Most transgender people who receive hormone therapy as teenagers do not regret it, according to a study published Monday in JAMA Pediatrics.
Researchers at University of Texas Southwestern Medical Center and other universities surveyed 376 transgender and gender-diverse people and found that five years after the initial treatment, 360, or nearly 97 percent, said starting hormone therapy was the right decision, and roughly 3 percent said they regretted taking the medication. Nearly 2 percent said they both regretted the transition and believe it harmed them. On average, the participants started hormone therapy at age 16.
The study is the largest yet to examine satisfaction and regret in people who transitioned before they reached adulthood.
Scott Leibowitz, a child and adolescent psychiatrist who serves on the board of the World Professional Association for Transgender Health, said the study “adds to the growing evidence base that demonstrates individualized gender-affirming care can be beneficial for a young person.”
“Experienced clinicians working with these young people will tell you that they are not a monolith, and that many young people are equipped to speak about regret in a sophisticated way,” Leibowitz said.
“This study adds to the importance of working with young people and their families to ensure they understand all possible outcomes when making a treatment decision and that these decisions should be reserved for the doctor’s office, and not with the politicians.”
Conservative leaders and activists have pointed to a handful of detransitioners as proof that young people with gender dysphoria will regret the interventions, but this new study is one of several that have found most people who transitioned as adolescents remain happy they did. Other studies from Princeton University and England have found regret levels between 0.3 and 4 percent.
Though some patients did regret medically transitioning, those rates are relatively low compared to other medical interventions. The rates of regret for back, knee and gastric bypass surgery, for instance, are all higher.
Not all young people who say they struggle with gender dysphoria undergo medical transition. In a previous JAMA study, Harvard researchers found that most do not receive puberty blockers or hormone therapy. That study found that less than 0.1 percent of transgender minors with private insurance took blockers or hormones and none under the age of 12 did.
Still, conservative leaders have made the medical interventions a key focus in recent years. More than half of U.S. states have banned young people under the age of 18 from medically transitioning, and the Supreme Court upheld those bans last year.
The nation’s first “detransition clinic” is now open at Texas Children’s Hospital in Houston as part of a settlement reached with Republican state Attorney General Ken Paxton’s office to resolve an investigation into state Medicaid billing for the hospital’s treatment of transgender youths.
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