THE EDITOR, Sir:
If true, it is horrifyingly tragic, not just sad. An article by Ryan T. Anderson in Public Discourse of March 5 is contending that in 2016, the US Centers for Medicare and Medicaid refused coverage of sex-change surgeries by Medicare plans because, “based on a thorough review of the clinical evidence available at this time, there is not enough evidence to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria.
“There were conflicting (inconsistent) study results of the best-designed studies. Some reported benefits while others reported harms. The quality and strength of evidence were low due to the mostly observational study designs with no comparison groups, potential confounding and small sample sizes. Many studies that reported positive outcomes were exploratory type studies (case series and case control) with no confirmatory follow-up.”
MORTALITY OF PATIENTS
Further, the author argues, the Centers for Medicare and Medicaid drawing on a study from Sweden, regarded as the largest and most robust study of sex-change surgeries, said: “The study identified increased mortality and psychiatric hospitalisation compared to the matched controls. The mortality was primarily due to completed suicides (19.1-fold greater than in control Swedes), but death due to neoplasm and cardiovascular disease was increased 2 to 2.5 times as well. We note, mortality from this patient population did not become apparent until after 10 years … .”
Ryan Anderson is negatively dogmatic about gender-reassignment surgery. The full title of his article is ‘Sex Change: Physically Impossible, Psychosocially Unhelpful, and Philosophically Misguided’.