October 2017 saw a spate of fearmongering articles alleging a rise in demand for surgical reversal of transgender genital surgeries. The Independent claimed that such reversal surgeries are “more in-demand than ever before”. What does this new demand look like?
It’s potentially why some of those seeking “reversal” surgeries are heading to a clinic in Serbia, where Professor Misoslav Djordjevic has been performing them for five years at the Belgrade Center for Genital Reconstructive Surgery.
A specialist in genital reconstruction with 20 years of experience, Prof Djordjevic began conducting the innovative procedures after a transgender patient who had undergone surgery to remove male genitalia requested a reversal.
It’s by no means a common practice. He has performed just 14 surgeries to date and is currently in the process of treating two “reversal” patients, reports The Daily Telegraph, explaining that the procedure is extremely complex and can cost up to €18,000 (£15,965).
Presenting data in this way is unhelpful. 16 postoperative trans people have sought surgical reversal – but out of how many? A naked numerator like this obscures understanding, and encourages imaginative speculation that may not align with reality. Is it 16 out of 100 total trans people who’ve had genital surgery? This would be very concerning indeed – a 16% rate of surgical reversal. Is it 16 out of 10,000? This would be a rate of 0.16% – not exactly an epidemic. The problem is that most people aren’t aware that there are millions of trans people in the world: 0.6% of the population being trans means about 44.6 million people around the world are trans.
Fortunately, more useful statistics are now available on the practice of surgical reversal of trans genital surgeries. This month, WBUR CommonHealth reported on findings from a still-unpublished study:
The most recent data on transgender patients who change their mind after surgery is a study led by Oregon Health and Science University, which has not been published but was presented at a conference earlier this month. In it, 46 surgeons from around the world reported reversing 36 transgender surgeries, including 16 phalloplasties, after treating somewhere between 18,000 and 27,000 patients.
36 surgical reversals out of 18,000-27,000 trans patients who’ve received surgery is a reversal rate of 0.13-0.2%. This is consistent with existing studies finding that rates of regret following genital surgery of about 2%, and indicates that only a small fraction of those who do experience regret will go on to seek reversal surgery. I’ve been in touch with the study’s authors, and while the study itself is not yet available, I look forward to continuing to cover this non-epidemic – denominator and all. ■
