Correction: The article “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study,” published in The American Journal of Psychiatry on Oct. 4, 2019, has been corrected following a review of the study’s methodology and some of its conclusions. This news item has likewise been corrected to reflect that the authors’ original conclusion was too strong in suggesting that the study’s findings support providing gender-affirming surgeries to transgender individuals who seek them.
The original news item contained the heading “Mental Health Outcomes Improve for Transgender Individuals After Surgery, Study Finds.” In a letter published in the August 2020 issue of The American Journal of Psychiatry, the study authors write that, although this study fills important gaps in the research, “Our conclusion based on the findings at hand in the article, which used neither a prospective cohort design nor a randomized controlled trial design, was too strong.”
The study, which reviewed 10 years of medical data for the entire population of Sweden, is one of the only analyses of transgender individuals’ mental health treatment for depression, anxiety disorders, and suicide based on an entire country’s population.
In this study, the researchers analyzed medical outcomes between 2005 and 2015 for 2,679 individuals in the Swedish population who had received a diagnosis of gender incongruence.
The study found that transgender individuals who had received a diagnosis of gender incongruence were:
- six times more likely to have a mood or anxiety disorder than the general population.
- three times as likely to be prescribed antidepressants and antianxiety medications.
- more than six times as likely to attempt suicide resulting in hospitalization.
The study also found that transgender individuals who had undergone gender-affirming surgery were significantly less likely to seek mental health treatment for depression and anxiety disorders as a function of years since the procedure.
However, after reviewing several letters pointing out methodological limitations of their approach, the authors published a correction noting that this observational study cannot establish the consequences of gender-affirming treatments on mental health. “Only future studies using even stronger methodologies can establish any causal impact of gender-affirming surgery on transgender people’s mental health,” says study co-author John Pachankis, Susan Dwight Bliss Associate Professor of Public Health at the Yale School of Public Health.
Richard Bränström, an associate professor at Karolinska Institutet in Sweden, joins Pachankis as the paper’s other co-author.
A correction, letters to the editor (see 35-41 in the references of the article, the response by the study authors and an editorial is available in the August 2020 issue of The American Journal of Psychiatry.
“Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study,” R Bränström, J Pachankis, The American Journal of Psychiatry, Oct. 4, 2019, DOI: 10.1176/appi.ajp.2019.19010080