Sex reassignment of transsexuals is associated with increased mortality, psychiatric morbidity

(10 for each case): one matched by birth sex; one matched by sex at end of follow-up. Hazard ratios with 95% CIs were calculated from Cox proportional hazards regression.

Findings: The sex reassigned group had three times higher mortality rate than the reference group matched for birth age and birth sex, after adjustment for psychiatric morbidity and immigrant status prior to baseline (Hazard ratio [HR] 2.8; 95% CI 1.8-4.3). The risk for death by suicide was much higher than in the reference group (HR 19.1; 95% CI 5.8–62.9).There was also a marked increased risk for psychiatric in-patient care (HR 2.8; 95% CI 2.0–3.9) and suicide attempts (HR 4.9; 95% CI 2.9–8.5), also when adjusting for psychiatric morbidity prior to baseline. Sex reassigned individuals have substantially higher mortality and are at higher risk for psychiatric morbidity and suicide attempts than the normal population. To reduce the risk of suicide it is important that clinicians don’t neglect the psychiatric co-morbidity. More research is needed to prevent and elucidate the causes of higher mortality rates for sex reassigned individuals.