Summary

In this short debate piece, Kirsty Entwistle, a clinical psychologist who had worked at England's NHS youth gender service in Leeds, backs Butler and Hutchinson's call for detransition research. She argues that stories detransitioners have shared online show decisions about puberty blockers (drugs that pause puberty), hormones and surgery being made on misleading information about how well they work and whether they are needed. She calls for long-term tracking of everyone treated by NHS and private clinics, for non-medical treatments for gender distress, and for a close look at the systems that shaped current practice. The piece raised concerns that were later examined by England's official evidence reviews and the Cass Review, an independent review of youth gender services. But it is opinion based on personal stories and gives no figures on how common these problems are.

Key findings

• Artiklen er et svar på to sider på Butler og Hutchinsons opfordring fra 2020 til forskning og tilbud til personer, der stopper eller omgør transition.
• Den bemærker en voksende gruppe detransitionister, mange i teenageårene og først i tyverne, der deler deres erfaringer i offentlige onlinerum, fordi der ikke findes specialtilbud til dem.
• Forfatteren argumenterer for, at langsigtet, organiseret opfølgning af alle, der har fået medicinsk behandling af NHS og private klinikker, er afgørende.
• Hun argumenterer for, at beslutninger om medicinsk behandling af kønslidelse er blevet truffet på misvisende oplysninger om, hvor godt den virker, og om den er nødvendig.
• Hun siger, at detransitionisters historier viser, at ikke-medicinske behandlinger af kønslidelse er stærkt tiltrængte.
• Hun opfordrer til et nærmere kig på de politiske og organisatoriske systemer, der førte til nuværende praksis, for at stoppe, at unge får medicinsk behandling, som de ikke har brug for.

Abstract

Butler and Hutchinson's clarion call (Butler and Hutchinson, 2020) for empirical research on desistance and detransition deserves careful consideration. It formally documents the needs of the emerging cohort of detransitioners, many of whom are in their teens and early twenties. In the absence of specialist services, some detransitioners have been sharing their experiences in public forums. The anecdotal reports by detransitioners indicate that systematic long-term follow-up of those who have been prescribed medical interventions by NHS and private clinics is essential to understanding the gestalt. Decision-making on the basis of misinformation on the effectiveness and necessity of medical interventions for gender dysphoria is a problem, and detransitioners indicate that nonmedical interventions for gender dysphoria are sorely needed. Analysis of the political and organisational systems that have brought us to the current situation is required in order to prevent more young people from being prescribed unnecessary medical interventions for gender dysphoria.

Conclusion

Detransitioners' testimonies reveal that decision-making about medical interventions for gender dysphoria has been based on misinformation regarding effectiveness and necessity. Systematic long-term follow-up of individuals prescribed medical interventions is essential, nonmedical interventions for gender dysphoria are sorely needed, and analysis of the political and organisational systems that led to the current situation is required to prevent more young people from being prescribed unnecessary medical interventions.