Summary

This study asked clinicians who work with trans and nonbinary young people what they had seen of youth who stop a gender transition. Of 61 who completed the survey, mostly in North America and Europe and mostly practising gender-affirming care, about two-thirds had followed at least one such young person, usually only 1 to 5 in their career. Asked about their latest case, providers often said the youth had mental health problems before transitioning, and many said the youth had gone back to identifying with their birth sex; about 4 in 10 noted some regret. The authors concluded that stopping is varied, probably uncommon, and happens under every treatment approach. Because the group was small, self-selected and reporting second-hand, the study cannot say how often youth stop or compare approaches.

Key findings

• 147 名開始填寫調查的臨床人員中，61 人回答得足夠而被納入；77% 從事性別肯定式照護，6.6% 採用荷蘭的「審慎等待」做法，16.4% 採用其他做法。
• 56% 表示追蹤過停止過渡的年輕人，8% 認為可能有；36% 從未看過。
• 在看過或可能看過這類青少年的 39 人中，82% 在整個職業生涯中看過 1 至 5 人，8% 看過 21 人或更多。
• 在他們最近的個案中，40% 表示年輕人回到了認同出生性別，31% 表示部分符合。
• 59% 表示年輕人在開始過渡前就有心理健康問題，只有 18% 表示沒有。
• 21% 表示年輕人對開始過渡感到後悔，另有 21% 看到「一點」後悔；38% 表示年輕人似乎對開始又停止並不開心。
• 多數人描述這些年輕人得到朋友的支持（71%），且能夠取得所需的醫療照護（68%），顯示在這些個案中，外在壓力不是主要原因。

Abstract

The idea of "detransition" is stimulating debates among researchers and providers working with trans and nonbinary youth (TNBY), but research on this phenomenon is still in its early stages. This study presents the characteristics and experiences of providers who work directly with TNBY, including some who have discontinued a transition. Sixty-one providers in trans health care were recruited internationally and responded to an online survey. They come from various regions of the world and disciplines and 77% worked according to the trans-affirming approach. Sixty-four percent of them had followed a youth who discontinued their transition. Among those, 82% reported a range of 1–5 youth in their entire career. Professionals reported their observations of discontinuation with regard to the youth's individual characteristics, and parental and social support. The results suggest that professionals had experience with youth who had discontinued regardless of their approach to intervention (e.g., trans-affirming, watchful waiting, or exploratory) and have observed a diversity of characteristics when describing the youth they followed.

Conclusion

From the providers' observations, youth who discontinue a transition form a diverse group. Many providers had encountered such youth, but most had worked with only a few, which the authors take to indicate the phenomenon may not be frequent. Because providers using a range of approaches (gender-affirming, watchful waiting or other) had all encountered discontinuation, the authors question the idea that one intervention approach explains it, and argue that providers should not try to avoid discontinuation "at any cost" but should support youth in exploring their needs, hopes, doubts and capacity to consent, whether or not they later discontinue. They also argue that media coverage of discontinuation has begun to limit access to gender-affirming care.