auung
> Our study has several limitations. First, its retrospective design meant we were unable to measure patient satisfaction and quality-of-life outcomes. Complications and any mention of regret were obtained from provider notes, which may be variable, and thus both may be under-reported. In addition, although an integrated health care system allows for continuity of care, some members may have transferred care or changed their insurance status and thus, subsequent complications, or reversal operations, would not have been captured. Next, our study was conducted at KPNC in an insured cohort of individuals with access to gender-affirming medical and surgical care. Therefore, our outcomes may not be representative of the general population, many of whom lack similar access to care. Finally, the time to develop postoperative regret and/or dissatisfaction remains unknown and may be difficult to discern.
You state that "the followups are into post-teenage years and most are very satisfied", but the authors were very explicit about not being able to determine this due to the study design.
The authors also report that:
> The median age at the time of referral was 16 years (IQR=2) and ranged from 12-17 years. Patients had a median post-operative follow-up length of 2.1 years (IQR 1.69).
Which implies that for many patients, the follow-up would have been within their teenage years.
One of the challenges in discussing this issue more broadly is that "trans" encompasses such a wide range of different groups with very little in common, from the distraught young girls who want surgeons to cut out their breasts, to the middle-aged men who picked up a cross-dressing hobby, to the trenders who got a colorful new haircut and started making pronoun demands of others.
The numbers for gender-affirming mastectomies only include children with a diagnosis of gender dysphoria, i.e. girls who want to be boys.
In the US it's hundreds of such surgeries each year, and rising, per https://www.reuters.com/investigates/special-report/usa-tran...
This is a lower bound as not all of these young girls get their breasts removed through health insurance, some will be paid for privately.
Breasts on boys are not healthy. They're not supposed to be there on a male. Removing them is not a gender affirming surgery.