Transgender People Who Have Gender-Affirming Surgery Less Likely to Need Mental Health Treatment

Transgender people who have gender-affirming surgery are less likely to need mental health treatment, according to scientists who say such interventions must be as easy as possible to access.

Gender-affirming treatments can help a person align their body with their gender identity. An individual might choose to take masculinizing or feminizing hormones, for instance, or have operations which surgically change their face, voice, or body.

For their study published in the American Journal of Psychiatry, researchers looked at data collected between 2005 and 2015 from a Swedish population register linked to a national healthcare database, and assessed the available information on the 2,679 individuals diagnosed with gender incongruence.

The health condition is characterized by feelings of distress because the gender a person was assigned at birth according to their sex does not match their internal feelings—for example, a person with a penis being described as a man despite identifying as a woman. Transgender people may experience gender incongruence, although not every trans person feels this way.

The research team recorded whether the individuals they assessed had gender-affirming hormone or surgical procedures, and whether they received mental health treatment. This included visiting the doctor for a mood or anxiety disorder, being prescribed antidepressants or anti-anxiety drugs, and/or being hospitalized following a suicide attempt.

Of the individuals with diagnosed gender incongruence, 70 percent took hormones. Some 48 percent had gender-affirming surgery, with 97 percent also having hormone treatment. Just under a third had neither treatment.

On average, when compared with individuals who don't have gender incongruence, those who did were six times more likely to be hospitalized after trying to end their life, and six times more likely to visit the doctor because of a mood or anxiety disorder. They were also three times more likely to be prescribed antidepressants and anxiolytics.

But the researchers found the longer the period of time since a patient person had gender-affirming surgery, the less likely they were to need mental health treatment. The likelihood dropped by 8 percent every year in the 10 years following 2005. However, hormone therapy wasn't found to have the same effect in this study.

Study co-author Richard Bränström, associate professor in the department of Clinical Neuroscience at Karolinska Institutet, Sweden, told Newsweek the study gives "strong support for providing gender-affirming care to transgender individuals who seek them."

In the U.S., the authors pointed out, some states deny the use of public funds for gender-affirming treatments, while the Veterans Health Administration prohibits the surgery at Veterans Affairs facilities and won't use its funds for such interventions.

Poor access to such treatments can push transgender people to seek hormones and surgery without medical supervision, which can be dangerous, they said.

Addressing the findings, Bränström said he was "somewhat surprised by the fact that even among transgender individuals treated 10 years ago, the risk of mental health problems were still somewhat elevated" when compared with the rest of the population.

"This calls for improvements in the mental health support provided to this group," he argued.

Acknowledging a limitation of the study, Bränström said: "This study was based on registry data only and we don't know any details about the living conditions and needs of each individual. Future studies should explore more in-depth individual factors and their influence on the mental health of this increasingly visible population."

Bränström said: "This study was done in Sweden, a country with universal health care and relatively strong social welfare system. It is important to understand the situation of transgender individuals in other countries in the world and other regional settings."

Last month, a separate study found that transgender people who undergo the widely discredited practice of gender conversion therapy are more likely to attempt suicide. The findings were published in the journal JAMA Psychiatry.

Amy E. Green, director of research for LGBTQ youth suicide prevention organization The Trevor Project, told Newsweek at the time that in contrast to conversion therapy, "health and mental health treatments that are based on accepting and affirming principles have a strong evidence-base and allow LGBTQ individuals to thrive."

If you have thoughts of suicide, confidential help is available for free at the National Suicide Prevention Lifeline. Call 1-800-273-8255. The line is available 24 hours, every day.

You can contact The Trevor Project TrevorLifeline 24/7 if you or someone you know is feeling hopeless or suicidal at 1-866-488-7386. Counseling is also available 24/7 via chat every day at, or by texting 678-678.

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Researchers have investigated the link between gender affirming treatment and mental health in transgender people. A stock image shows a person flying a transgender flag. Getty