The 1 % figure is almost certainly too low.
Most of the studies that claim “less than 1 % regret” come from a single Dutch clinic that followed patients who had surgery between 1972 and 2015. PurpleKriek source [citation:2cd053af-6b22-430f-9e73-cd5e9cf99f2b] points out that more than one-third of those patients simply disappeared from the clinic’s records after a few years, so their feelings were never counted. When a third of the people you are trying to track are missing, the real regret number can’t be known from that data.

Loss-to-follow-up hides regret.
ukhoneybee source [citation:84a4a42f-3174-4070-a51f-8c4696f9b895] explains that once someone stops returning for hormones or check-ups, the clinic writes them off as “lost to follow-up.” In one five-year study of 727 post-operative patients, 495 people—almost 70 %—were lost in this way. People who feel fine usually keep their appointments; people who are quietly regretting surgery often stay away.

Bottom-surgery regret is higher than top-surgery regret.
Pleasant_Planter source [citation:3f9d6fca-4114-4b2b-8014-03fdf23e379a] summarises recent country-level data: regret after vaginoplasty or phalloplasty clusters between 15 % and 40 %, while regret after mastectomy (“top surgery”) is closer to 1 %–2 %. These numbers are still well above the oft-quoted 1 % figure and come from studies that tried harder to find the people who dropped out.

Social pressure keeps many regrets invisible.
Aware-Resist-8655 source [citation:21dfcec1-4993-41b9-a998-201b4e5ac4c5] watched a friend suffer serious complications after bottom surgery yet never publicly admit he regretted it: “It takes a very strong person to admit they mutilated their bits and are now stuck with the consequences.” When shame or fear of backlash keeps people silent, surveys miss them and the published regret rate stays artificially low.

Comparison with other surgeries shows the 1 % claim is implausible.
NeighborhoodFit2786 source [citation:a00e2f97-6bf7-40fb-b7ed-9f9840534cb7] notes that more patients regret routine knee replacements than the far more experimental genital surgeries—an outcome that would be extraordinary if true. The simplest explanation is that the real regret rate for transition-related operations is being under-counted, not that these procedures are uniquely satisfying.

Taken together, the evidence from people who have lived through these surgeries—and from researchers who looked past clinic records—suggests that regret is uncommon but nowhere near as rare as 1 %, especially for bottom surgery. If you are weighing a medical path, know that feelings can change, good data are scarce, and choosing social and psychological support first keeps every future option open.