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Mental effects of hormone replacement therapy (HRT)
and surgery for male-to-female transgender persons.

This article is a collation of various studies on the mental effects of procedures done to male-to-female transgender adults and the spike in depression and suicide rates after these procedures. The author ties this into many trends personally observed among the online community where often the anonymity of transgender persons allows them to be more honest about their feelings.

 

References are provided at the bottom of the article.

Gender dysphoria: The condition of feeling one's emotional and psychological identity as male or female to be opposite to one's biological sex.

 

The rate of persons identifying as transgender in USA has doubled from 2003 to 2016 despite being relatively constant for decades prior. This is an important statistic to remember throughout this article.

There are 5 types of transgender women;

 

  1. People who are consumed by the feeling they are a woman in a mans body and have never been able to look in a mirror without becoming immediately depressed. It may be something deep wired into their brain since birth, it never just appears suddenly. These cases have been constant throughout history and typically represented all transgender persons but persons falling into this category are becoming a minority.

     

  2. Homosexual men who don't like other homosexual men and want to date straight men because they prefer everything about them. Their goal post transition is apparently to go dating as soon as they can 'pass' and being a woman will make this much more easy and it suits their effeminate style. These cases were rare but are becoming more common.

     

  3. People that develop a feeling that they are the wrong gender, a mild and treatable case of gender dysphoria. In roughly 75% of all cases, this is a phase and will go away naturally or with therapy. With friends/family who support this condition, they likely end up becoming transgender. The remaining 25 % who develop severe levels of condition even with therapy may have grown up in a community where even talking about it was bad and it took them many years to figure it out. The proportion of people who fall into this category is constant however the rate of people rushed into HRT and surgery without the condition being treated with therapy first is accelerating rapidly  towards the majority of transgender persons.

     

  4. Men who are depressed and believe that their problems will be solved by becoming women. Men who feel like 'women have it easy' are also likely closeted homosexual and develop this illness in their teens and later in life. It can be treated with therapy provided the underlying cause for depression is targeted, the first instance is commonly a physical disability.

     

  5. Men that have allowed their fetish for breasts and womens bodies in general to take over their life. A large amount of post HRT/surgery testimonies by people in this category focus first and foremost on breast development. These people are typically mentally healthy but spiral downhill very quickly into suicidal thoughts once they realise the damage they have caused to their body purely for the physical sense of being a woman. They are not women mentally. These cases bear a striking resemblance to those who undergo dozens of plastic surgeries, never content with how they look. Everything can always be improved until the realisation that society in general and especially intimate partners do not like 'plastic' people.

 

For the purposes of this article, this is covering cases 2-5 which represent a new majority in transgender persons, a majority which is rising every day for a variety of reasons.

 

The suicide attempt rate among transgender people has a wide range that is significantly higher than that of the general population however it is rising, and quickly, among those who have undergone HRT/surgery despite a highly increasing acceptance of transgenderism. Suicide attempt rates are very strongly linked to mental illness and especially depression. Transgender persons suffer depression at a rate of roughly 3x that of the general population however the suicide rate is up to 20x higher for those who transition. There is a clear disconnect between bullying and oppression and the suicide rate that must be talked about. A comparison can be made to minority groups who live under clear and constant oppression yet have a suicide rate that is perfectly proportional to the rate of diagnosed depression and mental illness.

The high suicide rate in transgender people is easily defined when the transgender community is split between those who are pre HRT, those undergoing the transition and those who have completed it. The range is dramatic, going from 17% to a peak of 56%. When surveyed on the quality of life post transition, the transgender community exhibits another clear disconnect with the statistics on depression with a suicide rate of 39% to 56% among respondents who claimed that their quality of life has become 'much better' to those who report 'much worse'. That is over double the suicide rate among people who claim their life has significantly improved after surgery. Clearly there is an additional factor at play here. These numbers are so high, the fact that this is even considered a viable option for a majority of transgender people necessitates this article.

This is extremely important to understand. The link between suicide and depression and/or untreated mental illness is very strong but the exact same transgender community, when split into pre and post HRT/op groups show a massive spike in diagnosed depression far beyond what existed pre HRT/op. The rate of bullying has not increased yet the rate of depression has jumped dramatically. A potential reason for this could be that the bullying in general directed at the transgender community affects all persons in it, no matter which of the 5 categories they fit into or what stage of the transition they are in (if started at all). However while the bullying level is constant, what is vastly different is the levels of depression and mental illness that those in categories 2) through 5) exhibit post HRT/op. 

 

Read the testimonies of people going through HRT and surgery and you will find a similar trend. The state of dysphoria, feeling you are in the wrong body is very strongly linked to suicidal tendencies when the dysphoria peaks. There are plenty of cases of those for whom the transition helped them, these were case 1) and unfortunately have become a minority. This would account for the massive disconnect in depression and suicide rates among the transgender community in recent years. Transgender people have always existed however the doubling rate of people claiming they are transgender that are not in category 1) is resulting in a rising rate depression afters HRT/surgery. It is clear the high suicide rates are strongly tied to the increasing proportion of transgender people who should never have undergone HRT or surgery. The only reason this is happening is because politically motivated doctors are refusing to diagnose cases 2) through to 5) as a treatable mental illness and destroying their professional integrity with recommending extreme, irreversible treatment to anyone who asks for it.

This fact is critical: The feeling of being in the wrong body is strongest and depression at its most critical levels among most transgender people is post HRT/surgery. Extrapolating from various studies can link this number to almost 6x above transgender people pre HRT/surgery. 

 

I want the reader to think about that. When dysphoria and depression are at critical levels and suicide is dangerously close, it is mostly in a time when a person has had HRT/surgery to become the other gender. Why would that be the case if for the first time in their life, they are the gender they feel inside? Prior to HRT/surgery, many transgender people had minor cases of dysphoria, a level which was treatable. After becoming the other gender, their depression and dysphoria takes a new turn and is now at maximum levels because for the first time in their life, they truly feel what it is like to be the wrong gender and the knowledge they have irreversibly damaged their bodies and that they can't go back is what drives them over the edge.

 

Let me be clear, people who fall into the 1) category above are an entirely different case and do not fall into and of the above trends. These people represent the transgender rate that has remained relatively constant throughout human history. Their condition is real and HRT/Surgery is proven effective as literally the only thing to help their mental state. They however represent the minority of transgender people today with the rest, the brand new crowd now (cases 2-5) accounting for the 2x increase in transgender people. Before HRT/surgery was so common and easily accessible, these people in time accepted their body and sexuality. Now they believe they have a new option. An option riddled with depression and suicide which only rears its head after transition has begun, an option that should never be encouraged unless they are medically diagnosed as falling into category 1.

 

Here I further implore the reader to look for testimonies of post HRT/surgery transgender people when it comes to attracting a partner. It is clear that the level of bullying trans people receive when attempting this can be shocking however once again we return to the levels of dysphoria present prior to the transition. People will place wildly different levels of importance on finding a romantic partner throughout their life and persons exhibiting medically diagnosed condition 1) will weigh up the options and likely determine that HRT/surgery is more important for their mental health. There would be many heterosexual men who would agree that a romantic partner is not worth it, so they are not alone in this regard. People who fall into categories 2-5 however with minor cases of dysphoria will likely later in life find this more important. The long-term depressive effects of this can be dramatic when based on decisions made so young in their life. The morbid reality of a lifetime full of rejection and abuse when seeking a partner does not truly dawn on them until they face it, a reality they can only witness when it is too late. 

I have not yet in this article made any mention about parents pushing transgenderism on their children which would be a 6th category and without a doubt the most dangerous of all. Hormone blocking before or during puberty not only renders the child incapable of developing the anatomy of the gender they wish to be as sexual re-assignment surgery can only be performed after age 18, it also blocks the development of their original anatomy resulting in a near 100% chance of sterilization. Therapy is the only safe option until at least puberty is complete. It is up to parents to figure out themselves whether they are willing to take an 80% chance that encouraging transgenderism will increase their child's risk of depression and suicide by 20x with a near 100% risk of sterilization. Playing Russian Roulette with your childs mental condition has nothing to do with being 'tolerant'.

Gender dysphoria is a mental condition and like all mental conditions, its spectrum is very wide from a mild, passing phase to a lifelong, severe condition. A direct result of dysphoria is diagnosed depression with a clear link to suicidal tendencies. Therapy is a proven treatment to roughly 75%-80% of cases of persons with gender dysphoria, all of those on the lower end of the severity spectrum. Acceptance and tolerance of the transgender community has not helped the majority of transgender persons and in fact has made the problem far more prevalent and dangerous. Permanent removal of fully-functioning organs when it was not needed can lead to critical levels of depression in an instant. It needs to be said that despite no increase in bullying and no increase in the prevalence of depression in general among transgender persons, there is a new rapid and severe onset of depression among transgender adults upon transitioning which ties in to attempting to treat mild cases with irreversible procedures.

 

References:

http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf

Total US transgender population doubles from 0.3% to 0.6% from 2003 – 2016

 

https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf

Trasngender suicide attempt rates at 46%

 

http://depts.washington.edu/mhreport/facts_suicide.php

Frequent suicide attempts are by people with untreated mental illnesses, especially depression

 

http://www.jahonline.org/pb/assets/raw/Health%20Advance/journals/jah/feature.pdf

Transgender community has a 2-3x higher rate of depression

 

https://couragerc.org/wp-content/uploads/TransgenderSurgery.pdf

75% of patients with gender dysphoria are 'cured' with therapy or phasing out of it

Post-op transgender patients have a 20x greater suicide attempt risk than general population

 

http://www.thenewatlantis.com/publications/growing-pains

Puberty (hormone) blockers have a near 100% sterility side effect as they cause persistent dysphoria, worsening the condition

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