D’Angelo, R. (2018). Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry, 26(5), 460–463 Til tidsskriftet

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The paper examines the unusually high patient drop-out rates in studies examining satisfaction with gender-affirming surgeries. This raises the possibility that patients who refuse to engage in follow-up research or lose contact with the gender clinics who treat them may have worse outcomes, and that failure to account for their outcomes may be masking a higher than claimed regret rates.

The paper highlights the following:

• Smith et al. report that sex reassignment is effective, based on a study of 162 adults who had undergone [gender confirmation surgery]. They were able to obtain follow-up data from only 126 (78%) of subjects because a significant number were “untraceable” or had moved abroad.

• De Cuypere et al. report that [gender confirmation surgery] is an effective treatment for transsexuals. Of 107 patients who had undergone [gender confirmation surgery] between 1986 and 2001, 30 (28%) could not be contacted and 15 (14%) refused to participate.

• Johannson et al. reported good outcomes for [gender confirmation surgery]. Of 60 patients who had undergone [gender confirmation surgery], 42 (70%) agreed to participate in the follow up research. Of the non-participants, 1 had died of complications of [gender confirmation surgery], 8 could not be contacted and 9 refused to participate.

• Salvador et al. reported that [gender confirmation surgery] has a positive effect on psychosocial functioning. Only 55 of the 69 patients (80%) could
  be contacted as 17 were lost to follow-up

• Van de Grift et al. reported 94–96% of patients are satisfied with SRS and have good quality of life. A total of 546
  patients with Gender Dysphoria who had applied for [gender confirmation surgery] at clinics in Amsterdam, Hamburg and Ghent were contacted to
  complete an online survey. Only 201 (37%) responded and completed the survey.