Summary

Doctors at a large US children's gender clinic reviewed records of 1,050 teens who had taken cross-sex hormones for at least six months. At their most recent contact, 93% were recorded as still taking hormones, 2% had paused and restarted, and 4% had stopped. Only five people (0.5%) stopped because they again identified with their birth sex. Others mostly stopped because they had reached the body changes they wanted, or had trouble getting or taking hormones. The authors conclude stopping is rare and should not be assumed to mean regret or detransition. But the figures only show short-term use of hormones in one clinic's records. About 1 in 5 patients had not been heard from for over a year, yet were counted as still on hormones. Average follow-up was under three years. And people who detransition often do not tell their original clinic.

Key findings

• 2007年1月から2022年12月の間にボストン小児病院でホルモンを開始した10代1,224人のうち、性別への苦痛の診断があり、ホルモンを少なくとも6か月連続で使用していた1,050人が対象となりました。
• 最後の連絡時、973人（93%）は引き続きホルモンを使用していると記録され、20人（2%）は3か月を超えてやめた後に再開し、37人（4%）は再開せずにやめていました。
• 5人（0.5%）は、再び生まれつきの性別を自認するようになったためにやめました。著者はこれを1%未満と述べています。
• やめた37人のうち14人は、望んでいた身体の変化に達したと述べました。著者と同時に掲載された論説によれば、ホルモンを入手できない、あるいは続けるのが難しいことが、他の主な理由でした。
• ホルモンを使用していると数えられた973人のうち210人は、他の医師に移った記録もないまま、1年を超えて連絡がありませんでした（最後の受診時の典型的な年齢は約20歳）。
• 追跡は短いものでした。論説は、結果がホルモン開始から平均約2.7年後に測定されたと報告しています。
• 著者らは、今後の研究では、デトランジションや後悔だと決めつけるのではなく、なぜ人々がやめるのかを尋ねるよう勧めています。

Abstract

Purpose: To understand the rate of, and reasons for, discontinuation of gender-affirming hormones (GAH) in transgender adolescents.

Methods: Retrospective cohort study of individuals starting GAH between January 2007 and December 2022. Individuals were included if they were diagnosed with gender dysphoria, were prescribed GAH, and took GAH continuously for a minimum of 6 months. Of 1,224 individuals who started GAH, 1,050 met the eligibility criteria for this analysis. The primary study outcome was the status of GAH use at last communication. We also assessed gender identity at the time of GAH discontinuation and reasons for discontinuation among individuals who discontinued GAH for periods of 3 months or longer.

Results: Of 1,050 eligible individuals, 973 (93%) had been on GAH continuously at last contact, 20 (2%) had discontinued GAH for greater than 3 months then restarted hormones, and 37 (4%) had discontinued GAH without restarting hormones. Of those who discontinued hormones without restarting, 5 (0.5%) individuals did so because they reidentified with the gender associated with their sex assigned at birth. This represents less than 1 percent of the cohort.

Conclusions: In a large cohort of transgender adolescents seeking GAH, persistent discontinuation of hormones was rare and primarily reflected having accomplished gender expression goals or difficulties accessing or taking hormones - rather than individuals reaffirming a gender identity associated with their assigned sex at birth. It is important for future research on individuals who discontinue GAH to evaluate the reasons for discontinuation and not to make assumptions about detransition and/or regret.

Conclusion

In a large cohort of transgender adolescents seeking GAH, persistent discontinuation of hormones was rare and primarily reflected having accomplished gender expression goals or difficulties accessing or taking hormones - rather than individuals reaffirming a gender identity associated with their assigned sex at birth. It is important for future research on individuals who discontinue GAH to evaluate the reasons for discontinuation and not to make assumptions about detransition and/or regret.