Sex Changes Not Effective, Say Researchers
By David Batty
The Guardian - UK 7-30-4
- There is no conclusive evidence that sex change
operations improve the lives of transsexuals, with many people remaining
severely distressed and even suicidal after the operation, according to
a medical review conducted exclusively for Guardian Weekend
tomorrow.
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- The review of more than 100 international medical
studies of post-operative transsexuals by the University of Birmingham's
aggressive research intelligence facility (Arif) found no robust
scientific evidence that gender reassignment surgery is clinically
effective.
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- The Guardian asked Arif to conduct the review after
speaking to several people who regret changing gender or believe that
the medical care they received failed to prepare them for their new
lives. They explain why they are unhappy with their sex change and how
they cope with the consequences in the Weekend magazine tomorrow (July
31).
-
- Chris Hyde, the director of Arif, said: "There is a
huge uncertainty over whether changing someone's sex is a good or a bad
thing. While no doubt great care is taken to ensure that appropriate
patients undergo gender reassignment, there's still a large number of
people who have the surgery but remain traumatised - often to the point
of committing suicide."
-
- Arif, which advises the NHS in the West Midlands about
the evidence base of healthcare treatments, found that most of the
medical research on gender reassignment was poorly designed, which
skewed the results to suggest that sex change operations are
beneficial.
-
- Its review warns that the results of many gender
reassignment studies are unsound because researchers lost track of more
than half of the participants. For example, in a five-year study of 727
post-operative transsexuals published last year, 495 people dropped out
for unknown reasons. Dr Hyde said the high drop out rate could reflect
high levels of dissatisfaction or even suicide among post-operative
transsexuals. He called for the causes of their deaths to be tracked to
provide more evidence.
-
- Dr Hyde said: "The bottom line is that although it's
clear that some people do well with gender reassignment surgery, the
available research does little to reassure about how many patients do
badly and, if so, how badly."
-
- There are around 5,000 post-operative transsexuals in
the UK, according to the transgender pressure group Press for Change
(PFC). It is estimated that up to 400 sex changes will be performed this
year on the NHS and privately. Each operation costs the NHS around
£3,000, while private patients pay upwards of £8,000 for surgery.
-
- Christine Burns, of PFC, said the campaign group's
research suggested that the vast majority of transsexual people enjoyed
much happier lives following surgery.
-
- Ms Burns added that the greatest flaws in medical
literature about gender reassignment were in those studies unsympathetic
to transsexual people. For example, one study was based on a survey of
seven transsexual prostitutes interviewed in one gay bar in
Chicago.
-
- She said: "The fact that research is badly constructed
isn't a poor reflection on transpeople, but on the people we should be
able to trust for our care. If they "lose" half the patients they ought
to be able to track the question is why? As we've repeatedly pointed out
ourselves there is really no difficulty in getting transpeople to come
forward and cooperate in research that is properly constructed and
conceived with people's true well-being in mind."
-
- Research from the US and Holland suggests that up to a
fifth of patients regret changing sex. A 1998 review by the Research and
Development Directorate of the NHS Executive found attempted suicide
rates of up to 18% noted in some medical studies of gender
reassignment.
-
- Andrew McCulloch, chief executive of the Mental Health
Foundation, has written to the mental health minister, Rosie Winterton,
requesting a "thorough assessment" of the long-term effects of sex
change operations. He wants the National Institute for Clinical
Excellence, which decides what treatments should be available on the
NHS, to draw up guidelines on gender reassignment.
-
-
- Transgender psychiatrists, who assess whether patients
should change sex, agree that more scientific research is needed. But
Kevan Wylie, chairman of the Royal College of Psychiatrists' working
party on gender identity disorders, said that all of his patients' lives
have drastically improved following gender reassignment surgery.
-
- Dr Wylie added that it was difficult to conduct
research on the outcome of gender reassignment, or to compare its
effects with alternative treatments, because transsexualism was such a
"rare experience". Urological surgeon James Bellringer, who has
performed more than 200 sex changes over the past four years, claimed
that trying to carry out research that involves studying a control group
of transsexual patients who were denied hormones and surgery would be
unethical.
-
- Mr Bellringer, who works at the main NHS gender
identity clinic at Charing Cross hospital in west London, said: "I don't
think that any research that denied transsexual patients treatment would
get past an ethics committee. There's no other treatment that works. You
either have an operation or suffer a miserable life. A fifth of those
who don't get treatment commit suicide."
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- SocietyGuardian.co.uk © Guardian Newspapers Limited
2004
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- http://society.guardian.co.uk/mentalhealth/story/0,8150,1272093,00.html
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