Anthony Almazan MD Candidate Harvard Medical School

Gender-Affirming Surgeries Linked to Better Mental Health Outcomes Interview with:

Anthony Almazan MD Candidate Harvard Medical School

Anthony Almazan

Anthony Almazan
MD Candidate
Harvard Medical School What is the background for this study?

Response: Gender-affirming surgeries are procedures offered to alleviate psychological distress and affirm the gender identities of transgender and gender diverse (TGD) people. Requests for these surgeries have been increasing in the United States over the past decade. However, the mental health benefits of these procedures have remained controversial due to the limited evidence base on this subject. What are the main findings?

Response: This is, to our knowledge, the first large-scale, controlled study to demonstrate an association between gender-affirming surgeries and improved mental health outcomes in transgender and gender diverse people.

In our study sample of 19,960 people (ages 18 to 65+), we found that a history of at least one gender-affirming surgery was associated with a 42% reduction in the odds of past-month psychological distress, a 35% reduction in the odds of past-year tobacco smoking, and a 44% reduction in the odds of past-year suicidal ideation. What should readers take away from your report?

Response: Due to the paucity of strong data describing the benefits of gender-affirming surgeries, the provision of these procedures has historically been driven by clinical consensus rather than robust evidence. This study offers stronger data to suggest that gender-affirming surgery offers evidence-based mental health benefits.

This study supports the provision of gender-affirming surgeries for TGD people, and it reaffirms the importance of policies that expand and protect access to gender-affirming surgical care. What recommendations do you have for future research as a result of this work?

Response: The field of gender-affirming surgery would benefit from a large-scale prospective cohort study on this subject, as well as observational research studies using probability-based population samples. 

The study’s lead author was Anthony N. Almazan, BA (MD/MPH candidate at Harvard). This investigation was supervised by senior author Alex S. Keuroghlian, MD, MPH, Associate Professor of Psychiatry at Harvard Medical School, Director of the National LGBTQIA+ Health Education Center at The Fenway Institute, and Director of the Psychiatry Gender Identity Program at Massachusetts General Hospital


Almazan AN, Keuroghlian AS. Association Between Gender-Affirming Surgeries and Mental Health Outcomes. JAMA Surg. Published online April 28, 2021. doi:10.1001/jamasurg.2021.0952

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Last Updated on April 28, 2021 by Marie Benz MD FAAD