Being transgender or transsexual.
Gender dysphoria, & gender identity.
Success and failure rates
This is an essay intended for general informational use only. If you believe
that you are personally experiencing Gender Dysphoria -- a belief that you currently identify as a gender different from your birth-identified sex -- we
recommend that you not rely upon the information in this essay, but seek professional counseling.
If you are feeling depressed, and would like immediate support -- or just a friendly conversation with a compassionate, nonjudgmental person, you might
consider calling an crisis or distress hot line; one may be listed at the front of your telephone
book. They are often reachable 24 hours a day, 7 days a week.
A timeline of success rates of sexual reassignment surgery:
1966: The earliest survey that we have been able to find into sexual reassignment surgery was conducted by Dr. Harry Benjamin in 1966. Dr. Benjamin was a pioneer in the study of gender identity. He developed the 7 point "Sex Orientation Scale" (S.O.S.) to classify various types of transvestism and transsexualism in genetic males.
He studied a group of 51 post-operative MTF (male to female) transsexuals and rated 44 of them (86%) as having made a good or satisfactory adjustment.
"Yet these successful outcomes should not deceive us as to the risks involved. While most transsexuals who underwent the operation were decidedly better off afterward than before, they did not become models of emotional stability and mental adequacy. A few do remain more or less disturbed, insecure, in precarious emotional balance, problem personalities who could perhaps be helped by psychiatric guidance. Alas, too few
seek it and that may be another reason why some drift occasionally into reactive depressions or into promiscuity, prostitution, and addictions. The salvaging of transsexuals does not always end with the operation, though without it there would have been no hope. ..." 5
"My observations have forced upon me the conclusion that most patients operated upon, no matter how disturbed they still may be, are better off afterward than they were before: some subjectively, some objectively, some both ways. I have become convinced from what I have seen that a miserable, unhappy male transsexual can, with the help of surgery and endocrinology, attain a happier future as a woman. In this way, the individual as well as society can be served. The rejection of the operation and/or treatment as a matter of principle is therefore not justified." 6
(Emphasis by us).
1996: German Study:
A study had followed 1,422 gender-reassigned
transsexual patients over a ten year interval. They found that only one
expressed regret, for a failure rate of less than 0.1%. 9
In contrast to the above success stories, the Vatican issued a "sub secretum" (secret) document in the year 2000 about transsexuality to papal representatives in each country. Later, the document was also sent to the heads of each national bishops' conference. In 2003 it was described in the Catholic News Service. 4 The document stated, in part:
"... that the [gender reassignment surgery or GRS 14] procedure could be morally acceptable in certain
extreme cases if a medical probability exists that it will 'cure' the
patient's internal turmoil."
This statement would seem to at least partly relax previous prohibitions by the Catholic Church against GRS, since the emotional distress faced by transgender persons is normally "extreme" and various studies have showed that the vast majority of persons going through GRS find the results helpful. Only a small percentage of post-operated transsexuals regret deciding to undergo surgery. However, most continue to have some difficulties with their gender identity and with the acceptance of others. So most clients cannot expect a complete resolution to their inner turmoil; GRS is not a cure-all.
However, the Catholic News Service noted in 2003 that:
"... a source familiar with the document said recent medical evidence
suggested that in a majority of cases the procedure increases the likelihood of depression and psychic disturbance." [Emphasis ours]
No citation was given by the Catholic News Service (CNS) to support this conclusion. We have been unable to locate any surveys that negate other surveys and support the source's beliefs. We have asked the CNS if they can supply additional information on the source that they cited. As is normal with essentially all of our information requests to religiously conservative news sources, our Email went unanswered and unacknowledged.
2006: The eTRANSGENDER web site stated that:
"The regret rate for gender reassignment [surgery] is less than 2% which is an amazing
measure of success. Basically, every therapy we know of has been tried with
transsexual people and none of them have been shown to alter a person's feelings
an inch." 2
2008: An article in Christianity Today (CT):
This is the leading American magazine for fundamentalists and other evangelical Christians -- dealt with transgender persons. 8 The article quotes Jerry Leach, director of Reality Resources, a ministry in Lexington, KY. He specializes in helping people dealing with what CT calls "gender confusion." This is a common term among conservative Christians who use it in preference to "being transgender" or Gender Dysphoria, perhaps because it implies that transgender persons can be cured through therapy by simply having their thinking straightened out through counseling so that they are no longer "confused."
He once seriously considered GRS for himself but believes that God saved him and healed him from his transgender desires. According to TransChristians:
"Focus on the Family and Exodus [International] direct their trans clients [to Reality Resources] as the only organization focused on adults with an unwanted gender identity." 10
Leach said that therapy is preferable to sexual reassignment surgery (now commonly called Gender Confirmation Surgery) for transsexuals. He is quoted as saying:
"Rather than cutting tissue by invasive surgery and starting a new life, which for the most part doesn't work, people need to find help psychiatrically. ... The essence of who you are in your genetics, anatomy, chromosomes, and DNA does not suddenly change by surgical amputation. ... This is a psychological and emotional malady. It's not like taking an appendix out." 8[Emphasis ours.]
Reality Resources closed in mid 2009.Its web site disappeared soon afterward. 13
2011: An article in Wikipedia reported, as updated on 2011-APR-19 reported:
"After transitioning, transsexual people sometimes regret their transition, or even choose to detransition to their original sex. However, every recent study done on the number of detransitions states that their number is well below 1%." 7
This number may be over-optimistic. The same article was subsequently updated. On 2011-AUG-23 it included a reference to a study in Sweden of 218 persons consisting of "all subjects with Gender Identity Disorder who were approved for sex reassignment in Sweden during the period 1972-1992." (The term "Gender Identity Disorder" is now obsolete; it has been replaced by "Gender Dysphoria.") They found that 8 persons or 3.8% regretted undergoing the procedure. Further examination revealed that two factors predicted which transgender persons would experience regret -- those with :
"lack of support from the patient's family," and/or
"the patient belonging to the non-core group of transsexuals." 11
They also noticed "that the outcome of sex reassignment has improved over the years."
2018-JUL/AUG:The Atlantic magazine contained a phenominal 20 page article on gender transitioning and the possibility of later detransitioning:
There does not seem to be any recent reliable information about the percentage of transgender individuals who have gone through a gender transition, found it to be a failure, and detransitioned back to their birth-identified gender. However, it does happen to a minority of transgender persons and is a major concern for them, their families and therapists.
Jesse Singal wrote an article in The Atlantic magazine with the engaging title: "Your child says she's trans. She wants hormones and surgery. She's 13." It describes how profoundly complex treatment choices are.
A few children first identify as transgender about the time of their third birthday. Many of them spontaneously revert to being cisgender while still a young child. But others continue identifying as other than their birth-identified gender throughout their chlldhood. As puberty approaches, this latter group is faced with a difficult decision:
Many therapists recommend puberty blocking medication that inhibits menstruation, breast development, etc. in genetic females, or facial hair, voice dropping, etc. in genetic males. This medication buys the child time so that they can mature emotionally and make better decisions whether to implement gender transitioning. This often involves:
injections of hormones of the sex opposite to their birth-identified sex: either estrogen or testosterone.
gender confirmation surgery that converts their body to be compatible with their gender identity.
Some therapists specializing in treating transgender youths now advocate an intensive "readiness assessment" review for clients seeking transition services. The main motivation for a comprehensive review is to prevent transgender persons going through a transition, later in life determining that it did not help them, and still later seeking to reverse the transition. On the other hand, many teen seeking to transition view such in depth assessments as a insulting, stigmatizing, and/or retraumatizing.
Additional reports in medical literature:
A search of PubMed for two terms: "transsexual" and "regret" uncovered 26 abstracts. See: http://www.ncbi.nlm.nih.gov/ The general consensus is that few post-operative transsexuals express regret for having undergone sexual reassignment surgery, if common procedures are followed. Thus surgery has been regarded as beneficial by almost all transsexuals, However, they continue to experience more emotional difficulties than cisgendered individuals. (Cisgendered refers to the vast majority of individuals whose perceived gender matches their birth-assigned gender)
There are two conflicting belief systems as to the nature of Gender Dysphoria and to which, if any, treatment works for transgender individuals. As in the field of sexual orientation, there are what we refer to as "two solitudes" -- two groups with diametrically opposed belief systems who rarely communicate with each other, and who hold two very different belief systems about Gender Dysphoria and transgender individuals.
In almost all cases:
Religious conservatives consider Gender Dysphoria to be a basic confusion over gender, that is best treated with prayer and Christian-based reparative therapy. They are generally certain that their assessment is correct because it agrees with their interpretation of the Bible.
Religious liberals, secularists, human sexuality researchers, psychiatrists, psychologists, other therapists, etc. -- as well as transgender persons and transsexuals themselves -- believe that the only effective treatment for Gender Dysphoria involves medications like puberty blockers for children and hormone treatment perhaps along with subsequent sexual reassignment surgery for those who qualify. They are typically certain that their assessment of Gender Dysphoria is correct because it agrees with their experiences and with the conclusions of surveys of post-operative transsexuals.
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
"The Standards of Care for Gender Identity Disorders (Fifth Version)," The
Harry Benjamin International Gender Dysphoria Association Inc., 1998-JUN-15, at:
"e T Spider," "The history of gender identity disorder and treatment,"
eTRANSGENDER, 2006-NOV-17, at: