Thread by @SEGMtweets

A new study of individuals who medically/surgically transitioned and subsequently detransitioned has been published. It suggests that detransitioners have complex problems not solved by transition & that the prevalence of detransition is underestimated./1
segm.org/new_detransiti…

The key take-aways are that complex mental health needs of gender dysphoric patients were frequently overlooked prior to medical transition; social influence played a key role in developing a trans identity/seeking transition; and inappropriate transition often led to regret. /2

The female study participants were on average 20 years old when they sought care to transition and 24 when they decided to detransition. Males were considerably older: the average ages to seek medical transition and to subsequently detransition were 26 and 33, respectively. /3

The leading reason for detransition for both sexes was becoming more comfortable with identifying with their natal sex due to a change in personal definition of female and male. This notion was cited by 65% of females and 48% of males. However, other reasons differed by sex. /4

For females, the second and third most frequently cited reasons for detransition were concerns about potential medical complications from transitioning (58%) and dissatisfaction with the physical results/too much change (51%). /5

In contrast, males endorsed dissatisfaction with the physical results/too little change, deteriorating physical health, continued mental health problems, and feeling that they were discriminated against (36% each) as the reasons for detransition. /6

50% of the study participants reported strong or very strong regret associated with transition. The majority of respondents were dissatisfied with their decision to transition (70%) and were satisfied with their decision to detransition (85%). /7

Nearly a third of detransitioners endorsed the response “someone else told me that the feelings I was having meant that I was transgender and I believed them” to describe how they felt about identifying as transgender in the past. /8

Many participants selected social media, online communities, and in-person friend groups as sources that encouraged them to believe that transitioning would help them. Some participants reported that mental health and medical clinicians pressured them to medically transition. /9

The study raises concerns about the the quality of health care provided to many of the participants. Although psychiatric conditions/trauma prior to the onset of gender dysphoria were common, 65% of the participants said these factors were not evaluated by gender clinicians./10

Less than a quarter of the participants (24%) told their treating clinicians that they discontinued medical treatment. This, in turn, suggests that clinicians may be unaware of their own patients who detransition and that clinic rates of detransition are likely underestimated./11

Most of the study subjects transitioned before 2015, the year when the landscape of gender care drastically changed. Many more young people are now expressing gender-related distress, while the "gender-affirmative," rather than exploratory, approach has become widespread. /12

The "informed consent model of care" further reduced the likelihood that gender dysphoric individuals receive proper evaluations. This suggests that many of the problems in gender medicine highlighted in the study are more prevalent today. /13

SEGM supports the study's call for inclusion of a measure of detransition in nationally representative surveys that collect health data, such as the Behavioral Risk Factor Surveillance System (@BRFSS) and Youth Behavior Risk Survey (YRBS #CDCYRBS). /14

Per #CDCYRBS, 3.4% of youth identify as transgender or are unsure. As the number of youth receiving medical & surgical gender interventions grows, it is vital to prepare the healthcare system to better meet the needs of this novel patient segment. /15
cdc.gov/mmwr/volumes/6…

The study is available at the link below. /end
link.springer.com/content/pdf/10…

@LisaLittman1