Americans who struggle with gender identity are “at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders” if they undergo gender transition surgery, according to a study published in the Oxford Academic Journal of Sexual Medicine on February 25. Yet the study, conducted by researchers from the Baylor College of Medicine, the University of Texas Medical Branch, and the University of Texas Health Houston, failed to draw the most straightforward conclusion due to ideological blinders.

The study found that males with gender transition surgery were 120% likelier to have depression (“25.4% vs. 11.5%”) and 388% likelier to have anxiety (“12.8% vs. 2.6%”) than males who had gender dysphoria without surgical intervention. Gender dysphoric females were 56% likelier to have depression (“22.9% vs. 14.6%”) and 48% likelier to have anxiety (“10.5% vs. 7.1%”) if they had undergone gender transition surgery.

These results had superlative statistical significance (“P<0.0001”) due to the study’s enormous dataset. The researchers analyzed 107,583 “U.S. patients aged ≥18 with gender dysphoria” from the global TriNetX database “between June 2014 and June 2024.” They assessed mental health outcomes “over two years post-surgery using clinician-verified ICD-10 [International Classification of Diseases, Tenth Revision] codes.”

These findings are consistent with other recent studies showing a correlation between gender transition surgeries and mental health issues. An April 2024 study funded by the National Institutes of Health (NIH) found that people with a history of gender transition surgeries had much higher rates for PTSD, suicide attempts, and suicides than people without such a history. (However, this comparison was not among adults with gender dysphoria but adults with an emergency room visit — a far less meaningful comparison.)

However, these more recent results undermine earlierstudies suggesting that gender transition surgeries provided positive mental health outcomes.

Returning to the Oxford Academic study, the most obvious conclusion to draw from its findings is that gender transition surgeries fail to work as advertised. The widespread model of “gender-affirming care” (GAC) is premised on the notion that medically altering the body of a gender dysphoric person to appear more like a member of the opposite sex is the best way to relieve his or her mental distress. As the fullest expression of such medical interventions, gender transition surgery should — if this theory is correct — provide gender dysphoric individuals with the fullest relief from their mental distress.

Yet, according to this large study, people who have undergone gender transition surgeries are still more likely to experience serious mental health issues, indicating that the surgeries did not relieve their mental distress. In fact, all else being equal, those who have undergone gender transition surgery appear to be more distressed than those who have not.

Thus, these findings suggest that medical professionals would best serve the mental health of people with gender dysphoria by not performing gender transition surgeries on them.

This obvious conclusion is not necessarily ironclad. One reasonable counterargument is that gender transition surgeries are usually reserved for gender dysphoric people with the most acute mental distress; therefore, we would expect that members of the group who underwent gender transition surgery would have experienced a higher rate of mental health issues even before surgery due to an element of self-selection.

Yet this argument doesn’t undermine the obvious conclusion so much as it highlights an inherent limitation in the study. To truly discern the effects of gender transition surgery on mental health outcomes, the study would have to measure mental health outcomes before and after surgery and measure the rate of change with accompanying measurements for a control group over the same period. (An even better methodology would conduct randomized control trials to minimize the opportunity for self-selection, but the American medical community jumped right over this step in their zeal to implement the GAC model.)

To put the counterargument another way, the data collected for this study does not rule out the theoretical possibility that the gender transition surgeries measured here actually improved mental health outcomes for those who underwent surgery, even though they still had far more mental health issues than other people with gender dysphoria. But proving this theoretical possibility would require different data than that analyzed by this study.

Researchers committed to “following the science” would not reject the obvious conclusion to which their findings point based on a theoretical objection their data do not address.

Alas, the research team did not arrive at this obvious conclusion. Instead, they wrote that their findings “suggest the necessity for gender-sensitive mental health support following gender-affirming surgery to address post-surgical psychological risks.” Even this conclusion calls into question the utility of gender transition surgeries. If mental health issues persist after surgery, what medical benefit is there to justify the inherent risks and complications?

Yet the research team’s assumptions precluded this fruitful line of inquiry. In a section labeled “background,” they wrote, “Transgender individuals face heightened psychological distress, including depression, anxiety, and suicidal ideation, partly due to stigma and lack of gender affirmation.” This claim assigns sociological reasons for psychological maladies, placing their treatment beyond the realm of their medical expertise. It also exposes an ideological commitment to affirming gender transitions and removing social stigma against transgenderism.

Even this background statement is undermined by the study’s findings. If “stigma” against transgender identity is measured by public outcry, then one of the hottest cultural flashpoints is the debate over males with fully intact genitalia exposing themselves in gyms, locker rooms, and similar private spaces reserved for women. If the psychological distress associated with gender dysphoria were truly due to social stigma, then surgeries that remove male sexual organs would, at least in part, take away the stigma, thereby reducing the psychological distress. But that is not the case, at least according to this study.

Despite the researchers’ evident ideological preferences — or, perhaps, the framing necessary to get the research published — this study takes its place in a growing constellation of scientific literature that throws doubt on the GAC model that has captured American medical institutions. Whatever framing or context accompanies it, the core finding is that people with gender dysphoria who have gender transition surgeries report far higher rates of mental health issues than people with gender dysphoria who do not have such surgeries. Such results should cause health care professionals to question whether gender transition surgeries have any medical benefit at all.