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

• 이 글은 전환을 중단하거나 되돌리는 사람들을 위한 연구와 서비스를 요구한 버틀러와 허친슨의 2020년 글에 대한 두 쪽짜리 답변입니다.
• 전문 서비스가 없어서 공개된 온라인 공간에서 경험을 나누는, 10대와 20대 초반이 많은 디트랜지셔너 집단이 늘고 있다고 지적합니다.
• 저자는 NHS와 민간 클리닉에서 의학적 치료를 받은 모든 사람에 대한 체계적인 장기 추적이 필수적이라고 주장합니다.
• 성별 고통에 대한 의학적 치료 결정이 그 치료가 얼마나 효과가 있고 필요한지에 대한 오해를 부르는 정보에 근거해 왔다고 주장합니다.
• 디트랜지셔너들의 이야기는 성별 고통에 대한 비의학적 치료가 절실히 필요함을 보여준다고 말합니다.
• 젊은이들이 필요하지 않은 의학적 치료를 받는 것을 막기 위해, 현재 진료로 이어진 정치적, 조직적 체계를 면밀히 살펴볼 것을 요구합니다.

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.