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

• 2007년 1월부터 2022년 12월 사이 보스턴 어린이병원에서 호르몬을 시작한 청소년 1,224명 중 1,050명이 성별 불쾌감 진단이 있고 호르몬을 6개월 이상 연속으로 복용했기 때문에 포함되었습니다.
• 마지막 접촉 시 973명(93%)이 여전히 호르몬을 복용 중인 것으로 기록되었고, 20명(2%)은 석 달 넘게 중단했다가 다시 시작했으며, 37명(4%)은 다시 시작하지 않고 중단했습니다.
• 5명(0.5%)은 다시 출생 성별로 정체화하게 되어 중단했으며, 저자들은 이를 1% 미만이라고 설명합니다.
• 중단한 37명 중 14명은 원하는 신체 변화에 이르렀다고 말했습니다. 저자들과 함께 실린 사설에 따르면 호르몬을 구하거나 유지하는 데 어려움이 있었던 것이 다른 주된 이유였습니다.
• 호르몬을 계속하는 것으로 집계된 973명 중 210명은 다른 의사에게 옮긴 기록 없이 1년 넘게 소식이 없었습니다(마지막 방문 시 전형적인 나이는 약 20세).
• 추적은 짧았습니다. 사설은 결과가 호르몬 시작 후 평균 약 2.7년에 측정되었다고 보고합니다.
• 저자들은 향후 연구가 디트랜지션이나 후회를 가정하기보다 사람들이 왜 중단하는지 물어야 한다고 권고합니다.

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.