Summary

Writing in the BMJ, Kinnon MacKinnon, Pablo Expósito-Campos and W Ariel Gould argue that people who stop or reverse a gender transition have been ignored by research and care, partly because the topic has become political. Drawing on a few small studies of volunteers, they describe detransitioners as varied, but often female and young when they transitioned. Their reasons range from a change in identity and gender distress that didn't go away, to health worries and discrimination. Many have medical and mental health needs that aren't being met. The authors recommend following patients for at least 5 to 10 years and not assuming that people who drop out of studies (over 30% in some) are doing well. It is a sensible research plan, not new evidence. There was no formal search, and some claims rest on news reports or the authors' own studies.

Key findings

• 这是一篇分析文章，不是对研究的完整综述：它总结了几项早期研究并提出建议，没有新的数据。
• 所引用的研究（例如对237名去过渡者的在线调查，其中92%为女性，以及加拿大对28人的访谈研究）表明，许多去过渡者出生时为女性，并在25岁之前过渡。
• 去过渡的原因包括认同改变、过渡没有解决的性别痛苦、身体或心理健康方面的担忧、歧视，以及治疗本身造成的痛苦（“反向焦虑”）。
• 去过渡之后，许多人描述有持续的性别痛苦、后悔、悲伤或复杂的感受，失去了LGBTQ+朋友的支持，并因害怕被评判而回避医生。
• 作者说，随访1至2年太短，因为去过渡通常发生在治疗后数年。他们建议至少随访5至10年。
• 他们警告说，在一些性别护理研究中超过30%的患者退出，研究人员不应假定这些人仍认同自己是跨性别者或没有进一步的需求。
• 他们建议根据人们接受的治疗而不是目前的认同来选择研究对象，使用“detrans”和“detransition”这些词，并将不带评判的去过渡护理纳入性别服务。

Abstract

Kinnon MacKinnon and colleagues call for robust, sensitive research to inform comprehensive gender care services for people who detransition

Conclusion

Rigorous and nuanced detransition research is indispensable. Investigating the experiences of people who detransition will provide a better understanding of the development of gender identity, as well as all health and psychosocial outcomes following gender care. This aligns with priorities identified by trans health experts. Unfortunately, ongoing debates and politicisation of gender care have resulted in the depiction of trans and detrans people as completely distinct groups with divergent needs and experiences, and who are doomed to conflict. However, we believe that trans and detrans people are more similar than different, and that detransition research holds value for advancing the healthcare of all those who transition, and for responsibly moving gender care research and practice forward.