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

• この記事は、トランジションをやめる、または元に戻す人々のための研究とサービスを求めたButlerとHutchinsonの2020年の呼びかけへの、2ページの返答です。
• デトランジショナーのための専門サービスがないため、10代後半から20代前半の人も多い、増え続けるデトランジショナーが、公開されたオンラインの場で自分の体験を共有していると述べています。
• 著者は、NHSや民間のクリニックで医学的治療を受けたすべての人を、長期にわたり、組織的に追跡することが不可欠だと主張しています。
• 性別への苦痛に対する医学的治療についての決定は、それがどれだけ有効で、必要なのかについて、誤解を招く情報に基づいて行われてきたと論じています。
• デトランジショナーの体験談は、性別への苦痛に対する医学的でない治療が切実に必要であることを示していると述べています。
• 若者が必要のない医学的治療を受けることを防ぐために、現在の実践に至った政治的・組織的なシステムを詳しく検証するよう求めています。

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.