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

• L'article est une réponse de deux pages à l'appel de Butler et Hutchinson (2020) en faveur de recherches et de services pour les personnes qui arrêtent ou inversent leur transition.
• Il note un groupe croissant de détransitionneurs, dont beaucoup ont entre l'adolescence et le début de la vingtaine, qui partagent leurs expériences dans des espaces publics en ligne faute de services spécialisés.
• L'auteure soutient qu'un suivi organisé à long terme de toutes les personnes ayant reçu un traitement médical dans les cliniques du NHS et privées est essentiel.
• Elle soutient que les décisions sur le traitement médical de la détresse de genre ont reposé sur des informations trompeuses sur son efficacité et sa nécessité.
• Elle dit que les histoires de détransitionneurs montrent que des traitements non médicaux de la détresse de genre sont cruellement nécessaires.
• Elle appelle à un examen attentif des systèmes politiques et organisationnels qui ont conduit à la pratique actuelle, afin d'éviter que des jeunes reçoivent un traitement médical dont ils n'ont pas besoin.

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.