4 ms·

That sounds unlikely, what and from where are the regret rate numbers you are comparing?

by trinn 3y ago

superchroma 3y ago
A cursory search reveals one study suggesting 30% continue to experience chronic pain and 1 in 5 regret knee replacement. https://www.aarp.org/health/conditions-treatments/info-2018/knee-replacement-surgery-regret.html https://www.aarp.org/health/conditions-treatments/info-2018/... Not great numbers, but sample sizes and study integrity, as with the data on gender affirming care, is the killer.
- trinn 3y ago
  Thanks for the info. What rates for gender-affirming care are you comparing this to though?
  - superchroma 3y ago
    The data there is not good. There are studies that claim it is low. They focus on surgery a lot. There are not many trans people (relative to the general population) and not many studies on them. There is not sufficient granularity between: - trans people who only take hormones, - who do that and have top surgery, - who are castrated and, - who have top and bottom surgery Personally, I think bottom surgery is not quite there and is definitely a medical frontier and free-for-all. Hormones and top surgery are fairly reversible via application of more money, exercise and time. Based on that, I am forced to fall back to first principles, and feel that given that the risk of lasting damage is low on some procedures, that those procedures which give perfectly acceptable and also potentially reversible results are reasonable to offer in this way.
    - deleted 3y ago
      [deleted]
  - throwaway626 3y ago
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503911/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503911/ Between 1% and 8%, depending on how detransition is defined. This article found 6.9% (12/175, 6 clearly detransitioning and 6 ambiguous) at one clinic, including anyone who sought and received care over a certain interval.
    - trinn 3y ago
      That is interesting but the same study also says that 21.7% of this cohort disengaged from the clinic. So the rate could be even higher, depending on if they stopped treatment entirely or changed to another service provider.
      - throwaway626 3y ago
        “Disengaged” here means that they did not make it through the assessment/pre-screening process and did not receive treatment, which is not what is meant by “detransition” or what is commonly understood as contributing to “regret rate”. When an elderly person rejects knee replacement prior to surgery e.g., because they’ve learned the risks, they’re also not counted in the regret rate for knee replacement. EDIT: Those that disengaged did not complete treatment, therefore they cannot regret completing treatment. Perhaps they regret starting treatment and perhaps they don’t; either way, that’s not the same thing as detransition. I can’t read their minds to figure out why they disengaged, and neither can anyone else.
        trinn 3y ago
        If I'm reading this correctly, this included disengagement prior to surgery but after hormonal treatment. So it could be that some in this group regretted the hormonal treatment so chose not to continue with the surgical intervention?

That sounds unlikely, what and from where are the regret rate numbers you are comparing?

by trinn 3y ago

That sounds unlikely, what and from where are the regret rate numbers you are comparing?

A cursory search reveals one study suggesting 30% continue to experience chronic pain and 1 in 5 regret knee replacement. https://www.aarp.org/health/conditions-treatments/info-2018/knee-replacement-surgery-regret.html https://www.aarp.org/health/conditions-treatments/info-2018/... Not great numbers, but sample sizes and study integrity, as with the data on gender affirming care, is the killer.

trinn 3y ago
Thanks for the info. What rates for gender-affirming care are you comparing this to though?
- superchroma 3y ago
  The data there is not good. There are studies that claim it is low. They focus on surgery a lot. There are not many trans people (relative to the general population) and not many studies on them. There is not sufficient granularity between: - trans people who only take hormones, - who do that and have top surgery, - who are castrated and, - who have top and bottom surgery Personally, I think bottom surgery is not quite there and is definitely a medical frontier and free-for-all. Hormones and top surgery are fairly reversible via application of more money, exercise and time. Based on that, I am forced to fall back to first principles, and feel that given that the risk of lasting damage is low on some procedures, that those procedures which give perfectly acceptable and also potentially reversible results are reasonable to offer in this way.
  - deleted 3y ago
    [deleted]
- throwaway626 3y ago
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503911/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503911/ Between 1% and 8%, depending on how detransition is defined. This article found 6.9% (12/175, 6 clearly detransitioning and 6 ambiguous) at one clinic, including anyone who sought and received care over a certain interval.
  - trinn 3y ago
    That is interesting but the same study also says that 21.7% of this cohort disengaged from the clinic. So the rate could be even higher, depending on if they stopped treatment entirely or changed to another service provider.
    - throwaway626 3y ago
      “Disengaged” here means that they did not make it through the assessment/pre-screening process and did not receive treatment, which is not what is meant by “detransition” or what is commonly understood as contributing to “regret rate”. When an elderly person rejects knee replacement prior to surgery e.g., because they’ve learned the risks, they’re also not counted in the regret rate for knee replacement. EDIT: Those that disengaged did not complete treatment, therefore they cannot regret completing treatment. Perhaps they regret starting treatment and perhaps they don’t; either way, that’s not the same thing as detransition. I can’t read their minds to figure out why they disengaged, and neither can anyone else.
      - trinn 3y ago
        If I'm reading this correctly, this included disengagement prior to surgery but after hormonal treatment. So it could be that some in this group regretted the hormonal treatment so chose not to continue with the surgical intervention?