Gender-Affirming Surgery Johns Hopkins researchers recently conducted a study Published in JAMA Surgery on postoperative regret among transgender and gender-diverse individuals who underwent gender affirming surgery (GAS).

The study found that fewer than 1% of these individuals reported regret. This rate of regret is significantly lower than the rates of surgical regret among cisgender individuals. The researchers concluded that the low regret among transgender surgery recipients may be linked to the careful implementation of existing evidence-based, multidisciplinary guidelines and standards of care for these patients.

The study aligns with the medical establishment view of gender-affirming care, as supported by the American Academy of Pediatrics and other medical organizations. It challenges the notion that many trans and gender-diverse people experience regret after obtaining gender-affirming surgery, which is a common refrain among anti-transgender activists and politicians.

The findings from this study provide evidence that the regret rate among transgender and gender-diverse individuals who undergo GAS is much lower than previously thought, and that the surgery can have a positive impact on their well-being

 Key findings:

• Exceptionally low regret: Less than 1% of TGD individuals reported regret after GAS, significantly lower than surgical regret rates among cisgender people.
• Distinct motivations: Differences in regret may stem from the underlying reasons for surgery. TGD individuals typically seek GAS for gender alignment, while cisgender individuals often undergo surgery for medical reasons like cancer treatment.
• Standardized care matters: Careful implementation of established guidelines and standards of care, including thorough assessments of gender dysphoria, appears to contribute to lower regret rates.
• Accurate evaluation remains a challenge: Assessing post-surgical satisfaction and regret effectively requires specialized tools and methodologies.

To address these challenges, the researchers propose:

• Utilizing Gender-Q: This validated patient-reported outcome measure specifically assesses TGD experiences and holds promise for accurate regret assessment.
• **Delayed ** Evaluating regret at least one year after surgery allows for biases from the immediate post-operative period to fade.
• Holistic assessments: Considering factors like age, race, education, and quality of life before surgery can provide a more complete picture of potential regret risks.
• Nuanced research: Further research exploring diverse TGD experiences and contexts can inform improved public policy and ultimately enhance the long-term health and well-being of TGD individuals.

This research offers strong evidence against the unsubstantiated claims of widespread regret after GAS. By prioritizing careful patient assessment, evidence-based care, and accurate regret measurement, healthcare professionals can ensure positive outcomes for TGD individuals seeking gender-affirming surgery.

The researchers are:

• Harry Barbee, Ph.D., assistant professor and interdisciplinary social scientist at the Johns Hopkins Bloomberg School of Public Health
• Bashar Hassan, M.D., a postdoctoral research fellow in plastic and reconstructive surgery at the Johns Hopkins Center for Transgender and Gender Expansive Health (CTH) and the University of Maryland Medical Center’s R Adams Cowley Shock Trauma Center
• Fan Liang, M.D., medical director at the CTH and assistant professor of plastic and reconstructive surgery at the Johns Hopkins University School of Medicine

In their article, the three report findings from a retrospective look at the limited amount of evidence-based studies addressing post-GAS regret. They also describe how research, health care and public policy can be guided by using scientific data to properly define post-surgical regret -; currently believed to be very low -; to address health needs across diverse populations. [Study source]