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Over 100,000 patient records show that those undergoing surgery face significantly higher rates of depression, anxiety, and substance abuse. Australian authorities and media outlets have remained silent on the bombshell finding.

People who undergo so-called “gender-affirming surgery” face a significantly elevated risk of mental health disorders, according to a groundbreaking study published in The Oxford Academic Journal of Sexual Medicine last month.

The research, which included data on over 100,000 patients, found that depression, anxiety, and substance abuse were markedly more common in gender dysphoric patients who opted for surgery than those who had not undergone such procedures.

“Those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation, and substance use disorders than those without surgery,” the researchers concluded.

The alarming discovery runs counter to the claims of Australian “gender medicine” providers like AUSPATH and Melbourne’s Royal Children’s Hospital which have long asserted that surgery leads to improved mental health and overall well-being.

What Did the Study Find?

The study was conducted using data from the TriNetX database and analysed the medical histories of 107,583 Americans diagnosed with gender dysphoria between June 2014 and June 2024. Its aim was to compare the mental health outcomes of those who underwent gender-affirming surgery with those who did not.

Researchers found that men who had surgery were more than twice as likely to experience depression, with 25.4% diagnosed with the condition compared to just 11.5% of those who did not have surgery.

For women, the risk of depression was about 1.6 times higher, with 22.9% of those who underwent surgery experiencing depression, compared to 14.6% of those who didn’t.

Anxiety rates were significantly higher among those who had surgery, particularly men. Those who underwent surgery experienced anxiety at a rate of 12.8%, nearly five times higher than the 2.6% recorded in men who did not have surgery.

Women also showed an increased risk of anxiety, with 10.5% of those who had surgery reporting anxiety, compared to 7.1% in those who did not — approximately a 50% higher rate.

Despite these concerning findings, researchers didn’t question the practice of “gender-affirming surgery”. Instead, they blamed the higher rates of mental health issues after surgery on external factors like social stigma and discrimination — and claimed the take-away from their research was that more post-surgery “gender-sensitive mental health support” is needed.

🚨BREAKING: A new study analyzed mental health outcomes in gender dysphoric patients (with no other previous mental health diagnoses) who did and did not receive “gender-affirming surgery.”

Those who received surgery had an “elevated risk of mental health disorders—including… pic.twitter.com/OZTEO0VSXb

— Colin Wright (@SwipeWright) February 28, 2025

Methodology and Data Analysis

The study used robust methods to ensure the accuracy of its findings. By employing propensity score matching, the researchers were able to control for factors such as age, race, and ethnicity, ensuring that the comparison groups were as similar as possible. This method helped reduce bias and provided a more reliable assessment of the mental health outcomes associated with “gender-affirming surgery”.

Furthermore, the study focused on mental health outcomes over a two-year period post-surgery, assessing conditions such as depression, anxiety, suicidal ideation, substance use disorders, and body dysmorphic disorder (BDD). By using clinician-verified ICD-10 codes, the research minimised recall bias, a common issue in survey-based studies, offering a more accurate and large-scale analysis.

Researchers also excluded patients with documented pre-existing mental health diagnoses, in order to “ensure that identified mental health outcomes likely represented new or emergent conditions rather than pre-existing disorders”.

What is ‘Gender-Affirming Surgery’?

Men who seek feminising surgery undergo vaginoplasty, which involves removing male genitalia and constructing a pseudovagina. The penis is excised, testicles removed, and a pseudovaginal canal created, typically using inverted penile skin or grafts. The glans is reshaped into a clitoris, and the scrotal skin forms labia.

Recovery takes up to 12 weeks of bed rest. Patients must perform lifelong dilation to prevent vaginal collapse. Risks include infection, scarring, urinary issues, and loss of sensation. Some men also receive breast implants.

Women who choose masculinising surgery undergo phalloplasty, in which a pseudopenis is constructed using skin grafts from the arm, thigh, or back. It often requires multiple surgeries over 1–2 years and can involve urethral lengthening, though complications like strictures are common.

Many women also undergo mastectomies to flatten the chest and a hysterectomy to remove female reproductive organs.

For both men and women, these procedures carry significant risks, uncertain outcomes, and lifelong medical maintenance, making them among the most complex surgeries performed today.

A woman’s forearm after “gender affirming surgery”, showing the removed skin tissue used for phalloplasty.

The WPATH Scandal and the Cass Report

So-called “gender-affirming care” has suffered significant setbacks over the last year.

In March 2024, leaked internal documents from WPATH (the World Professional Association for Transgender Health) — the leading organisation setting global standards for “gender medicine” — revealed that clinicians were performing irreversible procedures on minors and on vulnerable adults without proper consent.

The files also revealed that practitioners were using puberty blockers on children as young as 10, performing surgeries on patients with schizophrenia, and downplaying long-term harms like infertility and loss of sexual function.

The following month, the UK’s National Health Service published its long-awaited Cass Report, following four years of independent research by Dr Hilary Cass into the nation’s controversial gender clinics.

Dr Cass found that treatments for gender dysphoria in minors — including puberty blockers and hormone therapies — were based on “remarkably weak evidence,” with little research into their long-term effects. She also noted that the politicisation of the issue had left many clinicians afraid to speak openly, leaving children vulnerable to poor treatment pathways.

Moreover, Dr Cass raised concerns that children are not receiving enough mental health support for problems like trauma, depression, and autism, which could be contributing to their gender distress. Her report called for a more balanced approach to gender dysphoria, including examining other contributing factors like pornography and social contagion.

“A month after surgery, I totally regretted it… I wailed every day. It was like grieving a life I had lost.” 💔

At 29, Forrest bravely shares the painful reality of detransition—facing a truth he’d spent years trying to escape. #DetransAwarenessDay 🎬 pic.twitter.com/8tYQe4fuxL

— Genspect (@genspect) March 9, 2025

Silence from Australian Authorities and Media

AUSPATH, Australia’s peak body for “gender medicine”, has declined to comment on the WPATH scandal, and has dismissed the Cass Report, claiming it lacks relevance to Australia’s system.

According to documents still available on the AUSPATH website, “surgery is a fundamental aspect of how many trans people affirm their gender and maintain wellbeing, with access often significantly improving quality of life”.

Melbourne’s Royal Children’s Hospital — which runs Australia’s biggest child gender clinic — has remained tight-lipped on both revelations, still maintaining on its website that “with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved”.

Neither AUSPATH nor the Royal Children’s Hospital has publicly responded to the The Oxford Academic Journal of Sexual Medicine study.

Additionally, no Australian media outlet — whether ABC News, SBS News, The Age, The Sydney Morning Herald, The Australian, News.com.au, Daily Mail Australia, or Guardian Australia — has reported on the bombshell finding.

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Image courtesy of Pexels.