Abstract
Gender-affirming surgery (GAS) is often sought after to alleviate the distress of those who suffer from gender dysphoria (GD). While many studies have shown that a significant percentage of people benefit from this procedure, a number of individuals later regret their decision of undergoing surgery. Studies have illustrated what regret depicts, categorizing regret based on intensity, persistency, and sources, in the hopes to prevent an unwanted irreversible intervention. Here, an in-depth interview with a 35-year-old transwoman from Taiwan who underwent feminizing GAS at the age of 31 illustrates her unique cultural upbringing and the course of her regret. Her experience best matches the characteristics of true regret and major regret based on the classifications of Pfäfflin and Wiepjes, respectively, indicating that she expected GAS to be the solution to her personal acceptance issue, but, in retrospect, regretted the diagnosis and treatment as her problems were not solved and worsened to the extent of secondary dysphoria. This case report hopes to shed light on the complexity of GD and regret after GAS, while encouraging the pre-surgical evaluation of psychological comorbidities and post-surgical psychotherapy, and ensuring that patients are informed and give full consent. In addition, more elaborate, long-term, large-scale qualitative research, especially within more conservative cultural settings, is needed.
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Due to the nature of this research, that participant in this paper did not agree for their data to be shared publicly, so supporting data are not available.
Notes
People of the Hakka culture are conservative, endeavoring, and enduring. As early immigrants to Taiwan, they have long resided in the harsher areas of the island. Though Hakka women often play a central role in internal and external family affairs, it was the men who took the role of decision and inheritance.
Thai ladyboys or katoey are the more well-known, but pejorative terms of addressing transgender women or effeminate gay men. According to Winter (2006), most transgender women thought of themselves simply as phuying (women), with a smaller number thinking of themselves as phuying praphet song (a “second kind of woman”). Only a few thought of themselves as kathoey and mostly used among people of closer relationships.
GD diagnosis and medical certificate issuance are not part of Taiwan’s National Health Insurance (NHI) scheme, but paid out of pocket at different prices depending on the psychiatrists and their practices. GAS isn’t supported by NHI either as it is deemed as a cosmetic procedure.
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Partial financial support was received from the Ministry of Science and Technology (Grant No. 109-2813-C-075-002-B) MOST Research Grant for University Students.
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Shen, WC.V., Shen, BH. Partial Regret After Gender Affirmation Surgery of a 35-Year-Old Taiwanese Transgender Woman. Arch Sex Behav 52, 1345–1351 (2023). https://doi.org/10.1007/s10508-022-02442-0
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DOI: https://doi.org/10.1007/s10508-022-02442-0