Off-Topic "Scientific" Studies regarding Transpeople

[Comfyman]

This thread is supposed to serve for the gathering and discussion of scientific and "scientific" studies on trans-related topics such as SRS, hormone therapy and the consequences of these, as well as the scientists and researchers involved. The studies discussed can be either solid research or flawed, ideologically charged, and/or misleading studies, as well as articles etc. covering such. Please make sure to, if possible, point out and elaborate on flaws of the second type of studies mentioned above.

Please make sure to correct me in the following if I've made some serious error.

When you google for 'trans surgery regret rate', the top result (for me at least) is a CNN article about the stunningly low regret rate of 1% of gender-affirming surgeries.

https://archive.md/8TKHG

The meta-study mentioned in this article has the title 'Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence' (https://archive.ph/Tx5T4), was published in 2021 and, according to Research Gate, was cited 59 times at the point of writing this post. The supposed results were as follows:

A total of 27 studies, pooling 7928 transgender patients who underwent any type of GAS, were included. The pooled prevalence of regret after GAS was 1% (95% CI <1%–2%). Overall, 33% underwent transmasculine procedures and 67% transfemenine procedures. The prevalence of regret among patients undergoing transmasculine and transfemenine surgeries was <1% (IC <1%–<1%) and 1% (CI <1%–2%), respectively. A total of 77 patients regretted having had GAS. Twenty-eight had minor and 34 had major regret based on Pfäfflin’s regret classification. The majority had clear regret based on Kuiper and Cohen-Kettenis classification.

In their introduction section they write:

Significant improvement in the quality of life, body image/satisfaction, and overall psychiatric functioning in patients who underwent GAS has been well documented.5,13–19 However, despite this, there is a minor population that experiences regret, occasionally leading to de-transition surgeries.20 Both regret and de-transition may add an important burden of physical, social, and mental distress, which raises concerns about the appropriateness and effectiveness of these procedures in selected patients. Special attention should be paid in identifying and recognizing the prevalence and factors associated with regret. In the present study, we hypothesized that the prevalence of regret is less than the last estimation by Pfafflin in 1993, due to improvements in standard of care, patient selection, surgical techniques, and gender confirmation care. Therefore, the aim of this study was to evaluate the prevalence of regret and assess associated factors in TGNB patients 13-years-old or older who underwent GAS.20

From this we can infer that there seems to be a distinction between the feeling of regret of a patient and the process of 'detransition' and they attempt to classify the complaints of the patients from the conducted interviews and questionnaires into different types of regret:

After selecting the articles, we assessed study characteristics. We identified year of publication, country in which the study was conducted, population size, and number of transmasculine and transfemenine patients with their respective mean age (expressed with SD, range, or interquartile range if included in the study). In addition, we extracted information of the method of data collection (interviews versus questionnaires), number of regrets following GAS, as well as the type of surgery, time of follow-up, and de-transition procedures. We classified the type of regret based on the patient’s reasons for regret if they were mentioned in the studies. We used the Pfäfflin and Kuiper and Cohen-Kettenis classifications of regret (Table 1)

Now after looking at the amazing results of this meta-study you might think to yourself "Chud sisters, this can't be happening! I, too, want to get a gender affirmation surgery now!" But I ask you to hold on for a moment while next we take a look at the studies that were used for the meta-study. Surely a sample size of 7928 transgender people must stem from a wide variety and well diversified amount of studies, right? Well, when we take a look at the two largest studies we see that these are the dutch studies "Wiepjes et al, 2018" with a sample size of 4863 and a regret size of 14 (blue in the left and orange on the right, a regret rate of 0.2%), as well as "Kuiper et al, 1998" with a supposed sample size of 1100 people and a regret size of 10 (orange on the left and grey on the right, a regret rate of 0.9%). In the graph below we see that these two studies alone make up 75% of the entire sample size of the meta-study.

First let's look at the Wiepjes et al study with the title 'The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets', which was published in the Journal of Sexual Medicine and was cited 315 times according to Research Gate. So this puts the paper in the Top 1.8% of most cited papers.
The study looked at the historic data of the patients of the authors' own gender identity clinic in the Netherlands.

Study Design and Patient Selection
After approval of the local ethics committee, a retrospective medical record review was performed to identify all people seen in our gender identity clinic from 1972 until December 2015. Data were collected from the hospital registries of the VUmc. The total study population was defined as people who had been diagnosed with 1 of the following International Classification of Diseases diagnoses: 302.5 (transsexualism), 302.6 (gender identity disorder not otherwise specified), or 302.85 (gender identity disorder in adolescent or adult) according to the 9th edition or F64 (gender identity disorders) according to the 10th edition.12 In addition, the administrative employees of our gender identity clinic registered everyone who was referred to our gender identity clinic since the early 1970s. People reported on this list also were included in the study population. Some people of this study population have been described in previous studies.9,13e18 People were excluded from the study if they had been registered at our gender identity clinic but had actually never visited the clinic or if they had presented with other complaints than gender identity issues. Because of the retrospective design and the large study population, necessity for informed consent was waived by our local ethics committee.

Hospital Registries
The hospital registries store clinical data obtained during regular patient care performed in our center, including medical diagnoses (since 1985), medication prescriptions (since 2000), surgical interventions (since 2006), laboratory test results (since 2004), radiology results (since 1993), and visit dates (since 2007). The 1st visit was defined as the 1st appointment with the psychologist, psychiatrist, pediatrician, endocrinologist, or gynecologist for health care related to gender identity.

The results in regards to regret according to the researchers was

Regret was identified in 0.6% of transwomen and 0.3% of transmen who underwent gonadectomy. The characteristics of these people are presented in Table 4. Their ages at start of HT ranged from 25 to 54 years, and they expressed their regrets 46 to 271 months after initiation of HT. Reasons for regret were divided into social regret, true regret, or feeling non-binary. Transwomen who were classified as having social regret still identified as women, but reported reasons such as “ignored by surroundings” or “the loss of relatives is a large sacrifice” for returning to the male role. People who were classified as having true regret reported that they thought gender-affirming treatment would be a “solution” for, for example, homosexuality or personal acceptance, but, in retrospect, regretted the diagnosis and treatment.

But what does Table 4 look like?

You can see for one that everyone of the patients with regret are either listed as F-M-F or as M-F-M. Another point that is interesting is that the last patient who according to the clinic ever showed regret had his castration done in 2007, despite the rapid increase of patients (children included) during the last decades as you can see in the graph below.

Why this is the case, I don't know. But for the first point we can look at the clinics definition of regret as stated in the beginning of page 3:

Some people regretted the interventions they had undergone. Transwomen who started testosterone treatment after vaginoplasty or transmen who started estrogen treatment after oophorectomy and expressed regret were categorized as those who experienced regret. Reasons for regret as reported in their medical records were noted. Dates were set to the 1st of the month and personal identification data were removed from the research database.

So, the patients who were identified by the authors as those with regret had to explicitly express regret in such a way that it would show up in the medical records AND they needed to have started detransitioning. According to this definition a transperson who realized what they had done to their body and then committed suicide without starting to detransition would not show up as regret case. Never mind the fact that the authors of course portray the results of their own clinic and thus have both an ideological as well as a financial agenda.

Finally let's look at Kuiper et al, 1998. Also a dutch study with the title 'Gender Role Reversal among Postoperative Transsexuals' (https://archive.ph/xYuyD) and cited 59 times according to Research Gate. This one is a bit strange and unclear. In the meta-study, the sample size for this one is stated to be 1100 individuals. Yet the purpose of the study is to find people with post-op regrets and interview them about the causes. In their method section and the beginning of the results section the authors write:

Method Procedure
The subjects for the study were traced in three different ways: by advertising in national newspapers/magazines, by making the study known among self-help groups of transsexuals, and by inviting patients of the Amsterdam gender team, known to live again in their former gender role. When someone agreed upon participation in the study, arrangements were made for an interview. All subjects chose to be visited at home for the interviews, which lasted for 3 hours on average. At the time of the study around 1100 transsexuals (800 MFs and 300 FMs) had undergone SRS in the Netherlands. The Amsterdam gender team had medically treated 95% of them. Until two years before the study most of the applicants were seen and diagnosed by a few private working clinicians from outside the team.
Instrument
For the purpose of this study a semi-structured questionnaire was developed. It consisted, among other things, of questions on gender identity and gender role development, history of cross-dressing, sexuality, psychiatric history in the past and the present, the initial reason for applying for SRS, the way the diagnostic process proceeded before and during SRS, and questions about realizing, explaining and coping with feelings of regret.

Results
Subjects
All together we obtained data from 9 MFs and 1 FM (table 2). None of the subjects had been patients of the interviewers.

The 1100 people who are stated as the sample size in the meta-study in reality seem to be the overall people who have had SRS up to the point of the study in the Netherlands. This number around the year 1998 also matches up when you compare it to the chart above showing the development of people having undergone SRS in the Netherlands. The actual sample size of the study rather seems to be the ten people who were interviewed but probably doesn't really give a clear perspective about the overall regret rate since it isn't clear how many people were actually reached and how many chose to not participate in the study despite having regrets. If we were to say that the ten people were the actual representative sample size of transpeople with regrets, the results are very high. In the study on page six and seven (as you can see below), six of the ten participants clearly stated that they had regrets with one other saying they had doubts and nine out of ten said that they wouldn't choose to get SRS again.

 

[one sky]

I don't remember where I ran into this one, but the line "fernandino has died in my womb" always struck me as a cool poetic thing for a troon to say.
Kinda haunting honestly.

 

[Ferryman]

Nice thread OP, been looking for something like this.

I don't remember where I ran into this one, but the line "fernandino has died in my womb" always struck me as a cool poetic thing for a troon to say.
Kinda haunting honestly.

Call me heartless, but reading that quote made me snort coffee out my nose and immediately think of the "Zanzibart... forgive me." meme for some reason.

 

[Jacques1194]

Thank you for this OP.I too was hoping there was a thread for the "science" of transgenderism.

 

[Coo Coo Bird]

I don't remember where I ran into this one, but the line "fernandino has died in my womb" always struck me as a cool poetic thing for a troon to say.
Kinda haunting honestly.

Indeed many representations of shame in figurative arts portray the ashamed subjects in the act of covering up. A famous example is Masaccio’s (1401–142 Cacciata dei progenitori dall’Eden (The Expulsion from the Garden of Eden)Footnote 7. Adam is represented in the act of covering his eyes, and Eve in the act of covering her genitals. Both appear in great distress. Without pretending to propose any biblical hermeneutics, it may be worth also mentioning the episode known as “the drunkness of Noah”, subject of much interpretative work (Pedone, 2012) and of many representations (Michelangelo’s painting in the Sistine ChapelFootnote 8). The Genesis narrates the story of Ham, one of Noah’s sons, who finds his father undressed and overcome by the effects of alcohol. He looks for his brothers, Shem and Japheth: “And Shem and Japheth took a robe, and putting it on their backs went in with their faces turned away, and put it over their father so that they might not see him unclothed”. They cover their father and walk away from the scene to overcome their shame (Genesis, 20–23).Footnote 9 See also La Pudicizia by Antonio Corradini (1688–1752)Footnote 10. Mentioned earlier, the photographer Alessandra Favetto illustrates shame as a woman nearly fully covered by a veil.2

Are academic papers actually written by aliens? Why do you need citations that being passed out drunk and naked are embarrassing, and what does any of it have to do with sex changes?

 

[Merton J. Dingle]

Reading the OP makes me feel like I'm reading the debunking of some paper published by an Intelligent Design journal in the 2000s.

 

[Ogre Magi]

There's a similar thread in PG for those interested

 

[ToroidalBoat]

Seems any research with conclusions favoring The Narrative™ are questionable. And any research going against it may be more or less censored in Current Year Clown World.

 

[Markass the Worst]

According to this definition a transperson who realized what they had done to their body and then committed suicide without starting to detransition would not show up as regret case.

All these supposed "scientific" studies in favor of trannyism suffer from this, it's called survivorship bias. I'm not aware of any study favoring trannyism that accurately accounts for survivorship bias.

 

[Comfyman]

There's a similar thread in PG for those interested

Didn't see that one, sorry. I was only searching for 'studies', 'scientific studies' etc. If the thread is too similar, it's fine by me if this one gets merged into the other or something. I directly put it here on this board since I felt that the topic was closest to transpeople in general and not another specific lolcow (sub-)community.

 

[Ogre Magi]

Didn't see that one, sorry. I was only searching for 'studies', 'scientific studies' etc. If the thread is too similar, it's fine by me if this one gets merged into the other or something. I directly put it here on this board since I felt that the topic was closest to transpeople in general and not another specific lolcow (sub-)community.

No problem. Not sure what would happen on the administrative side of merging or not, but when I saw this thread I thought it was the other one. Regardless, you did some good work collecting some studies for us to read.

 

[Bloitzhole]

I could see the dutch clinic having a lot fewer detransitioners and generally people reporting regret if their data predates the gender-trendiness of the mid-2010s tbh.

 

[Lucille Bluth]

There was an article about an old study (2004) which came to the conclusion that sex changes weren't effective. Obviously, this would never fly in 2023. (Link).

And a 2011 journal titled "Autogynephilia: an underappreciated paraphilia". I'll have to find an accessible link since it's been so long since I skimmed the whole paper.

 

[AirdropShitposts]

Didn't see that one, sorry. I was only searching for 'studies', 'scientific studies' etc. If the thread is too similar, it's fine by me if this one gets merged into the other or something. I directly put it here on this board since I felt that the topic was closest to transpeople in general and not another specific lolcow (sub-)community.

Don't worry about it, I think there's actually a distinction here! Yours seems to be about scientific studies proving troonery works and shit like that, I was going bit more for claims that oppose and contradict established science especially at a fundamental level. The way I was going with stuff like HRT is how it's not even falsifiable, no study can prove or disprove it because there's no hypothesis in the first place. But the focus I intended with the PG thread was more stuff like troons claiming they have real "working" vaginas, get periods, are getting more emotional, etc. This isn't stuff anyone is ever going to actually do a scientific study on because it's so absurd in the first place. Some of the stuff discussed in that thread about things being published was more about how these absurd claims were finding their way into more reputable sources despite the lack of evidence or outright lunacy of it.

Maybe that's too fine of a distinction to justify two threads but I suppose people and the jannies can decide on that. It has been taking some time to put together what I intended for the other one anyway. I have no problem with making whatever work if people just want to do one thread for all things like this.

 

[Comfyman]

All these supposed "scientific" studies in favor of trannyism suffer from this, it's called survivorship bias. I'm not aware of any study favoring trannyism that accurately accounts for survivorship bias.

It was especially funny regarding the meta-study, where the authors claim to search for general regret (as they say in the introduction "occasionally leading to de-transition surgeries") and then the largest study they use defines regret in the most narrow and ridiculous way.

 

[Ferryman]

There was an article about an old study (2004) which came to the conclusion that sex changes weren't effective. Obviously, this would never fly in 2023. (Link).
View attachment 5314519
And a 2011 journal titled "Autogynephilia: an underappreciated paraphilia". I'll have to find an accessible link since it's been so long since I skimmed the whole paper.
View attachment 5314520

Ask and ye shall receive.

All these supposed "scientific" studies in favor of trannyism suffer from this, it's called survivorship bias. I'm not aware of any study favoring trannyism that accurately accounts for survivorship bias.

Because there aren't any. Modern academia is so flush with bias that I'm positive someone can make a living just shitting out literature reviews that call out all the garbage getting published these days.

 

[Ealen]

As a general rule, troon science is bad. Very few studies producing reliable effects due to low sample sizes, convenience sampling, high loss to follow-up rate etc. As a result these meta-analyses end up being composed of a bunch of smaller studies that don't have any predictive validity but the authors can quote a sample size of like 400 even if that's from an analysis of 15 different studies all with different methodologies.

This article contains a lengthy section on SRS, responding to a document used in debates by twitch streamers and highlighting these issues and more. For a more comprehensive overview of studies on suicidal ideation, discrimination, and other arguments put forth by trans academics, this article by Sean Last covers the wider scientific literature.

 

[Standardized Profile]

Some excerpts from a wide-ranging literature review [archive] of morphological variation among normal people and varieties of troon.

tl;dr: Troons don't have natal sex or opposite sex brains. There are several distinct troon brain phenotypes. This may be a type of "brain intersexuality," but none of the study participants were somatic intersexuals. There is no evidence that the brain is hard-wired for opposite-sex physiology, such as a "phantom vagina" or "phantom penis."

MTF HSTS:

Overall, in vivo MRI studies indicate that the main morphological parameters of the brain (ICV, GM, WM, and CSF) are congruent with their natal sex in untreated homosexual MtFs. However, some cortical regions show feminine volume and thickness and it should be underscored that CTh presents an F > M morphological pattern. Nevertheless, with respect to CTh, this feminine cortical pattern is not the same as the one shown by control females (compare Fig. 2a and b). On the other hand, the main white matter fascicles in MtFs are demasculinized, while others are still masculine (Fig. 3a). Moreover, most of the differences appear to be located in the right hemisphere. So far, the studies on the white matter, like those above on gray matter, strongly suggest that MtFs have their own brain phenotype that mainly affects the right hemisphere.

MTF AGP:

All we know about the morphology of the brain of nonhomosexual MtFs comes from a single VBM study (Savic & Arver, 2011). Nonhomosexual MtFs have the same total intracranial volume as control males. They also show a larger gray matter volume in cortical regions in which the male and female controls did not differ in the study. These regions were the right parieto-temporal junction, the right inferior frontal, and the insular cortices. It was concluded that their data did not support the notion that the nonhomosexual MtF brain was feminized.

With respect to subcortical structures, it was reported that untreated nonhomosexual MtFs had a relatively smaller putamen and thalamus than male and female controls although these two latter groups did not show sex differences in the two structures (Savic & Arver, 2011).

In summary, the cortex of nonhomosexual MtFs presents morphological peculiarities in regions in which male and female controls do not differ.

FTM:

In FtMs, the gross morphological parameters correspond to their natal sex; their cortex is generally feminine but differs from males in different regions than do control females (compare Fig. 2a and c). Furthermore, some brain bundles are masculinized (Fig. 3b). All these findings suggest that homosexual FtMs have their own phenotype with respect to cortical thickness, subcortical structures, and white matter microstructure. Moreover, these changes are mostly seen in the right hemisphere.

Conclusions:

The review of the available data seems to support two existing hypotheses: (1) a brain-restricted intersexuality in homosexual MtFs and FtMs and (2) Blanchard’s insight on the existence of two brain phenotypes that differentiate “homosexual” and “nonhomosexual” MtFs. The studies on the effects of cross-sex hormone treatment on the brain of MtFs and FtMs consistently indicate dramatic effects on the gray and white matter after short- to medium-term treatments but the long-term effects on the brain require evaluation. Finally, the postmortem studies should be interpreted in light of these in vivo findings as well as of their underlying mechanisms.

Guillamon, A., Junque, C. & Gómez-Gil, E. A Review of the Status of Brain Structure Research in Transsexualism. Arch Sex Behav 45, 1615–1648 (2016). https://doi.org/10.1007/s10508-016-0768-5

 

[Human Institute Director]

This article gives you a good idea of how bad things have gotten. And it's more of a meta-study so it covers a lot of ground.

If you ever had faith in academy, forget about it asap. Even hard sciences might face this issue, but soft/social sciences are already conquered grounds.

Reality's Last Stand provides some solid debunks for troon science nonsense. They don't even have to go deep into statistics most of the time, just have consistent semantics and biological definitions. It's that easy.

 

[ConsentAccidentVictimNo98]

I'll have you know Shon Faye's book from like 2020 says that being trans is fine and it stops suicide!!! Oh, and it's necessary to go against capitalism.