Why Gender Reassignment Surgery Isn't a Cure-all for Many Trans People

Some patients who went through gender reassignment surgery reported feeling just as out of place. A few were even suicidal. 

Imagine coming to the realization that you are in the wrong body. Inside you feel a certain way, but your appearance reflects something different. How do you cope with this dichotomy? Can you? If you’re transgendered, one approach is sexual reassignment surgery. Correct the outside appearance, and the symmetry should allay any conflict. However, a new meta-analysis conducted by UK researchers finds that some patients are just as distressed after the operation as before. Researchers reviewed 100 studies of post-operative transsexuals from around the globe to draw their conclusions.


British newspaper The Guardian was the motivating force behind this study. It interviewed several people who had gone through such an operation and regretted it. In the meta-analysis, researchers found zero evidence that undergoing such a procedure had any value to the patient. Researchers at the University of Birmingham's aggressive research intelligence facility (Arif) conducted the study.

The director of Arif, Chris Hyde, expressed doubt on whether gender reassignment surgery was beneficial. “There's still a large number of people who have the surgery but remain traumatized,” he said. “Often to the point of committing suicide." Unfortunately, in their final analysis, Arif investigators determined that the lion’s share of the research on this topic so far was poorly designed and executed.

Though things have been tough for the transgendered, acceptance is beginning to take root.

Between 100 and 500 of these procedures occur in the US in any given year, according to the Surgery Encyclopedia, although a separate report indicates that, in terms of male-to-female transitions (MF) alone, between 800 and 1,000 occur annually.

According to some accounts, those who undergo a sex change sometimes feel the hormone therapy, which they must undergo for a year prior to surgery, “pushes” them into it. Others say they will never be accepted in their new body, and so would rather go back to the old one. In one of the studies, over half of the participant pool disappeared. The reason was unknown.

This may reflect the disdain for their new body or worse, according to Dr. Hyde. Though the majority of patients do well, Dr. Hyde contends, those who do not are woefully unprepared for how bad they feel. Some say that losing half of the participants in such a study reflects how little regard the transgendered receive in society.

A recent study out of the University of California, San Diego proves that many trans people feel at odds with their own physical gender. The ability to identify this may someday work to help trans children understand who they are. After puberty, transitioning becomes more difficult, medically speaking. This neurological discovery could help clear up questions of whether a transition should occur or not, as brain imaging data is objective. It could also help to tell whether a person will take well to sexual reassignment.

New study uses brain imaging to show neurological differences between transgendered and cisgendered.

Laura Case at UC San Diego wanted to see if she could use brain imaging to detect an incongruity between the brain and the body, in terms of gender identity. Eight trans men, or those who are female biologically but identify as male, were tested, along with eight cisgender women—used as a control group.

Using magnetoencephalography and an MRI, researchers found that trans men had less activity in a region of the brain known as the supramarginal gyrus. This area gives us a sense of our body parts belonging to us. It may mean that that sense is less pronounced in the transgendered than in cisgendered or traditionally gendered people. Whether this feeling came first and caused a biological response, or the biological manifestation shaped the psychology of the person, is not yet known. One previous study found that white matter in four regions of the brain of trans men closely resembled that of cisgender men.

More research is planned, which will look into the neurobiology of the transgendered, and the impact of sexual assignment surgery on them. For many of us, gender is something we take for granted. Unfortunately, trans people must try to find their way in a dichotomous world where the true diversity of humanity is often ignored, overlooked, ridiculed, or shunned.

The supramarginal gyrus. Image y Gray, vectorized by Mysid, colourd by was_a_bee. (File:Gray726.svg) [Public domain], via Wikimedia Commons.

The truth is that many more people are born with ambiguous sex organs than we think. Oftentimes in the past, doctors at the time of birth decided arbitrarily which gender the child was going to be, simply by which sex organ was easier to fashion. Those born with ambiguous genatalia are known as “intersex.” This occurs in about one in 1,500 or 2,000 births or 1.7% of the world population. Due to this, for many, identifying as gender fluid may make more sense.

By all accounts, intersex babies are just as healthy as their cisgender counterparts. Unfortunately, our society’s focus on labels makes the lives of those who are trans difficult. Perhaps instead we should love them for who they really are, regardless of what they have in their pants.

The other important notion is that it's human nature to think, “If only _____ were true, I’d be content.” But no matter the physical situation, contentment cannot come from without, no matter how we think the outcome might transform us. Though in some cases, it seems gender reassignment surgery can be life changing, contentment itself, no matter your gender, be it strict or fluid, can only come from within.

To hear one person’s story click here: 

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Political division is nothing new. Throughout American history there have been numerous flare ups in which the political arena was more than just tense but incideniary. In a letter addressed to William Hamilton in 1800, Thomas Jefferson once lamented about how an emotional fervor had swept over the populace in regards to a certain political issue at the time. It disturbed him greatly to see how these political issues seemed to seep into every area of life and even affect people's interpersonal relationships. At one point in the letter he states:

"I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend."

Today, we Americans find ourselves in a similar situation, with our political environment even more splintered due to a number of factors. The advent of mass digital media, siloed identity-driven political groups, and a societal lack of understanding of basic discursive fundamentals all contribute to the problem.

Civil discourse has fallen to an all time low.

The question that the American populace needs to ask itself now is: how do we fix it?


Discursive fundamentals need to be taught to preserve free expression

In a 2017 Free Speech and Tolerance Survey by Cato, it was found that 71% of Americans believe that political correctness had silenced important discussions necessary to our society. Many have pointed to draconian university policies regarding political correctness as a contributing factor to this phenomenon.

It's a great irony that, colleges, once true bastions of free-speech, counterculture and progressiveness, have now devolved into reactionary tribal politics.

Many years ago, one could count on the fact that universities would be the first places where you could espouse and debate any controversial idea without consequence. The decline of staple subjects that deal with the wisdom of the ancients, historical reference points, and civic discourse could be to blame for this exaggerated partisanship boiling on campuses.

Young people seeking an education are given a disservice when fed biased ideology, even if such ideology is presented with the best of intentions. Politics are but one small sliver for society and the human condition at large. Universities would do well to instead teach the principles of healthy discourse and engagement across the ideological spectrum.

The fundamentals of logic, debate and the rich artistic heritage of western civilization need to be the central focus of an education. They help to create a well-rounded citizen that can deal with controversial political issues.

It has been found that in the abstract, college students generally support and endorse the first amendment, but there's a catch when it comes to actually practicing it. This was explored in a Gallup survey titled: Free Expression on Campus: What college students think about First amendment issues.

In their findings the authors state:

"The vast majority say free speech is important to democracy and favor an open learning environment that promotes the airing of a wide variety of ideas. However, the actions of some students in recent years — from milder actions such as claiming to be threatened by messages written in chalk promoting Trump's candidacy to the most extreme acts of engaging in violence to stop attempted speeches — raise issues of just how committed college students are to
upholding First Amendment ideals.

Most college students do not condone more aggressive actions to squelch speech, like violence and shouting down speakers, although there are some who do. However, students do support many policies or actions that place limits on speech, including free speech zones, speech codes and campus prohibitions on hate speech, suggesting that their commitment to free speech has limits. As one example, barely a majority think handing out literature on controversial issues is "always acceptable."

With this in mind, the problems seen on college campuses are also being seen on a whole through other pockets of society and regular everyday civic discourse. Look no further than the dreaded and cliche prospect of political discussion at Thanksgiving dinner.

Talking politics at Thanksgiving dinner

As a result of this increased tribalization of views, it's becoming increasingly more difficult to engage in polite conversation with people possessing opposing viewpoints. The authors of a recent Hidden Tribes study broke down the political "tribes" in which many find themselves in:

  • Progressive Activists: younger, highly engaged, secular, cosmopolitan, angry.
  • Traditional Liberals: older, retired, open to compromise, rational, cautious.
  • Passive Liberals: unhappy, insecure, distrustful, disillusioned.
  • Politically Disengaged: young, low income, distrustful, detached, patriotic, conspiratorial
  • Moderates: engaged, civic-minded, middle-of-the-road, pessimistic, Protestant.
  • Traditional Conservatives: religious, middle class, patriotic, moralistic.
  • Devoted Conservatives: white, retired, highly engaged, uncompromising,
    Patriotic.

Understanding these different viewpoints and the hidden tribes we may belong to will be essential in having conversations with those we disagree with. This might just come to a head when it's Thanksgiving and you have a mix of many different personalities, ages, and viewpoints.

It's interesting to note the authors found that:

"Tribe membership shows strong reliability in predicting views across different political topics."

You'll find that depending on what group you identify with, that nearly 100 percent of the time you'll believe in the same way the rest of your group constituents do.

Here are some statistics on differing viewpoints according to political party:

  • 51% of staunch liberals say it's "morally acceptable" to punch Nazis.
  • 53% of Republicans favor stripping U.S. citizenship from people who burn the American flag.
  • 51% of Democrats support a law that requires Americans use transgender people's preferred gender pronouns.
  • 65% of Republicans say NFL players should be fired if they refuse to stand for the anthem.
  • 58% of Democrats say employers should punish employees for offensive Facebook posts.
  • 47% of Republicans favor bans on building new mosques.

Understanding the fact that tribal membership indicates what you believe, can help you return to the fundamentals for proper political engagement

Here are some guidelines for civic discourse that might come in handy:

  • Avoid logical fallacies. Essentially at the core, a logical fallacy is anything that detracts from the debate and seeks to attack the person rather than the idea and stray from the topic at hand.
  • Practice inclusion and listen to who you're speaking to.
  • Have the idea that there is nothing out of bounds for inquiry or conversation once you get down to an even stronger or new perspective of whatever you were discussing.
  • Keep in mind the maxim of : Do not listen with the intent to reply. But with the intent to understand.
  • We're not trying to proselytize nor shout others down with our rhetoric, but come to understand one another again.
  • If we're tied too closely to some in-group we no longer become an individual but a clone of someone else's ideology.

Civic discourse in the divisive age

Debate and civic discourse is inherently messy. Add into the mix an ignorance of history, rabid politicization and debased political discourse, you can see that it will be very difficult in mending this discursive staple of a functional civilization.

There is still hope that this great divide can be mended, because it has to be. The Hidden Tribes authors at one point state:

"In the era of social media and partisan news outlets, America's differences have become
dangerously tribal, fueled by a culture of outrage and taking offense. For the combatants,
the other side can no longer be tolerated, and no price is too high to defeat them.
These tensions are poisoning personal relationships, consuming our politics and
putting our democracy in peril.


Once a country has become tribalized, debates about contested issues from
immigration and trade to economic management, climate change and national security,
become shaped by larger tribal identities. Policy debate gives way to tribal conflicts.
Polarization and tribalism are self-reinforcing and will likely continue to accelerate.
The work of rebuilding our fragmented society needs to start now. It extends from
re-connecting people across the lines of division in local communities all the way to
building a renewed sense of national identity: a bigger story of us."

We need to start teaching people how to approach subjects from less of an emotional or baseless educational bias or identity, especially in the event that the subject matter could be construed to be controversial or uncomfortable.

This will be the beginning of a new era of understanding, inclusion and the defeat of regressive philosophies that threaten the core of our nation and civilization.