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View Public Comments for Gender Dysphoria and Gender Reassignment Surgery (CAG-00446N)

Carter, Angela
Clinical Director and Physician
The Equi Institute

I am the physician of over 300 transgender people. I have seen most conclusively that hormone therapy and surgical interventions like orchiectomy and vaginoplasty for transgender women and mastectomy and metoidioplasty for transgender men are most beneficial and greatly improve quality of life.

It is clear in my clinical practice that gender affirming surgery reduces suicidality, self harm, and isolation. Many of my patients express a feeling of being stuck, not being able to move forward in their life, not being able to achieve what they want to do due to the barriers of their dysphoria. I see an almost miraculous change as they begin hormones, then achieve their goals of surgery. They can finally relate to their partners and their own body in the way that feels good to them. They can present their full self to the world and feel confident and happy with their bodies. Many lift themselves up out of severe PTSD and poverty and begin to pursue the things they want to do in life.

Special attention must be given to those with intersectional identities, such as transgender people of color and youth as the oppression and discrimination they face is much greater, and thus has a larger psychological impact.

Physical transition also increases safety, as people who do not "pass' as the gender that they identify with have a greater risk of harassment, discrimination, and violent actions being perpetrated upon them.

There is a dearth of research, and I encourage you with whatever power you may have to change this. We need more data. It is easy to see in clinical practice, but no one is writing the journal articles that make the clinical data valid in the eyes of science.

Here are a few supporting studies.

Please feel free to contact me if you have any questions.

Thank you,
Angela Carter, ND