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

• 這是一篇分析文章，不是對研究的完整回顧：它摘要了幾項早期研究並提出建議，沒有新資料。
• 所引用的研究（例如對 237 名去過渡者的網路調查，其中 92% 為女性，以及加拿大對 28 人的訪談研究）顯示，許多去過渡者出生時為女性，並在 25 歲以前過渡。
• 去過渡的原因包括認同改變、過渡沒有解決的性別困擾、對身體或心理健康的擔憂、歧視，以及治療本身造成的痛苦（「反向焦慮」）。
• 去過渡後，許多人描述持續的性別困擾、後悔、悲傷或心情複雜、失去 LGBTQ+ 朋友的支持，以及因為害怕被評判而避免就醫。
• 作者表示，追蹤 1 至 2 年太短，因為去過渡通常發生在治療後數年。他們建議至少追蹤 5 至 10 年。
• 他們警告，在某些性別照護研究中超過 30% 的患者退出，研究者不應假設這些人仍自認為是跨性別，或沒有進一步的需求。
• 他們建議依據人們接受的治療而非目前的認同來選擇研究對象，使用「detrans」和「去過渡」這些用語，並在性別服務中建立不帶評判的去過渡照護。

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.