogging on trans and crossdreamer issues for seven years, and there is one game that never cease to amaze me. I call it the "Science Proves What I believe" complex. And it does not matter what people believe; they always seem to find a report or a paper somewhere that seem to support their position.
Anti-trans activists often lie about research to
"prove" that transitioning is harmful.
Photo by SIphotography.
If they cannot find such a paper, they often start misrepresenting reports, probably hoping that no one will bother to check.

The Internet is vast, though, and with a lot of clever people. There are always some people out there who take the time to check and double-check dubious statements. Cristan Williams over at Transadvocate is one of them.

Like me, she will go directly to the researcher and ask, if needed.

"The Swedish Study"

Recently we have seen a lot of anti-transgender activity where people are trying to prove that trans people who undergo gender reassignment surgery are not helped by such therapy.

Indeed, the argument now is that transitioning in this way is harmful for the ones involved, and that the alleged failure of the treatment  proves that they were delusional in the first place.

People fighting against transgender rights (TERFs, Fox News and religious fundamentalists included) make a lot out of a Swedish study on transgender people, claiming that it proves that gender reassignment leads to suicide.

Dr. Paul R. McHugh, the former psychiatrist-in-chief who closed down the gender reassignment surgery programme over at Johns Hopkins Hospital, has repeatedly said that transitioning is “biologically impossible,” and that people who promote gender reassignment surgery are collaborating with and promoting a mental disorder. He is using the Swedish study to "prove" this.
Suicide among those undergoing gender reassignment surgery

This is what the study actually says about suicide among post-op transsexual people:
“The overall mortality for sex-reassigned persons was higher during follow-up  than for controls of the same birth sex, particularly death from suicide.”
The sentence is not saying that transgender people who has had gender reassignment are more likely to commit suicide than  transgender people who have not done so. The researchers are, for instance, comparing post-op transgender women with non-op non-transgender men. What the paper says is that those who have had such surgery are more likely to commit suicide that non-transgender people assigned the same sex as them at birth.

The researchers behind the study explicitly say that research suggests that gender reassignment of transsexual persons improves their quality of life and reduces their gender dysphoria. Given the social harassment and ostracism experienced by trans people,  a higher suicide rate among them is to be expected.

Cristan asked the main researcher behind the study, Cecilia Dehjne, about this. She puts it this way:
“Medical transition alone won’t resolve the effects of crushing social oppression: social anxiety, depression and posttraumatic stress.”
"Male patterns of criminality"

As for a claim made by transphobic "radical feminists" -- that the study shows that trans women show “male patterns of criminality” -- Dehjne points out that this only applies to the older data. For the period between 1989 to 2003, you will find no such pattern.

Dehjne explains:
“What the data tells us is that things are getting measurably better and the issues we found affecting the 1973 to 1988 cohort group likely reflects a time when trans health and psychological care was less effective and social stigma was far worse.”
Science tells a different story

I know that a lot of crossdreamers struggle with gender dysphoria. Many of these also have to fight both internal and external demons when it comes to deciding whether they should transition or not, and whether they should undergo "bottom surgery".

There isn't always a simple to solution to these dilemmas, given the complexity of life and the diversity of  life journeys. Those who have followed this blog for a while, know that I am one of those who -- for various reasons -- have decided not to go down that road.

At the same time we also see an increasing acceptance of the idea that you might transition socially without undergoing genital reconstruction.  But that does not change the fact that many need and are helped by such surgery.

I know that the general consensus among researchers in this field is such surgery most often does help, and that the regret rates are very low indeed (from one to four present). This tells me that the current  attempts to rewrite research in order to prove the opposite, very often are based on a desire to push trans people back into the closet.

If you, whether you are trans or a trans ally, come across people who misrepresent the Swedish study in any way, refer them to this post and/or the following:
This is an extended version of a blog post originally published over at tumblr.


  1. Ah, good ol' Confirmation Bias. It's all too rampant and a sign of non-critical thinking skills. Or sheer laziness of thought.

    Ever read the book Wizard's First Rule? Said rule also applies: (People) believe things mainly because they either want them to be true or fear them to be true.

  2. Very useful info. Of course, it doesn't address the issue of transitioning crossdreamers...

  3. of course you can spin facts the way you want to and in this field many do. Complete gender role reassignment does help some people and this is a fact, conversely not everyone who is dysphoric needs to go to such lengths. I think we have improved the conversation from when the myth was that if you were a true transsexual it was either transition or die. We now understand the dysphoria is graded and that our response to it should vary depending on the individual.

    But it is clear that some people must transition and lead normal and productive lives afterwards and this should not be dismissed as folly.

    The people working hard to dismiss the "transgender agenda" are now trying to paint the statistics in their favour so they can discredit this movement as a bunch of mental defectives trying to destroy their normal societies.

  4. Something I found about transitionning crossdreamers: "One thing is for sure in that some autogynephilic transsexuals do very well after transition and others do not. We do not know why. Anne Lawrence (Blanchard’s main disciple) is an example of an autogynephilic who has gone on to successfully transition without reservation or regret."


  5. @Forestier,

    We have no exact numbers for this, because no researcher has ever asked the right question. Still, my guess is that a majority of trans women have been crossdreamers, in the sense of getting aroused by the idea of having sex as their target sex. It is very hard to imagine them not having fantasies of this kind unless they have no sexual drive at all. I mean, we can hardly expect them to fantasize about having sex as their assigned gender now, can we?

    I accept that some transgender women, and especially those that are androphilic, do not think of this as crossdreaming and do not report it as such, but I think there are many good reasons for this being so, the most important being that they think of it as normal, given their gender identity. Terms like "transvestic fetishism" and "autogynephilia" are extremely stigmatizing, and given that their crossdreaming is just one of many ways their transgender identity expresses itself, it makes absolutely no sense of them to identify with such terms.

    This implies, as Joanna points out, that as being transsexual goes, the crossdreaming part is not really a very important factor to take into consideration. What drives most trans people into transitioning is not the crossdreaming per se, but the gender dysphoria. The gender dysphoria can express itself through obsessive crossdreamer fantasies, but is normally something much more.

    I get a lot of feedback from transgender women who have previously have read and discussed crossdreamer issues. They seem to do all right, most of them, and crossdreaming is no longer the dominating issue in their lives. Being a woman is, with all that entails. (And yes, I think of them as better examples of successful transitioning than Anne Lawrence, who still thinks of herself as a sexually perverted man. To me she is internalized transphobia personified.)

    I know of two or three crossdreamers who have regretted transitioning, and who have transitioned back. They seem to have been so caught up in the sexual part of transgender, that they have found it hard to adapt to the full life of a woman. They are the outliers in this community. They deserve our attention, but do not in any way change the overall conclusion: The great majority of trans people who feel themselves compelled to transition and who do so, are better off.

  6. Question: How common is it for a FTM or MTF to regret transitioning?

    I am find a lot of personal experiences on the net
    that have commentators saying stuff like there is a trans cult and transition is bad etc.

    Did these transition regreters read this:
    "There are a number of hypothetical examples that demonstrate individuals for whom transition would be the wrong treatment to take:
    A woman who had been sexually abused, and viewed transition as the only way to regain control over her sexuality.
    Crossdressers may originally approach a therapist seeking sex reassignment surgery, but such a surgery would actually cause negative psychological impact.
    Crossdressers may also become complacent with their erotic fantasies, and begin to suspect that this means they should transition, even though this surgery would still cause negative psychological impact.
    Felons fleeing from justice, and view transition as a way to evade prosecution."
    - Rationalwiki (pro-LBGT wiki site)

    Trans cult? HA HA HA HA HA.
    As if transgender people force people to transition.

  7. "According to the World Professional Association for Transgender Health's Standards of Care, a psychiatrist must diagnose a patient with gender dysphoria and provide a letter approving HRT in order for therapy to commence. However, as this process can take quite a while, and some psychiatrists may have unreasonable expectations, many self-medicate as HRT medications are not controlled substances in most countries." - Rationalwiki


  8. On the other hand, I heard on that link in the comments section some cis gay people transition to be "straight".

    Um, oh my goodness...
    Non-trans people transitioning???

    Um, didn't it obvious why they regret it?
    Nothing to do with a trans cult.

    So, Jack can you do a post about people online who post experience about regreting transitioning?

  9. I have already made a quick post about people regretting transitioning over at tumblr. That one was just a reference to Brynn Tannehill's write-up on trans regret myths over at Huff Post. You can read Brynn's post here.

    The fact that some people find it hard to adapt to a new role does not come as a surprise to me, given the complexity of this issue and the way society treat trans people. The regret rate is extremely low, however, between 1 and 4 percent according to the research I have seen, so this is clearly not a big problem.

    I fear that transphobes are using the few stories there are to undermine the support for transgender health care and invalidate the identities of those who thrive in their new life as a woman or a man, as might be. I also see that these stories may stop transgender people who might have benefited from transitioning from doing so.

    Fortunately new ideas about transitioning is taking hold, policies that do not require that you undergo "bottom surgery" to e accepted as trans, socially or legally. This should give people who are still struggling with doubt more time to reflect on their identity and their lives before doing anything completely irreversible. This new way of thinking also opens up for gender roles and gender expressions that let trans people find ways outside the binary.

  10. I read something an homophobic article by a right-winger on transitioning. It made me sick.

    Can, you reblog that Huff Post article or put it in resources?

  11. //I read something an homophobic article by a right-winger on transitioning. It made me sick.//

    Yes, homophobia goes hand in hand with transphobia in such circles.

    I have added the HuffPost article to the resource page, here

    Here is a link to the article itself:

  12. They tried to cite the high suicide rates of transsexuals to say that those who committed suicide did so because of transitioning and so therefore the low rates of transition regret doesn't count because most who did regret it committed suicide before they could answer the study thing.

    No evidence, just speculation in that disgusting article written by an ex-trans person and right-winger nutjob.

    Ex-trans? Oh, some trans people figured out they weren't trans all along? And somehow that's
    "proof" that all trans people are really delusion and need therapy?

  13. They are actually causing the suicides they use as an argument for invalidating trans people.

  14. Another very interesting thread. I also enjoy Brynn's writing (and speaking) very much. She's remarkable.

    About transitioning regret: I have wondered about this too, and chalked it up to people learning that sometimes our hearts are influenced by too many things to keep track of, and so, we learn through doing and experiment what is really true for ourselves. And I trust that this is what the professionals try to help with, through their checklists, interviews, RLE requirements, and so forth. In the end, it's the individual's decision and belief. As we discussed on another thread there is no absolute difference that can be diagnosed so that decision must be made on instinct, self-awareness, and experience... I believe.

    For me, I thought long and hard about it. I'm afraid that I'm stuck in the middle, wishing I'd been born female, envy females, but aware that for me, changing my physical sex would not change the fact that I wasn't born female. I've also wondered if I might answer this differently had I been born more recently, when society does seem more accepting. Perhaps, even, if I'd had the rectitude to make my wishes known as a child, perhaps then, I'd catch my development early enough that I'd avoid the more obvious masculinization that happens in puberty. Ah well, we will never know that, now will we?

    Take care,



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