Am I in Better Mental Health Now that I’ve Had Genital Reconstruction Surgery?
My Experiences In Light of a New Study
This article has been going around a lot on social media. I found it on Facebook and shared it, only to have it shared by dozens of other people. This is by far the most I remember anyone sharing anything I’ve posted or shared (despite my enormously popular pun posts).
So what is the topic of this popular article? Transgender surgery. I know. Right now, you might be saying, “uh oh, what now?” Surprisingly, it is good news this time.
Although it is about only one study that looks at an admittedly narrow group of people, the results nonetheless suggest that transgender people might benefit from better long-term mental health if they receive gender-affirming surgery.
The title of the article doesn’t specify what “transgender surgery” really means — it could be a mastectomy for trans masculine folks, chest augmentation for trans feminine people, or any number of procedures involving reworking of the genitals. It is implied in the article, though, that the study mostly looked at people who had “gender confirming surgery,” also understood as genital reconstructive surgery (GRS). In colloquial terms, trans people refer to this as “bottom surgery.”
As someone who has struggled with mental health issues most of my life (primarily depression) and who had GRS several years ago, I thought I might have a perspective on the authenticity of these findings. In other words…
Do The Findings Ring True for Me, Someone Who Has Had “Transgender Surgery?”
First, I want to point out that the reporting of this study comes from ABC News, a mainstream news outlet. Therefore, I found myself reading it through a couple times to ensure that the findings of the study were accurate.
A quick search of Google (my friend) showed me that the story has been reported by other outlets, but also by the Yale University School of Medicine (which published the original study), and the American Psychiatric Association. So far, so good.
As someone with the experiences they describe, I have to say that the results seem to hold water with me as well. It’s been over two years since I had genital reconstruction surgery and I feel pretty damn good, emotionally and mentally.
I am much more comfortable in my own skin (although I don’t think dysphoria ever goes away for those who suffer from it). The war between me and my body, though, is now at least a cease-fire, if not an armistice.
I feel like I have more confidence when out in the world. Our current world is just messed up enough that someone pre-surgery can get pretty worked up about, say, peeing in public bathrooms if they have not had GRS. Even if they transitioned years ago.
So, yeah, life has been somewhat simpler since surgery and that has to have had a positive effect on my mental health.
But I can’t help thinking…
There’s Probably More to This
The problem is things like this are never cut and dried. The article mentions that the study group was mostly higher income.
The study looked at mental health care treatment of the respondents ten years before and after surgery, and found that the need for mental health visits and treatment decreased 8% for each year post surgery.
I can think of some obvious opportunities for bias and skewed data here. First, one issue for many (probably most) transgender patients is limited access to appropriate and sufficient health care, especially mental health care. The very fact that these patients had access to mental health treatment and visits with providers over a twenty year period stands them apart from a lot of other trans people, unfortunately.
Also, we know that mental health is often affected by environmental factors. Being trans and dealing with a world often hostile to trans people can be one huge stressor. But so can being a person of color, poor, disabled, or any number of other things. I could make a case for the surgery helping with how I feel about my relationship with my own body and even with how others see me. However, being trans is still only one of many stressors that can cause poor mental health outcomes.
Another thing to consider is that not everyone has the same access to gender affirming care, and the results of GRS are not always the same. Even with the best surgeons, we know that complications still happen. But some people do not have access to the best surgeons, so the number of poor outcomes would probably be higher.
Finally, I remember going through a period of adjustment after surgery. I had a whole new set of body parts I needed to learn to use and care for. Though they still didn’t come with an instruction manual, at least I now had the surgeon and her assistants to help me learn.
However, I still had to learn how to do so many things differently. And, unlike women who were born with vulvae, I had to do something called dilating to ensure the opening stayed, well, open.
In other words, it was a lot of work and there was a high learning curve. I have to imagine that this would add stress in the short term. In the long term, who knows? I have few issues, but others might.
We Don’t Know What We Don’t Know
The overriding issue for me, though, is just how little we still know. I am enthused about this study simply because there has been so little research done so far. We don’t know how people outside of the demographics of the small study group would respond, for instance.
Would the experience and results be different for trans people of color?
Are there differences in outcomes between trans men and trans women?
What about non-binary people who have some kind of surgery (I know of AFAB non-binary folx who have had hysterectomies and mastectomies, for instance)?
One of the investigators in the study mentioned that they have not been able to find correlation between hormone treatment and mental health outcomes the way they have with surgery. Why would that be? Does it simply mean we need more study? The article — and the study itself — are unclear on the subject.
Can We Consider This a Bit of Rare Good News, Though?
Yes, absolutely. I personally feel somewhat validated, as if my good feelings about transition and surgery have been born out by this study, at least a little bit.
I think this will be looked at as good news by anyone considering surgery. Especially if they wonder if surgery would really change anything for the better.
For me it has, and the study seems to suggest I am not the only one.
