撤稿：挪威研究报告18例睾酮治疗后复转及22%未经医疗干预即终止治疗案例

挪威国家性别不一致中心转诊儿童和青少年的治疗轨迹

Authors: Cecilie Bjertness Nyquist, Leila Torgersen, Linda W. David, Trond Haaken Diseth, Kjersti Gulbrandsen, Anne Waehre
Journal: Acta Paediatrica
Year: 2025
Source: pubmed.ncbi.nlm.nih.gov/39648282/

Summary

Clinicians at Norway's national gender service used its own records to trace every child and teenager referred over 20 years. Of 1,258 referred, 62% went on to cross-sex hormones. Nearly all of the 11% given puberty blockers (97%) moved on to hormones. 22% of those who attended left without any medical treatment. Eighteen females stopped testosterone and detransitioned, and 11 people in the group died, though causes of death were not recorded. The authors admit the detransition count is probably too low, because people who stop often drop out of the clinic's sight. In July 2026 the journal withdrew (retracted) the paper after a research-integrity panel found it lacked ethics committee approval and patient consent. Five authors were found to have committed misconduct, which they are appealing. Its figures should not be quoted as settled evidence.

Key findings

该期刊于2026年7月撤回了这篇论文，原因是研究没有获得挪威医学研究伦理委员会的批准，也没有获得患者的适当同意。撤稿并未指出数据有误。
在2000年至2020年间被转介的1,258名儿童和青少年中，861人（68.4%）出生时为女性，转介时的平均年龄为14.4岁。
135人（10.7%）开始使用青春期阻断剂，其中出生时为男性的更常见，他们中97%继续使用跨性别激素。
所有被转介者中有783人（62.2%）开始使用跨性别激素。
在至少就诊一次的1,198人中，有264人（22.0%）没有接受任何与性别相关的医学治疗就离开了诊所。
记录显示停用激素的18人（占开始使用的783人的2.3%）全部出生时为女性，并在2015年至2021年间开始使用睾酮。11人不再认为自己是跨性别者；7人仍然认为自己是（其中5人对已有的变化感到满意，2人担心生育能力）。
1,258人中有11人（0.9%）在2023年底前死亡；没有死因的资料。

Abstract

Aim: We aimed to describe treatment trajectories, detransition and mortality rate among children and adolescents referred to the Norwegian National Center for Gender Incongruence (NCGI). Methods: The cohort included all 1258 persons under 18 years at referral to the NCGI from 2000 to 2020. Trajectories were registered until end of 2023. Results: In total, 861/1258 (68.4%) were assigned female gender at birth (AFAB). Mean age at referral was 14.4 years. Puberty suppression with gonadotropin-releasing hormone agonists (GnRHa) was initiated among 135/1258 (10.7%), significantly more persons assigned male gender at birth (AMAB) than AFAB (p < 0.001). Gender-affirming hormonal treatment (GAHT) was initiated in 783/1258 (62.2%). The continuation rate from GnRHa to GAHT was 97%. Discharge rate from NCGI without gender-affirming medical treatment among those who attended at least one appointment, was 264/1198 (22.0%). Eighteen AFAB detransitioned after initiated GAHT, eleven due to a cessation of transgender identity. Mortality rate in the cohort until end of 2023 was 11/1258 (0.9%). Conclusion: Different trajectories including medical pathways and assessments without gender-affirming treatment were observed. GAHT was initiated in 783/1258 (62.2%), including eighteen AFAB detransitioning after testosterone treatment. There was a high continuation rate from GnRHa to GAHT. Various trajectories highlights the need for long-term follow-up in care.

Conclusion

This study provides valuable insights to gender-affirming care for children and adolescents, owing to its large sample size, including all children and adolescents referred to a national gender clinic over two decades. The study reports varying trajectories, encompassing both medical pathways and assessments ended without gender-affirming medical treatment. Our findings highlight the necessity for long-term follow-up and support of people referred to gender clinics. There is a need for ongoing research on gender-affirming treatment in young people to evaluate the short- and long-term benefits and risks of early treatment interventions, as well as patient-reported outcome measures.

Methodological limitations

Retracted for ethics breaches: The journal withdrew the article on 30 July 2026 after a research-integrity panel from Oslo University Hospital, Akershus University Hospital and the University of Oslo found it lacked approval from a regional ethics committee and proper consent. Five Oslo-based authors were found to have committed misconduct and are appealing (Retraction Watch, September 2026). The problem is ethics, not known data errors.
Records filled in afterwards: The data came from a clinic register built by going back through patient files, so some information may be missing, as the authors say.
Treatment elsewhere missed: Treatment from other providers was recorded only if clinic staff were told and wrote it down. People who treated themselves or got treatment privately or abroad were missed.
Detransition likely undercounted: People who stop treatment may stop coming to the clinic, and what happened after discharge was often unknown. So 18 detransitions (2.3%) is a minimum. The authors point to a Finnish study where 7.9% stopped, for comparison.
Uneven, often short follow-up: Referrals ran to 2020 and tracking to 2023, so follow-up ranged from about 3 to over 20 years. Recent referrals had little time to start or stop treatment, and the authors say recent percentages cannot be interpreted.
Rules changed over time: The criteria for treatment changed over two decades, so the combined rates mix very different eras of practice.
No information on when it began: The study could not separate gender distress that began in childhood from distress that began in the teens, which may matter for later desistance (no longer having gender distress).
Too few cases to draw conclusions: The authors say the detransition numbers are too small to draw any conclusions. All 18 were born female, and detransition was only counted when a stop in hormones was recorded.
Causes of death missing: Deaths came from the national register without causes, so the 0.9% death rate, including any suicides, cannot be interpreted.
Already filtered by referral: All young people were referred by local child mental health clinics after a first assessment. This may favour more severe cases and limits how far results apply to young people never referred.
No patients' own views: The study recorded treatment steps only, with no measures of gender distress, mental health, quality of life or satisfaction.
Clinic judging itself: The authors were clinicians and researchers at the national clinic whose practice is described. One author (Waehre) declared she had been an outside reviewer for Sweden's 2020–2022 national evidence review on gender dysphoria.

detrans.ai

Summary

Key findings

Abstract

Conclusion