Studies Expose Hidden Suicide Risks After Gender Surgery

This article is about the mental health risks and suicides after gender surgery.

Introduction

Transgender individuals often face significant challenges, including higher rates of depression, anxiety, and suicidal thoughts. These struggles are usually linked to societal stigma, discrimination, and a lack of acceptance or affirmation of their gender identity.

For many, gender-affirming surgery is a critical step in aligning their physical body with their true gender identity. But what happens to their mental health after surgery?

A recent study aimed to answer this question. The findings offer important insights for transgender individuals and valuable information for healthcare providers.

Study 1: Examining gender-specific mental health risks after gender-affirming surgery: a national database study

The first study was published by The Journal of Sexual Medicine in February 2025. It analyzed data from over 107,000 transgender adults in the U.S. These individuals were diagnosed with gender dysphoria.[1]

Gender dysphoria is a condition where a person experiences distress due to a mismatch between their gender identity and their physical body.

Researchers divided participants into groups based on whether they had undergone gender-affirming surgery and how long it had been since their procedure. They also compared mental health outcomes between transgender men and women.

The study tracked their mental health conditions using medical records. These included depression, anxiety, suicidal thoughts, and substance use disorders.

The goal was to observe the differences in conditions between those who had surgery and those who did not. Additionally, they aimed to understand how gender played a role in these outcomes.

Key Findings: What Did the Study Show?

The results were both revealing and worrying.

Transgender individuals who underwent gender-affirming surgery were at a significantly higher risk for mental health issues compared to those who did not have surgery.

Here’s a breakdown of the findings:

1. Depression and Anxiety: 
   • Both transgender men and women who had surgery were more likely to experience depression and anxiety. For example, 25.4% of transgender men who had surgery experienced depression, compared to 11.5% of those who did not.
   • Similarly, anxiety rates were higher in those who had surgery (12.8% vs. 2.6% for transgender men).
2. Suicidal Ideation: 
   • The study found that suicidal thoughts were more common among those who had undergone surgery.
   • This finding highlights the ongoing psychological challenges faced by transgender individuals even after gender-affirming procedures.
3. Substance Use Disorders:
   • Transgender individuals who had surgery had a higher risk of struggling with substance use disorders.
   • This is particularly true for those who underwent feminizing procedures.
4. Gender Differences: 
   • Transgender women (assigned male at birth) showed particularly high risks for depression after surgery.
   • They also experienced increased substance use disorders. Transgender men (assigned female at birth) faced elevated risks but to a slightly lesser extent.

Study 2: Understanding Suicide Risk and Mortality Among Transgender Individuals—Insights from a Danish Study

The first study highlighted the mental health challenges faced by transgender individuals after gender-affirming surgery. A second large-scale study from Denmark sheds light on an even broader and more urgent issue. [2]

Transgender people face disproportionately high rates of suicide attempts and mortality compared to the general population.

This study, published in JAMA in June 2023, provides critical insights into the risks faced by transgender individuals. It underscores the need for societal and healthcare interventions to address these disparities.

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The Study: What Was Done?

This groundbreaking study analyzed data from over 6.6 million Danish-born individuals aged 15 and older who lived in Denmark between 1980 and 2021. Using national hospital records and legal gender change documentation, researchers identified 3,759 transgender individuals (about 0.06% of the population).

They compared rates of suicide attempts and suicide deaths over a 42-year period. They also examined other causes of mortality between transgender and non-transgender individuals.

The study aimed to answer a pressing question.

• Do transgender individuals face a higher risk of suicide?
• Are they at a higher risk of premature death compared to the general population?

To ensure accuracy, the researchers adjusted their findings. They considered factors like age, sex assigned at birth, and the time period in which people lived.

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Key Findings: What Did the Study Show?

The results were stark and sobering.

Transgender individuals faced significantly higher rates of suicide attempts, suicide deaths, and overall mortality compared to their non-transgender peers.

Here are the key findings:

1. Suicide Attempts:
   • Transgender individuals were nearly 8 times more likely to attempt suicide than non-transgender individuals.
   • The rate of suicide attempts was 498 per 100,000 person-years for transgender people. In contrast, it was just 71 per 100,000 for non-transgender people.
2. Suicide Deaths:
   • Transgender individuals were 3.5 times more likely to die by suicide.
   • The suicide mortality rate was 75 per 100,000 person-years for transgender people, versus 21 per 100,000 for non-transgender people.
3. Non-Suicide-Related Deaths:
   • Transgender individuals were nearly twice as likely to die from causes unrelated to suicide, like illness or accidents.
   • The rate of non-suicide deaths was 2,380 per 100,000 person-years for transgender people. In comparison, it was 1,310 per 100,000 for non-transgender people.
4. Overall Mortality:
   • Transgender individuals had twice the risk of dying from any cause compared to the general population.
   • The all-cause mortality rate was 2,559 per 100,000 person-years for transgender people, versus 1,331 per 100,000 for non-transgender people.

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Study 3: Long-Term Outcomes After Gender Surgery—Insights from a Swedish Study

The first two studies provided foundational findings. Building on these, a third study from Sweden offers a long-term perspective. It examines the outcomes of sex reassignment surgery (SRS) for transgender individuals.

This study was published in PLoS One in February 2011. It followed 324 transgender individuals who underwent SRS in Sweden between 1973 and 2003. The goal was to assess their long-term physical and mental health outcomes. This included mortality, psychiatric care needs, and criminal convictions. These were compared to the general population.[3]

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The Study: What Was Done?

This study was one of the first large-scale, long-term follow-ups of transgender individuals who had undergone SRS.

Researchers tracked 324 individuals (191 male-to-female and 133 female-to-male) and compared their outcomes to a control group of 3,240 non-transgender individuals matched by age and birth sex.

The study analyzed data over a 30-year period, focusing on:

1. Mortality: Rates of death from any cause, including suicide.
2. Psychiatric Morbidity: Rates of psychiatric hospitalizations and suicide attempts.
3. Criminal Convictions: Rates of criminal activity, if any.

The study adjusted for factors like prior psychiatric history. It also took into account immigrant status. This was done to ensure the results were as accurate as possible.

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Key Findings: What Did the Study Show?

The results revealed significant disparities in long-term outcomes between transgender individuals who underwent SRS and the general population. Here are the key findings:

1. Higher Mortality Rates:
   • Transgender individuals were 2.8 times more likely to die during the follow-up period compared to the general population.
   • The risk of death by suicide was 19 times higher for transgender individuals than for controls.
2. Increased Suicide Attempts:
   • Transgender individuals were 4.9 times more likely to attempt suicide than the general population.
3. Higher Psychiatric Morbidity:
   • Transgender individuals were 2.8 times more likely to need psychiatric inpatient care, indicating ongoing mental health challenges.
4. Criminal Convictions:
   • Female-to-male individuals (assigned female at birth) had a higher rate of criminal convictions compared to their birth sex controls. This trend was not observed in male-to-female individuals.

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A Holistic Approach to Healing for Gender Dysphoria

The findings from these three studies paint a clear picture. Gender-affirming surgeries and medical interventions can alleviate gender dysphoria. However, they are not standalone solutions to the profound mental health challenges faced by transgender individuals.

Elevated risks of suicide, depression, anxiety, and mortality highlight the need for comprehensive, long-term support. This support should address not only the physical and psychological aspects of gender dysphoria. It must also consider the deeper emotional and spiritual dimensions of well-being.

Just like when treating diabetes or hypertension, a doctor should not just hand out prescriptions—they should look for the underlying cause of the disease to provide the best treatment.

The same approach should be taken with gender dysphoria. Instead of simply affirming feelings, it’s important to explore the root cause of the distress and help the person find true healing.

Those struggling with gender dysphoria deserve the chance to talk to someone who can offer not just psychological support but also spiritual guidance—helping them understand, accept, and embrace their God-given identity.

True healing involves more than just the mind; it also involves the heart and soul.

Catholic Groups & Resources for Gender Dysphoria Support

1. Person and Identity Project

• Description: A Catholic initiative that provides resources for parents, schools, parishes, and dioceses to address gender ideology from a Christian perspective.
• Support Focus: Helps individuals and families understand and embrace Christian anthropology regarding sex and identity.
• Website: catholicwomensforum.org

2. Diocese of Fairbanks’ Pastoral Guide to Gender Identity

• Description: A pastoral resource to help Catholics understand gender identity from a Catholic perspective, offering practical guidance and compassionate support.
• Support Focus: Aims to foster clarity and healing in light of Catholic teaching while providing pastoral care for individuals with gender dysphoria.
• Website: dioceseoffairbanks.org

3. Catholic Therapists Network

• Description: A directory of Catholic mental health professionals who integrate Catholic faith and psychology into their practice.
• Support Focus: Provides counseling and therapeutic support for individuals struggling with gender identity while staying faithful to Catholic teachings.
• Website: catholictherapists.com

4. More Helpful Sites

1. Support group helps parents of children with gender confusion
2. https://catholictimescolumbus.org/news/hannah-heil/support-group-helps-parents-of-children-with-gender-confusion
3. https://catholicmhm.org/
4. https://www.femcatholic.com/news/meet-the-psychologist-whos-filling-the-gap-in-faith-based-resources-on-sexuality-and-gender
5. https://napa-institute.org/on-the-unity-of-body-and-soul-coakley/
6. https://www.drvc.org/making-sense-with-father-tad/
7. https://dioceseoffairbanks.org/pastoral-guide-to-gender-identity
8. https://www.catholicnh.org/community/public-policy/issues/gender-identity/

These resources can be valuable for individuals, families, and faith communities seeking faith-based support for gender dysphoria while embracing their God-given biological sex.

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References:

1. Joshua E Lewis, Amani R Patterson, Maame A Effirim, Manav M Patel, Shawn E Lim, Victoria A Cuello, Marc H Phan, Wei-Chen Lee, Examining gender-specific mental health risks after gender-affirming surgery: a national database study, The Journal of Sexual Medicine, 2025;, qdaf026, https://doi.org/10.1093/jsxmed/qdaf026
2. Erlangsen A, Jacobsen AL, Ranning A, Delamare AL, Nordentoft M, Frisch M. Transgender Identity and Suicide Attempts and Mortality in Denmark. JAMA. 2023 Jun 27;329(24):2145-2153. doi: 10.1001/jama.2023.8627. PMID: 37367977; PMCID: PMC10300682.
3. Dhejne C, Lichtenstein P, Boman M, Johansson AL, Långström N, Landén M. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLoS One. 2011 Feb 22;6(2):e16885. doi: 10.1371/journal.pone.0016885. PMID: 21364939; PMCID: PMC3043071.

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