Research shows a surgical procedure called a vaginoplasty used to help males transition to female can result in numerous complications.
Attempted suicide rates among people who identified as transgender more than doubled after receiving a vaginoplasty, according to a peer-reviewed study published in The Journal of Urology.
The study analyzed the rates of psychiatric emergencies before and after gender-altering surgery among 869 males who underwent vaginoplasty and 357 females who underwent phalloplasty in California from 2012 to 2018.
Researchers found the rates of psychiatric emergencies were high both before and after gender-altering surgery, with similar overall rates in both groups. However, suicide attempts were markedly higher in those who received vaginoplasties.
“In fact, our observed rate of suicide attempts in the phalloplasty group is actually similar to the general population, while the vaginoplasty group’s rate is more than double that of the general population,” the study authors wrote.
Among the 869 patients who underwent vaginoplasty, 38 patients attempted suicide—with nine attempts before surgery, 25 after surgery, and four attempts before and after surgery. Researchers found a 1.5 percent overall risk of suicide before vaginoplasty and a 3.3 percent risk of suicide after the procedure. Almost 3 percent of those who attempted suicide after undergoing vaginoplasty did not present with a risk of suicide prior to surgery.
Among the 357 biologically female patients who underwent phalloplasty, there were six suicide attempts with a 0.8 percent risk of suicide before and after surgery.
Overall, the proportion of those who experienced an emergency room and inpatient psychiatric encounter outside of suicide attempts was similar between the vaginoplasty and phalloplasty groups. Approximately 22.2 percent and 20.7 percent of patients, respectively, experienced at least one psychiatric encounter.
The study found a 33.9 percent chance that a biological man undergoing vaginoplasty would experience a psychiatric encounter post-surgery compared with a 26.5 percent chance for biological women who underwent phalloplasty, if an episode had occurred before surgery. The authors stressed the importance of counseling biological males undergoing a feminizing transition with a history of prior psychiatric emergencies.
