50 Years of Sex Changes, Mental Disorders, and Too Many Suicides

Public Discourse 2 February 2016
Studies show that the majority of transgender people have other co-occurring, or comorbid, psychological disorders.

A 2014 study found 62.7% of patients diagnosed with gender dysphoria had at least one co-occurring disorder, and 33% were found to have major depressive disorders, which are linked to suicide ideation. Another 2014 study of four European countries found that almost 70% of participants showed one or more Axis I disorders, mainly affective (mood) disorders and anxiety.

In 2007, the Department of Psychiatry at Case Western Reserve University in Cleveland, Ohio, committed to a clinical review of the comorbid disorders of the last 10 patients interviewed at their Gender Identity Clinic. They found that “90% of these diverse patients had at least one other significant form of psychopathology . . . [including] problems of mood and anxiety regulation and adapting in the world. Two of the 10 have had persistent significant regrets about their previous transitions.”

Yet in the name of “civil rights,” laws are being passed at all levels of government to prevent transgender patients from receiving therapies to diagnose and treat co-occurring mental disorders.

The authors of the Case Western Reserve University study seemed to see this legal wave coming when they said:

This finding seems to be in marked contrast to the public, forensic, and professional rhetoric of many who care for transgendered adults . . . Emphasis on civil rights is not a substitute for the recognition and treatment of associated psychopathology. Gender identity specialists, unlike the media, need to be concerned about the majority of patients, not just the ones who are apparently functioning well in transition.

As one who went through the surgery, I wholeheartedly agree. Politics doesn’t mix well with science. When politics forces itself on medicine, patients are the ones who suffer.

What about the suicides?
Let’s connect the dots. Transgender people report attempting suicide at a staggering rate—above 40%. According to Suicide.org, 90% of all suicides are the result of untreated mental disorders. Over 60% (and possibly up to 90% as shown at Case Western) of transgender people have comorbid psychiatric disorders, which often go wholly untreated.

Could treating the underlying psychiatric disorders prevent transgender suicides? I think the answer is a resounding “yes.”

The evidence is staring us in the face. Tragically high numbers of transgender people attempt suicide. Suicide is the result of untreated mental disorders. A majority of transgender people suffer from untreated comorbid disorders—yet against all reason, laws are being enacted to prevent their treatment.

I write out of deep concern for the transgender men and women who attempt suicide, who are unhappy, and who want to go back to their birth gender. The other ones—those who appear to be functioning well in transition, at least for now during their “reprieve”—are celebrated in the media. But I hear from others—the ones who prefer to stay hidden, who are contemplating suicide, whose lives are torn apart, who have had the surgery but still have debilitating physical or psychological issues—the ones whose reprieve is over.

In the 1970s and now, gender-reassignment surgery is routinely performed when requested. Transgender people are the one population allowed to diagnose themselves with gender dysphoria solely on the basis of their desire for sex-reassignment surgery, and not because the medical community has found objective proof that such surgery is medically required.

After fifty years of surgical intervention in the United States, a scientific basis for surgical treatment of transgender people is still lacking. A task force commissioned by the American Psychiatric Association did a review of the literature on the treatment of gender identity disorder and in 2012 stated, “The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low.” In 2004, the review of more than 100 international medical studies of post-operative transsexuals found “no robust scientific evidence that gender reassignment surgery is clinically effective.”
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