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

• Het artikel is een antwoord van twee pagina's op de oproep van Butler en Hutchinson uit 2020 voor onderzoek en diensten voor mensen die stoppen met of transitie terugdraaien.
• Het wijst op een groeiende groep detransitioners, velen in hun tienerjaren en begin twintig, die hun ervaringen in openbare online ruimtes delen omdat er geen gespecialiseerde diensten voor hen zijn.
• De auteur betoogt dat langdurige, georganiseerde follow-up van iedereen die medische behandeling kreeg van NHS- en particuliere klinieken essentieel is.
• Ze betoogt dat beslissingen over medische behandeling van genderklachten zijn gebaseerd op misleidende informatie over hoe goed het werkt en of het nodig is.
• Ze zegt dat de verhalen van detransitioners laten zien dat niet-medische behandelingen voor genderklachten hard nodig zijn.
• Ze pleit voor een nauwkeurige blik op de politieke en organisatorische systemen die tot de huidige praktijk hebben geleid, om te voorkomen dat jongeren medische behandeling krijgen die ze niet nodig hebben.

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.