About that survey


Last week, I wrote a response to an interview on the radio program, Issues, Etc., in which the author of a new book on the transgender movement noted that the suicide rate, attempts and successes, remains high for those who take medical and surgical steps to transition.  He said that those who transition “currently don’t have good outcomes.” When he goes on to cite the 41% suicide attempt rate, he said that those who transition fall into this category.

In my response, I asked, “What survey?” A friend sent me a link to a survey, and I recalled that I had already read it, and that it is the only recent survey of this type so it likely is the survey the author had cited.

Here is the survey: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

Here is the Issues, Etc., podcast:

Here is the post, with my reactions to the interview:


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The survey speaks of other, similar surveys. After citing other surveys’ statistics which show both reduced suicide rates and those which show no improvement, they write, “Data is inconsistent with respect to psychiatric morbidity post sex reassignment.” Also noted is that, because of the nature of surveying post-op trans folks, it was impossible to use proper scientific method, such as the double-blind method. Thus, when the survey in question is cited (and those like it), absolute terms should not be used.

Here is the conclusion of the survey report: “This study found substantially higher rates of overall mortality, death from cardiovascular disease and suicide, suicide attempts, and psychiatric hospitalisations in sex-reassigned transsexual individuals compared to a healthy control population. This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up. Even though surgery and hormonal therapy alleviates gender dysphoria, it is apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons. Improved care for the transsexual group after the sex reassignment should therefore be considered.”

I will now work from this comment—“Even though surgery and hormonal therapy alleviates gender dysphoria, it is apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons”—to demonstrate that one should not simply quote a statistic about our rates of attempted suicide and success in carrying it out.

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This report surveyed people who transitioned from 1973 to 2003. Sex reassignment began in the early part of the twentieth century, and became known across the USA when Christine (formerly George) Jorgenson returned from Denmark in 1952, where she had undergone surgery.

Jorgenson was the rare person to be public about being transsexual. In the early days of the surgery, transsexuals were forced to change their entire lives; it was part of the deal with their being qualified for surgery.

They had to create all new lives for themselves. Taking a new name, they shed their past. It was not unusual for them to have to leave family and friends, to go to a new town, to start over. Hopefully, they could pass as their desired sex and blend in, that they might find employment and housing, and that they not be exposed to physical and verbal abuse.

When looking at suicide attempt and success rates for those who have transitioned, family, social, economic, religious, and more factors must be factored into the consideration. Trans folks are not led to seeking a permanent way out through suicide only because of their internal identity struggle. Hardly. While it is impossible to quantify, one suspects that external factors might carry more weight than the internal elements.

Since the years of the survey, things have improved tremendously for us. They have a long way to go. From my experience, from conservation with dozens of trans folks, and from the many books I’ve read, it is the ongoing outside problems which create trouble for transitioned transgender folks. We reach peace with our bodies and living in our identified sex and gender, but we continue to be ostracized, emotionally battered, and concerned about our physical welfare. People say terrible things to us, give us looks which make us feel that we are carnival monsters on display, deliberately use our old names and the wrong pronouns, and on and on—none of which have to do with our having had surgery.

We are left to feel like we are freaks. We are not invited to certain family gatherings. We are asked to come to this funeral or that wedding as our birth sex. We are kicked out of our churches. We don’t get job promotions for much the same reasons as many women are overlooked. We might be fired simply because we are transgender, and given a false reason for the firing.

I have experienced some of these. Some of my oldest friends unfriended me on Facebook without saying a word to me. I have avoided some events, not wanting to be an offense to someone who might be there, who doesn’t accept me. In public, I have been started at, pointed at, and laughed at. I have been called “he” many times, and have had people continue to use masculine pronouns after I corrected them.

Despite the negatives which continue, trans folks are accepted way better than during the years of the survey, making one wonder what an up-to-date survey would say. A correlative is with the homosexual population. A similar survey of gays and lesbians from, say, the 1930s to 1960s, would look worlds different than one from even the 1980s, and not even in the same galaxy as one taken today. The better society treats we trans folks, the better it will go for us, too. And, I am confident, suicide attempt and suicide success rates would continually drop.

Do trans women and men, who have transitioned, continue to have greater struggles than the general population, which lead to attempting, even succeeding, at killing themselves? Yes. Much of their struggles are not of their making, but that of the world around them.

No one should quote this survey as if it provides a black-and-white statistic as to the ongoing problem of suicide for transitioned individuals.  It does not address external factors, it admits that proper scientific methodology was not used, and life for the transgender population in the second decade of the twenty-first century has improved greatly since the years covered by the survey.

As to how great the suicide problem is, we do not have a grasp on an accurate number, but we do know this: When we are treated in the same manner as the rest of the population, we stand a tremendously better chance of finding peace in this life.

Peace in life; it’s one thing that every single person on earth longs to possess.


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