It is frequently claimed that fewer than 1 percent of patients who undergo “gender-affirming” surgery come to regret it. This talking point is everywhere, deployed in courtrooms, legislation, news segments, and policy debates as proof that these surgeries are safe and effective.
What most people don’t know is that this widely repeated claim comes from a single paper published in 2021: “Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence” by Bustos et al. The study appeared in Plastic and Reconstructive Surgery Global Open, a pay-to-publish version of the flagship journal of the American Society of Plastic Surgeons. And although systematic reviews are generally considered the highest tier of evidence, this particular review has been shown to contain so many major flaws and data errors that it should not be relied on for any public health decision.
And yet it remains one of the most cited pieces of evidence used to justify gender-affirming surgery—including for minors. It is perhaps the most influential zombie paper in gender medicine, being dragged around like Bernie Lomax in the movie Weekend at Bernie’s by activists, journalists, and supposed “experts” who need its corpse propped up to sell the illusion that it’s alive.
The central claim of the paper is simple: that among 7,928 transgender patients pooled across 27 studies, only 77—less than 1 percent—reported regret, and just 34 expressed what the authors categorized as “major” regret. They conclude that “there is an extremely low prevalence of regret in transgender patients after GAS.” This is the origin of the “1 percent regret” statistic for gender surgeries that has been repeated ad nauseam ever since.
But serious problems emerge the moment you look more closely. Shortly after publication, a Letter to the Editor by Pablo Expósito-Campos and Roberto D’Angelo appeared in the same journal, cataloging a list of serious concerns. The authors pointed out that numerous relevant studies fitting their search criteria had been omitted from the review. At the same time, the paper included studies that should have been omitted. More troubling still were the blatant data extraction errors, with sample sizes misreported, outcomes misrepresented, and methods misunderstood.
Source: The Zombie Study Behind the ‘1% Regret’ Myth for ‘Gender-Affirming’ Surgery
I worked on a few cases in mental heatlh with people who had undergone stomach surgery for obeisity.
The common presenting problem was that they thought all their problems would be solved once they had lost weight.
They realised that they still woke up depressed, or unconfident or what ever and that the surgery, which they had banked on to solve all their problems and lead them to the promised land, had not delivered.
I see the same issue with the gender ‘realignment’ surgery. Ony with even worse physical outcomes such as sexual dysfunction, scar tissue, unwanted hair growth, pain, chronic UTI’s etc etc.
That this has been sold to unsuspecting people suffering from mental health issues such as BPD and autism as a panacea by professionals who should have known better is a tragidy beyond rational belief.
I forsee a sea of legal cases stretching out into the future.
It will be the thalidomide of our time…