Overwhelming majority doesn't regret top surgery, new study finds

Despite what gender-affirming care opponents say, the overwhelming majority of study subjects are highly satisfied with their surgeries.

Trans flag outstretched above crowd of people representing top surgery study
Image: Shutterstock @cunaplus

Despite claims that young people may regret gender-affirming surgeries over time, a comprehensive study confirms that overall long-term satisfaction with top surgery procedures is “overwhelmingly positive”.

Previous research already confirmed that only 1% of gender-affirming care patients regretted their surgeries, but most of those studies focused more on short-term satisfaction. This new research tells us that most people are highly satisfied with surgeries decades after, and nearly no one regrets the procedure.

The long-term study was published in the JAMA Surgery journal on August 9, 2023. It surveyed 139 participants who had gender-affirming mastectomies, more often referred as top surgery, and measured their quality of life years after having the procedure.

The study’s median satisfaction rate on a scale of one to five was five, with five being the greatest satisfaction. The medium regret score was zero on a scale of zero to 100, with zero being the lowest regret. All of the surgeries were completed at the University of Michigan over thirty years between January 1, 1990, and February 29, 2020.

Top surgeries are one form of gender-affirming care that transmasculine, non-binary or other people get to reshape the skin and tissue of their chest so that they have a flatter build.

The study acknowledged that there has been increased legislation worldwide continues that to restrict gender-affirming care. Opponents claim that young people may regret making surgical changes to their bodies, but there is no evidence to support decisional regret.

Not everyone who transitions will choose to have surgery, and those who do have surgery typically do so after years of waiting and consideration. Plastic and Reconstructive Surgeon, Dr Loren Schechter, wrote an editorial in response to the study comparing gender-affirming care with other surgical disciplines, saying: “When rates of regret in gender-affirming surgery are compared with other surgical interventions, the results are striking.”

None of the top surgery study participants had a reversal procedure, and roughly 25% of participants went on to have additional gender-affirming surgeries. Those conducting the study said: “These results suggest sustained intent and consistency in decision-making.”

Despite misinformation and fear-mongering, the research suggests that giving trans people access to gender-affirming care is essential and these procedures are life-saving.

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