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스웨덴인 2,467명 중 21명만 법적 성별 변경을 되돌림 - 그러나 법적 되돌림은 디트랜지션의 일부만 포착

성별 불쾌감이 있는 성인의 법적 성별 변경 후 안정성

코호트 및 등록 연구역전환과 후회
Authors
Kristen D. Clark, Richard A. White, Georgios Karamanis, Malin Indremo, Fatih Özel, Alkistis Skalkidou, Thomas Frisell, Fotios C. Papadopoulos
Journal
JAMA Network Open
Year
2025
Source
https://doi.org/10.1001/jamanetworkopen.2025.27780

Summary

Researchers in Uppsala used Swedish national records to follow everyone first diagnosed with gender dysphoria between 2013 and 2023, 7,293 people. They checked who changed legal gender and who changed back. About a third (2,467) made a legal change. Only 21 changed back, so the estimated chance of keeping the new legal gender for 10 years was about 98%. The records are complete, but narrow. In Sweden, changing back needs a new application and a psychological assessment, so it is only a small, formal part of detransition. People who stop hormones, regret surgery or re-identify with their birth sex without changing their papers are not counted. Most people were followed for only a few years after their legal change, while detransition often happens 5 to 10 years after transition. The study shows that changing legal gender back is rare; it does not show that detransition is rare.

Key findings

  • 연구는 2013년부터 2023년 사이 스웨덴에서 처음 성별 불쾌감 진단을 받은 7,293명 전원(출생 시 여성 4,083명, 남성 3,210명)을 대상으로 했고, 평균 약 5년씩 추적했습니다.
  • 2,467명(34%)이 첫 진단 평균 3.2년 후 법적 성별을 바꿨고, 10년 안에 바꿀 추정 확률은 58%였습니다.
  • 법적 성별을 출생 성별로 되돌린 사람은 21명뿐이었습니다. 바꾼 사람의 0.9%, 전체 집단의 0.3%였습니다.
  • 새로운 법적 성별을 10년 동안 유지할 추정 확률은 약 98%(아마 96%에서 99% 사이)였으며, 출생 시 여성과 남성 사이에 차이가 없었습니다.
  • 되돌린 21명은 다른 사람들과 비슷했고, 18세 이전에 진단받은 사람은 2명뿐이었으며, 되돌렸을 때 평균 약 30세였습니다.
  • 저자들은 법적 성별을 되돌리는 것이 디트랜지션과 같지 않으며 이유나 정체성에 대해 아무것도 말해주지 않으므로 최소치로 다뤄야 한다고 강조합니다.
  • 논문의 논의 부분은 법적 변경을 한 사람의 되돌림 비율을 0.09%라고 쓰는데, 이는 자체 결과의 0.9%(2,467명 중 21명)보다 10배 낮습니다.

Abstract

IMPORTANCE: The number of people seeking treatment for gender dysphoria (GD) has risen in recent decades, yet data remain limited for understanding cases of detransition (ie, the reversal of social, medical, or legal transition). Legal gender change in national registers poses an opportunity to examine legal gender reversals, which may reflect an aspect of the detransition process, while also informing an understanding of the stability after a legal gender change. OBJECTIVE: To determine the probability of obtaining a legal gender change and its stability over time among people diagnosed with GD in Sweden during a 10-year study period. DESIGN, SETTING, AND PARTICIPANTS: In this population cohort study using data from Swedish national registers from January 1, 2013, to December 31, 2023, individuals who received their first International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), diagnosis code for GD during the study period were included. While participants may have received a GD ICD-10 code as youths, legal gender changes only occurred for adults (aged ≥18 years) based on legal requirements during the time of data collection. EXPOSURE: Gender dysphoria. MAIN OUTCOMES AND MEASURES: Legal gender change and its stability, that is, absence of legal gender reversal, as reported in the registry. Kaplan-Meier survival analysis was used to determine the probability of legal gender change and its stability during a 10-year study period. RESULTS: A total of 7293 people with a GD diagnosis were included (36 025 person-years). Approximately one-third of the sample (n = 2467) obtained a legal gender change during the study period. The probability of legal gender change at 10 years following diagnosis was 58.3% (95% CI, 56.2%-60.4%). Twenty-one cases of legal gender reversal were identified. The probability of legal gender stability at 10 years following the initial change was 97.7% (95% CI, 96.3%-99.2%), with no differences by sex assigned at birth for either outcome. CONCLUSIONS AND RELEVANCE: In this cohort study using national population registry data, a significant proportion of participants with GD in Sweden obtained legal gender change within 10 years of follow-up. Despite significant growth of the population with GD, the probability of legal gender stability during the 10-year study period was high, at almost 98%. These results highlight that legal gender reversal was an infrequent occurrence in a national sample.

Conclusion

In this cohort study using national population registry data, a significant proportion of participants with gender dysphoria in Sweden obtained legal gender change within 10 years of follow-up. Despite significant growth of the population with gender dysphoria, the probability of legal gender stability during the 10-year study period was high, at almost 98%, and legal gender reversal was an infrequent occurrence in a national sample. No differences by sex assigned at birth were observed, and most individuals who legally reverted were in their twenties at first diagnosis. The authors note that legal gender reversal is not synonymous with detransition, should be considered a lower-bound approximation, and cannot be generalized to social or medical detransition.