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US News

Transgender operations nearly tripled from 2016 to 2019 due to Obama-era policies: study

By
Melissa Koenig
Published Aug. 24, 2023
Updated Aug. 24, 2023, 5:55 p.m. ET

The number of gender surgeries in the US nearly tripled in the three years up until 2019 — driven by insurance policy changes introduced by former President Barack Obama, a new study says.

Only around 4,550 Americans sought such sex-change surgeries in 2016 — a number that shot up to more than 13,000 by 2019, according to a Columbia University study published Wednesday in JAMA Network Open.

“Consistent with prior studies, we identified a remarkable increase in the number” of such procedures, study author Dr. Jason Wright wrote.

“These findings suggest that the number of procedures performed in the US has increased dramatically, nearly tripling from 2016 to 2019.”

The rise followed the number of procedures doubling at least twice before, between 2000 to 2005 and again from 2006 to 2011, Wright wrote, citing previous studies.

A transgender woman in a hospital bed with bandages covering her face and stitches over her upper lip
Transgender influencer Dylan Mulvaney underwent cosmetic surgery in December as part of her transition
A transgender woman smiles
The surgery was designed to make her face appear more feminine

The tripling of cases seen in the study “is likely due in part to federal and state laws requiring coverage of transition-related care,” Wright wrote of Obama administration policies to expand insurance coverage for transgender care.

The study included breast and chest procedures, genital reconstructive procedures and other facial and cosmetic surgical procedures. It did not consider the use of puberty blockers or hormone treatments.

The rise dipped slightly in 2020, to 12,800 procedures — still close to triple the 2016 number — which is “likely reflective of the COVID-19 pandemic,” Wright wrote of the final year examined in his report.

In total, researchers about 48,000 people underwent surgeries in the five-year span from 2016 through 2020.

Dr. Geoffrey Stiller visits a patient, Sarah Bergman, who he recently performed a vaginoplasty surgery, a surgical procedures addressing gender reassignment.
Dr. Geoffrey Stiller visits a patient, Sarah Bergman, who he recently performed a vaginoplasty surgery, a surgical procedure addressing gender reassignment. The Washington Post via Getty Images

At the same time, the overall number of “health system encounters for gender identity disorder” rose from 12,855 in 2016 to 38,470 in 2020.

“The rapid rise . . . suggests that there will be a greater need for clinicians knowledgeable in the care of transgender individuals and with the requisite expertise to perform [gender-affirming surgery] procedures,” the report concludes.

To conduct the study, researchers analyzed records of both in-patient and out-patient procedures from two national surgery databases.

The doctors found that slightly more than half of the patients seeking care from 2016 through 2020 were between the ages of 19 through 30, while 22 percent were between the ages of 31 to 40 and just about 8 percent were ages 12 through 18.

The rise dipped slightly in 2020, to 12,800 procedures -- still close to triple the 2016 number -- which is "likely reflective of the COVID-19 pandemic," Wright wrote of the final year examined in his report.
The rise dipped slightly in 2020, to 12,800 procedures — still close to triple the 2016 number — which is “likely reflective of the COVID-19 pandemic,” Wright wrote of the final year examined in his report. Universal Images Group via Getty Images

“This is in line with prior work that demonstrated that most patients first experience gender dysphoria at a young age with approximately three-quarters of patients reporting gender dysphoria by age seven years,” Wright wrote.

“These patients subsequently lived for a mean of 23 years for transgender men and 27 years for transgender women before beginning gender transition treatment.”

Among the youngest patients, the most common surgeries were breast and chest procedures, with more than 3,000 preteens and teenagers undergoing the surgery over the course of the five years examined.

Breast surgeries were also the most common type of surgery conducted on all age groups, followed by genital surgeries — the number of which increased with age.

The study comes as an increasing number of Republican-led states seek to ban gender-affirming procedures in adolescents.

Those efforts, however, are facing increasing backlash.

In June, a federal judge in Arkansas struck down its ban, and Senate Democrats voted against legislation that would bar a military health benefits program from covering gender procedures on children that could result in sterilization.