Commentary: Johns Hopkins Study Once Again Illuminates the False Notion of Transgender Regret

Photo by Aiden Craver on Unsplash

By David M. Greenwald
Executive Editor

The right has made a huge issue out of the notion that many trans people experience regret after obtaining gender-affirming surgery.  That has been one of the linchpins of the push locally—the notion of “de-transitioning” where many have argued that there are too many “bodies and minds falling apart in the aftermath of transition.”

This has become fodder for political debates and used across the county by groups like Moms for Liberty as evidence that minors and other young people should be prohibited from receiving gender-affirming medical care.

But a new article in the prestigious Journal of the American Medical Association by three researchers from Johns Hopkins University calls that into question.

The study was published this Wednesday.

They note that “policymakers across the US have been using the potential for surgical regret to justify an unprecedented wave of legislation that bans transgender and gender-diverse youths from accessing gender-affirming care,” which they argue is “a safe and effective form of health care that allows TGD individuals to align their bodies with their own internal sense of self.”

Those policies are drive by the notion that individuals “who undergo gender-affirming surgeries (GAS) would later regret their decision to undergo such procedures.”

The study finds, “Despite this supposed fear, evidence suggests that less than 1% of TGD individuals who receive GAS report surgical regret.”

“This rate of surgical regret among (transgender and gender diverse) patients appears to be substantially lower than rates of surgical regret following similar procedures among the broader population, including cisgender individuals,” the report summary said, in part.

“In fact, one systematic review found that the average prevalence of surgical regret was 14.4% among all research studies analyzed, which the authors suggested was relatively low,” the summary continued.

The low regret among transgender surgery recipients may be linked “to why they obtained the surgery to begin with,” the report explained.

“That reduction in regret also may due to careful implementation of existing evidence-based, multidisciplinary guidelines and standards of care for those who are (transgender or gender diverse), such as requiring a well-documented history of gender dysphoria,” according to a statement from Johns Hopkins.

Far from being an anomalous finding, this research aligns cleanly with the medical establishment view of gender-affirming care.

The American Academy of Pediatrics, the American Medical Association and the American Psychological Association all support that treatment, as does the World Professional Association of Transgender Health.

This spring, the Associated Press noted, “In updated treatment guidelines issued last year, the World Professional Association for Transgender Health said evidence of later regret is scant, but that patients should be told about the possibility during psychological counseling.”

They also cited a Dutch study from several years ago that “found no evidence of regret in transgender adults who had comprehensive psychological evaluations in childhood before undergoing puberty blockers and hormone treatment.”

Moreover, they note, “Some studies suggest that rates of regret have declined over the years as patient selection and treatment methods have improved.”

They continue, “In a review of 27 studies involving almost 8,000 teens and adults who had transgender surgeries, mostly in Europe, the U.S and Canada, 1% on average expressed regret.”

This is exactly in line with the current Johns Hopkins study.

But the battle over such policies has been fierce.

In February 2023, Mississippi Governor Tate Reeves signed a bill banning “gender-affirming care in the state for anyone younger than 18 — part of a broad effort in conservative states to restrict transgender athletes, gender-affirming care and drag shows,” the Associated Press reported.

“Sterilizing and castrating children in the name of new gender ideology is wrong,” Reeves wrote on Twitter. “That plain truth is somehow controversial in today’s world.”

Jensen Luke Matar, executive director of the Mississippi-based Transgender Resources Advocacy Network and Services Program, denounced the bill in a statement.

“Mississippi lawmakers are insisting that they know what’s best for transgender youth and ignoring the recommendations of every major medical association,” Matar said. “Patients, along with their health care providers — not politicians –- should decide what medical care is in the best interest of a patient. I know from years of working directly with trans youth in Mississippi that they need support, love, and affirmation – not this brazen political attack that cuts off their access to life-saving care.”

Meanwhile, Heritage Action—a national group affiliated with the Heritage Foundation in Washington—praised passage of the bill.

“Dangerous cross-sex hormones and experimental surgeries are not a compassionate solution for children struggling with gender dysphoria,” Heritage Action’s executive director, Jessica Anderson, said in a statement. “These dangerous procedures both fail to address underlying mental health issues and also leave children suffering with irreversible psychological and physical damage for the rest of their lives.”

The overwhelming number of studies to the contrary illustrate that once again this is an ideological rather than a science-based objection.

But these studies are likely not going to quell the criticism of such approaches despite the extraordinary high rates of suicidal ideations among trans-identifying youth, and their overall satisfaction with current procedures.

About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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  1. Walter Shwe

    Conservatives only tell the side of the story that conforms to their own narrow-minded right wing ideology. Right wingers also sometimes resort to making mountains out of molehills to falsely make a minor issue appear to be a major one. The JAMA article proves both of my contentions.

  2. David Greenwald

    BREAKING: Gov. Mike DeWine (R-Ohio) has vetoed HB 68. This bill would have banned gender-affirming care for trans youth as well as banned them from participating in school sports that match their identity.

    1. Sharla Cheney

      This week a Federal Judge blocked Idaho’s gender-affirming transgender care ban, saying it violated the right to due process and equal treatment under the law. The Judge also stated that “Parents should have the right to make the most fundamental decisions about how to care for their children.”

      1. Keith Olsen

        “Parents should have the right to make the most fundamental decisions about how to care for their children.”

        Do you think the judge might also think that parents have the right to know what pronouns their kids are using in school, who has access to their kids while in school and what their children are being taught?


        1. Walter Shwe

          So-called parental rights = Authoritarianism

          Abuse at home is a major concern for teachers and educators. The Centers for Disease Control and Prevention (CDC) reportedat least one in seven minors are abused or neglected by parents or guardians, and a 2021 article inPediatricsreported that transgender adolescents experienced higher rates of physical, psychological, and sexual abuse compared to their heterosexual, cisgender peers.

          “We’ll truly hit a milestone in our district when ‘sensitive issues’ aren’t sensitive at all, and these children can choose to simply exist exactly how they are,” Jessica Hardy, a third grade instructor who is the district’s Teacher of the Year,toldthe board.

          She’s right. She’s also right that we are far, far from such a scenario.
          Reporting transgender kids to their parents isn’t the responsibility of a teacher; the opposite: A teacher’s job is to keep kids safe—which means not reporting changes in their gender to their parents.

        2. Sharla Cheney

          The focus of the decision was on protecting transgender children’s rights under the Constitution.  Government control of what children are called at school was not an issue in this particular case. I don’t think I can presume to say how the Judge would rule on that issue.

          1. David Greenwald

            There is nothing immutable about a pronoun. If a kid doesn’t want to tell their parents, there is probably a reason.

        3. Keith Olsen

          There is nothing immutable about a pronoun. If a kid doesn’t want to tell their parents, there is probably a reason.

          That’s one of the issues I brought up, how about the other two?

        4. Walter Shwe

          What, did my comment hit a nerve, too truthful?

          Walter commented on 12/12/23:

          Nope. The sole reason that the right falsely asserts that the left is authoritarian is because the left was first in correctly calling out the right for being authoritarian. Trump said it publicly and Project 2025 puts it in writing.

        5. Keith Olsen

          Walter, the comment I’m referring to was my comment that got deleted for some reason.   It’s hard to follow a comment thread when comments get deleted.

  3. beth

    Hi David,
    There are lots of people on both sides of the aisle who believe it’s impossible for children to be born in the wrong body. We also believe sex is binary and immutable. And we are witnessing the worse socio-medical scandal of the century.

    Why do you think so many European countries (France, Finland, UK, Sweden, etc) have halted all “gender affirming” medicine, including puberty blockers, wrong-sex hormones, and surgeries for minors? Is it because they have socialized medicine unlike the US profit-driven gender industry?

    I have spoken to reports at The NY Times, The Economist, and Reuters about my family’s experience with DJUSD schools and Kaiser Permanente Oakland Proud gender clinic for children. I have also donated over $5k to detransitioners, including Chloe Cole, Prisha, Laura Becker, and Tulip Richie to help with their medical and legal bills.

    I am happy to send you the (unpublished) article about the soaring rates of destransitioners from the reporter I met with at the The Economist.

    —– Forwarded Message —–
    From: Rob Gifford <>
    To: Beth Bourne <>
    Sent: Wednesday, April 12, 2023 at 08:31:55 AM PDT
    Subject: Re: gender article update? Beth in Davis CA

    So sorry to be slow responding. You may have seen already, the piece came out last week, see attached.
    I wrote a longer segment on detransitioners but unfortunately it was edited out.
    Anyway, we put the story on the cover – see here:
    (you may be able to find it on news stands)
    Or here is the online version…/the-evidence-to-support…
    And the online editorial…/what-america-has-got-wrong…
    All best and thanks again for your help. I hope we can stay in touch.

    Rob Gifford
    The Economist
    Rob Gifford
    Senior Editor
    1-11 John Adam Street, London WC2N 6HT, United Kingdom

    1. David Greenwald

      You are free to believe what you want. But one of the data points that has been thrown out is the issue “regret” and this study from Johns Hopkins once again debunks that claim.

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