The Swedish Study Myth: Debunking Dhejne et al. (2011) Misrepresentations

“A Swedish study proves trans women retain male patterns of criminality and violence.”

This study has been weaponized in debates about:

• Bathroom access
• Prison placement
• Medical transition
• Sports participation
• Basically any anti-trans policy argument

Let's look at what the study actually says.

Full citation: Dhejne C, Lichtenstein P, Boman M, Johansson ALV, Långström N, Landén M (2011) “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden”

The actual study:

• Followed 324 individuals in Sweden who underwent full surgical transition
• Covered the period 1973-2003 (30 years)
• Compared them to matched controls of their birth sex
• Looked at health outcomes, mortality, suicide attempts, and crime

Primary purpose: To assess whether medical transition helps patients and what support they might need post-transition.

Critical point: This studied people who completed surgical and hormonal transition - a much smaller and more specific group than “transgender people” generally.

The researchers divided the cohort into two time periods:

Finding: Trans people in this period were more likely to have criminal convictions than their matched birth-sex controls.

From the study:

“Male-to-females… retained a male pattern regarding criminality. The same was true regarding violent crime.”

Context: This cohort received inadequate mental health provision during their transition.

Finding: Trans people in this period showed no statistically significant difference in criminal convictions compared to their matched birth-sex controls.

Context: This cohort received adequate mental health provision during their transition.

The study found male-to-female transitioners in the early cohort were:

• Over 6 times more likely to be convicted of an offense than female comparators
• 18 times more likely to be convicted of a violent offense than female comparators
• No statistically significant difference from natal males

But remember:

• This was the 1973-1988 cohort
• The 1989-2003 cohort showed no such pattern
• We're talking about 324 surgically transitioned people in Sweden over 30 years

Common misrepresentations:

1. Cherry-picking: Only citing the 1973-1988 cohort, ignoring the later one
2. Overgeneralization: Applying findings about surgically transitioned people to all trans people
3. Temporal misapplication: Using 1970s-1980s data for 2020s policy
4. Geographic misapplication: Using Swedish healthcare system data for UK/US policy
5. Context stripping: Ignoring that it was about post-surgical health outcomes, not public safety

What the study CANNOT tell you:

• ❌ Whether trans women are dangerous in public spaces
• ❌ Whether bathroom policies increase assault risk
• ❌ Whether self-identified (non-surgical) trans people pose risks
• ❌ Anything about modern trans populations
• ❌ Anything about trans people who aren't in Sweden

Lead researcher Cecilia Dhejne has repeatedly clarified how her study is being misrepresented.

From a 2015 interview:

“The individual who is making claims about trans criminality, specifically rape likelihood, is misrepresenting the study findings.”

On the later cohort:

“If one divides the cohort into two groups, 1973 to 1988 and 1989 to 2003, one observes that for the latter group (1989-2003), differences in mortality, suicide attempts, and crime disappear.”

Specifically on criminality patterns:

“This means that for the 1989 to 2003 group, we did not find a male pattern of criminality.”

On how it's being used:

“The study as a whole does not say that medical transition results in trans people being violent. It says nothing about trans people posing any threat to anyone else.”

Murray Blackburn MacKenzie (MBM), a “gender critical” policy analysis group, argues that Dhejne's clarifications are misleading.

MBM claims:

“The statement is only true in the trivial sense that patterns of criminality were simply not examined separately by sex for each period and so no such finding could be made.”

They argue:

• The published paper didn't break down criminality by sex AND time period simultaneously
• Dhejne's statement about the 1989-2003 cohort refers to ALL trans people combined (MtF + FtM)
• Therefore, we can't conclude that MtF specifically showed no male pattern in the later period

MBM concludes:

“In the absence of any new peer-reviewed publication… the original published results remain the best available large scale quantitative comparative source.”

1. Author Intent is Crystal Clear

Dhejne isn't being ambiguous. She explicitly states:

• The study is being misrepresented
• The later cohort showed no male pattern of criminality
• The findings are being misapplied

2. Technical Pedantry vs. Substance

MBM's argument essentially says: “The author didn't publish a specific table breaking it down exactly this way, so we'll assume the opposite of what she says.”

This is backwards logic. The absence of a hyper-specific table doesn't override the author's clear statements about what the data shows.

3. Motivated Reasoning

MBM is not a neutral academic source. They are a “gender critical” advocacy group with a vested interest in keeping this study weaponized against trans people.

4. The Author Knows Her Own Data

Dhejne has access to the full dataset. If she says the later cohort showed no male pattern, she's basing that on the actual data, whether or not she published every possible cross-tabulation.

5. Even If MBM Were Right, It Doesn't Matter

Even accepting MBM's most generous interpretation:

• Still only 324 surgically transitioned people
• Still from 1973-2003 in Sweden
• Still says nothing about bathrooms, changing rooms, or public spaces
• Still can't be generalized to self-identified trans people
• Still doesn't support modern policy claims

Modern studies on actual bathroom policies find:

• No increase in sexual assault in jurisdictions with trans-inclusive bathroom policies
• No increase in privacy violations in such jurisdictions
• Trans people are victims of harassment and assault in bathrooms at higher rates

Key studies:

• American Academy of Pediatrics (2019): No safety issues in schools with inclusive policies
• Hasenbush et al. (2019): No link between trans-inclusive policies and safety incidents
• UK Government data: Trans people experience hate crimes at twice the rate of general population

Let's say, for argument's sake, we accepted the study's early cohort findings at face value. What would that tell us?

What it would tell us:

• In 1970s-1980s Sweden
• Among people who underwent full surgical transition
• With inadequate mental health support
• There were elevated crime rates

What it would NOT tell us:

• Anything about trans people who don't have surgery
• Anything about modern trans populations
• Anything about trans people with proper healthcare
• Anything about specific risks in bathrooms or changing rooms
• Anything about trans people in other countries
• Anything useful for 2025 policy decisions

The improved outcomes in the later cohort suggest: Better healthcare and social support = better outcomes.

If we take the study seriously, it actually shows:

• ✅ Better mental health support during transition = better outcomes
• ✅ Conditions improved dramatically between the cohorts
• ✅ The later cohort (1989-2003) showed no concerning patterns
• ✅ This supports providing good healthcare to trans people

Yet it's being weaponized to argue:

• ❌ Trans people are inherently dangerous
• ❌ We should restrict trans rights
• ❌ Medical transition doesn't help

The study's actual conclusion undermines the claims being made with it.

The Dhejne et al. (2011) Swedish study:

What it actually examined:

• 324 surgically transitioned people in Sweden (1973-2003)
• Found elevated rates in early cohort (1973-1988)
• Found no difference in later cohort (1989-2003)
• Suggests better healthcare support = better outcomes

How it gets misused:

• Cherry-picking early cohort data
• Ignoring later cohort showing no issues
• Applying to all trans people (not just surgical patients)
• Using 1970s-1980s data for 2020s policy
• Ignoring author's repeated corrections

The MBM objection:

• Claims author's clarifications are technically misleading
• Based on absence of specific published cross-tabs
• From a “gender critical” advocacy group
• Even if valid, doesn't change the policy irrelevance

The bottom line:

• The author says it's being misrepresented
• The later cohort showed no concerning patterns
• It can't support modern policy claims regardless
• Modern research shows no safety concerns with trans-inclusive policies

• Dhejne C, et al. (2011) “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden” PLOS ONE
• Dhejne interview (2015) regarding misuse of study findings
• Murray Blackburn MacKenzie (2020) analysis and critique
• Hasenbush A, et al. (2019) “Gender Identity Nondiscrimination Laws in Public Accommodations: a Review of Evidence Regarding Safety and Privacy in Public Restrooms, Locker Rooms, and Changing Rooms” Sexuality Research and Social Policy
• American Academy of Pediatrics (2019) “School Restroom and Locker Room Restrictions and Reduced School Connectedness Among Transgender and Gender-Diverse Students”
• Stop Hate UK: Transgender hate crime statistics
• Fair Play for Women submission to Parliament (2020) - includes discussion of Swedish study

This article examines one of the most commonly misrepresented studies in trans policy debates. Understanding what research actually says - and doesn't say - is crucial for evidence-based policy.