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

• 설문을 시작한 임상의 147명 중 61명이 포함될 만큼 충분히 답했습니다. 77%가 성별 확정 진료를, 6.6%가 네덜란드식 ‘지켜보며 기다리기’ 접근을, 16.4%가 다른 접근을 실천했습니다.
• 56%는 전환을 중단한 젊은이를 지켜본 적이 있다고 했고 8%는 아마 그랬다고 생각했으며, 36%는 한 번도 본 적이 없었습니다.
• 그런 젊은이를 봤거나 봤을 수도 있는 39명 중 82%는 전체 경력 중 1~5명을 봤고, 8%는 21명 이상을 봤습니다.
• 가장 최근 사례에서 40%는 젊은이가 다시 출생 성별로 정체화했다고 했고 31%는 부분적으로 그렇다고 했습니다.
• 59%는 젊은이가 전환을 시작하기 전에 정신 건강 문제가 있었다고 했고, 18%만 없었다고 했습니다.
• 21%는 젊은이가 전환을 시작한 것을 후회한다고 했고 또 다른 21%는 ‘약간’의 후회를 봤으며, 38%는 젊은이가 시작했다가 중단한 것을 기뻐하지 않는 것 같다고 했습니다.
• 대부분은 젊은이가 친구들의 지지를 받았고(71%) 필요한 의료를 받을 수 있었다고(68%) 설명했는데, 이는 이런 사례에서 외부의 압력이 주된 이유가 아니었음을 시사합니다.

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.