In the fall of 2019, the American Journal of Psychiatry published a paper with the laborious title, “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.”
In the press release issued at the time of publication by the American Psychiatric Association, the first sentence clarifies the main takeaway from the study: “For transgender individuals, gender-affirming surgery can lead to long-term mental health benefits.” In the executive summary by the study’s own authors, they explained the primary conclusion of the research in similar terms (while emphasizing also that this was the first study of its kind, a “total population study of transgender individuals”). The authors wrote, “the… association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them” [emphasis added].
In plain words, the authors claimed that “post-transition” individuals who’d had surgical interventions were less likely to seek mental health treatment for anxiety or mood disorders, and they used this “evidence” to promote the prescriptive norm that sex reassignment surgeries and other interventions should be more freely given to those who seek them.
The findings were widely promoted and celebrated by the media and special interest groups. But behind the scenes, the paper received a lot of criticism from other academics who wrote to the authors expressing their concerns. And it turns out the critics were right, because this past weekend the paper’s authors and the journal quietly issued a “correction” to the paper, the upshot of which is that the primary stated conclusion of the study was false.
The news of the reversal has been touted by Ryan Anderson of the Heritage Foundation and covered by CBN News; but unfortunately the rest of the media seems to have missed the memo: quite a contrast to the loud and wide proclamation of the original findings.
To be clear, it is no exaggeration to say that the “correction” is a complete reversal of the original paper as regards its stated findings and prescriptive conclusions. Here is the key part of the correction, in the paper authors’ own words [emphases added]: “Upon request, the authors reanalyzed the data to compare outcomes between [transgender] individuals… who had received gender-affirming surgical treatments and those… who had not. … [T]he results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison.”
Given the affirmative and assertive nature of the originally stated conclusion, though, it is simply a travesty that this reversal is not being given the attention it deserves. This is not some stolid academic question, a debate of ethereal qualities being waged in some foggy and remote ivory tower: this question has very practical and real impact on individuals’ lives and health outcomes. The paper was expressly directed toward healthcare practitioners, and was meant to amplify the recommendations already issued by groups like WPATH (World Professional Association for Transgender Health) that hormonal and surgical interventions should be provided to those seeking them as a means of “alleviat[ing] the stress of persistent discordance between experienced gender and assigned sex.” [Incidentally, as Anderson notes, “The original results already demonstrated no benefits to hormonal transition. That part didn’t need a correction.”] With this correction, clarifying that the mutilative and dangerous surgical interventions common in “transition” (mastectomies, hysterectomies and castrations being some of the main ones) have no clear mental health benefits, one wonders how many patients and their clinicians were influenced into taking life-altering actions on the basis of the original paper and its reception? We may never know; but any media who touted the original study’s publication should do the bare minimum in making amends by reporting its “correction” with equal emphasis and prominence. As to whether they will do that, though… well, let’s not hold our breath while waiting.