Jackson Daniel
Psychiatry and Behavioral Sciences, Norton College of Medicine, Upstate Medical University, Syracuse, USA.
Cureus. 2023 Mar 20;15(3):e36425. doi: 10.7759/cureus.36425. eCollection 2023 Mar.
Gender-affirming treatment remains a topic of controversy; of particular concern is whether gender-affirming treatment reduces suicidality. A narrative review was undertaken evaluating suicide-related outcomes following gender-affirming surgery, hormones, and/or puberty blockers. Of the 23 studies that met the inclusion criteria, the majority indicated a reduction in suicidality following gender-affirming treatment; however, the literature to date suffers from a lack of methodological rigor that increases the risk of type I error. There is a need for continued research in suicidality outcomes following gender-affirming treatment that adequately controls for the presence of psychiatric comorbidity and treatment, substance use, and other suicide risk-enhancing and reducing factors. There is also a need for future systematic reviews given the inherent limitations of a narrative review. There may be implications on the informed consent process of gender-affirming treatment given the current lack of methodological robustness of the literature reviewed.
性别肯定治疗仍然是一个有争议的话题；特别令人关注的是性别肯定治疗是否能降低自杀倾向。我们进行了一项叙述性综述，评估性别肯定手术、激素和/或青春期阻滞剂治疗后的自杀相关结果。在符合纳入标准的23项研究中，大多数研究表明性别肯定治疗后自杀倾向有所降低；然而，迄今为止的文献缺乏方法学严谨性，增加了I型错误的风险。有必要继续研究性别肯定治疗后的自杀倾向结果，充分控制精神疾病共病、治疗、物质使用以及其他自杀风险增加和降低因素的存在情况。鉴于叙述性综述的固有局限性，未来也需要进行系统综述。鉴于所综述文献目前缺乏方法学稳健性，这可能会对性别肯定治疗的知情同意过程产生影响。
