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We conducted a systematic literature review of all peer-reviewed articles published in English between 1991 and June 2017 that assess the effect of gender transition on transgender well-being.
We identified 56 studies that consist of primary research on this topic, of which 52 (93%) found that gender transition improves the overall well-being of transgender people, while 4 (7%) report mixed or null findings.
This search found a robust international consensus in the peer-reviewed literature that gender transition, including medical treatments such as hormone therapy and surgeries, improves the overall well-being of transgender individuals.
The literature also indicates that greater availability of medical and social support for gender transition contributes to better quality of life for those who identify as transgender.
Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent.
Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques. Factors that are predictive of success in the treatment of gender dysphoria include adequate preparation and mental health support prior to treatment, proper follow-up care from knowledgeable providers, consistent family and social support, and high-quality surgical outcomes (when surgery is involved). Transgender individuals, particularly those who cannot access treatment for gender dysphoria or who encounter unsupportive social environments, are more likely than the general population to experience health challenges such as depression, anxiety, suicidality and minority stress.
While gender transition can mitigate these challenges, the health and well-being of transgender people can be harmed by stigmatizing and discriminatory treatment. An inherent limitation in the field of transgender health research is that it is difficult to conduct prospective studies or randomized control trials of treatments for gender dysphoria because of the individualized nature of treatment, the varying and unequal circumstances of population members, the small size of the known transgender population, and the ethical issues involved in withholding an effective treatment from those who need it. Transgender outcomes research is still evolving and has been limited by the historical stigma against conducting research in this field.
Overall, 68% (n = 13) had improved in at least two areas of functioning.
In 3 cases (16%) outcome were judged as unsatisfactory and one of those regarded sex change as a failure.