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

• 這篇文章是兩頁的回應，回應 Butler 和 Hutchinson 2020 年對停止或逆轉過渡者的研究與服務的呼籲。
• 文章指出有越來越多的去過渡者，許多人是十幾歲或二十出頭，他們因為沒有專門的服務，而在公開的網路空間分享自己的經歷。
• 作者主張，對所有由 NHS 和私人診所給予醫療處置的人進行長期、有組織的追蹤至關重要。
• 她主張，關於性別困擾的醫療處置的決定，是根據有關其效果如何、是否有必要的誤導性資訊做出的。
• 她說，去過渡者的故事顯示，針對性別困擾的非醫療治療極為需要。
• 她呼籲仔細檢視導致現行做法的政治與組織體系，以防止年輕人接受不必要的醫療處置。

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.