The surge in children and teens identifying as transgender and seeking gender-affirming medical interventions has been rapid and dramatic, but how many will stop or reverse their gender transition remains unknown.
According to a new Canadian study, only 2.9 per cent of teens referred to one of four specialized paediatric gender clinics clinics detransitioned — changed back to their original gender identity — over a median follow-up of 2.4 years.
The authors said the findings suggest gender identity among teens is stable, detransition “uncommon” and that the results “may offer reassurance to those concerned that adolescents are too young to understand their gender identity or make decisions about medical transition.”
“These findings support that within a clinical context involving comprehensive psychosocial assessment and support, gender identity among adolescents is highly stable, and rates of reidentification with birth assigned gender and cessation of (gender-affirming hormones) are low,” the authors wrote.
Critics, however, said the study is inflating persistence and presenting a skewed picture because the follow-up time was too short to detect a true detransition rate. Because of the way the study was designed, the authors can’t say what happened after the youth moved into adult care and how they identify today.
The study also involved children seen between 2012 and 2017, before a spike in cases and dramatically changing demographics. Doctors are now seeing predominantly biological females, many with accompanying complex mental health problems and many identifying as non-binary.
“It’s an open question whether the detransition rate of someone who started their transition in 2012 is going to be the same rate as someone who started their transition in 2020 or 2022,” said Dr. Laura Targownik, a physician scientist and professor of medicine at the University of Toronto.
The number of children and teens seeking gender-affirming care almost tripled in Canada and the U.S. between 2017 and 2020, the study’s authors noted.
“Despite there being broad consensus among major medical organizations about the necessity of gender-affirming care, some government bodies continue to raise questions about access to gender-affirming care,” they said.
Two recent Canadian studies , however, found “considerable uncertainty” remains about the benefits of gender treatment for kids, echoing the findings of a large British study that led to a ban on puberty blockers.
The Canadian team’s retrospective chart review involved 445 teens diagnosed with gender dysphoria and seen at gender clinics in Vancouver, Calgary, Ottawa and Halifax.
Most — 74 per cent — were born female, and most were between ages 13 and 18 when referred.
The mean age of starting gender-affirming hormones was just over 16.
The teens were seen every six months and, at each visit, asked about their gender identity and whether they were continuing hormone use.
Between 2018 and 2020, the researchers looked back at the data in the youths’ medical records. The last visit prior to the chart review was at most six months, senior author Dr. Margaret Lawson, a senior scientist emeritus with the CHEO Research Institute, said in an email to National Post.
The teens had at least one year of follow up after their first gender clinic visit.
Of the 445, 421 (95 per cent) continued with their presenting gender identity or re-identified as nonbinary “from initial referral to end of the observation period,” the researchers wrote; 24 (five per cent) changed their gender identity during the follow-up period.
Although 24 changed their gender identity, only 13 (2.9 per cent) “returned to gender identity typically aligned with sex at birth,” the authors wrote.
Only one per cent of the 353 adolescents who started on gender-affirming hormones stopped taking them, Lawson and her colleagues report in the Journal of Adolescent Health.
“The study also found that no one who initially identified as non-binary returned to a binary gender aligned with their birth sex,” first author Dr. Daniel Metzger, a paediatriac endocrinologist at BC Children’s Hospital, said in a statement to National Post.
“For many youth, access to appropriate care is associated with improved well-being and mental health outcomes,” Metzger said.
“Other research has also reported low rates of detransition and treatment discontinuation, although findings vary depending on the population studied.”
Estimates vary wildly, with reported rates of detransition — halting or reversing a gender transition — ranging from as low as one per cent to as high as 30 per cent, according to York University researchers.
Some detransitioners have sued their doctors , alleging their desire for extreme interventions was never challenged and alternative treatments never properly discussed.
But critics say detransitioning is getting outsized attention because most who pursue gender transition don’t alter course. Stories in the media of detransitioners have been accused of feeding anti-trans rhetoric and bolstering lobbyists pushing for laws restricting or banning gender-affirming care for minors.
The Canadian paper suggests that appropriately selected youth who undergo comprehensive holistic assessments “are likely to at least be persistent in the short to medium term,” said Targownik, who is a transgender woman.
“It could be that many of them are continuing to do great and if we reached out to them today, in 2026, they’d say, ‘Hey, I’m doing great. Leave me alone,’” she said.
“Or we could reach out and they say, ‘I desisted when I was 22.’ We don’t know. And we can’t tell from this data.”
The science on detransition is still evolving. Other research has found people who detransition do so after an average of five to seven years.
“I don’t expect the detransition rate at a median two years to be terribly high, but if you follow these patients for five years, or 10 years, you might have a clearer picture,” Targownik said.
The finding that most youth prescribed hormones remained on hormones “does provide some reassurance that they’re not just starting patients on hormones and they’re desisting right away,” said Targownik, who supports the rights of children and parents to access this care and who said it’s important not all criticism come from people opposed to gender-affirming care.
“But (the researchers) don’t talk about, were these patients seeing psychiatrists? Were they seen for other problems? Were they getting admitted to hospital for mental health decompensation?”
“They’re basically using persistence as a proxy for, ‘Well, they’re doing OK enough that they didn’t have to abandon their transition or that their clinicians didn’t feel that they were suffering from a such a grievous harm that it had to be stopped.”
Surveys have also found that detransitioners may sometimes feel reluctant to tell their doctors out of worry they wasted people’s time, even if they knew something was off.
Lawson, who has been providing gender-affirming care to transgender adolescents since 2006, said detransition “is very unlikely to occur even after 10 or more years identifying with (a) gender identity different than the identity aligned with their birth sex.
“Individuals who do not support gender-affirming medical care for adolescents are likely to look for reasons that might discount the findings of our study and publication,” Lawson said.
“However, as principal investigator of this study, I can assure you that our study’s methodology is extremely sound.”
All 445 teens were followed in specialized clinics. The study doesn’t include kids who sought care somewhere else, youth who didn’t seek medical interventions or teens who lacked parental support, the authors note.
Relying on medical records also risks not capturing all relevant data “such as social and psychological factors influencing treatment decisions,” they added.Gender identity also relied on the adolescent or parent reporting it.
National Post
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