Science regarding transexualism


Here are some factors likely predicting the probability of transitioning (ranked by importance).

0. Autogynephilia
1. Autoandrophobia (AAF)
2. Being a failed man
3. Attraction to trans girls
4. Not wanting children
5. Whether or not your social situation pushes or discourages MTF transition
6. Being attracted to heterosexual males
7. Wanting to Attract cis lesbians
8. Desire to alter your consciousness (HRT will affect your brain)


The reason why people change their sex from female to male is mostly due to the following factors
0. Body discomfort
1. Autoandrophilia
2. Failing to develop autogynephilia
3. Not wanting children

People born female will typically not transition unless they experience very strong body discomfort.
Last edited:


If this theory is correct the following must hold
0. MtF individuals will be less uncomfortable with their bodies prior to transitioning than FtM, especially young transitioners.
1. AFAB individuals will detransition more often despite being more dysphoric prior to transition as a group.
2. More mental illness among MtF individuals (excluding dysphoria, AGP when born male, AAP when born female).
3. MtF individuals will do better after transitioning.
4. MtF individuals will on average be significantly less sexually successful prior to transitioning even compared to repressors.
Hello, Ive been experiencing gender dysphoria from, what now given the proper education, the very beginning. However I am 27 and feel I am realizing this too late. That being said I’ve been very fem my whole life (I think this is why I didn’t experience dysphoria too badly until recently) and people usually are flabergasted when I tell them my age, they usually believe I’m around 18 or younger. Should I transition or is it too late for me?


Hello, Ive been experiencing gender dysphoria from, what now given the proper education, the very beginning.
If you only have minor body discomfort there is no real need to transition.
However I am 27 and feel I am realizing this too late.
Age is of course not the only factor to consider but generally you want to be younger than 25 before starting HRT.

That being said I’ve been very fem my whole life (I think this is why I didn’t experience dysphoria too badly until recently) and people usually are flabergasted when I tell them my age, they usually believe I’m around 18 or younger. Should I transition or is it too late for me?
You having a feminine personality isn't by itself a particularly good reason to transition.
If you only have minor body discomfort there is no real need to transition.

Age is of course not the only factor to consider but generally you want to be younger than 25 before starting HRT.

You having a feminine personality isn't by itself a particularly good reason to transition.
I think you slightly misread my post. In terms of demeanor I present as very masc (well as close to it as I can manage) but my masculine traits I mentioned are physical rather than social; ie I’m 5’7 and I just started getting facial hair this year


Girl brain?
A lot of trans individuals think they a female trapped in a male body, scientifically this would mean having a brain more like that of the sex they transition to prior to HRT. MRI scans do however show that prior to Hormone replacement therapy the brains of transgender individuals will be mostly that of their natal sex, only subtle differences

The "born in the wrong body" narrative is problematic since it can result in people transitioning when doing so isn't beneficial or to refrain from transitioning thinking they are not really transgender becuase they have masculine personality traits when born male.


Being transgender is less genetic than owning a dog

You dont have a female brain prior to HRT (only subtle differences)

Benefits from Hormone Replacement Therapy
only MTF participants showed a statistically significant increase in general quality of life after initiating hormone therapy

3.1.1 Sexual function
In a review about multiple orgasms in biological males Wibowo, Wassersug (2016) mention that ejaculation and exposure to androgens may be at least in part responsible for the post-ejaculatory refractory period and thus the inability to have multiple orgasms in one sexual session in cis men. Kinsey (mentioned in Wibowo, Wassersug 2016) reported that among young males, capacity for multiple penile orgasms are more prevalent in kids and teens. Warkentin et al. (2016) reported a case of a prostate cancer patient who became penile-multi-orgasmic on anti-androgen treatment.

Having a good sex-life is very important

The societal impact
Chemical castration work in the case of sex-offenders

Evidence show that it's safe to let transwomen use female bathrooms

Policy proposal
We need to drastically expand the usage of Hormone Replacement Therapy among individuals that are born male. Body dyshproria isn't the only condition that can be treated with HRT.
  1. lower the age limit for MtF HRT to 14 or lower (full HRT, informed consent)
  2. more funding to transgender healthcare
  3. do a trial among criminals to examine whether or not forced HRT in the form of community treatment order would be beneficial for society or the the individuals subjected to it
Humans rights objections to point 3 are invalid unless you also promote the complete halting of forced druggings in the case of individuals viewed to be mentally ill.


Explaining the apparent HSTS category
HSTS here doesn't refer to all exclusively andropholic transfeminine individuals, only a portion of them.

Gay males are already degenerate in the sense that they are not really into reproductive sex.

This degeneracy factor explain why they are more likely to transition, it's not that they have more gender issues than the average male (the opposite is probably true).

If they transition early their dating pool will widen and increase in attractiveness due to the female dating advantage and the fact that the gay male dating pool is more limited in numbers.

One risk is "autoandrophilia", if they are directly attracted to men they might prefer having a male body, it's likely that these individuals mostly do not transition in the first place.

Autoandrophilia could be a reason for why many gay males with gender issues desist at puberty, they start finding male bodies (including their own) sexually attractive.

Sources of body dysphoria
If you are rejected constantly by straight guys becuase you are male that may cause body dysphoria and there is no denying that many of these guys would be willing to have sex with you if you actually transitioned.

If you have internalized homophobia you might feel likeit's wrong for you to have sex with men when you are a male yourself.

It's also likely that many gay males who want to transition lie about having gender dysphoria to be viewed as valid, they might also lie to themselves.

If a gay male is less attractive he might view him not finding himself attractive as dysphoria and thus transition, once female she will get a lot of male attention and validation and thus feel better about her body.


AFAB individuals with regret despite having had gender dysphoria
You having been dysphoric prior to transitioning does not mean you will not regret it

Mentally ill and dysphoric ftm thinking of detransition

She eventually decided to detransition because she rather suffer from body dysphoria than to be treated like a male.

She tried to make some activists to improve the treatment of males (especially incels) which of course ended in total failure.


Girlbrain theory 2.0
It's not clear what percentage of M2F transsexuals this apply to.

While you might start out with a female/feminine brain due to environment and hormones your brain will masculinize, especially at puberty. Thus when proper brainscans are made after puberty transfeminine will have mostly male brains prior to hormone replacement therapy.

Female sexuality
This is sometimes called "autogynephilia" and it seem to be very similar between trans and cis females.


you may still see some differences (especially before HRT) due to male socialization and puberty.

Studies on children
As far as i know no proper brainscan study has been done on children but the following study does give support to the theory that transchildren have a brain of the sex they want to transition into prior to puberty

While this may hold true for a significant portion (possibly a majority) of people who transition from male to female it is on it's own insufficient in explaining why people transition.

You having a brain that is feminine (when male) does not nessicarily mean dysfunction will follow, if you are able to function properly as a male you will probably not transition, how well you function will depend a lot on environment and this explain the twin study results.


About "tailcalled"
He is/was a believer in the blanchard topology but when he collected his own data it became very obvious the typology he believed in was psuedoscience.







Unfortunatily the individual still defend ray blanchard and his pseudoscience and when i pointed out how he was wrong he resorted to publicly accurding me of having essentially being insane "schizotypal traits" or lying while failing to point to anything i said that was false.


"the theory i believe in being falsified isn't important" this is a big "no no", any deviation from theory has to be taken very seriously.




This refutes the erotic target location error theory so it's highly significant and no there isn't any way around this.

This is taken from females who are radical transphobes and call themselves feminists, these are not the type of people who tend to enjoy feminine gender roles which could be the the explanation of lower rate among these cis girls.

This support the notion that what's called "autogynephilia" simply is normal female sexuality (it will still be different prior to HRT due to different hormones).

Flawed methodology
Almost all data is collected from the samplesize subreddit and not from actual trans girls, thus he end up collecting data for "gender issues" instead of what actually causes people to transition. This of course didn't stop him from denying that narcissism was a factor becuase it wasn't in his flawed data-set.


Well-known member
What are they doing? Are they using reddit as a research tool?

They look like the cultural studies guys that use goodreads to understand market trends in the consumer literature


Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results
Depression decreased and reported quality of life improved after initiating Hormone Replacement Therapy

In multivariate regression analysis puberty supression was found to decrease depression measured with the CESD scale (P = 0.008) in MtF individuals but that did not have any statistically significant benefit in terms of quality of life. Unfortunatily the sample size was too small to find a statistically significant benefit from Cross Sex Hormones.


Table 1 Baseline characteristics at Wave 1
                            Total       Female to Male  Male to Female
Number of participants      50          33              17
Age in Years (SD)           16.2 (2.2)  16.6 (2.5)      15.5 (1.6)
%Depressed in past year (n) 64% (32)    60.6% (20)      70.6% (12)
% Suicidal (n)              10% (5)     9.1% (3)        11.8% (2)
% In Counseling (n)         90% (45)    87.9% (29)      94.1% (16)
% On Psych Medication (n)   34% (17)    36.4% (12)      29.4% (5)



Study: Access to HRT before 18 improved mental well-being

Statistically significant difference was found with regard to "past-year suicidal ideation" which was adjusted for gender identity, sex assigned at birth, sexual orientation, race/ethnicity, famility support of gender identity, educational attainment, total household income.

Statistically significant difference with regard to "past-month severe psychological distress" was found after adjusting for gender identity, sex assigned at birth, sexual orientation, race/ethnicity, familily support of gender identity, educational attainment, total household income, having recieved pubertal supression.

In both cases the statistical significance was p<0.0001 when compared to people who never started HRT, you will only find a difference that large less than once in 10000.

After adjusting for demographic and potential confounding variables, access to GAH during adolescence (ages 14–17) was associated with lower odds of past-month severe psychological distress (aOR = 0.6, 95% CI = 0.5–0.8, p < .0001), past-year suicidal ideation (aOR = 0.7, 95% CI = 0.6–0.9, p = .0007), past-month binge drinking (aOR = 0.7, 95% CI = 0.5–0.9, p = .001), and lifetime illicit drug use (aOR = 0.7, 95% CI = 0.5–0.8, p = .0003) when compared to access to GAH during adulthood.


The drop in libido from MtF HRT is temporary
In TW, total, dyadic, and solitary SDI scores decreased during thefirst 3 months of HT. However,after 36 months, total and dyadic SDI scores were higher than baseline scores. Solitary scores after 36 monthswere comparable with baseline score


In TW, estrogens plus antiandrogens are administered. Antiandrogen therapy consisted of 25 to 50 mg of cyproteroneacetate once daily (Androcur). Estrogen therapy generally consisted of 2 mg of estradiol valerate (Progynova) twice daily. Inpatients older than 45 years, estradiol was administered trans-dermally in the form of estradiol patches (Dermestril or Systen) in a dose of 100mg/72 hours
That is much bigger cypro dosage than ideal (it should be 12.5 mg or less for cyoproterone acatate), this may explain the following:
Gonadectomy resulted in highe rtotal and dyadic SDI scores in TW after 24 months, but not in TM and/or at all other follow-up visits
There is of course zero real medical advantages with orchiectomy, high/moderate dose estradiol injections are more than enough to suppress testosterone.

I am not convinced using an anti-androgen is beneficial even when when the estradiol dosage is low, you might be better off just having higher T. Cyproterone Acatate is probably the best option temporarily supressing T.

There evidence in favor of low starting dosage for estradiol is very weak but even if low initial dose is beneficial that (such as 4mg oral estradiol valerate per day) is not something you should remain on for years.


Study: MtF HRT improved quality of life
When the effect of hormones only was looked at only AMAB individuals got a statistically significant benefit in terms of quality of life

MtF prior to transitioning
Body Image scale, 43.25
Quality of Life scale, 62.50
Quality of Sexual Life scale, 56.25
Interpersonal Relation-ship scale, 50.25

MtF after transition
Body Image subscale average score was 68.75 (p<0.05)
Quality of Life score was 72.2 (p<0.05)
Quality of Sexual Life scale score was 62.05(p<0.05)
The Interpersonal Relationship scale reported an average score of 75 (p<0.05)

FtM comparison
Despite being significantly more dysphoric prior to transitioning they did not improve as much in terms of quality of life. It seems like AFAB individuals where more reluctant to transition (less of them in the study, more dysphoric) but the ones that actually transitioned were very happy with the physical results regarding their bodies.
MtF Body image: +25.5
FtM body image: +41.4
MtF quality of life: +9.7
FtM quality of life: +5.5

FtM prior to transitioning
Body Image scale, 21.85;
Qual-ity of Life scale, 63.25
Quality of Sexual Life scale, 50.25
Interpersonal Relationship scale, 50.02.

FtM after transition
Body Image subscalescore was 63.25 (p<0.05)
the average Quality of Life score was 68.75 (p=ns)
the average Quality of Sexual Life scale score was 56.25 (p=ns)
the Interpersonal Relationship scale average score was 81.25(p<0.05).

Most MtF individuals in the study probably didn't pass
This explains why their social relationships did not improve as much as FtM individuals, it was difficult for them to pass as the opposite sex.
Age: 32.7±8.8 yr
Height: 172±7.38 cm


Study: Trans females who had surgery had better mental health than cis females
This is self-reported, in this study trans females who hadn't had any surgery had worse mental health than cis females while trans females who had FFS or SRS scored slightly higher on average.


This however does not mean there surgeries are beneficial since there will be confounding factors skewing these results.

Participants were asked to complete the survey if they identified themselves as a transgender woman. While there is a potential for individuals to falsify their identity, we believe this likelihood is low. It should be remembered that the term transgender is an all-encompassing term that includes individuals in a variety of points in their transition. As a result of recruitment efforts, only individuals who either received care from a FFS surgeon or clinic or were involved with transgender support groups or organizations were asked to complete the survey. This is an important point because transgender women who are early in their transition may not be well connected to support groups or physicians who specialize in transgender services. The quality of life of these transwomen is not well-represented by this study. We also did not collect data on the medical co-morbidities of our participants.
For some insane reason they didn't separate out the people who were not on HRT which might explain why the group who had SRS but not FFS did better than the no-surgery group.


This gives os a system of equation we can solve where the solution is

HRT = 58.4918
noHRT = 10.3
SRS = -7.7818
FFS = -0.03636

If this is correct then SRS is actually detrimental while SRS is neutral in terms of mental health, unfortunately these figures are very unreliable. It would have been better if they actually separated out the noHRT group so we wouldn't have to do these questionable calculations to get at least some idea.

But the noHRT vs HRT figure does not at all agree with the previous study so obviously difference in HRT usage alone cannot explain these differences. Next we are instead going to solve for how many that have transitioned more than a year ago to see if that gives more reasonable figures.

Treatment(1+ year) = 53.71
(less than a year) = 10.71
FFS = 1
SRS = -4.01

If we instead use the percentage who have transitioned more than 6 years as a variable we get

treatment(6+) = 109.23
treatment(0 to 5) = 20.9
FFS = 11.36
SRS = -37.33


Long term outcomes are better
No hospotilizations for suicide attempt after 3 years. A factor in this is likely that they will no longer have any reason to have anything to do with the awful mental health industry but it's still very likely that people simply do better over time as they learn to live as their new biological sex.

Of course not everyone have surgery and individuals who do not have surgery actually receive less treatments, these groups however are not equal.

People are required to be screened for mental health problems before gender-affirming surgery and might therefore have particularly high odds of mental health treatment in the perioperative year because of their perhaps involuntary receipt of mental health services. These individuals might be less likely to voluntarily seek treatment for mental health problems with greater time since surgery.

But even if they would not voluntarily contact psych-quacks they would still likely end up in a psych-ward after a serious suicide attempt due to someone else alerting authorities regarding it.


Why do some people regret transitioning?
The main reason causing regret is lack of social support.

The study above is however outdated (done 1998) and it did not study transexuals who did not opt for SRS, there is a very large (probably majority) who do not want SRS in the first place.

We found transsexuals to be more at risk for dropping out of treatment when they were MFs, showed more psychopathology, more GID symptoms in childhood, yet less gender dysphoria at application
So if you were more dysphoric as a child but it's getting better now you might not be the best candidate for medical transition. It so worth nothing that childhood gender identity disorder is largely defined as being gender-nonconformative 0 1 it's not surprising that many of these will later realize medical transition isn't for them.

Only non-homosexuals reported some regrets during treatment, and two during and after SR, which they all related to a lack of acceptance and support from others.
This is a general pattern we are seeing in these studies, social factors are the biggest factor when it comes to regrets and worse outcomes.

Overall, adolescents with poorer peer relations, poorer general family functioning, advanced age, and a female sex assigned at birth showed more behavioral and emotional problems, or lower psychosocial functioning. Thus, the present study confirms the important role the social environment - both peers and family support - play with regard to the mental health outcomes in this group. Consequently, incorporating the family and social environment into Transgender Healthcare seems crucial in order to adequately tend to the needs of adolescents with GD.

As we see the regret rate is dropping despite more people transitioning.

The FMs who applied for reversal were younger at application than those who did not(median 22 years compared to 27 years for the whole FM group). Conversely, the MFs who later applied for reversal were older when they applied for sex reassignment than those who did not (median 35 years vs. 32 years for the whole MF group). Since the group is small, these data must, however, be interpreted cautiously.
What many people ignore is that surgeries is more or less a requirement for AFAB individuals, you will not be taken seriously as a male if you do not have a penis or if your penis is very small. There is less need for surgery if you are AMAB and can pass facially without FFS.
It is worth nothing that surgeries (especially mastectomy) can leave visible scars which can out people as transgender.
Eleven FMs (28.9%) weresatisfied with their breast removal, 5 (13.2%)were dissatisfied due to the visibility of the scars,and 22 (57.9%) were not completely satisfied.Four FMs were satisfied with their metaidoio-plasty or phalloplasty. One FM was dissatisfied because of urinary problems, while four were not completely satisfied.
The dating market is changing
Old studies are misleading since what was true 10 years ago no longer holds
  1. now it's significantly harder to date as heterosexual male
  2. the transbian dating pools is a lot bigger making it easier to date as gynephilic trans female.
  3. dating as androphilic female is now a lot easier.
Because of that we can expect trans-females to have better outcomes when they transition while gynephilic trans-males will have significantly worse outcomes.


Study: gynephilic trans females have androgynous brains (average) prior to HRT
For some reason the abstract of this study does not agree with the actual results they got which can be due to the authors not wanting to discredit already discredited theories by blanchard


12 of 14 volumes were on average between the male and female average, one was larger than the male average and one was smaller than the female average. Individually these figures are not statistically significant (sample size was too small for that) but together the result will be highly statistically significant.

4 of 13 were closer to the female average than the male average.

This is one of the studies James Cantor used to push for pseudoscience (he probably didn't even read the full text)


Suicide mortality
Someone did a freedom of information request to get data from the tavistock clinic.

This however is not particularly useful since they do not provide any additional data

We do however have the following study looking at suicide mortality, they found that medical transition from male to female significantly reduces suicide mortality and the number of trans people dying from suicide has not gone up with as the number of trans people they followed increased.



The issue with this study is not separating based on whether or not the individuals were on HRT and also not providing figures for the total number of people of each of these groups.

Depression comparison
Let's compare to people being treated for depression


So the suicide mortality of trans people 2017 was similar to the suicide mortality of insured people treated for depression in united states 1992 to 1994 (any treatment).

The following study on people who started transitioning before July 1, 1997 found that out of 966 MtF transexuals No suicides occurred within the first 2 years of hormone treatment, while there were six suicides after 2–5 years, seven after 5–10 years, and four after more than 10 years of cross-sex hormone treatment at a mean age of 41.5 years (range 21–73 years).

The study followed these individuals until 2017 meaning all participants alive by then had been followed for over 20 years.

From this we get that while suicide mortality was a big issue in the past over time that has become less and less of an issue which is to be expected with transgenderism becoming more and more socially accepted.


Study: 92% of detransitioners were AFAB, 2% didn't have gender dysphoria
There is nothing surprising with these results. It matches really well will what i have observed looking at various detransition spaces but of course a formal study is better.

body dysphoria & social dysphoria: 84%
only body dysphoria: 8%
Only social dysphoria: 6%
no dysphoria: 2%

Unfortunately the study did not separate AMAB from AFAB individuals and this was 92% detrans females, we can still even from this conclude most AMAB detransitioners had some form of dysphoria but it's very far from ideal.

Previous studies had shown detransition to be largely due to lack of social support but this survey had a different result


34 participants (14%) added a variety of other reasons such as absence or desistance of gender dysphoria, fear of surgery, mental health concerns related to treatment, shift in gender identity, lack of medical support, dangerosity of being trans, acceptance of homosexuality and gender non-conformity, realization of being pressured to transition by social surroundings, fear of surgery complications, worsening of gender dysphoria, discovery of radical feminism, changes in religious beliefs, need to reassess one’s decision to transition, and realization of the impossibility of changing sex.
Realization that my gender dysphoria was related to other issues
In reality of course you as an individual cannot really know why you have gender dysphoria, you may attribute it to something like innate neurological condition or that something happened to you but you as an individual cannot actually test that.

TERFs have been heavily pushing the notion that sexualization of females or sexual abuse would cause gender dysphoria but there isn't actually any evidence for that. If someone has gender dysphoria and also happened to have been groped she before the onset of dysphoria she may attribute the dysphoria to that even though it wasn't the actual cause of it, it just happens to conveniently fit with the TERF ideology.

Furthermore, two respondents highlighted the need to look into individual experiences and needs without forcing them into a rigid model of transition.
This is already a thing in the trans community. It's often referred to as "non-binary".

Some people who just struggle with dysphoria already go for the bare-minimum to deal with that and do not really socially transition.
A few respondents rightly criticized the fact that the option of medically transitioning only was not available in the questionnaire.
It's common knowledge that many people begin with medical transition without starting social transition, there is really no excuse for not including it in the survey.

Let me know if there is any better study published regarding this.

realization of the impossibility of changing sex
This makes me further question the motives of the individuals who conducted this study. They are essentially condoning science-denial.

You of course limited in how far you can transition but just HRT alone can do a lot.

The world "realization" implies what they concluding was clearly correct which in these cases it was at best questionable. The word "concluded" should have been used instead.

Does the study reflect the true gender figures?
The fact that online detrans spaces are heavily dominated by detrans females (some only for detrans females) is probably due to the fact that detrans males are far less common.

A cross-sectional survey was conducted, using online social media to recruit detransitioners. Access to the questionnaire was open from the 16th of November until the 22nd of December 2019. Any detransitioner of any age or nationality was invited to take part in the study. The survey was shared by Post Trans (—a platform for female detransitioners—via public posts on Facebook, Instagram and Twitter. Participants were also recruited through private Facebook groups and a Reddit forum for detransitioners (r/detrans). Some of the latter platforms were addressed exclusively to female detransitioners.
There are spaces for male repressors but these people generally do not really want to start HRT in the first place but if they finally cave and transition they generally regret not doing so sooner.

hardly any detransitioners there.


Effects on the brain
Transitioning will change the proportions of your brain and mental abilities towards the sex you are transitioning to. MtF transition will improve linguistic intelligence and diminish spatial intelligence.

Estrogen is neuroprotective and can be used as an anti-psychotic in both men and women

The current 14-day randomized placebo-controlled trial in 53 men with schizophrenia was conducted to evaluate the efficacy of 2 mg oral estradiol valerate as an adjunct to atypical antipsychotic treatment. Results demonstrated for estradiol participants a more rapid reduction in general psychopathology that occurred in the context of greater increases in serum estrogen levels and reductions in FSH and testosterone levels.

studies showing HRT has insignificant effect on cognitive performance:

This study shows that testosterone had an enhancing, and not quickly reversible effect, on spatial ability performance, but no deteriorating effect on verbal fluency in adult women (FMs). In contrast, anti-androgen treatment in combination with estrogen therapy had no declining effect on spatial ability, nor an enhancing effect on verbal fluency in adult men (MFs).

Some people may get aroused at the though of becoming physically and emotionally weak and thus tell themselves they are getting dumber when they are not.

Other individuals were mentally weak long before they started on hormones, they transitioned because they cannot really make it as males (the difficulty will keep going up).

You can keep it doing exercise or complement your HRT with stanozolol or oxandrolone (like cis female bodybuilders).




Study: medical transition reduces suicide attempt rate from 27% to 1%

Interestingly people with a non-binary identity seem to be doing better here

Data were from the Trans PULSE Project, a CIHR-funded, community-based study of how social exclusion impacts that health of trans people. Trans PULSE was created as a partnership between community organizations, trans community researchers, and academic researchers. Survey data were collected (online or on paper) in 2009-2010 from trans people in Ontario age 16 or older (n=433). To be eligible to take the survey, participants had to indicate they were included within a broad definition of “trans”, but were not required to identify any particular way (e.g. transsexual), or to have begun or completed a transition – either a social transition to live in another gender, or a medical transition through hormones and/or surgeries.

Participant recruitment was undertaken using respondent-driven sampling (RDS), a network-based sampling method in which participants each recruited up to three additional participants, and recruitment networks were tracked (Heckathorn, 2002).

All data were self-reported. Participants were asked if they had ever seriously considered suicide or taking their own life, if this was related to being trans, and if it occurred in the past 12 months. Participants were also asked about suicide attempts, whether this occurred during the past 12 months, and whether they had seen or talked to a health professional following an attempt. They also reported their age at first suicide attempt.

Of the ones who attempted suicide most did their first attempt when they were teens:


Long-term survey: people did significantly better after 5-year follow-up
Clinicians did report improvement less often than the patients but MtF transition was still found to be beneficial judging by the clinician.


Here homosexual and heterosexual refers to sexual orientation relative to the birth-sex which is somewhat transphobic.