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Societal Impact Of Gender-affirming Surgery And Its Role In Detransitioning
Sacha C. Hauc, MD, MPH, Raymond Wen, BS, Cristiane Ueno, MD.
The Ohio State University, Columbus, OH, USA.
Purpose: Gender-affirming surgery (GAS) significantly reduces psychological distress and promotes well-being among transgender individuals. This study evaluates the societal benefits of GAS and factors contributing to detransition, using data from the 2015 U.S. Transgender Survey.
Methods: A cross-sectional survey analyzed data from over 27,000 transgender and non-binary respondents across all 50 U.S. states. Participants provided self-reported demographic and healthcare-related information. Key exposures included demographic factors, healthcare access, and GAS status.
Results: About 90% of detransition cases were linked to external pressures, such as family rejection (20.80%) and job insecurity (31.36%). Lower income (OR = 1.684; P = 0.0386) and workplace discrimination (OR = 1.277; P = 0.0343) increased detransition risk. Strong family support decreased the odds of detransition by 24% (OR = 0.765; P = 0.0454). Those who underwent GAS were 27% less likely to detransition compared to those who did not (OR = 0.725; P = 0.0192). GAS also correlated with significant societal benefits, including reduced harassment (OR = 0.693; P = 0.0078) and increased civic participation (OR = 1.339; P = 0.0005).
Conclusion: GAS improves safety, reduces substance use, and enhances civic engagement, highlighting the need for broader access and supportive policies. Detransition primarily stems from external pressures, not internal regret, suggesting that GAS is beneficial and should be accessible to those seeking it.
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