There was a reference to this study in a current thread, which reminded me to post this.
The main researcher in the 2011 Swedish study "Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden by Dr. Cecilia Dhejne, et al 2011" has since clarified in 2015 that it does not prove what it seems to say that it proves.
This is what the study says (selected extracts only):
journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885
Results
The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.
Crime rate
Transsexual individuals were at increased risk of being convicted for any crime or violent crime after sex reassignment (Table 2); this was, however, only significant in the group who underwent sex reassignment before 1989.
Gender differences
Comparisons of female-to-males and male-to-females, although hampered by low statistical power and associated wide confidence intervals, suggested mostly similar risks for adverse outcomes (Tables S1 and S2). However, violence against self (suicidal behaviour) and others ([violent] crime) constituted important exceptions. First, male-to-females had significantly increased risks for suicide attempts compared to both female (aHR 9.3; 95% CI 4.4–19.9) and male (aHR 10.4; 95% CI 4.9–22.1) controls. By contrast, female-to-males had significantly increased risk of suicide attempts only compared to male controls (aHR 6.8; 95% CI 2.1–21.6) but not compared to female controls (aHR 1.9; 95% CI 0.7–4.8). This suggests that male-to-females are at higher risk for suicide attempts after sex reassignment, whereas female-to-males maintain a female pattern of suicide attempts after sex reassignment (Tables S1 and S2).
Second, regarding any crime, male-to-females had a significantly increased risk for crime compared to female controls (aHR 6.6; 95% CI 4.1–10.8) but not compared to males (aHR 0.8; 95% CI 0.5–1.2). This indicates that they retained a male pattern regarding criminality. The same was true regarding violent crime. By contrast, female-to-males had higher crime rates than female controls (aHR 4.1; 95% CI 2.5–6.9) but did not differ from male controls. This indicates a shift to a male pattern regarding criminality and that sex reassignment is coupled to increased crime rate in female-to-males. The same was true regarding violent crime.
Conclusion
This study found substantially higher rates of overall mortality, death from cardiovascular disease and suicide, suicide attempts, and psychiatric hospitalisations in sex-reassigned transsexual individuals compared to a healthy control population. This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up. Even though surgery and hormonal therapy alleviates gender dysphoria, it is apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons. Improved care for the transsexual group after the sex reassignment should therefore be considered.
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Cristan Williams interview with Dr. Cecilia Dhejne, 2015
I found parts of Dhejne's clarification difficult to grasp as it seems to contradict the published paper. However, it would appear that the paper was not written up with sufficient care to differentiate throughout between the two cohorts (1973 - 1988 and 1989 - 2003) so it is easily open to misinterpretation. Dhejne does not acknowledge this but it is obvious from the detailed questioning needed to winkle out the facts. Maybe being written in English rather than Swedish was a factor?
www.transadvocate.com/fact-check-study-shows-transition-makes-trans-people-suicidal_n_15483.htm
That is a long article - this is Dhejne's summary at the end (my bolding):
"The study as a whole covers the period between 1973 and 2003. If one divides the cohort into two groups, 1973 to 1988 and 1989 to 2003, one observes that for the latter group (1989 – 2003), differences in mortality, suicide attempts, and crime disappear. This means that for the 1989 to 2003 group, we did not find a male pattern of criminality.
As to the criminality metric itself, we were measuring and comparing the total number of convictions, not conviction type. We were not saying that cisgender males are convicted of crimes associated with marginalization and poverty. We didn’t control for that and we were certainly not saying that we found that trans women were a rape risk. What we were saying was that for the 1973 to 1988 cohort group and the cisgender male group, both experienced similar rates of convictions. As I said, this pattern is not observed in the 1989 to 2003 cohort group.
The difference we observed between the 1989 to 2003 cohort and the control group is that the trans cohort group accessed more mental health care, which is appropriate given the level of ongoing discrimination the group faces. What the data tells us is that things are getting measurably better and the issues we found affecting the 1973 to 1988 cohort group likely reflects a time when trans health and psychological care was less effective and social stigma was far worse. "
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This study is referenced repeatedly in articles about post-SRS criminality and suicide rates. Dhejne is aware that it is routinely misinterpreted but has not, unfortunately, taken the opportunity afforded on PLOS to add a comment to clarify how the paper should be understood.
journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885
I am no good at all when it comes to statistics so I am hoping that someone who is good at that sort of thing happens along this way!
If you put the original paper alongside the detail of Dhejne's clarification in the Cristan Willaims article and also stick to the 1989 to 2003 cohort - what does the study actually show? (Not a rhetorical question!)
Cristan's conclusion relates only to what it does not show:
"To be clear:
No, the study does not show that medical transition results in suicide or suicidal ideation. The study explicitly states that such is not the case and those using this study to make that claim are using fallacious logic.
No, the study does not prove that trans women are rapists or likely to be rapists. The “male pattern of criminality” found in the 1973 to 1988 cohort group was not a euphemism for rape.
No, the study does not prove that trans women exhibit male socialization. The “male pattern of criminality” found in the 1973 to 1988 cohort group was not a claim that trans women were convicted of the same types of crime as cis men."