I know it's hard to find help when you're struggling with things like tapering and withdrawal, but I hope I can build a community where people can help each other through this time.

Erin Reed at Erin In The Morning:

A new study published in JAMA Pediatrics explores the long-term experiences of transgender youth, focusing on individuals six to ten years after transitioning. The findings show that transgender youth who transition at a young age report high levels of satisfaction with their care. Notably, only 3% of participants discontinued hormone therapy, according to the study's main sample. The research employed innovative methodologies to address “loss to follow-up,” a common issue when participants stop responding to surveys, and utilized a prospective approach. This study is likely to become one of the most significant pieces of evidence countering critics who argue for banning transgender care.

The study began recruiting participants in 2013, with final recruitment completed by 2017. All participants were 12 years old or younger at the time of enrollment. Researchers followed these individuals through their transitions and gender-affirming care, conducting multiple surveys along the way. The survey referenced in this study was issued in 2023. The study included only those who had started gender-affirming care—269 youth in total. Of these, 220 responded to the 2023 survey, and researchers found that just 3% had discontinued care. Additionally, satisfaction rates were extremely high, averaging 6.5 on a 7-point scale, demonstrating that 6 to 10 years after transition, transgender youth remain highly satisfied with their treatment and overall experiences. One of the most innovative aspects of this study wasn't just its prospective design but how it addressed a common issue known as “loss to follow-up.” Many studies that rely on surveys to collect patient experiences around medical care experience this problem, which occurs when a significant number of participants fail to return surveys. This is a frequent challenge in survey-based research. Critics of transgender care often exploit this issue to dismiss studies showing the positive effects of gender-affirming care, arguing that those who didn’t respond likely had negative experiences, despite no evidence that this is the case.

The study dealt with this problem by utilizing clinical notes, following up directly with a subset of the questions, evaluating patient emails, and even looking at hormone discontinuation rates among those who did not follow up. What they found was that those who did not follow up had very similar continuation rates for gender affirming care to those who did follow up, only around 6% in the secondary sample discontinued hormone therapy. This finding is important, as it will likely neuter further attempts to argue that loss to follow up is a significant issue in research around gender affirming care, which was an argument used by the Cass Review which has been used to crack down on youth and adult care in the United Kingdom.

The findings of this study align with other recent research, including a study from Australia that also used innovative methodologies to address the issue of “loss to follow-up.” That study, also published in JAMA Pediatrics, found that only 4% of transgender youth reidentified with their sex assigned at birth. It successfully collected data on 548 of 552 patients by using clinical notes to support its conclusions. Similarly, studies in the United States have reported very low rates of desistance or detransition. A Dutch study also reported comparably low rates, along with many other studies. According to a review of literature by Cornell University, the regret rate for gender-affirming care ranges from 0.3% to 3.8%, depending on the study's methodology. Within hours of its release, anti-trans activists and bloggers, including Benjamin Ryan, published critiques of the study. They argued that the participants were not representative of transgender youth today, noting that the sample included a higher proportion of individuals assigned male at birth than is typically seen. Critics also pointed out that the population studied was younger and more affluent than average. Additionally, they claimed the follow-up period was still too short, referencing the Cass Review and speculating—with little evidence—that detransition might commonly “take five to 10 years” to occur.

[...] This study is poised to become a cornerstone in affirming the importance of gender-affirming care for transgender youth. Its extended follow-up period and findings that show no significant differences between those who completed follow-ups and those who did not directly rebut common anti-trans arguments. The innovative methodology strengthens the case for previous studies, undermining the assumption that those who fail to follow up regret their care. As more research like this emerges, it becomes increasingly clear that claims questioning the effectiveness of gender-affirming care lack a solid foundation and will continue to fall short.

A new study published in JAMA Pediatrics reports that an overwhelming majority of trans youth are highly satisfied 6-10 years after transitioning, with only 3% in the survey discontinuing the transition process.

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Evan Urquhart at Assigned Media:

The highly contentious issue of detransition has become, in recent years, a spur for increased restrictions on trans people’s healthcare. Among the most contentious questions is how frequently young people who once identified as trans decide to detransition, with activists promoting high estimates and the mainstream endorsing the view that detransition is relatively infrequent. The rapacious appetite of anti-trans activists and the journalists who love them for any sort of numbers that can be used to exaggerate the rate of detransition had resulted in studies on discontinuation of treatments such as hormone therapy having been increasingly used as stand-ins for detransition rates, including in some mainstream news outlets. Although this conflation of discontinuation with detransition has never been never scientifically justified, a new study in the Journal of Adolescent Health casts further doubt on efforts to conflate discontinuation with detransition. It found 16 percent of trans people discontinued treatment (typically hormone therapy), but that 80 percent of those who did continued to identify as transgender. 

The study’s first author is Kinnon McKinnon, who has become one of the leading researchers on detransition. “This is one of the first community studies to offer preliminary insights into the diversity of TGD young people in Canada and the US, including the wide variety of reasons that a minority of youth and young adults may discontinue gender-affirming medical treatments,” McKinnon told Assigned Media via email.

Reached using a combination of online outreach measures, the study surveyed 9,674 LGBTQ+ young people in Canada (75.5 percent) and the US (24.5 percent) on their experiences, with a focus on experiences of family and community support for their identities. Of the larger group of respondents, 731 young people reported ever having started gender-affirming medical treatments, with 16 percent of them reporting stopping or reversing treatment. (Sixteen percent is higher than most estimates of detransition rates, but lower than the high estimate for discontinuation, 30 percent, based on a study of prescriptions for those accessing gender-affirming care through the US military.)

Unlike earlier studies of discontinuation, this study asked participants about their reasons for discontinuing treatment and found that detransition was far from the most common. In fact, over one third (37 percent) of those who reported discontinuing treatment told researchers they wished they hadn’t stopped. Meanwhile, 32 percent described a shift in gender identity as having been a motivating factor. The most commonly given reason for discontinuing treatment was health issues, named as a factor by 37 percent of those who discontinued treatment. If a significant percentage of those who discontinue gender-affirming treatments wish they hadn’t, why are they discontinuing? Hints to possible answers to that question can be found in the study, which found that espousing a Christian identity and growing up Christian was significantly associated with discontinuing treatment, while having a supportive family and household income above $100,000 were both inversely correlated. This suggests that trans people with social support and financial security are less likely to discontinue treatment.

Several other factors that were correlated or inversely correlated with discontinuing treatment, including nonbinary identity.