So a paper in the "International Journal of Transgenderism" from 2014 is the final word on the topic six years later?

Link to the paper: https://sci-hub.se/https://doi.org/10.1080/15532739.2014.899174

How many "MtF" people were in the study in total? 56.

(Study also included 27 "FtM" - suggesting that those who conducted the research see female people as less than half as important as male people. Otherwise, why not study the two sexes in equal number?)

What did the "transition" of the male study participants consist of? Taking estriadol and androgen blocking medication.

How long were these people studied? A total of one year, from the time they started taking cross-sex hormones and androgen blockers to 12 months later.

What was the sexual orientation of the "MtF"s in the study? 52 of the 56 were attracted to men (presumably exclusively since elsewhere one of the other 4 is described as bisexual).

So 92.8% of the males in the study were gay males, whereas in real life 80% of males who "transition" are heterosexual men with AGP, and clinicians like Blanchard and Bailey say it's the straight AGP guys who suffer "the most severe gender dysphoria." Yet somehow we're supposed to believe that this study is relevant to the TIM population overall?

How old were the male participants in the study? According to Table 3, they had a mean age 32.7, +/- 8.8 years.

Again, not at all typical of the age range of post-pubescent TIM transitioners today. Whereas the vast majority of TIFs who take cross-sex hormones & get surgeries are confined to a very narrow age bracket - teens and early 20s - TIMs vary vastly in age when they begin to start taking CSH and anti-androgens. Many are in their teens & 20s, but many are in middle age, late middle age, the senior years, and even the late senior years (70s and 80s).

How was it decided that their "transition" is beneficial? By having them fill out The World Health Organization Quality of Life–100 (WHOQOL-100) questionnaire two times - at the beginning of the study and one year later.

The WHO- QOL-100, a very blunt instrument, can be examined here: https://www.who.int/healthinfo/survey/WHOQOL_BREF.pdf

Comparing the answers to the questionnaire given the first time and 12 months later, both MtF and FtM subjects in the study

reported a statistically significant improvement in body image (p < 0.05).

This is not surprising since all these people started out unhappy with their secondary sex characteristics and hyper-focused on their looks, and cross-sex hormones (plus androgen blockers in the case of males) do typically bring about cosmetic changes in the first year that such persons are will be ever on the watch for, highly attuned to and pleased about.

Moreover, MtF subjects reported a

statistically significant improvement in the quality of their sexual life and in the general quality of life (p < 0.05)

Well of course, coz TIMs, whether they are gay guys or AGP straight guys are motivated to "transition" for sexual reasons, and males at the age the study subjects were at the time (mean age 32.7, +/- 8.8 years, from Table 3) generally link their "general quality of life" to the "quality of their sexual life."

This is hardly convincing evidence that "MtF transition is beneficial." A study that lasts only one year, that one year being the very first year the participants began on cross-sex hormones and anti-androgens, is not only limited to the "honeymoon period" of so-called "transition," it covers only the first leg of the honeymoon period.

Also, why the averages that make it sound like every guy in the study had the same/similar improvements? Were there really no guys in this study who had little improvement, or no improvement - or felt disappointed and even worse at the end than at the beginning?

Other research in this area has shown that people who are pleased, indeed "euphoric," about their "transitions" in the very short/near term often end up feeling very differently when the excitement and "high" of the initial period wears off. Some crash and are deeply unhappy. Which is why after 10 years, quality of life is often rated very low - and there is a great deal of clinical depression, suicide attempts and completed suicides.

But the general point is: you can't arrive at conclusions pertaining to longterm outcomes by studying only very short term results, especially when those results are based on answers to a very generalized questionnaire that was designed for entirely different purposes.

For example, in the USA, between 40 and 50% of first marriages end in divorce, and the divorce rates go up for subsequent marriages. But if you asked couples after they'd been together for only a year whether they were happy, most would've said yes, certainly!

Same goes for parenting: you can't get an idea of whether most people are happy, unhappy or have mixed feelings about being parents by exclusively studying people who only have newborn babies. You've got to check in with parents of those babies at intervals all along the way, and not come to any conclusion until their firstborn are at least 18 or 21, perhaps even older.