Summary

This study asked clinicians who work with trans and nonbinary young people what they had seen of youth who stop a gender transition. Of 61 who completed the survey, mostly in North America and Europe and mostly practising gender-affirming care, about two-thirds had followed at least one such young person, usually only 1 to 5 in their career. Asked about their latest case, providers often said the youth had mental health problems before transitioning, and many said the youth had gone back to identifying with their birth sex; about 4 in 10 noted some regret. The authors concluded that stopping is varied, probably uncommon, and happens under every treatment approach. Because the group was small, self-selected and reporting second-hand, the study cannot say how often youth stop or compare approaches.

Key findings

• 調査を始めた147人の臨床医のうち、61人が含まれるのに十分な回答をしました。77%がジェンダー肯定的ケア、6.6%がオランダの「見守り」アプローチ、16.4%が別のアプローチを実践していました。
• 56%はトランジションをやめた若者を担当した経験があると答え、8%はおそらくあると思うと答え、36%は一度もありませんでした。
• そのような若者を診た、またはおそらく診たと答えた39人のうち、82%はキャリア全体で1～5人を診ており、8%は21人以上を診ていました。
• 直近の症例では、40%が若者が生まれつきの性別の自認に戻ったと答え、31%はそれが部分的に当てはまると答えました。
• 59%が、若者はトランジションを始める前にメンタルヘルスの問題があったと答え、なかったと答えたのは18%だけでした。
• 21%が、若者はトランジションを始めたことを後悔していたと答え、さらに21%が「少し」の後悔を見ました。38%は、若者は始めてやめたことを喜んでいるようには見えなかったと答えました。
• 大半は、若者が友人から支えられており（71%）、必要な医療を受けることができた（68%）と述べており、これらの症例では外部からの圧力が主な理由ではなかったことを示唆しています。

Abstract

The idea of "detransition" is stimulating debates among researchers and providers working with trans and nonbinary youth (TNBY), but research on this phenomenon is still in its early stages. This study presents the characteristics and experiences of providers who work directly with TNBY, including some who have discontinued a transition. Sixty-one providers in trans health care were recruited internationally and responded to an online survey. They come from various regions of the world and disciplines and 77% worked according to the trans-affirming approach. Sixty-four percent of them had followed a youth who discontinued their transition. Among those, 82% reported a range of 1–5 youth in their entire career. Professionals reported their observations of discontinuation with regard to the youth's individual characteristics, and parental and social support. The results suggest that professionals had experience with youth who had discontinued regardless of their approach to intervention (e.g., trans-affirming, watchful waiting, or exploratory) and have observed a diversity of characteristics when describing the youth they followed.

Conclusion

From the providers' observations, youth who discontinue a transition form a diverse group. Many providers had encountered such youth, but most had worked with only a few, which the authors take to indicate the phenomenon may not be frequent. Because providers using a range of approaches (gender-affirming, watchful waiting or other) had all encountered discontinuation, the authors question the idea that one intervention approach explains it, and argue that providers should not try to avoid discontinuation "at any cost" but should support youth in exploring their needs, hopes, doubts and capacity to consent, whether or not they later discontinue. They also argue that media coverage of discontinuation has begun to limit access to gender-affirming care.