Never trust someone who says they know precisely how commonly people detransition. Research on the subject, especially pertaining to minors, remains maddeningly hazy.
It's really important to assess the prevalence of detransition, but that should not overshadow the importance of the prevalence of desistance, those who change their minds before they begin medicalizing.
Parents especially benefit from knowing that watchful waiting instead of impulsive action usually ends up being the wisest course. It certainly was for us; our 11-year-old desisted from her non-binary identification on her own after 2.5 years of us not making a big deal of it or acting on any rash recommendations.
This 2021 US/Canadian study showed that the desistance rate among boys first diagnosed before puberty was 88% by late puberty:
To me, the Roberts study as the largest (952 subjects) and one of the longest at 9 years, is key info: 30% desistance/detransition rate from hormones after 4 years.
Pair that with the Littman survey that showed that by the 4 year mark only half of her eventual detransitioners had yet decided to detransition, and it's hard to deny that the "fraction" of those who detransition is going to be a very large one, especially considering how much less gatekeeping is being done now with those wanting to get hormones, compared to how much was being done when most of the data being analyzed in these studies was being generated.
Less gatekeeping = higher eventual detransition rates, as the kids who never got a real evaluation before being written their prescriptions realize that, alone, unadvised except for their online trans community and un-evaluated except by themselves, they made a mistake.
Frustrating to see "right-wing" and "politicized" thrown around by those who want to muffle inquiry about detransition. I know these are real problems, as Trump administration is cutting research. However, can we appreciate the fact that, identity aside, medical treatments for transition have a price on health and turn physically healthy people into possibly lifelong patients? This is especially important with minors.
Once someone goes down the medical pathway, it is difficult to turn back.
However, I think there are many who quietly quit the medical interventions. They may not make any announcements, or change pronouns ("they" becomes a handy pronoun here), but they are no longer invested in the identity. Detranstioners speak of a loss of friends when they question their transitions. Lost in transition?
Right. Also, there could be people whose detransition is not clear-cut; for example, a natal female might abandon plans for a double-mastectomy and switch back to she/her pronouns, but still take exogenous hormones and identify as trans. Is that person a detransitioner? Who decides?
Fact is, there's no clear-cut definition of trans. If we can't say for sure who has actually transitioned, we can't know for certain who has detransitioned.
Talia, I am warning you for a second time that if you cannot be respectful, I will need to block you. Feel free to disagree all you like, but I demand that people mind their manners.
This is a somewhat frustrating article. Why extensively cite results from the literature that show modest Detrans rates—- with study shortcomings (poor data quality, self selected populations, short term follow-up, etc. ) only noted at the end of the discussion on each paper. I would much rather have seen the inverse: a discussion of each study’s shortcoming upfront, with less emphasis on the results quoted. Or perhaps a chart listing each study and its significant shortcomings. At a glance, it would make the point the article leads with: we don’t know what Detrans rates are and high quality, long term studies are needed to know more.
One more point- it may be impossible to ever know Detrans rates, since indications are that detransitioners do not return to the clinics where they were treated (and why would they?). Or at least until detransition clinics open to provide much needed support and assistance.
MacKinnon and Littman's studies (and Turban's) can't say how well their samples represent the general population who meet their criteria, so this sort of statement
"Dr. MacKinnon noted in his recent podcast that about one-third to 60% of detransitioning involves some form of regret" is qualified, unless those samples are known to be representative more generally.
Also, your graph shows a sharp rise in males as well, from 2009 to 2016, from 24 to 426....just not as fast as the females. That is fast and I'm guessing many also had comorbidities, etc. The male/female ratio is country dependent.
Lastly, there are reviews about the rate that describe the studies involved:
Regarding the evidence itself, Feigerlova noted: "The certainty assessment of the included studies using the GRADE approach revealed a very low overall quality evidence."
"Very low" GRADE means (e.g. in the recent McMaster systematic reviews): "Very low certainty=we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect."
what we've seen time and time again are stats and claims regarding anything related to this topic are either designed to market gender services or manipulate the public.
for example, systematic reviews conducted by UK, sweden and finland found low certainty of any benefit of pediatric gender interventions and a high certainty of negative outcomes. in the process these reviews looked at 100s of studys published by US medical journals and found these journals allowed low evidence findings to be published, knew these findings were being used to deceive the public and prevented qualified comments that pointed out the errors. in short - they lied.
and we see this same deception in some of the cited work in this article.
the "recent paper.. of 957 detransitioners" can best be understood as part of the effort to manipulate the public. their participant pool specifically excludes "detrans" people. how are they excluded? participants only included people from hand picked groups that detrans people are not likely to be a part of. the same is true of any stat based on trevors transgender survey. this would be like being asked to count the cows in the east and west valleys. then looking only the east valley, finding there are none and then reporting there are no cows in both the east and west valleys. meanwhile there could be a million cows in the west valley that went uncounted.
the systematic review conducted by french gender clinic operator Eva Feigerlova should also be looked at sceptically. she says she looked at 15 studys but we dont know which ones. shes in the business of operating a hospital dept whose purpose is promoting, marketing and selling gender interventions. would you trust trump if trump said hes the best president of all time? its just a sales pitch.
german insurance records found by year 4, 50% stop taking gender meds, per my understanding.
an even better question than if people detrans is if transiton is a choice. if one said 100% of people who once watched TV continued to watch TV throughout their life, would that justify men to watch TV in the womens restroom? there is a lot of unvetted conflation. once people figure it out im guessing we will find that gender ID is just a hobby. and whats wrong with that? let your freak flag fly. just dont do it in my living room
"The imperative to study detransitioning is also impeded by fears among gender-medicine researchers, which are certainly not unfounded, that doing so will produce results that will be leveraged by the right wing in an effort to undermine this field of medicine."
The researchers are afraid studies will show their treatment of patients is of no benefit or even harmful. You would think they'd care enough about their patients to validate what they're doing instead of trying to blame the right wing boogeyman, especially when opposition to medicalizing kids is bipartisan.
It's really important to assess the prevalence of detransition, but that should not overshadow the importance of the prevalence of desistance, those who change their minds before they begin medicalizing.
Parents especially benefit from knowing that watchful waiting instead of impulsive action usually ends up being the wisest course. It certainly was for us; our 11-year-old desisted from her non-binary identification on her own after 2.5 years of us not making a big deal of it or acting on any rash recommendations.
This 2021 US/Canadian study showed that the desistance rate among boys first diagnosed before puberty was 88% by late puberty:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8039393/
This 2024 German study showed that desistance rates in the 15-24 age group ranged from 50% to 73% after 5 years:
https://ourduty.group/2024/06/11/german-study-desistance-is-common/?s=09
A newer study from Norway provides a higher quality analysis from 2000-2023 among minors:
https://pubmed.ncbi.nlm.nih.gov/39648282/
Thanks, terrific summary.
To me, the Roberts study as the largest (952 subjects) and one of the longest at 9 years, is key info: 30% desistance/detransition rate from hormones after 4 years.
Pair that with the Littman survey that showed that by the 4 year mark only half of her eventual detransitioners had yet decided to detransition, and it's hard to deny that the "fraction" of those who detransition is going to be a very large one, especially considering how much less gatekeeping is being done now with those wanting to get hormones, compared to how much was being done when most of the data being analyzed in these studies was being generated.
Less gatekeeping = higher eventual detransition rates, as the kids who never got a real evaluation before being written their prescriptions realize that, alone, unadvised except for their online trans community and un-evaluated except by themselves, they made a mistake.
Frustrating to see "right-wing" and "politicized" thrown around by those who want to muffle inquiry about detransition. I know these are real problems, as Trump administration is cutting research. However, can we appreciate the fact that, identity aside, medical treatments for transition have a price on health and turn physically healthy people into possibly lifelong patients? This is especially important with minors.
Once someone goes down the medical pathway, it is difficult to turn back.
However, I think there are many who quietly quit the medical interventions. They may not make any announcements, or change pronouns ("they" becomes a handy pronoun here), but they are no longer invested in the identity. Detranstioners speak of a loss of friends when they question their transitions. Lost in transition?
Right. Also, there could be people whose detransition is not clear-cut; for example, a natal female might abandon plans for a double-mastectomy and switch back to she/her pronouns, but still take exogenous hormones and identify as trans. Is that person a detransitioner? Who decides?
Fact is, there's no clear-cut definition of trans. If we can't say for sure who has actually transitioned, we can't know for certain who has detransitioned.
Exactly.
I know my own opinion, thanks. However, should I need you to tell me what I think, I'll be sure to contact you.
Talia, I am warning you for a second time that if you cannot be respectful, I will need to block you. Feel free to disagree all you like, but I demand that people mind their manners.
I don't often receive psychoanalyses from strangers on the Internet. One will do.
This is a somewhat frustrating article. Why extensively cite results from the literature that show modest Detrans rates—- with study shortcomings (poor data quality, self selected populations, short term follow-up, etc. ) only noted at the end of the discussion on each paper. I would much rather have seen the inverse: a discussion of each study’s shortcoming upfront, with less emphasis on the results quoted. Or perhaps a chart listing each study and its significant shortcomings. At a glance, it would make the point the article leads with: we don’t know what Detrans rates are and high quality, long term studies are needed to know more.
One more point- it may be impossible to ever know Detrans rates, since indications are that detransitioners do not return to the clinics where they were treated (and why would they?). Or at least until detransition clinics open to provide much needed support and assistance.
Published studies traditionally mention their limitations in the end, not the beginning. I followed the same sequence.
Why quantify such an intensely personal choice? I'd sooner listen to 1 detransitioner's story on Andrew Gold's Heretics YouTube.
There's a chart of limitations of individual studies in https://link.springer.com/article/10.1007/s10508-023-02623-5
https://link.springer.com/article/10.1007/s10508-023-02623-5/tables/2
Not every study but many of them.
Thanks!!!
MacKinnon and Littman's studies (and Turban's) can't say how well their samples represent the general population who meet their criteria, so this sort of statement
"Dr. MacKinnon noted in his recent podcast that about one-third to 60% of detransitioning involves some form of regret" is qualified, unless those samples are known to be representative more generally.
Also, your graph shows a sharp rise in males as well, from 2009 to 2016, from 24 to 426....just not as fast as the females. That is fast and I'm guessing many also had comorbidities, etc. The male/female ratio is country dependent.
Lastly, there are reviews about the rate that describe the studies involved:
Respaut, Terhune, Conlin, 2022, Reuters: Why detransitioners are crucial to the science of gender care https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
Cohn, 2023, The detransition rate is unknown, https://link.springer.com/article/10.1007/s10508-023-02623-5
Thank you for your reporting!
Regarding the evidence itself, Feigerlova noted: "The certainty assessment of the included studies using the GRADE approach revealed a very low overall quality evidence."
"Very low" GRADE means (e.g. in the recent McMaster systematic reviews): "Very low certainty=we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect."
Hey , could I ask you to take a look at this study claiming that there's no advantage for trans women in cycling https://link.springer.com/article/10.1007/s40279-023-01928-8?fbclid=IwAR1efH0vHZti0rdZIb6Svc5Yfm5Ba3yj5FflzNGYecZuPG_cq8vSVfO0LsI Is there any other studies contradicting this showing?They do have an event.It's like
what we've seen time and time again are stats and claims regarding anything related to this topic are either designed to market gender services or manipulate the public.
for example, systematic reviews conducted by UK, sweden and finland found low certainty of any benefit of pediatric gender interventions and a high certainty of negative outcomes. in the process these reviews looked at 100s of studys published by US medical journals and found these journals allowed low evidence findings to be published, knew these findings were being used to deceive the public and prevented qualified comments that pointed out the errors. in short - they lied.
and we see this same deception in some of the cited work in this article.
the "recent paper.. of 957 detransitioners" can best be understood as part of the effort to manipulate the public. their participant pool specifically excludes "detrans" people. how are they excluded? participants only included people from hand picked groups that detrans people are not likely to be a part of. the same is true of any stat based on trevors transgender survey. this would be like being asked to count the cows in the east and west valleys. then looking only the east valley, finding there are none and then reporting there are no cows in both the east and west valleys. meanwhile there could be a million cows in the west valley that went uncounted.
the systematic review conducted by french gender clinic operator Eva Feigerlova should also be looked at sceptically. she says she looked at 15 studys but we dont know which ones. shes in the business of operating a hospital dept whose purpose is promoting, marketing and selling gender interventions. would you trust trump if trump said hes the best president of all time? its just a sales pitch.
german insurance records found by year 4, 50% stop taking gender meds, per my understanding.
an even better question than if people detrans is if transiton is a choice. if one said 100% of people who once watched TV continued to watch TV throughout their life, would that justify men to watch TV in the womens restroom? there is a lot of unvetted conflation. once people figure it out im guessing we will find that gender ID is just a hobby. and whats wrong with that? let your freak flag fly. just dont do it in my living room
"The imperative to study detransitioning is also impeded by fears among gender-medicine researchers, which are certainly not unfounded, that doing so will produce results that will be leveraged by the right wing in an effort to undermine this field of medicine."
The researchers are afraid studies will show their treatment of patients is of no benefit or even harmful. You would think they'd care enough about their patients to validate what they're doing instead of trying to blame the right wing boogeyman, especially when opposition to medicalizing kids is bipartisan.