Recently, a group from the Gender Dysphoria Alliance (GDA) wrote an open letter to 29 major US medical institutions asking for a shift from theory-based care to evidence-based care for those who suffer from gender dysphoria. As the letter states, “When theory, rather than evidence, informs healthcare practices, safety is compromised.”
The healthcare institutions might do well to heed their call. For example, a recent study published in the journal Pediatrics showed that trans youth “had higher odds of all suicidality outcomes, and transgender males and transgender females had high risk for suicidal ideation and attempt.”
According to Paul McHugh, former psychiatrist-in-chief at Johns Hopkins Hospital and University and Distinguished Service Professor of Psychiatry at Johns Hopkins University, “ten to fifteen years after surgical reassignment, the suicide rate of those who had undergone sex-reassignment surgery rose to twenty times that of comparable peers.” McHugh based this statement on a follow-up study of people who received the surgery that extended over thirty years in Sweden, where the culture is very supportive of transgender people.
The Centers for Medicare and Medicaid Services acknowledged the results of the study in Sweden, which found high rates of suicide, along with other mental illnesses, among transgender people. Its memo states,
The study identified increased mortality and psychiatric hospitalization compared to the matched controls. The mortality was primarily due to completed suicides (19.1-fold greater than in control Swedes), but death due to neoplasm and cardiovascular disease was increased 2 to 2.5 times as well. We note, mortality from this patient population did not become apparent until after ten years. The risk for psychiatric hospitalization was 2.8 times greater than in controls even after adjustment for prior psychiatric disease (18 percent). The risk for attempted suicide was greater in male-to-female patients regardless of the gender of the control. Further, we cannot exclude therapeutic interventions as a cause of the observed excess morbidity and mortality. The study, however, was not constructed to assess the impact of gender reassignment surgery per se.
If ideology drives healthcare organizations to judge how they are to treat individuals struggling with gender dysphoria, then those individuals may be in for a world of hurt.