detrans.ai 

Back to studies

عيادة أمستردام تُبلغ عن ندم أقل من 1% بعد استئصال الغدد التناسلية — لكن 36% فُقد أثرهم والندم احتاج نحو 11 عاماً

دراسة أترابية أمستردام لعدم الارتياح الجندري (1972-2015): اتجاهات الانتشار والعلاج والندم

دراسات الأتراب والسجلاتالانتكاس والندمارتفاع التشخيصات والتأثير الاجتماعي
Authors
Chantal M. Wiepjes, Nienke M. Nota, Christel J. M. de Blok, Maartje Klaver, Annelou L. C. de Vries, S. Annelijn Wensing-Kruger, Renate T. de Jongh, Mark-Bram Bouman, Thomas D. Steensma, Peggy T. Cohen-Kettenis, Louis J. G. Gooren, Baudewijntje P. C. Kreukels, Martin den Heijer
Journal
The Journal of Sexual Medicine
Year
2018
Source
https://doi.org/10.1016/j.jsxm.2018.01.016

Summary

This study reviewed the records of everyone seen at the main Dutch gender clinic in Amsterdam from 1972 to 2015, nearly 6,800 people. Referrals rose about 20-fold, and a smaller share of adults went on to hormones. Among those who had their ovaries or testes removed, the clinic found regret in 0.6% of trans women and 0.3% of trans men. The study is widely cited as showing very low regret. But regret was counted only when someone came back to the clinic and started hormones of their birth sex. About a third of patients stopped coming to the clinic. Regret took about 11 years on average to appear, and almost all cases were people who began treatment before 1998. The authors themselves say their figure may be too low. The low rate is best read as a minimum count of reversals recorded by the clinic.

Key findings

  • حضر 6,793 شخصاً (4,432 وُلدوا ذكوراً و2,361 إناثاً) عيادة أمستردام من 1972 إلى 2015، وارتفعت التقييمات سنوياً 20 ضعفاً، من 34 في 1980 إلى 686 في 2015.
  • انخفضت نسبة البالغين الذين يبدؤون الهرمونات خلال 5 سنوات من أول زيارة من نحو 90% (1980) إلى 65% (2010).
  • بين البالغين على الهرمونات لسنة ونصف على الأقل، أُزيلت خصى أو مبايض 76% من النساء المتحولات و82% من الرجال المتحولين.
  • وُجد الندم، المحتسب ببدء هرمونات جنس الولادة بعد هذه الجراحة، لدى 0.6% من النساء المتحولات و0.3% من الرجال المتحولين، أي 14 شخصاً إجمالاً.
  • عُبّر عن الندم بين نحو 4 و22 سنة بعد بدء الهرمونات، في المتوسط نحو 11 سنة.
  • بدأ 13 من الأشخاص الـ 14 ذوي الندم الهرمونات بين 1978 و1997؛ ويلاحظ المؤلفون أنه ربما لم تتم متابعة المرضى الحديثين لفترة كافية لإظهار الندم.
  • صُنّفت الأسباب إلى «ندم اجتماعي» و«ندم حقيقي» (مثل الاعتقاد بأن التحول سيحل قضايا كالمثلية) أو الشعور بأنهم لا ثنائيون.
  • يذكر المؤلفون أن 36% من المرضى توقفوا عن المجيء إلى العيادة بعد عدة سنوات من العلاج.

Abstract

BACKGROUND: Over the past decade, the number of people referred to gender identity clinics has rapidly increased. This raises several questions, especially concerning the frequency of performing gender-affirming treatments with irreversible effects and regret from such interventions.

AIM: To study the current prevalence of gender dysphoria, how frequently gender-affirming treatments are performed, and the number of people experiencing regret of this treatment.

METHODS: The medical files of all people who attended our gender identity clinic from 1972 to 2015 were reviewed retrospectively.

OUTCOMES: The number of (and change in) people who applied for transgender health care, the percentage of people starting with gender-affirming hormonal treatment (HT), the estimated prevalence of transgender people receiving gender-affirming treatment, the percentage of people who underwent gonadectomy, and the percentage of people who regretted gonadectomy, specified separately for each year.

RESULTS: 6,793 people (4,432 birth-assigned male, 2,361 birth-assigned female) visited our gender identity clinic from 1972 through 2015. The number of people assessed per year increased 20-fold from 34 in 1980 to 686 in 2015. The estimated prevalence in the Netherlands in 2015 was 1:3,800 for men (transwomen) and 1:5,200 for women (transmen). The percentage of people who started HT within 5 years after the 1st visit decreased over time, with almost 90% in 1980 to 65% in 2010. The percentage of people who underwent gonadectomy within 5 years after starting HT remained stable over time (74.7% of transwomen and 83.8% of transmen). Only 0.6% of transwomen and 0.3% of transmen who underwent gonadectomy were identified as experiencing regret.

CLINICAL IMPLICATIONS: Because the transgender population is growing, a larger availability of transgender health care is needed. Other health care providers should familiarize themselves with transgender health care, because HT can influence diseases and interact with medication. Because not all people apply for the classic treatment approach, special attention should be given to those who choose less common forms of treatment.

STRENGTHS AND LIMITATIONS: This study was performed in the largest Dutch gender identity clinic, which treats more than 95% of the transgender population in the Netherlands. Because of the retrospective design, some data could be missing.

CONCLUSION: The number of people with gender identity issues seeking professional help increased dramatically in recent decades. The percentage of people who regretted gonadectomy remained small and did not show a tendency to increase. Wiepjes CM, Nota NM, de Blok CJM, et al. The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets. J Sex Med 2018;15:582-590.

Conclusion

The number of people with gender identity issues seeking professional help increased dramatically in recent decades. The percentage of people who regretted gonadectomy remained small and did not show a tendency to increase. (Discussion: the authors add that their findings could underestimate regret because some people might seek reversal elsewhere or experience regret without pursuing reversal, and that with an average time to regret of 130 months it may be too early to examine regret in people who started hormones in the past 10 years.)