Summary
Clinicians at Norway's national gender service used its own records to trace every child and teenager referred over 20 years. Of 1,258 referred, 62% went on to cross-sex hormones. Nearly all of the 11% given puberty blockers (97%) moved on to hormones. 22% of those who attended left without any medical treatment. Eighteen females stopped testosterone and detransitioned, and 11 people in the group died, though causes of death were not recorded. The authors admit the detransition count is probably too low, because people who stop often drop out of the clinic's sight. In July 2026 the journal withdrew (retracted) the paper after a research-integrity panel found it lacked ethics committee approval and patient consent. Five authors were found to have committed misconduct, which they are appealing. Its figures should not be quoted as settled evidence.
Key findings
- مجله این مقاله را در ژوئیه 2026 پس گرفت، زیرا پژوهش تأییدیهٔ کمیتهٔ اخلاق پژوهش پزشکی نروژ و رضایت مناسب بیماران را نداشت. پس‌گرفتن به خطاهای داده‌ها اشاره نداشت.
- از 1,258 کودک و نوجوان ارجاع‌شده از 2000 تا 2020، تعداد 861 نفر (68.4%) زن‌متولد بودند و میانگین سن هنگام ارجاع 14.4 بود.
- 135 نفر (10.7%) بلوکر بلوغ را شروع کردند، بیشتر مردمتولدها، و 97% از آن‌ها به هورمون‌های جنس مخالف ادامه دادند.
- 783 نفر (62.2%) از همهٔ ارجاع‌شدگان هورمون‌های جنس مخالف را شروع کردند.
- 264 نفر از 1,198 نفری که دست‌کم یک ملاقات داشتند (22.0%) بدون هیچ درمان پزشکی مرتبط با جنسیت کلینیک را ترک کردند.
- هر 18 نفری که قطع هورمون برایشان ثبت شد (2.3% از 783 شروع‌کننده) زن‌متولد بودند و بین 2015 و 2021 تستوسترون را شروع کرده بودند. 11 نفر دیگر خود را ترنس نمی‌دیدند؛ 7 نفر هنوز می‌دیدند (5 نفر از تغییرات خود راضی بودند، 2 نفر نگرانی باروری داشتند).
- یازده نفر از 1,258 نفر (0.9%) تا پایان 2023 فوت کرده بودند؛ علت مرگ در دسترس نبود.
Abstract
Aim: We aimed to describe treatment trajectories, detransition and mortality rate among children and adolescents referred to the Norwegian National Center for Gender Incongruence (NCGI). Methods: The cohort included all 1258 persons under 18 years at referral to the NCGI from 2000 to 2020. Trajectories were registered until end of 2023. Results: In total, 861/1258 (68.4%) were assigned female gender at birth (AFAB). Mean age at referral was 14.4 years. Puberty suppression with gonadotropin-releasing hormone agonists (GnRHa) was initiated among 135/1258 (10.7%), significantly more persons assigned male gender at birth (AMAB) than AFAB (p < 0.001). Gender-affirming hormonal treatment (GAHT) was initiated in 783/1258 (62.2%). The continuation rate from GnRHa to GAHT was 97%. Discharge rate from NCGI without gender-affirming medical treatment among those who attended at least one appointment, was 264/1198 (22.0%). Eighteen AFAB detransitioned after initiated GAHT, eleven due to a cessation of transgender identity. Mortality rate in the cohort until end of 2023 was 11/1258 (0.9%). Conclusion: Different trajectories including medical pathways and assessments without gender-affirming treatment were observed. GAHT was initiated in 783/1258 (62.2%), including eighteen AFAB detransitioning after testosterone treatment. There was a high continuation rate from GnRHa to GAHT. Various trajectories highlights the need for long-term follow-up in care.
Conclusion
This study provides valuable insights to gender-affirming care for children and adolescents, owing to its large sample size, including all children and adolescents referred to a national gender clinic over two decades. The study reports varying trajectories, encompassing both medical pathways and assessments ended without gender-affirming medical treatment. Our findings highlight the necessity for long-term follow-up and support of people referred to gender clinics. There is a need for ongoing research on gender-affirming treatment in young people to evaluate the short- and long-term benefits and risks of early treatment interventions, as well as patient-reported outcome measures.