https://pubmed.ncbi.nlm.nih.gov/37556147/

I keep hearing the anti-trans crowd scream about how so many people who have transitioned regret it. They constantly push that trans men who have mastectomies, removing their breasts then wish they had not done so. In fact, that myth is used to push anti-transitioning care laws. Even in the comments I have some who ask about the ones who have their breast removed as if it is a large and growing number. This is a new study, peer reviewed, done by medical professionals. It debunks that myth and shows it for the made up lie it is. I will post the entire thing, it is short but rather hard to read with all the numbers they throw in. But I will put the conclusion right at the top in bold red. It shows that the 1% regret rate is true. That means for every 100 people who female to male and have their breasts removed, 99 are happy and doing better. Only one person had regrets, and in truth they can get fake breasts implanted if they are that unhappy. Again for the sake of that one person the anti-trans people want to stop the good outcomes for the other 99 people. Doesn’t make sense, does it? Hugs

Conclusions and relevance: In this cross-sectional survey study, the results of validated survey instruments indicated low rates of decisional regret and high levels of satisfaction with decision following gender-affirming mastectomy. The lack of dissatisfaction and regret impeded the ability to perform a more complex statistical analysis, highlighting the need for condition-specific instruments to assess decisional regret and satisfaction with decision following gender-affirming surgery.

Long-Term Regret and Satisfaction With Decision Following Gender-Affirming Mastectomy

Affiliations collapse

Affiliations

¹University of Michigan Medical School, Ann Arbor.
²Section of Plastic Surgery, University of Michigan, Ann Arbor.
³Michigan Institute for Clinical Health Research, Ann Arbor, Michigan.
⁴Institute for Healthcare Policy and Innovation, Ann Arbor.
⁵Seattle Children’s Hospital, Seattle, Washington.

PMID: 37556147
PMCID: PMC10413215 (available on 2024-08-09)
DOI: 10.1001/jamasurg.2023.3352

Abstract

Importance: There has been increasing legislative interest in regulating gender-affirming surgery, in part due to the concern about decisional regret. The regret rate following gender-affirming surgery is thought to be approximately 1%; however, previous studies relied heavily on ad hoc instruments.

Objective: To evaluate long-term decisional regret and satisfaction with decision using validated instruments following gender-affirming mastectomy.

Design, setting, and participants: For this cross-sectional study, a survey of patient-reported outcomes was sent between February 1 and July 31, 2022, to patients who had undergone gender-affirming mastectomy at a US tertiary referral center between January 1, 1990, and February 29, 2020.

Exposure: Decisional regret and satisfaction with decision to undergo gender-affirming mastectomy.

Main outcomes and measures: Long-term patient-reported outcomes, including the Holmes-Rovner Satisfaction With Decision scale, the Decision Regret Scale, and demographic characteristics, were collected. Additional information was collected via medical record review. Descriptive statistics and univariable analysis using Fisher exact and Wilcoxon rank sum tests were performed to compare responders and nonresponders.

Results: A total of 235 patients were deemed eligible for the study, and 139 responded (59.1% response rate). Median age at the time of surgery was 27.1 (IQR, 23.0-33.4) years for responders and 26.4 (IQR, 23.1-32.7) years for nonresponders. Nonresponders (n = 96) had a longer postoperative follow-up period than responders (median follow-up, 4.6 [IQR, 3.1-8.6] vs 3.6 [IQR, 2.7-5.3] years, respectively; P = .002). Nonresponders vs responders also had lower rates of depression (42 [44%] vs 94 [68%]; P < .001) and anxiety (42 [44%] vs 97 [70%]; P < .001). No responders or nonresponders requested or underwent a reversal procedure. The median Satisfaction With Decision Scale score was 5.0 (IQR, 5.0-5.0) on a 5-point scale, with higher scores noting higher satisfaction. The median Decision Regret Scale score was 0.0 (IQR, 0.0-0.0) on a 100-point scale, with lower scores noting lower levels of regret. A univariable regression analysis could not be performed to identify characteristics associated with low satisfaction with decision or high decisional regret due to the lack of variation in these responses.

Conclusions and relevance: In this cross-sectional survey study, the results of validated survey instruments indicated low rates of decisional regret and high levels of satisfaction with decision following gender-affirming mastectomy. The lack of dissatisfaction and regret impeded the ability to perform a more complex statistical analysis, highlighting the need for condition-specific instruments to assess decisional regret and satisfaction with decision following gender-affirming surgery.

Conflict of interest statement

Conflict of Interest Disclosures: Ms Bruce and Dr Morrison reported receiving grants from The Plastic Surgery Foundation during the conduct of the study. Dr Lane reported receiving salary support via an F32 training grant (F32HS028748-01) from the Agency for Healthcare Research and Quality outside the submitted work. No other disclosures were reported.