When it comes to gender-affirming health care, Republicans (among others) like to see themselves as experts in spite of having negligible (at best) qualifications and expertise in the field. When it comes to pushing anti-trans legislation that would prevent trans and nonbinary folks from accessing safe, age-appropriate gender-affirming health care, what conservatives are really trying to do is demonize trans folks and allies and stomp out the open existence of an already vulnerable and marginalized community. It’s all about hate, not concern.
Sadly, there are plenty of moderates and even progressives who fall into rhetoric traps concerning gender-affirming health care, as though the right to privacy between a patient and their physician disappears the moment one realizes the patient in question is not cisgender. Really safe, legal abortion access, for example, is no different than access to safe, legal gender-affirming health care, but likely due to structural transphobia and ignorance, even some allies don’t want to see it that way.
Trans people shouldn’t need to prove a thing to anyone who isn't a trusted medical professional, but given the ongoing discourse around trans rights and dignity, it’s important and valuable to discuss research and studies that are available. One exciting study comes to us from the medical journal Annals of Plastic Surgery as published in May 2022, which found that out of 209 trans youth who received gender-affirming mastectomies (sometimes known as “top surgery”) between the ages of 12 and 17, more than 90% were happy with their decision, and just two out of more than 200 expressed regret, but still did not pursue reversals of the surgery within the follow-up spans of the study (three and then seven years later).
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As a quick review of terms before we get into the study and its findings, gender-affirming health care is a really broad spectrum. Truly, what it means for one person’s care is not necessarily indicative of what it might mean for another person, even if they are the same age or live in the same area. For children (and even some adults!), gender-affirming health care be entirely non-invasive; it can include, for example, a physician encouraging parents to use new pronouns or a chosen name for the child or teen, or advice to seek trans-inclusive or explicitly supportive mental health counseling or group therapy.
Vivian Topping, director of advocacy and civic engagement at the Equality Federation, and Shannon Minter, legal director of the National Center for Lesbian Rights
It can also, of course, include things like puberty blockers and hormonal therapy, as well as surgeries. These surgeries also vary widely but can include things like mastectomies or chest construction (again, often known as “top surgery”) as well as phalloplasty, valvuloplasty, and vaginoplasty, which is often called “bottom surgery.” Some people who pursue one (or more than one) path for care identify as trans, some identify as nonbinary, and some identify as trans nonbinary. There are other less discussed gender identities too, like genderqueer and agender.
Again, it all just depends.
None of these surgeries, treatments, or processes make someone more or less trans or more or less of their gender identity. You never need to know any of this information in order to respect a person’s identity, which includes using the correct pronouns, providing bathroom access, and so on.
With that out of the way, let’s check out the study. The study looked at adolescents between 12 and 17 at the time of their referral for gender-affirming mastectomies, which were performed between Jan. 1, 2013 and July 31, 2020. All of the patients in this study were assigned female at birth.
The median age of referral came in at 16 years old. The study looked at surgical techniques, comorbidities, mental health, and use of testosterone, as well as any postoperative complications, which in this case include feelings of regret.
For patients who had a follow-up more than one year later, complications found included hematoma infection (3.6%), hypertrophic scars (2.9%), seroma (0.7%), and suture granuloma (0.7%). Ten percent had a revision. The aforementioned two patients expressed regret, but neither pursued a reversal surgery at either the three- or seven-year mark post-surgery.
Republicans love to talk about trans folks and regret, so let’s see how quickly they jump to read and discuss this study …