Transition surgery improves the quality of life for trans women, study finds

Scientists from the European Association of Urology have published groundbreaking new research indicating that gender surgery significantly improves quality of life for the majority of trans patients.

The study – which is the first of its kind – found that 80 per cent of male-to-female patients perceived themselves as women post-surgery.

Led by DrJochen Hess, of the university hospital in Essen, Germany, the study followed 156 patients for a median of more than six years after surgery. The team developed and validated the new Essen Transgender Quality of Life Inventory, which is the first methodology to specifically consider transgender quality of life.

They found that there was a high overall level of satisfaction with the outcomes of surgery. After comparing patients’ quality of life during the last four weeks before surgery with their quality of life while publicly identifying as trans, there was a highly significant increase. This indicates a large improvement in quality of life over the course of the transitioning process.

Dr Hess said:

Around three-quarters of patients showed a better quality of life after surgery. 80% perceived themselves to be women, and another 16% felt that they were 'rather female'. Three women in four were able to have orgasms after reassignment surgery.

It's very important that we have good data on Quality of Life in transgender people. They generally suffer from a worse QoL than non-transgender population, with higher rates of stress and mental illness, so it's good that surgery can change this, but also that we can now show that it has a positive effect.

Until now we have been using general methods to understand quality of life in transgender individuals, but this new method means that we can address well-being in greater depth

Recent data estimates that 1.4 million adults in the USA identify as transgender, which is about 0.6% of the population. Comparable European figures are not yet available, but there is wide variation between reported prevalence in individual European countries.

The team notes that there are limitations to the study. There was a high drop-out rate, and the results are from a single centre – yet they clearly indicate that surgery can improve the lives of trans women.

Professor Jens Sønksen, of the University of Copenhagen, said:

This study suffered from a high drop-out rate, which needs to be considered alongside the main data.

Nevertheless, this is a large important study, one of the largest clinical transsexual surveys ever attempted, and the fact that has been performed using a specific validated questionnaire is significant.

This is probably the best view of quality of life in after sex-reassignment that we have

Reacting to the results of the study, journalist and broadcaster Paris Lees told indy100 that she wasn't surprised by the results and said it vindicated what the trans community had been saying for years.

The renewed public interest in trans issues has spawned a lot of negativity, but it’s also brought fascinating research. Time and time again, research is validating what the trans community have been saying for years: that we should support trans people for who they say they are. 

As someone who has undergone medical transition, this study isn’t surprising.

Gender reassignment is one of the most successful operations in terms of patient satisfaction on the NHS. Many people have had it and are getting on with their lives private.

Ultimately this is a private medical issue for people to work out with their doctors. Although we shouldn’t have to justify ourselves, this study is further vindication of what we’ve been saying for years.

Lees stresses that, when it comes to trans issues, we should rely on evidence instead of our preconceptions what trans people are.

When we discuss transgender issues, it’s really important that we focus on the evidence. It’s out there. We will win the struggle to be accepted and for healthcare because there’s no evidence that supporting trans people to live healthy and happy lives causes problems.

Juno Roche, activist, campaigner and author of the forthcoming book Queer Sex: A Trans and Non-Binary Guide to Intimacy, Pleasure and Relationships, told indy100:

It doesn’t surprise me in the slightest that enabling trans folk to have the procedures that allow them to feel more comfortable within their bodies means that those people are happier than if they continued to live with a measure of dysphoria.

Not every trans person wants surgery, and there are many trans people living very happy lives with the bodies and genitals they were born with.

I’m not sure that my vagina made me feel ‘more of a woman’ – I always felt that – but surgery allowed me to modify my body to fit my idea of my existing self.

Although this research indicates an improvement in the quality of life of trans women post-surgery, the quality of life of trans people is still significantly lower than the general population.

More: We asked 14 trans activists how cis people can be better allies in 2018