As well as there only being a very small group who actually had the surgeries 12.8% vs 59.2% of people 'wanting' the surgeries, where is the data for those people who DIDN'T want surgeries? The 27.9% seems to be missing? How did they compare? Now that would be interesting to see. Do you have it?
The biggest issue in my mind though, did you notice then that those having those surgeries still reported significant distress levels. All the while they have been more likely to have also received counselling AND they still have significant distress levels.
Did they investigate why?
Because we also know from both detransitioners, and transitioners and their clinicians that a great deal of distress is still caused by surgeries going poorly and discovering that these surgeries have not helped at all.
Where are the statistics for those transitioners?
Have they then included anything about them? We know from a study done in Europe that 8-9% of medically treated transitioners up to 2017 detransitioned after medical treatments.
That is a pretty significant % to include in this study.
What also causes me concern in regard to this study, is that it does not include the significant latest cohort of young transitioners - that bump after 2015 that is the majority of young female transitioners.
So, in effect, it is not as relevant to today's transitioners.
The conclusion drawn by this study is looking weaker than you would like it to be.