The most common gender affirming surgery is breast augmentation -- in cis (non-trans) women.
The regret rate is around 20%.
Gender affirming surgeries in trans people have around a 1% regret rate.
Guess which people need approval from a mental health provider...
@joelle the study suggests that the mental approval process is beneficial, because there is a low regret rate. They say:
> We believe this study corroborates the improvements made in regard to selection criteria for GAS.
So the low regret rate is the effect of the selection criteria.
One can discuss about how to determine if the selection filter is too much stringent, but not that it is not useful.
@joelle I cannot follow you. This study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/ suggests that selection criteria are useful because regrets are very low, 1%. And you said initially that the regrets in the wild west of breast augmentation is 20%. So this is already a proof that some regolumentation is beneficial.
We can discuss if the 20% of regrets are linked also to the low quality of some surgeon, and not only to patients not knowing really what they want. But, the difference is rather large.
@mzan The authors note that selection criteria have improved (I.E. gotten loser) for GAS. They didn't actually study that though, it's conjecture. They also didn't compare not having the psychological gatekeeping with having it (if they think the modern standards are better, then what about even loser ones? They don't know because they didn't study it).
@mzan We see basically no change in regret between the incredibly difficult standards imposed on trans people in the 50s and 60s and the current standards which are much looser.
We've known trans people present the story the gatekeepers want to hear, to access medical care. That was true in the 1950s and is true now. Yet despite this, the regret rate remains nearly zero.
I'm also unaware of any studies actually looking at whether gatekeeping lowers regret (Bostos, et al, 2021 didn't).