[Ed note: … which is nearly identical to the much-touted percentage who commit suicide when they are denied the surgery]
Even if we were to believe that a course of medical mutilation could make someone happier, this therapy seems often not to be therapeutic. A large number of those who undergo sex reassignment, as many as one in four by some estimates, pronounce themselves unhappy with the procedure. Dr. McHugh in a 1992 essay wrote about its long-term consequences: “Age accentuates the sad caricature of the sexually reassigned and saps their bravado. Some, pathetically, ask about re-reassignment.” Dr. James Bellringer, a British physician who has performed hundreds of sex-reassignment surgeries at the Charing Cross Hospital gender-identity clinic, points out in defense of the practice that about one-fifth of those who are denied the procedure attempt suicide; but a study conducted by the British National Health Service found practically identical — 18 percent — suicide-attempt rates for those who had undergone the procedure. (Mr. Avner, whose feline transformation also took a toll on his personal life — “Being a tiger is more important to me than humanity, which is difficult for many women to cope with” — was found dead of an apparent suicide.) The Aggressive Research Intelligence Facility, which advises the NHS on the effectiveness of treatments, conducted a broad review of the research literature and “found no robust scientific evidence that gender reassignment surgery is clinically effective,” according to the Guardian, the liberal newspaper that commissioned the review. A study by the scholarly journal BJUI (formerly the British Journal of Urology) found that some 24 percent of those who undergo reassignment reported that they were unhappy with the cosmetic results, and 20 percent reported that they were in general dissatisfied with the procedure. Those numbers would be high for nose jobs or breast implants; they are sobering for a course of therapy that involves elective amputations.