Michael Knowles Highlights 2019 Study Correction and New Data on Mental Health After Transgender Surgery

Top Points

• Knowles said a major 2019 study once cited as proof that transgender surgeries improve mental health was later corrected: He emphasized that the corrected analysis found no evidence that surgery reduced anxiety, depression, or suicide-related hospitalizations.

• Knowles cited newer large-scale data showing worse mental health outcomes for patients who received surgery: He pointed to research involving more than 100,000 individuals that associated surgical transition with increased rates of depression, anxiety, suicidal ideation, and substance use disorders.

• Knowles argued that these findings contradict the prevailing narrative that surgery reliably improves psychological well-being: He said policymakers and clinicians should not present irreversible medical procedures as guaranteed mental-health treatments when the evidence is mixed or suggests potential harm.

Full Report:

On a recent episode of The Michael Knowles Show, host Michael Knowles discussed research on the mental health effects of gender-affirming surgery and argued that the evidence does not show clear psychological benefit from surgical intervention. Knowles cited a 2019 study, once widely touted as showing positive effects on mental health, which was later corrected by its authors to acknowledge that the data did not support claims of benefit. He also referenced more recent analyses that he said show increased risks of anxiety, depression and related conditions following surgery.

Knowles Says Corrected 2019 Study Found No Mental Health Advantage

Knowles told his audience that a high-profile 2019 study published in The American Journal of Psychiatry initially claimed that gender-affirming surgeries were associated with reduced need for mental health treatment among transgender individuals. After questions were raised about the methodology and interpretation, the authors issued an official correction noting that the results did not support a mental health benefit from surgery. The correction stated that the data “demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts.” 

Knowles used this correction to argue that the purported mental health benefits of surgery do not rest on strong evidence, given that this study had been cited repeatedly as demonstrating the largest dataset available at the time.

Knowles Cited Newer Large-Scale Data Suggesting Elevated Mental Health Risks

In addition to the correction to the 2019 study, Knowles referenced more recent research that analyzed health records from a very large sample of transgender patients. One such analysis, published in The Journal of Sexual Medicine and using data from over 107,000 individuals, found that those who underwent gender-affirming surgery had higher documented rates of depression, anxiety, suicidal ideation and substance use disorders than matched groups who did not have surgery.

Knowles said these findings challenge the narrative that surgery reliably improves long-term mental health outcomes and underscore the need for a careful review of the evidence before promoting surgical interventions as mental health treatments.

Knowles Framed the Issue as a Gap in Reliable Evidence

Knowles argued that the combination of the corrected 2019 study and the newer retrospective research shows that the evidence base is not settled and may not support the claim that surgery reduces mental health conditions such as anxiety and depression. He stressed that decisions about irreversible medical interventions deserve transparent discussion of the data, the limits of existing studies, and the range of outcomes observed in large populations.

Knowles Urged More Transparent and Nuanced Discussion

Knowles concluded the segment by urging policymakers, clinicians and the public to examine the full range of research rather than relying on selective interpretations. He said the available data, including corrected analyses and large-sample studies, highlights the importance of ongoing mental health support regardless of whether medical transition is pursued, and that surgery should not be presented as a guaranteed path to improved mental health.

Reference

• The Michael Knowles Show. Episode discussing transgender surgery outcomes and the reassessment of major studies on mental health. Daily Wire.

• Knowles, Michael. Commentary on the 2019 American Journal of Psychiatry study correction and subsequent large-scale research findings. The Michael Knowles Show, Daily Wire.

• Bränström, Richard, and John E. Pachankis. “Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.” American Journal of Psychiatry, 2019. Author Correction, 2020.

• Meier, S. C., et al. Studies analyzing mental health outcomes among transgender individuals after surgical intervention. Journal of Sexual Medicine.