Risk of Suicide and Self-Harm Following Gender-Affirmation Surgery.

Autor:	Straub JJ; Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA., Paul KK; Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA., Bothwell LG; Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA., Deshazo SJ; Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA., Golovko G; Department of Pharmacology, University of Texas Medical Branch at Galveston, Galveston, USA., Miller MS; Department of Psychiatry and Behavioral Services, University of Texas Medical Branch at Galveston, Galveston, USA., Jehle DV; Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Apr 02; Vol. 16 (4), pp. e57472. Date of Electronic Publication: 2024 Apr 02 (Print Publication: 2024).
DOI:	10.7759/cureus.57472
Abstrakt:	Introduction With the growing acceptance of transgender individuals, the number of gender affirmation surgeries has increased. Transgender individuals face elevated depression rates, leading to an increase in suicide ideation and attempts. This study evaluates the risk of suicide or self-harm associated with gender affirmation procedures. Methods This retrospective study utilized de-identified patient data from the TriNetX (TriNetX, LLC, Cambridge, MA) database, involving 56 United States healthcare organizations and over 90 million patients. The study involved four cohorts: cohort A, adults aged 18-60 who had gender-affirming surgery and an emergency visit (N = 1,501); cohort B, control group of adults with emergency visits but no gender-affirming surgery (N = 15,608,363); and cohort C, control group of adults with emergency visits, tubal ligation or vasectomy, but no gender-affirming surgery (N = 142,093). Propensity matching was applied to cohorts A and C. Data from February 4, 2003, to February 4, 2023, were analyzed to examine suicide attempts, death, self-harm, and post-traumatic stress disorder (PTSD) within five years of the index event. A secondary analysis involving a control group with pharyngitis, referred to as cohort D, was conducted to validate the results from cohort C. Results Individuals who underwent gender-affirming surgery had a 12.12-fold higher suicide attempt risk than those who did not (3.47% vs. 0.29%, RR 95% CI 9.20-15.96, p < 0.0001). Compared to the tubal ligation/vasectomy controls, the risk was 5.03-fold higher before propensity matching and remained significant at 4.71-fold after matching (3.50% vs. 0.74%, RR 95% CI 2.46-9.024, p < 0.0001) for the gender affirmation patients with similar results with the pharyngitis controls. Conclusion Gender-affirming surgery is significantly associated with elevated suicide attempt risks, underlining the necessity for comprehensive post-procedure psychiatric support. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Straub et al.)
Databáze:	MEDLINE
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