Massive research analysis destroys conservative argument against letting trans people transition

None of the studies found that transitioning causes overall harm.

Analysis of 56 studies proves transgender individuals benefit from transitioning. (CREDIT: Derek Davis/Portland Press Herald via Getty Images)
Analysis of 56 studies proves transgender individuals benefit from transitioning. (CREDIT: Derek Davis/Portland Press Herald via Getty Images)

New analysis of available research shows unequivocally that transgender people benefit from taking steps to transition their bodies to match their gender identity, contradicting popular conservative claims.

According to the What We Know Project, a Cornell University-based program that compiles and assesses research on various LGBTQ topics, out of 56 studies covering the impact of transitioning on transgender adults since 1991, 52 — or 93 percent — showed positive results, and four yielded results that were “mixed or null.” None of the studies found that transitioning causes overall harm.

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According to the analysis, transitioning typically results in “improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.” Not only do trans people benefit from transitioning, but those benefits have increased over time “as both surgical techniques and social support have improved.” Likewise, surgical regret is increasingly rare, ranging from 0.3 percent to 3.8 percent, and largely results from insufficient social support or poor surgical outcomes from older techniques.

That’s not to say that transgender people don’t face higher races of depression and anxiety. But the studies attribute those outcomes to stigma and discrimination in society. Transitioning, they reveal, actually helps mitigate those concerns.

“The quality and quantity of research on gender transition are robust, showing unmistakably that it’s highly effective,” Nathaniel Frank, director of the What We Know Project, explained in a New York Times op-ed Monday.

These findings directly contradict a narrative anti-LGBTQ conservatives have been building in recent years. For example, a report published in 2016 by The New Atlantis claimed to be “a careful summary and an up-to-date explanation of research — from the biological, psychological, and social sciences — related to sexual orientation and gender identity.” Written by Lawrence Mayer and Paul McHugh, two individuals who have publicly espoused bias against transgender people, the report warned against allowing transgender people to transition.

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A ThinkProgress review has found that, of the 56 studies included in the What We Know analysis, not one of them was actually cited in Mayer and McHugh’s “comprehensive” review.

Mayer and McHugh’s instead relied on research that didn’t qualify for the What We Know review, such as a 2011 Swedish study that is frequently cited by conservatives to argue that people who have transitioned are more likely to commit suicide. The study’s lead author, Cecilia Dhejne, has repeatedly rebuked those who distort her research in this way, pointing out that — consistent with What We Know’s findings in other studies — the higher suicide rate was only found in people who transitioned prior to 1989. Dhejne’s subsequent 2014 study was included in the review as showing positive outcomes for transgender people who have transitioned.

The Pentagon has also used the 2011 Swedish study to justify its decision to recommend to the Trump administration that transgender individuals be banned from serving in the military. As it was in Mayer and McHugh’s analysis, the Swedish study was distorted a similar fashion to suit the administration’s agenda. Neither cited Dhejne’s 2014 study.

As ThinkProgress previously reported, Vice President Pence impaneled his own working group to address the ban on transgender people serving in the military last month, which effectively overruled recommendations from other military leaders. That group included anti-LGBTQ activists like Tony Perkins of the Family Research Council and the Heritage Foundation’s Ryan T. Anderson, who recently released a book rejecting the benefits of transitioning, which cited McHugh and similarly distorted the 2011 Swedish study. Unsurprisingly, the Pentagon’s report closely mirrors the arguments Anderson made in his book.

It’s also worth noting how the What We Know Project arrived at its decision to review the 56 studies cited in its analysis. An initial search of 4,347 peer-reviewed articles about transgender people and transition surgeries was whittled down to 589 studies that appeared to address the research question. That was then narrowed down to 124 studies that specifically assessed the wellbeing of transgender people who have undergone transition.

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Those 124 studies were then vetted once more to eliminate studies that did not actually connect trans people’s well-being to their transition, studies that focused on children, and studies that focused on physical outcomes, which were more about surgical technique than mental health. Because the 2011 Swedish study did not connect outcomes to surgery, it was not included.

What We Know conveniently links to all 56 studies so that they can easily be reviewed by others.

This post has been updated to clarify distinctions between Dhejne’s 2011 and 2014 studies.