Tuesday, January 3, 2012

Stunning ... or Stunned? You Decide!

In a pattern consistent with the anti-gay junk science of Paul Cameron, we find Walt Heyer grossly misconstruing two important studies in the last couple of years about transsexuals.

A recent Swedish study reports that having gender surgery increases suicide attempts and lowers the quality of life. It also points to increased occurrence of psychiatric issues and depression after sex change surgery. This research allows us to claim that changing genders is frequently more folly than effective treatment for the wide range of gender issues that do exist.
Shall we go take a closer look at what that Swedish study actually says?  Looking at the study in more detail, it claims that suicide among post-op transsexuals is approximately 19 times higher than in the general population.  That's bad - very bad by any measure. 

However, before we go diving off the deep end, let's examine the raw numbers a bit further, because they are very informative.

The Swedish study covers a very long period of time, from 1973 to 2003 - healthy thirty year period which is good for a longitudinal study like this.

Of these, we find that 10 of the patients tracked committed suicide in that thirty year period.  That is 10 out of a total population of 324 - approximately 3% of the transgender population.

If we go a step or two further, and look at suicide attempts as well as suicides, we have a total count of 39 out of 324 or 12%.

Both of these are disturbingly high numbers, but frankly any suicide is tragic, and deserves to be addressed.

However, that's nowhere near the brutal numbers of suicide attempts recorded by the NTDS Report on transgender health released in 2010.  (Unlike Heyer, who merely links to an MSNBC report on the study, I've linked to the study's download page so you can look for yourself)

When asked “have you ever attempted suicide?” 41% of respondents answered yes. 
Intriguingly, the Swedish study actually demonstrates a significant drop in the overall suicide rate compared to the raw data of the NTDS report.  Please recognize that the NTDS report didn't specifically study transsexuals, but rather the entire spectrum of transgender people, so we can't quite make an "apples to apples" comparison, but the numbers are interesting when compared with each other, since the NTDS study would include both pre and post operative trans people.

Heyer concludes that surgery is not a solution for transsexuals.  The Swedes are much more measured in their assessment, concluding that surgery alleviates the gender dysphoria aspects of transsexualism, but does not address other issues that the transsexual may be facing.
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.
While Heyer is quick to leap to conclusions that suit his agenda, they aren't really borne out by reading the studies that he is referring to.  He then goes on to claim that transsexuals suffer from a whole host of other conditions, and that the referring professionals are being negligent in their conduct:
Transgenders suffer from psychiatric issues ranging from dissociative disorders, separation anxiety to full blown delusional disorders. I don’t fault the individuals who suffer and eventually request the life changing surgery. In my view, the responsibility lies with the surgeons and approving psychologists, unqualified and unfit, who do not care about the long-term results of changing genders. The approving psychologists in too many cases are more about giving the wanna-be transgender anything he or she wants, than in providing effective diagnosis and treatment for real psychiatric disorders.
Yes, there may be comorbid conditions that the transsexual is suffering from in parallel with the gender identity issues.  A carefully executed transition will include dealing with those additional conditions.  Long term follow-up post-transition, post-surgery is also a valuable support, as transsexuals do face significant discrimination pressures in the world.

The real issue is one of dealing with the social hostility and discrimination that transgender, and especially transsexual, people face on a daily basis just living their lives.  The NTDS report is quite clear about the higher levels of stress and discrimination that transgender people face in society, and it isn't exactly rocket science to understand the connection between discrimination, economic and social, and suicide attempts.

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