Assessing life satisfaction, self-harm, and suicidal thoughts in transgender women following genital gender-affirming surgery

Aim: Gender dysphoria causes significant psychological distress in individuals, leading many to seek medical interventions, including hormone therapy and gender-affirming surgery (GAS). This study sought to enhance the understanding of life satisfaction and self-harm and suicidal thoughts among transgender women after genital GAS. Methods: A retrospective cohort of 102 transgender women who underwent GAS during 2011-2021 at Sahlgrenska University Hospital, with a follow-up period of at least 1 year after genital GAS, was studied. Data were collected as part of a larger initiative that focused on transgender women. The participants were surveyed using the Life Satisfaction Questionnaire, Gender Congruence and Life Satisfaction Scale, and a general demographic health survey. Data were analyzed using descriptive statistics. Results: Of the 98 eligible participants, 50 completed the questionnaire. Although 28% of the respondents experienced thoughts of self-harm or suicidal ideation postoperatively, they reported overall satisfaction with life and mental health, suggesting that surgical treatment may have had a positive impact on life satisfaction and gender congruence. Conclusion: Our study highlights the significant issues of thoughts of self-harm or suicidal ideation among transgender women after genital GAS. Although the prevalence thereof was lower than that reported previously, it remains concerning. Nevertheless, most participants reported life satisfaction and finding life meaningful post-surgery. These findings emphasize the need for integrating continuous mental health support with access to GAS to address the mental health challenges of transgender women after genital GAS, while aiming to improve the quality of life as the primary goal.