Detransition among minors who accessed pubertal suppression or hormonal therapy is currently estimated at 1-30% with higher figures in the US. No robust studies of regret among minors or young adults have ever been conducted. I lead the largest study on detransition in North America. @theonepercent
The study you linked is among the better ones from the US but it is reflective of a sample who socially transitioned at very young ages (early onset) which is not representative of people who realize a trans identity in adolescence or young adulthood (late onset). These are considered two distinct populations in gender affirming healthcare research.
The biggest limitation in estimating prevalence of detrans or regret is lack of prospective longitudinal research collecting data at 10+ years post tx. Detrans/regret occurs at means of 4-10 years (ranging months to 20+ years). In US, 2 & 5 year prospective studies are the longest term prospective studies available and they were not designed to examine detrans/regret as an outcome of interest. Many studies aiming to report prevalence of regret have between 20-40% patients lost to follow-up which is another limitation to having a clear sense (the article I co wrote with a couple colleagues in the BMJ discusses issues in studying detrans). To be very clear, trans rights and respect for gender diversity ought to be considered alone, irrespective of detransition or treatment regret, but the science of studying this particular outcome is very poor at the moment.
This piece undermines its own argument. Kumar acknowledges that “completed suicides among trans youth are vanishingly rare”. This fact directly undercuts the main urgency used to justify fast-tracking medical interventions.
If suicidality isn’t as widespread or extreme as commonly portrayed, then what’s the harm in slowing down and seriously exploring other explanations? Some of these youth might be gay, gender-nonconforming, autistic, or responding to social and peer dynamics.
Kumar also treats several unsettled scientific debates as if they’re closed. He omits the literature on desistance, ignores rapid-onset presentations, and assumes the Dutch protocol applies cleanly to today’s very different cohort. But even the Dutch model was cautious, narrow, and highly screened.
He calls for “evidence-based counseling” while selectively citing only evidence that supports transition. An honest evidence-based approach would admit we’re in uncharted territory, and that many interventions are being adopted before long-term outcomes are known.
Framing healthy adolescent bodies as “wrong” may actually create the distress we’re trying to solve. The strategic failure here is also medical, not just legal.
Detransition among minors who accessed pubertal suppression or hormonal therapy is currently estimated at 1-30% with higher figures in the US. No robust studies of regret among minors or young adults have ever been conducted. I lead the largest study on detransition in North America. @theonepercent
This study has 220 participants and the rate is 2-4% regret — 5 years on average after beginning treatment.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2825195
Can you provide any sources that would back up your 1-30% estimate and higher than 30% in the US?
The study you linked is among the better ones from the US but it is reflective of a sample who socially transitioned at very young ages (early onset) which is not representative of people who realize a trans identity in adolescence or young adulthood (late onset). These are considered two distinct populations in gender affirming healthcare research.
The biggest limitation in estimating prevalence of detrans or regret is lack of prospective longitudinal research collecting data at 10+ years post tx. Detrans/regret occurs at means of 4-10 years (ranging months to 20+ years). In US, 2 & 5 year prospective studies are the longest term prospective studies available and they were not designed to examine detrans/regret as an outcome of interest. Many studies aiming to report prevalence of regret have between 20-40% patients lost to follow-up which is another limitation to having a clear sense (the article I co wrote with a couple colleagues in the BMJ discusses issues in studying detrans). To be very clear, trans rights and respect for gender diversity ought to be considered alone, irrespective of detransition or treatment regret, but the science of studying this particular outcome is very poor at the moment.
https://pubmed.ncbi.nlm.nih.gov/35452119/
https://pubmed.ncbi.nlm.nih.gov/38944803/
https://www.bmj.com/content/381/bmj-2022-073584
https://pubmed.ncbi.nlm.nih.gov/40096683/
Thank you for this
This piece undermines its own argument. Kumar acknowledges that “completed suicides among trans youth are vanishingly rare”. This fact directly undercuts the main urgency used to justify fast-tracking medical interventions.
If suicidality isn’t as widespread or extreme as commonly portrayed, then what’s the harm in slowing down and seriously exploring other explanations? Some of these youth might be gay, gender-nonconforming, autistic, or responding to social and peer dynamics.
Kumar also treats several unsettled scientific debates as if they’re closed. He omits the literature on desistance, ignores rapid-onset presentations, and assumes the Dutch protocol applies cleanly to today’s very different cohort. But even the Dutch model was cautious, narrow, and highly screened.
He calls for “evidence-based counseling” while selectively citing only evidence that supports transition. An honest evidence-based approach would admit we’re in uncharted territory, and that many interventions are being adopted before long-term outcomes are known.
Framing healthy adolescent bodies as “wrong” may actually create the distress we’re trying to solve. The strategic failure here is also medical, not just legal.