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

• El artículo es una respuesta de dos páginas al llamamiento de 2020 de Butler y Hutchinson a investigar y crear servicios para las personas que paran o revierten la transición.
• Señala un grupo creciente de detransicionistas, muchos de ellos adolescentes y de poco más de veinte años, que comparten sus experiencias en espacios públicos en línea porque no hay servicios especializados para ellos.
• La autora sostiene que es esencial un seguimiento organizado y a largo plazo de todas las personas que reciben tratamiento médico en clínicas del NHS y privadas.
• Sostiene que las decisiones sobre el tratamiento médico del malestar de género se han basado en información engañosa sobre lo bien que funciona y si es necesario.
• Dice que las historias de los detransicionistas muestran que hacen mucha falta tratamientos no médicos para el malestar de género.
• Pide un examen minucioso de los sistemas políticos y organizativos que condujeron a la práctica actual, para evitar que los jóvenes reciban un tratamiento médico que no necesitan.

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.