Suicide rate of those who have undergone reassignment

Even then I think it would be difficult isolate surgery alone as a cause of any increase in the suicide rates.
That’s a key aspect of this difficult issue, specially under the current narrative that push the affirmation model to children and young people. Transition and PB are sold as the cure and ticket to a happy life away from those dangerous thoughts that makes some uncharitable associations tell a parent “better a x than a dead z”.
I think that further research should be backed rather than blocked.

I don't really see myself as old school because I'm sure the majority of people going through transition today face similar battles with society and themselves to myself. My apologies. I was trying to find a way to distinguish those trans people who are not the shouty, angry, lobbying, biology denying activists.

And if you happen to find 2 of those small holding havens let me know

What I think is important for me though is deciding which hills I'm metaphorically wil!ing to die on and those which I'm not. Trans healthcare is in a dire situation and I would say that is the single most important thing that can be addressed by effective campaigning. What I'm not willing to worry about is things like pro-nouns on my email, I have a name, if somebody wants my attention they probably need to use it unless they're willing to do something crazy enough to make me look up.

As for changes in attitudes I would say life generally has become less pleasant if you are out / open about being trans. A lot of negative media attention is going to have its impact whether that be distrust, suspicion or in a few cases real hatred. That's not to say it's any more difficult than for any other particular minority group because those with power in society, mainly white men of a certain class are heavily invested in the status quo. Whether that is treading on women or demonizing minorities to ensure society remains divided enough so that no one notices or cares enough about how they continue to take us all for a ride.

Personally, I'd like to switch the clock back a few years but, I think we are too far down the rabbit hole now. If I win the lottery a small holding in the middle of nowhere with a few animals and the least human contact I can get away with is something I think I'd quite like.

Normal is not a word I'd use a lot though, I think we are just a less common version of the human condition. That does make some more uncomfortable than others but, I'm given to thinking it's them that have the problem.

That. Every day, all day long. THAT @Steph751 is precisely it.

That's the conversation I have regularly (you and @BlueLipstickRocks could be my friends, your voices, what you are saying, sounds so familiar).

And that is the difference between 'old style' and the new, shoutier trans perspective. You have internalised your differences, accepted them as being part of you, distinct and somewhat dfferent from the wider society. What you want and need is what we had almost globally here in the UK, the unspoken nod of acceptance (no matter it made everyone involved feel uneasy at times) it was what got everyone through their day and, given the specific circumstances (humans can't change sex just their apearance), was a reasonable compromise for decades.

Now that is not acceptable to many. What is wanted is not that compromise, that nod and unspoken agreement. What is demanded is parity, total acceptance of the individual statement of sex. And that is what is causing issues that have ever wideining ripples, making that unspoken nod less likely, disrupting the every day lives of many more than ever before.

What we - that is society as a whole, not we women - should be discussing is those stats. Working out the truths behind healthcare for trans people and working to improve it, to make it fit for purpose. Even in these cash strapped times the NHS can and should be able to offer a more holistic service.

But then that could be said for very many aspects of everyone's life these days!

I'd be surprised if surgery itself increased the suicide risk by 7%. If there were truth in that I think the NHS would have put the brakes on it a long time ago

I don't think so, because we are talking about a small increase in the rate of suicide in a relatively small number of people.

From the latest ONS release:
In 2019, there were 5,691 suicides registered in England and Wales, an age-standardised rate of 11.0 deaths per 100,000 population.

I don't know what is the total number of trans people in the UK who have undergone GRS, but I presume it is a few thousand.

Assuming a population of 10,000 such trans people (to keep the figures simple), if the rate of suicide in this group were the same as in the general population, then there would be approximately 1 per year (1 tenth of the number for 100,000 in the general population gives 1.1 per year). Increase this by 7% and it becomes about 1.18 people per year. The numbers are so small that it would be difficult to draw any conclusions, since 2 or 3 suicides in one year would skew the figures enormously, but might be due to completely different reasons than anything to do with their surgery or the fact that they are trans. It would also be skewed if there were no suicides one year, even though this is very likely in this small number of people.

The 20x figure mentioned in the OP is a completely different matter. But it's reported in that paper that:

Despite the long history of this treatment, however, outcome data regarding mortality and psychiatric morbidity are scant. With respect to suicide and deaths from other causes after sex reassignment, an early Swedish study followed 24 transsexual persons for an average of six years and reported one suicide.[5] A subsequent Swedish study recorded three suicides after sex reassignment surgery of 175 patients.[6] A recent Swedish follow-up study reported no suicides in 60 transsexual patients, but one death due to complications after the sex reassignment surgery.[7] A Danish study reported death by suicide in 3 out of 29 operated male-to-female transsexual persons followed for an average of six years.[8] By contrast, a Belgian study of 107 transsexual persons followed for 4–6 years found no suicides or deaths from other causes.[9]

At the moment, we just don't have enough data (although the numbers in the above paragraph do generally seem quite high for such a small number of people over a short period of time).

Detransitioners should definitely be heard, their voice is important in driving improvement and they should be afforded a good level of support. However, treatment satisfaction rates regularly reported as being in the 90's if not the high 90's as a percentage make me think that they (the government) have to be careful not to let often emotive politics lead to the baby being thrown out with the bath water in order to satisfy their base at the expense of wellbeing.

You are right about lack of GIC follow up though. With the exception of a post surgical follow up and subsequent discharge from the GIC there has been no specialist follow up apart from if you count a private surgery some years later. Is that unusual, I honestly don't know? I had another significant surgery 15 years ago that wasn't trans related which also has had no follow up. Gender surgery is far from being alone amongst the types of cases that are discharged to general practice for long term periodic monitoring.

I don’t think the suicidability is just related to the SRS, but as mentioned up thread unresolved MH will also play a part. The figures are about America no UK. I seem to remember the high suicide rate post-op was what ended surgeries at J Hopkins clinic.
It’s really something that needs further research. I found this while looking for the GLAAD statistic that still eludes me:
“ Zucker and colleagues (2016) point out that while 10 of 666 (1.5%) of patients receiving SRS between 1972 and 2010 made formal regret applications, 10 of 324 (3.1%) who received SRS between 1973 and 2003 had killed themselves (Dhejne 2011, Zucker 2016). Another 29 of 324 (8.9%) receiving SRS in that period had made documented suicide attempts (Dhejne 2011, Zucker 2016).” Quite sobering.
It’s great when it works, but detransitioners and regretted need to be heard as part of figuring out what’s good for whom; as well as the how and why of best treatment.

I'd be surprised if surgery itself increased the suicide risk by 7%. If there were truth in that I think the NHS would have put the brakes on it a long time ago

But they don't do follow up from gender clinics as standard - so how would they know?

Personally, I don't find aging particularly hard other than wishing I was 21 again but with the extra 20 years of life experience that may be useful. If we stay healthy and keep fit I wouldn't think we suffer any more than anyone else. Osteo risks are generally mitigated by low dosage HRT and because a roughly annual check is made of your bloods and BP/cholesterol levels, we are possibly at less risk than someone who hasn't visited the Gp in years. But, that annual visit and a patch change twice a week doesn't make me feel like a life long medical patient.

As for gain, the benefits and peace of mind far outweigh the risks, I don't think I'm unusual in thinking that. I do have to agree with you about middle aged men though, there is one sat in my living room who likes the idea of himself being attractive to younger women. I think it's his age.

It astounds me actually (as a middle aged woman) that men would voluntarily choose to try to resemble one. I do remember India W in Celebrity Big Brother being horrified that none of the men were interested. Any middle aged woman could have told you that they're after those much younger than them. Middle aged men don't seem to have such problems.

It is sad that no more imparcial and serious research has been possible yet. I cannot find the reference but I’m pretty sure GLAAD said the suicidal risk increased 7% after surgery. I imaging also with age. Aging as a transwomen must be very hard. I see pictures of bold men that transform themselves into reasonable good looking middle age women and yet the delusion must be hard to sustain as time passes.
One video I saw of a transwomen talking about transition said it doesn’t change your sex that all you gain is a more beautiful appearance and she was content after a long struggle to accept her own nature. I think that the ‘passing’ etc must really take its toll.

Thanks to Steph and Blue for their input.

Personally I feel that they (Pb's) would have been beneficial for me, saving me the later surgery. I do believe those decisions are best made between the patient, their parents and the medics involved in their care. For myself, I struggled before puberty but it was a lot worse afterwards but, it wasn't an option back then.

Well. That's me told

But what it suggests is that the surgery and transition doesn't help the problem

No it doesn’t suggest that. It suggests, as the same researchers have pointed out, that transition may help gender dysphoria but transsexuals still will likely need some sort of additional support.

Transition solves some problems, it doesn’t solve all of them. It may even create others. Whether they are easier for people to live with is for them to decide.

I suspect that what makes many women edgy is that transsexuals make up 2% of the people under the Stonewall "umbrella", and the rest under that umbrella are transgender people who as far as one can tell have no intention of having radical and life-changing surgery: people who feel able to state that they are lesbians but also state (in the same video) that the very idea of having surgery on their genitals makes them cringe. (There is someone with a beard who has stated both these things in a YouTube video of her own making.)

This means that there is no way for a woman to tell a transgender person from a predatory male person who has chosen to claim to be trans in order to gain access to places in which they really ought not to be if women (both natal and transsexual) are to be safe, such as women's prisons, women's hospital wards, women's sports, women's changing rooms, and so on.

This strikes me as remarkably hard on people who are transsexual, and who are liable to be looked at with the same suspicion when they have done absolutely nothing to deserve it.

wrong to describe being transsexual as a psychological disorder.

Clearly if you can’t function emotionally, psychologically, socially or sexually because you reject the sex of your body without prescription medication and surgery then yes, that it’s a psychiatric disorder.

That describes many/ most transsexual people.

Steph thank you for your post, it was very informative. I think the issue now is that it is children who are being put on this pathway at a very young age, rather than an adult making a decision.

Hand on heart do you think things would have been better had you not gone through puberty? Or was it better to wait so all are given the opportunity, like many posters have said previously on here, to see how they feel once puberty is over?

Thank you to both you and Blue. It saddens me that your voices are generally drowned out these days.

Bluelipstick,

I'm new to this forum so please bear with me if I don't do the right @'s or if I should have highlighted something etc..I only really wanted to talk about something I have experience of and this thread seemed a good place to start. From what you say, we've clearly trodden a similar pathway but have arrived at different view points. I'm keen to understand your view of yourself as an 'old school transsexual'. How do you see yourself as different from a transsexual diagnosed today? Aside from the ICD code on your paperwork being from an earlier version, what makes you think that? I know we all experience life individually but, I'm thinking in terms of a cohort for example, an old school transsexual.

I too transitioned some time ago, it seems like an age now and makes me feel older than I'd like. I was in my early 20's from 1996, having my vaginoplasty in 1999 and then some facial work in 2016 when my finances finally allowed me the luxury. I just don't think I have arrived at the point where I see myself an old school transsexual and somehow different from those who are on an NHS pathway today.

I do agree with you about the mental health element, in the absence of a physiological test or an identified gene which I wouldn't dismiss out of hand, then we are at the moment only left with feelings and the distress of a body that doesn't or didn't feel right. I don't think that diminishes the condition. Mental and physical processes interact all the time and now after around 80 years of modern gender treatments, with some truly awful interventions along the way, they appear to have arrived at a pathway that seems to be beneficial for most who follow it. That's not to say it can't or won't be improved in the future and it's not to say it gets it right 100 percent of the time but, I almost baulk at some of the suggestions I see around which would put treatment back 30 or 40 years.

I personally don't think things are really that different now to my own experience. I'm a similar age to you so, I'm guessing our pathways were quite similar. I can only speak anecdotally as I have a friend who went through the NHS pathway between 2015 and 2020 and her experience seems to have been very similar to mine apart from she waited 12 months to see a GIC which seems to have increased a lot more in the last few years. Obviously, I only have her word but, I've no reason to disbelieve her. She seemed to experience what I would call differential diagnosis over a period of time, round about a year including counselling and the involvement of several clinicians ranging from psychotherapists to medical Dr's. This was followed by about 18 months on HRT before a second independent opinion and a surgical referral. The whole process took her around about 5 years and seemed pretty thorough. I think the only real difference to my own experience was that the medical staff didn't seem to be as hung up on gender stereotypes as some once were. That, I can only see as a good thing. Given the amount of supervision in comparison to some other conditions, I'd find it difficult to believe that the incidence of inappropriate surgical referrals differ significantly from 20 or so years ago.

As for post op suicidal ideation, it all feels a bit meaningless to compare trans people with those who aren't. Surely they'd do better to look at a country where many are denied interventions for example the US and see if there is a significantly worse outcome for those who receive treatment when compared to those who are denied it. Personally, my distress initially was down to the dislike of my physical reality. Once interventions started to take effect it was more down to the way in which society treated me such as family rejection and the general animosity you can encounter when you don't confirm to the binary.

You're right, there's no magical fix but, on a personal level my pain score used to be 10/10. The treatment I received allowed that to sit at about 2/10 which in my book although it's not a measure of perfection it is a reasonably reliable measure of success.

Anyway, I didn't mean to ramble that much, I got a bit carried away, I'm just interested in what makes you feel you're old school and therefore different from those who experience a similar thing today?

I'm not sure whether to laugh or despair at this statement...

they "don't want "penis amputation", they want a reconfiguration of their genital tissues into a more typically female arrangement."

Shizuku
Who is arrogant, me or the psychologists I am quoting?

My guess would be both. My experience of psychologists is that they always do think they know everything, until they have to accept that they didn't -- see "hypnotic age regression" and "lobotomy" and sundry other things which psychologists were convinced at the time were right and which turned out to be wrong and/or dangerous.

Of course being trans isn't "normal". Who said it was?

Um, isn't that rather transphobic?

It may be that it is confounding factors, rather than the surgery and transition, that is behind the numbers. But what it suggests is that the surgery and transition doesn't help the problem, and they have their own significant risks in and of themselves.