[crote]

That paper doesn't state what you think it does.

If you read the Discussion, you'd see that this study actually contrasts other similar studies, which saw no such outcome. It even explicitly states that the overall mortality rate was only significantly increased for the group operated before 1989, and mentions that

> However, the latter might also be explained by improved health care for transsexual persons during 1990s, along with altered societal attitudes towards persons with different gender expressions.

This study is often used in an attempt to discredit transgender healthcare. In fact, it is used so often that there is even an interview[0] with the author about its misrepresentation. The interview links half a dozen other studies done since then which confirm that transgender healthcare does indeed work, and is in fact quite effective.

[0]: https://www.transadvocate.com/fact-check-study-shows-transit...