Transgenderism has become an increasingly popular yet controversial topic of discussion. Many government health bodies such as the NHS in the United Kingdom now offer surgery for individuals wanting to undergo sex reassignment surgery. Some critics argue that this treatment method is clinically ineffective. Should health bodies such as the NHS continue offering such treatments when it is possible that they are a waste of taxpayers’ money?
At birth, people are assigned a biological sex based on their genitals. Transgender people suffer from a mental condition known as gender dysphoria, which means that their gender identity does not match their biological sex. There are many ways that gender dysphoria can occur. Most of these are associated with hormonal imbalances, where hormones have different effects on the brain, reproductive organs and genitals. This means that an individual suferring from gender dysphoriamay feel like a male but have the body of the female.
Transgenderism has come under unnecessary scrutiny in recent years and many transgender individuals have been accused of being illegitimate or ‘going through a phase’. In the case of prepubescent children, any unexpected gender-specific feelings or behavioural tendencies are usually part of a phase, and often disappear after they experience the hormonal changes of puberty. However, in the case of adults, gender dysphoria is usually a permanent condition and should be treated as such.
The mismatch between gender identity and assigned biological sex is what causes significant distress to transgender individuals. Some of the problems they could face include: lack of support from family and friends, discrimination and abuse. These reasons and many more account for the astronomical attempted suicide rate among transgender individuals, which has been estimated to be around 41% compared to 5% in the general population. Many transgender individuals decide to undergo sex reassignment surgery in order to remove the mismatch between their biological sex and gender identity.
Some critics argue that sex reassignment surgery is clinically ineffective, one example is a review of more than 100 medical studies, carried out by the University of Birmingham’s aggressive research intelligence facility, who claim that:
“There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation”
They attribute this to a large number of people dropping out from studies: the individuals who drop out are more likely to have been dissatisfied with the surgery or to have committed suicide, so the results are skewed in favour of positive outcomes.
This is echoed by the fact that any studies which suggest that sex reassignment therapy improves the quality of life for patients also report high rates of participants dropping out.
A Swedish study used a different approach which accounts for people who drop out by using the Swedish national register to keep track of them. The researchers concluded that:
“Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.”
Their results showed that after surgery, around 8% of the individuals attempted suicide compared to 1% of the general population over the same period of around 10 years. These values are very similar to the lifetime statistics for attempted suicide rates among transgender people and the overall population (41% and 5% respectively), seeming to suggest that surgery has no bearing on the rate of attempted suicide for transgender individuals. Also, psychiatric hospitalisation rates did not change for transgender individuals following surgery, suggesting that sex reassignment surgery does not improve the mental health of transgender individuals.
I approached this article with scientific objectivity and with the utmost sympathy for transgender individuals, but the evidence is clear: sex reassignment surgery is clinically ineffective. With the NHS having spent around £10m on transgender patients in the last 5 years, it may be time for them to reconsider their treatment methods.
On the other hand, the sole purpose of the NHS is not to prevent death, but also to improve quality of life. Sex reassignment surgery does alleviate gender dysphoria, so it has a positive impact on the lives of transgender individuals. There are many other services offered by the NHS that do not inherently save lives, so maybe sex reassignment surgery is justifiable.
Regardless of whether government-funded sex reassignment surgery is justifiable, it’s clear that more needs to be done to reduce the suicide rate among transgender individuals. Psychological support and social acceptance will be key in saving transgender lives.