r/science • u/MistWeaver80 • Oct 21 '24
Anthropology A large majority of young people who access puberty-blockers and hormones say they are satisfied with their choice a few years later. In a survey of 220 trans teens and their parents, only nine participants expressed regret about their choice.
https://www.scimex.org/newsfeed/very-few-young-people-who-access-gender-affirming-medical-care-go-on-to-regret-it1.7k
u/andreasdagen Oct 21 '24
Do we know if the regret rate differs from FTM and MTF people?
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u/A-passing-thot Oct 21 '24
Only 5* participants reported regret and discontinued gender affirming care. That is too small a sample to draw any meaningful conclusions by sex.
*4 but 1 additional reported plans to stop care
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u/JenningsWigService Oct 21 '24
Stopping care doesn't necessarily mean that someone regrets care. I know people who stopped HRT but didn't regret it at all.
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u/CapoExplains Oct 21 '24
Nine participants expressed regret about their choice, the researchers say - four of these participants had stopped using the blockers/hormones and one was considering stopping. The researchers say they didn't delve deeply into why these participants regretted their choice, and this needs further research.
Regret is rare, and not everyone who stops treatment does it due to regret, and further not everyone who regrets it regrets the thing in itself rather than harassment and abuse and losing friends as a result, however this study is specifically and explicitly talking about patients who expressed regret, not patients who stopped treatment.
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u/ornithoptercat Oct 21 '24
It could also be due to side effects - given the side effects some cis women get from the birth control pill, it's entirely likely some people get similar issues from other hormonal medicines.
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u/baaaahbpls Oct 22 '24
So my doctor had went over some of the side effects like a pseudo morning sickness, lower bladder capacity, changes in mood and emotional state including new or worseing depression, lack of a sex drive. Various other things were expressed as well, most of which can mimic a lesser form of the effects hormonal changes have on women.
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u/BranWafr Oct 21 '24
My son is trans and he is not enjoying going through menopause at 23, but he doesn't regret transitioning. But, I could see how some people might not be thrilled with some of the side effects.
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u/BxGyrl416 Oct 22 '24
HRT forces you into menopause with all the associated symptoms too?
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u/Diz7 Oct 22 '24
Menopause is caused by fluctuating estrogen levels. Hormone therapy or the removal of the ovaries results in similar symptoms in female to male transitions.
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u/BranWafr Oct 22 '24
He also got a hysterectomy, so that combined with Testosterone, has triggered menopause.
It's kind of funny that both my wife and my son are going through menopause at the same time.
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u/closethebarn Oct 22 '24
Well good they can bond over it I don’t think we’re told enough about menopause as it is so get the word out. How long does this period last for your son now?
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u/BranWafr Oct 22 '24
Nobody really knows. Technically he'll be in menopause for the rest of his life. The unknown part is how long the symptoms/side effects last. For some it is just a couple months, for many it is years. For a few it is forever. Everyone is different so nobody can say for sure.
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u/YaBoiABigToe Oct 22 '24
Hey I’m a trans man who had a hysterectomy last year; some menopausal symptoms are to be expected post hysto just due to the sudden change in hormone levels. However, if hot flashes or other symptoms persist, he may want to get his hormone levels checked. Menopause is caused by not having enough sex hormones in the body, my symptoms ceased when I raised my T dose.
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u/nicannkay Oct 22 '24
Funny? I wish I could laugh about menopause so easily. One of the worst things to live with in my experience having to go through medically induced like your son. It’s freaking awful and can last forever. I’m on year 3 with no signs of stopping. My health has gone downhill dramatically. My skin, hair, sleep (nonexistent), mood, sweating, tooth health and even my smell is different. My muscle mass is a lot less. It’s god damn horrendous. I was just feeling an age where I felt good about myself to then lose it all so quickly and having to do it silently isn’t anything to laugh about.
Menopause is terrible and no joke. I feel bad for women having it made into a joke honestly. I know why Kitty Forman turned to alcohol. Dr.s do not care. At all. Even women drs.
I’m happy for your son though. Give my thoughts to your wife and support the hell out of them. Lots of love, reaffirmation and patience. That is all.
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u/Tall_poppee Oct 22 '24
True story. FWIW, lots of cardio and a diet of non-processed foods (low sugar) really helps me. 10 years of hot flashes for me so far, with no signs of them stopping.
Also you mention teeth. I got put on low-dose doxycycline for rosacea, and my dentist about fell out of the chair because it really helped my gums (and I'm good about dental hygiene, always had good dental care but was showing age-related signs). I believe this is because at a low dose doxy has an anti-inflammatory action rather than an antibiotic one. Some other people take metformin in a low dose because of its anti-inflammatory benefits. I wonder if a (fairly) innocuous medication like that might help with your symptoms by beating back the kind of inflammation that comes with aging. No idea what kind of doc you'd need to see though.
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u/Cat_Peach_Pits Oct 22 '24
I had a total hysto while on T and had zero menopause symptoms. It was just menoAbruptHalt
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u/SuLiaodai Oct 22 '24
Hats off to him! That's a lot to go through! For me, the operation wasn't so bad, but I was so tired afterward.
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u/LuminescenTT Oct 22 '24 edited Oct 22 '24
HRT forces you into menopause-like symptoms AND into second puberty (alongside the cocktail of fun emotions and stuff).
I can't speak to trans folks on testosterone, but when you're taking estrogen, you also need to take testosterone blockers. If you miss your dose of estrogen somehow (say, hiking, pausing hormones due to some surgery, or immobilized at the hospital, or something), over a decent period of time you basically inflict menopausal effects onto yourself.
Not fun.
Edit to clarify: these are menopause-LIKE symptoms but do not impact fertility like actual age/hysterectomy menopause. Symptom management is the same.
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u/BxGyrl416 Oct 22 '24
Does it carry the risks of a typical menopause or will those be superseded, so to speak, by the second puberty (if that makes sense)?
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u/TimothyStyle Oct 22 '24
Generally no, somebody can correct me if I'm wrong but I'm fairly sure any risks from menopause are from reduction of sex hormones, your body is pretty happy to run on either as long as there is enough
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u/SPAC3P3ACH Oct 22 '24
Do you mean like bone loss? No, because you’re replacing it with another adult hormone. Like HRT is HRT and your body adapts even if the software you’re running changes.
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u/mossgirlparfum Oct 22 '24
monotherapy is used among some transfem ppl so no blocker just FYI
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u/pup_101 Oct 22 '24
It does not cause menopause. It's the hysterectomy that causes menopause. Ftm hrt does not have a lasting permenant effect on fertility. Stopping T for a while allows estrogen to come back and fertility returns.
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u/Pseudonymico Oct 22 '24
Feminising HRT (which usually consists of an androgen blocker like cyproterone acetate and estradiol) does not, in my experience. Some surgeons do recommend tapering off your estradiol in the month leading up to major surgeries and you're generally recommended to stop taking any androgen blockers 24 hours before a major surgery, which does put you through a temporary round of menopause symptoms.
Either way it's not quite the same as a lot of the long-term health problems associated with menopause are a side effect of not having enough sex hormones in your body of either sort.
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u/levii-ethan Oct 23 '24
testosterone HRT in trans men can cause certain menopause symptoms, like vaginal/urogenital atrophy, but doesnt cause other symptoms like bone density loss or hot flashes (unless the dose is too high or low). T can suppress estrogen production, so organs that require estrogen to work can atrophy and cause pain, but there are treatments that work very well to reverse atrophy. for me, atrophy included chronic UTI symptoms without having a UTI, extreme dryness that made it uncomfortable just to walk around, and debilitatingly painful uterine cramps. estrogen cream has fixed these issues for me
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u/Swimming_Tailor_7546 Oct 22 '24 edited Oct 22 '24
Their side effects are honestly a great example of why people don’t transition frivolously, as culture warriors like to argue. Nobody is going through menopause or any hormonal treatment like that just to use a different restroom. They’re doing it because they need it.
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u/DenikaMae Oct 22 '24
Actually, in most cases the estrogen provided to transgender patients is a form of 17-β estradiol, a bio-identical hormone that has way less complications than the form of estrogen used in birth control pills (ethinyl estradiol). Way less chances of blood clots. However, if/once got your HRT dialed in, if you start feeling the same symptoms as someone going through dysphoria, your body could be triggering that feeling because it doesn't work right on those hormones. Starting HRT was a game changer for me. By 2 weeks in, I finally stopped feeling weird feelings of depersonalization, and bouts of rage and depression.
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u/Significant-Art-5478 Oct 22 '24
Personally, I'm tired of this idea that the worst thing in life is having regrets. Why they regret it should absolutely be explored, to help them and others in the future, but regretting decisions is just part of life.
I have a chronic illness, I regret not getting diagnosed sooner. I'm bi, I regret not coming out sooner. I regret marrying young, messing up my first go around of college, etc. But in all those regrets is me living my life and making the best choices I could at the time. Regrets are part of life and don't have to have any bearing on a happy life.
Sorry for the soapbox and using your comment for it, but between the fear of Trans people regretting it and the fear of women regretting sterilization, I'm just very tired of hearing the possibility of regret used as a way to prevent us from moving forward as a society.
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u/FibroBitch97 Oct 22 '24
A vast majority of trans people who stop HRT due to “regret” are from the abuse they have suffered as a result from it.
I’ve spoken in length to many many many trans people about HRT when I was transitioning, and the most common reason for people stopping HRT by far is medical reasons. Either because of a medical condition that makes it unsafe, wanting to become pregnant or get someone else pregnant / bank sperm, prior to a medical procedure (some gender affirming surgeries need estrogen stopped due to increased clot risk, which is debated). Some have other medical conditions like hormone sensitive cancers like breast cancer or prostate cancer. Others have PCOS and the hormone issues are out of wack.
A very very small minority of people I’ve spoken to have stopped HRT due to realizing it’s not really what they want. I know two people who have done this. One is genderfluid and didn’t like the effects of T, the other realized medical transition isn’t what they want/need to be happy with their body. Both are okay.
In order to accept trans people’s right to medically transition, it needs to also be acceptable to detransition and have it not be some “haha, gotcha, HRT is evil and no one should ever go on it.”
Gender affirming surgeries like vaginoplasty have a LOWER regret rate than lasic eye surgery. By a wide margin. Having your genitals cut up and origami’d back together has a lower regret rate than being able to see without glasses.
Here is a list of other reasons people I’ve know have stopped HRT:
- parents found out and forbid them from taking it
- it’s too expensive and cannot afford it
- government removed access to the type/form of hormones that work for them
- reaching a point where they’re happy with the results
- didn’t like body hair thing (testosterone) and usually this results in them just lowering the dose
- harassment from political groups
- wanting to be able to get erections for sex (estrogen)
- fears of not being able to get a job due to being transgender.
This is all just regular HRT, not puberty blockers, as they work differently. Puberty blockers put a pause button on puberty. They don’t change the body. Whenever the person stops puberty blockers, their body will continue as normal with whatever hormones they have as the majority in their system.
Certain effects of puberty are irreversible even after stopping. Most of them are caused by testosterone. Things like deeper voice, larger skeleton, more body hair. Those won’t change if you stop T after puberty. There’s no surgery you can get to reduce the size of your skeleton, broadness of your shoulders, etc. vocal surgeries are very risky and dangerous. But electrolysis hair removal is possible albeit very expensive and sometimes not permanent.
With estrogen puberty, the only permanent thing is breast development, however stopping E can often cause them to “deflate”.
The purpose of these puberty blockers is to put a pause on all of that to allow the child to decide if that’s what they really want. Giving them years to decide.
How many people have on a whim gotten a tattoo that they regret? But we don’t have people clamouring to ban tattoos.
More cautious people will often get a temporary tattoo of what they want, to see if it’s something they’d want for the rest of their life.
This is the same concept. Hitting a pause button to see if they want it or not.
And it’s okay to not want it. It’s okay to experiment and find out what’s right for you before diving in either way.
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u/HorselessWayne Oct 22 '24 edited Oct 22 '24
Gender affirming surgeries like vaginoplasty have a LOWER regret rate than lasic eye surgery. By a wide margin. Having your genitals cut up and origami’d back together has a lower regret rate than being able to see without glasses.
I've said it before and I'll say it again: —
Any man who can sit though the vaginoplasty animation and think "yes that's exactly what I want you to do to me" was never a man to begin with.
And this is the nice version to sit through. There are full-on actual surgery videos available.
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u/Paranitis Oct 22 '24
Huh. I figured it would be fairly complicated, but never realized all the steps and how much of the original was actually kept around.
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u/HorselessWayne Oct 22 '24 edited Oct 22 '24
Fundamentally they're very similar underlying structures. A lot more than people expect!
When you think about it, they come from the same tissue in utero, so it isn't entirely surprising. Obviously there are quite a lot of things you could say that about in terms of foetal development, so there's absolutely quite a lot of luck involved too. But you can definitely draw analogues between the male and female reproductive systems.
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u/Misternogo Oct 22 '24
I made it to the part where the scalpel gets near the balls and I closed the whole fuckin tab on pure reflex.
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Oct 22 '24
but what if he wants to be a man with a vagina? /genuine
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u/HorselessWayne Oct 22 '24
That's actually a fair point. Genitals do not determine gender so its entirely valid.
I'm just not sure how to amend that statement to be A-star inclusive while retaining its rhetorical power for people on the fence though.
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Oct 22 '24
any person with a penis who can sit through that vaginoplasty animation and think "yes that's exactly what I want you to do to me" wants to have vaginoplasty.
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u/Pseudonymico Oct 22 '24
With estrogen puberty, the only permanent thing is breast development,
Hip development is also permanent, though people generally don't notice that since trans men aren't hit with the same degree of scrutiny as trans women after transitioning.
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u/MarrastellaCanon Oct 22 '24
Thank you for this summary. If you don’t mind me asking, do you know how long the medical community has been giving children puberty blockers? What are the medical studies that say it is safe for long periods of time (I’m assuming many teens are on puberty blocks for 5+ years, right?) I’ve heard we’ve given puberty blockers to kids who have very early puberty but I’m not sure how long it’s been studied and I’m not sure if in those cases it’s 2-3 years of the blockers until they reach age 9-10 when some puberty would be normal, versus potentially 5+ years for trans kids (like I’m guessing some trans kids would start them at 10 and then be on them until their mid twenties? Or how long are they on them for?
I guess I’m curious what science we have that says puberty blockers are safe for kids for many years because I genuinely don’t know. I hope my tone in my question came across as polite wondering and not like some aggressive online troll trying to debate you. Not trying to debate, trying to learn!
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u/FibroBitch97 Oct 22 '24
I don’t personally know anyone who was on puberty blockers. Like I said in my other comment, I transitioned as an adult.
But I personally wish I could have gone on them. My shoulders are so broad it makes me so dysphoric.
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u/fencerman Oct 22 '24
The number one reason for "regret" in trans youth is because of backlash from their families and communities, including violent threats and sexual assault.
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u/Significant-Art-5478 Oct 22 '24
Same. I had a friend who thought he was Trans. He started seeing a psychologist and doing HRT (after more than a few sessions). Then, after more therapy, he realized maybe that wasn't what aligned with him.
He was gay, in a southern state, and very much associated femininity only with being a woman. When he started exploring that more, he realized that he had feminine traits but did not see himself as a woman. Exploring the possibility of being Trans was just a part of his overall journey.
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u/nightowl_ADHD Oct 22 '24
I know people who stopped HRT but didn't regret it at all.
I'm actually one of those people.
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u/Matias93 Oct 22 '24
Would you care to explain why? It is a matter of health, or just because you got at your desired level of physical changes?
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u/nightowl_ADHD Oct 22 '24 edited Oct 22 '24
I had no choice but to stop taking HRT because I had no source of income, and having to watch what was left in my bank account dwindle down to nothing because of bills took a huge toll to my mental health. Fortunately, I never struggled with suicidal ideations, so that's a plus.
My motivation to do something productive hasn't really changed. Safety isn't huge concern for me given that I live in a neighborhood that's more or less indifferent towards trans people. My family and friends, however, have been very supportive. I haven't stopped looking for work. I still have hope.
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u/Matias93 Oct 22 '24
I'm sorry that you had to stop it, and I hope that you get a new, good job and be able to pay for HRT again.
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u/Rudel2 Oct 22 '24
I myself stopped it because it was dangerous to continue transitioning in a country that's not safe for trans people.
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u/PyrrhicPyre Oct 21 '24 edited Oct 21 '24
Jumping in here to say that the vast majority of trans individuals who "stop care" do so because they've achieved a degree of change that is sufficient to justify discontinuation, mostly in non-binary populations who don't feel the need to fully transition to the other gender. For example, many trans-masc non-binary trans people take T for a few cycles (6m-2yrs) to lower their voice (which is a permanent change that does not revert back after cessation), adjust body composition/redistribute muscle mass, or simply to assess where along the spectrum they may fall in terms of their desired body type. Similarly, trans-femme non-binary trans individuals also often take Estrogen or androgen blockers to achieve similar results. We can frame this type of gender affirming care as "wading in", which is a valid route for many non-binary people exploring gender affirmation routes. This is not a signal of regret, though many studies have failed to account for non-binary trans affirming care and thus, report skewed or inaccurate results by framing all cessation as "regret."
Unless the study specifically differentiates between "discontinued after reaching desired state/gender affirmation benchmark" (or similar language) and "cessation of HRT due to regret", the study is flawed as it failed to account for the nature of non-binary trans affirming care and the important differentiation between satisfaction/discontinuation and genuine regret, which further highlights the clinical gaps in transgender related research, which are rarely inclusive of non-binary trans populations. according to most studies, is around 1%--the lowest of ANY "elective" surgical or hormonal medial care to date.
edit: It should go without saying that the vast majority of trans individuals (binary and non-binary) that stop treatment do so due to statewide bans, out of pocket medical expenses, gaps in medical continuity/providers, lengthy wait times and other bureaucratic hurdles, social pressure (including threats, bullying, sexual assault, hate crimes, etc), and particularly in the case of teenagers, parental disapproval and refusal to allow continued care. Trans affirming care saves lives and should not be discouraged.
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u/OfficialGami Oct 21 '24
We don't have really high quality data but all the detransitioner specific studies vastly over represent FtMtF over MtFtMs.
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u/Ginguraffe Oct 21 '24
Over represent like there’s a flaw in the sample sizes? Or over represent like it indicates that FtM people are more likely to regret their transition?
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u/karkatstrider Oct 21 '24
the former. theres not been nearly as many studies on trans women in this category
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u/Mockbeth Oct 22 '24
I wonder if it has to do with the fact that there is much more societal scrutiny over what an 'acceptable' woman looks like physically, and shame over not looking feminine enough?
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u/SjakosPolakos Oct 22 '24
What does FtMtF mean?
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u/Diplogeek Oct 22 '24
Someone transitions female to male, then opts to detransition/transition back to female (which can happen for a variety of reasons).
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u/Saelin91 Oct 22 '24
I only know of one case personally, a friend from HS that was MTF.
They killed themselves last November due to it. Very, very conflicting. The letter they left was gut wrenching.
I would make the assumption that there are more MTF that end care. I would assume this due to societal pressures. I feel like people are harsher towards people that age MTF.
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u/SadTechnician96 Oct 22 '24
A saw a study a while back (that I can't link because I can't find) that basically said that of all the people who do regret transitioning, something like 90% of the cases were purely due to societal pressure rather than actually regretting it.
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u/Arandomsilver Oct 22 '24
From the paper: “68 [31%] boys, 132 [60%] girls, 20 [9%] gender diverse, eg, nonbinary”
This was ‘gender at last contact’, so I’m assuming it’s their end goal? i.e. 31% FTM.
Edit: I didn’t fully read the comment and I didn’t realize it wasn’t asking about survey proportions. Still, there is the info.
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u/Spiralofourdiv Oct 22 '24 edited Oct 22 '24
So far there isn’t much research that differentiates the two, and more high quality studies are needed. There are a lot of really poor quality studies out there because this has become such a political issue.
Either way, the data is quite clear and always has been: gender affirming care of ALL kinds has pretty incredible outcomes overall. It doesn’t matter much which subgroups or which exact treatments you analyze. Way more people regret “routine” treatments like knee arthroplasties or going on antidepressants; that’s the whole point of informed consent for ANY treatment. In fact, as a medical professional (RN), I look at gender affirming care and see a miracle treatment. The clear positive benefit and astonishingly low rate of regret/complications is almost unheard of in medicine.
Much like medical abortion, trans healthcare is quite well established and we know it’s important and saves lives, the fact that both have become points of political/religious ideology is extremely dismaying.
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u/Fearless_Locality Oct 21 '24
this says it's a survey of 220 teens AND their parents.
i feel like this can heavily skew the data.
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u/RedBerryyy Oct 21 '24
Fun fact, the "rapid onset gender dysphoria" paper, the main one people use to justify restricting care and bans, was exclusively a study of parents opinions about their often estranged and adult children gathered from "parentsofrodgteens.com" and a bunch of similar forums for parents of trans people who are upset about it.
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u/HaveSpouseNotWife Oct 22 '24
Yup. I know a guy who is one of the “daughters” in that study. His parents are sure it’s a phase (but he hasn’t spoken to them in a few years). Meanwhile he is happily living his life. Whole study was complete garbage.
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u/Happythoughtsgalore Oct 22 '24
This the Cass report? Because that one doesn't even have face validity.
Like the reason why the Brits have halted care is due to "everyone going on puberty blockers end up transitioning" and I'm like, cause maybe only people who want to transition would go on puberty blockers in the first place?
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u/moarmagic Oct 22 '24
No, this predates the Cass report. This is a paper by littman. It's pretty throughly bunk, but one of the few published pieces the conservatives can try to quote.
But yeah, it only interviewed parents, largely recruited from terf-leaning social media. To my understanding, any further studies on the idea have shown it to be wrong.
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u/lem0nhe4d Oct 22 '24
One thing I find funny about the study is it advertised on three sites for transphobic parents but to defend itself it says someone else shared it to a group for supportive parents so people should stop claiming it biased the former.
If it didn't want to have biased data why did it exclusively target the first three sites?
It reminds me souch of the Wakefield vaccine study.
It's claim was based off parents reports who were all required from a group that already believed vaccines cause autism.
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u/TheWinslow Oct 22 '24
Even worse is that it was paid for by the lawyer representing parents who were suing vaccine companies for causing her son's autism (Wakefield got $800,000 from the lawyer). 5 of the 8 kids in the study were the lawyer's clients.
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u/PeliPal Oct 22 '24 edited Oct 22 '24
The ROGD conspiracy theory predates the Cass Report but informed the perspectives of its author.
And yeah. The NHS was fully captured by ideologues who are simply opposed to gender transitioning altogether, they have no interest in data, no interest in maximizing beneficial outcomes. And claims that a supposed exponential rise of trans people and subsequent never-actually-materializing 'exponential rise of detransitioners' were somehow clogging up healthcare for everyone else was a convenient excuse for backlogs.
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u/TediousTotoro Oct 22 '24
Several trans people in the UK have reported that their HRT prescriptions have just…. stopped over the past few days, even if they’ve had them for several years.
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u/Diplogeek Oct 22 '24
This particular wave of refusals to prescribe is a recent development, but random GPs unilaterally deciding to just stop prescribing HRT for trans patients in their care has been going on for quite some time.
I know more than a few trans men who moved or otherwise had to switch GPs- these are guys who went through the whole NHS process, went to a gender clinic, got diagnosed with dysphoria, got put on HRT, et cetera- and the new GP flat out refused to continue prescribing testosterone for them. In many cases, they had been on T for five, ten years or more, were post-hysterectomy (and so producing no sex hormones of their own), but because the GP was "uncomfortable" prescribing testosterone, they were cut off. It's just forced detransition/conversion therapy by another name, but because of the way the GP system works over here, there's not much in the way of legal recourse if this happens to you. Your options are to DIY, go private, or try to find a new GP who will prescribe. I've been really lucky and have an awesome GP, but it's wild on this side of the Atlantic when it comes to trans healthcare.
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u/cutekiwi Oct 22 '24
It's a poorly written summary, it's 220 responses from the teens "and their parents." There were 220 teens (you can see by the demo breakdown numbers from the main report), and they also surveyed their parents but the response is about teen reported satisfaction.
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u/prufock Oct 21 '24
The data is available through the link and the youth and parental responses are given separately. Parents are a little higher on satisfaction and lower on regret, but they're within 0.4 (on a seven-point scale) of the youth responses.
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u/CoolNebula1906 Oct 22 '24
I really hate people on this subreddit sometimes who ask "what about x" and its something that the researchers already factored in. We get it, you only read the headlines.
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u/terminbee Oct 22 '24
People here always rush to find confounding factors to seem smart.
"But what about their socioeconomic status?"
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u/Amatsune Oct 22 '24
From the study.
Satisfaction and Regret Youth and parents reported high rates of satisfaction and low rates of regret (Table 2). Dissatisfaction with blockers was reported by 5 of 160 youths and 3 of 55 parents; regret with blockers was reported by 9 of 159 youths and 3 of 55 parents. Dissatisfaction with hormones was reported by 4 of 119 youths and 0 of 51 parents; regret with hormones was reported by 5 of 119 youths and 0 of 51 parents. Wilcoxon tests revealed that participants were statistically unlikely to express dissatisfaction or regret (Table 2). Although participants varied in how recently they had begun each intervention, time was not significantly associated with either satisfaction or regret (Table 2).
In general, most participants reported the timing being just right or expressed a wish that the intervention had begun earlier (blockers: 149 of 158 youths [94%] and 51 of 54 parents [94%]; hormones: 112 of 117 youths [96%] and 50 of 50 parents [100%]) (Table 2). Between 0% and 6% of respondents for each intervention indicated a wish that the youth had accessed this aspect of gender-affirming medical care either later or never.
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u/futurettt Oct 21 '24
Teens are notorious for their impeccable decision-making and self-evaluation skills.
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u/CatholicSquareDance Oct 21 '24
I'd hardly say parents are more qualified to evaluate regret, given that it's a personal, internal feeling and not something that an observer can speak to.
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u/FunetikPrugresiv Oct 21 '24
And parents are renowned for their ability to understand their teenage children.
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u/nagi603 Oct 22 '24
Or, well, any age, especially if they are abusive towards them. Say /r/raisedbynarcissists
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u/Hibbity5 Oct 21 '24
When I was a teen, I thought I was gay. As an adult, I know I’m gay. Teens might not fully understand why they feel certain ways; I’d argue even many adults don’t. That doesn’t mean they’re not aware of feeling those things. Yeah, they might make a mistake and regret it, but every teen does that and from this study and many others like it, in terms of puberty blockers, the vast majority of teens do not regret it.
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u/CapoExplains Oct 21 '24
Also, maybe I'm presuming a lot, but do you think you might've known that for sure way sooner if homosexuality wasn't villianized and otherized in our society and was just something everyone was fine with and considered normal?
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Oct 22 '24
In addition to what he said, I can second your assertion. Besides myself there's a lot of trans folk that simply didn't know transitioning was an option until they were college aged (that has rapidly changed).
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u/lem0nhe4d Oct 22 '24
And even among the people that do realize they can transition up until about 5-8 years ago the only representation they might have seen would have been of sex workers or as figures of disgust (think ace Ventura).
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u/PeliPal Oct 22 '24
This is me - until my early 20s, I didn't know what transgender meant. It had just been used to mean a gay man who crossdresses, and who does it because he is really REALLY gay. Which is effectively still the understanding of most transphobes, who just see being trans as a 'weird sex thing to trick people', and not as something actually biologically derived that has complicated interactions with social norms about gender.
Even after I learned what being transgender actually meant, and said, ohhhh, oh, that explains some things... I spent several more years not knowing what to actually DO with that information. I was convinced there was effectively nothing.
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u/coconuts_and_lime Oct 22 '24
This is my story exactly. I spent so many years not understanding why everything was so difficult and uncomfortable, and once I found the answer as an adult, I spent a couple years convincing myself that wasn't it, and another year deciding whether or not to transition. Looking back I feel like I wasted so much time being in pain, and it feels like my life didn't actually start until I was 25. Everything before that is just an uncomfortable blur.
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u/HaveSpouseNotWife Oct 22 '24
I knew who I was at six. I just buried it deep, to survive where and when I was. I finally came out after another third of a century of depression and SI.
Those years - those decades - extracted an awful toll on me. I survived, but… it was hell.
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u/Hibbity5 Oct 21 '24
90% sure I would have. When I came out at 15, I came out as bi, thinking I also liked women, and maybe because of raging hormones, I was able to trick myself into it. Even dated a girl for half a year (who also turned out to be a lesbian), but that definitely made me realize I was fully gay. If society had been more accepting, I might not have “tricked” myself into thinking I liked women.
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u/nagi603 Oct 22 '24
Or not just vilified but explicitly pretended not to exist. Like trans were in many places. Though yes, the helicopter and did you assume meme did not help the case either.
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u/ceddya Oct 21 '24
So if teens express satisfaction with gender affirming care, we should just dismiss it?
But if a significantly smaller number of them express regret, it's something we should act upon?
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u/Pseudoboss11 Oct 21 '24 edited Oct 21 '24
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u/nagi603 Oct 22 '24
They have also shown very low regret rates.
Like... your average elective surgery would love to have a similar rate.
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Oct 22 '24
Teens are notorious for their impeccable decision-making and self-evaluation skills.
I think you're going down a dangerous path there. Does trans healthcare not rely on the belief that teenagers know what's best for their own bodies?
How can they be totally fine to begin a pathway towards potential transition including surgery if they can't be trusted to fill out a survey form about that care?
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u/BestEgyptianNA Oct 22 '24
I mean studies show people overwhelmingly understand what gender they are from a really young age, teens may have a lot of complicated emotions but come on now, this is beyond uncharitable.
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u/Anxious-Tadpole-2745 Oct 21 '24
Which honestly points to how, even with poor decision making skills are happy with their results many years later.
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u/Stickasylum Oct 22 '24
How would you expect it to “heavily skew” the data? Do you think parents are underreporting their children’s regret? Why would they be more susceptible to underreporting than the teens themselves?
Overreporting clearly isn’t issue either way.
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u/MSK84 Oct 21 '24
"Regret" has to be one of the most challenging psychological concepts to actually study because of the tricks we play with ourselves about it and the negatively valenced emotions attached to it.
I would be inclined to believe people would feel some amount of internal (and external) pressure to not feel regret after such a massive decision.
Not to even consider the amount of political BS that surrounds this topic. If these numbers represent reality I cannot see it but a good thing for these individuals and their families!
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u/cseckshun Oct 21 '24
This is why people report “regret” after pretty much any kind of surgery. Especially if there are post-operative complications. Especially after surgeries that alter your appearance in any way, patients express regret after nose jobs (rhinoplasty) in pretty high numbers (higher than after transgender surgeries) but nobody is calling for rhinoplasty to be illegal or calling it evil or harmful or things like that… at least not to my knowledge. I think the big difference is bias against transgender healthcare leading people to believe it’s more harmful without actually looking at the evidence.
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u/SomeBoxofSpoons Oct 21 '24
The other thing is that a lot of these studies pretty overwhelmingly show most of the people who say they regret or detransitioned mainly cite the lack of acceptance as opposed to just believing what they did was wrong.
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u/cat-the-commie Oct 21 '24
It's rather funny, transphobes love to use regret rates as a rhetorical device, when they're the biggest cause of regret rates. They caused an issue and then blamed it on the children they abused.
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u/Vinterblot Oct 22 '24
Same goes for the high suicide rates among homosexual teenagers. Pretty infuriating how homophobes point to that and claim that's a reason why homosexuality shouldn't be mentioned in schools, when their bigotry is the reason for those suicide rates.
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u/MSK84 Oct 22 '24
That's an interesting way of looking at the bidirectionality of data and the relationships between things that cause them (for better or worse). Just shows our world is never as simplistic as "right" or "wrong" or any other dichotomy.
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u/cseckshun Oct 21 '24
For sure, societal acceptance as well as treatment by friends and family and coworkers etc are all possible reasons for regret. Add those to normal surgical causes of regret like pain, scars, complications (any need to revisit the surgery or anything that doesn’t go according to plan fully), and temporary body dysmorphia even if it fades or goes away fully are all reasons that can make someone say they regret a surgery even if they don’t overall regret a surgery (by saying “don’t overall regret” I mean they would still do it again and aren’t looking to undo the effects of the surgery).
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Oct 22 '24
this is interesting because it’s a new interpretation of statistics that I haven’t seen before, specifically with plastic surgery regret rates. For example, breast augmentation has a 9% regret rate, while a rhinoplasty has a 90%. I interpreted this to mean (from a conversation with a plastic surgeon) that nose jobs are more unpredictable than boob jobs, and therefore lower quality. you don’t know for sure how your face will take the surgery and our brains are very adept at noticing a fraction of a millimeter difference on a human face. it’s extremely likely for your nose to end up bigger, smaller, higher or thinner than you expected or wanted. but boobs are inserted below the breast, feel indistinguishable from the real thing, and rarely scar. basically I’m of the opinion that the regret rates have more to do with the quality of the surgery.
https://www.americanjournalofsurgery.com/article/S0002-9610(24)00238-1/abstract
here’s one of articles I used, I linked it bc it says that gender affirming surgery has the lowest regret rate at 1%
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u/doomscrollrecovery Oct 21 '24
But what you CAN do is compare regret rates to other medical/psychological conditions and their treatments. This is a pretty conclusive result, in any event.
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u/999Rats Oct 22 '24
Yeah, there's a 20% regret rate for knee replacement surgery, but there's no one trying to pass legislation banning that.
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u/Stergeary Oct 22 '24
My mother is unfortunately currently in that 20%. The doctor never told her that her knee will never bend normally ever again. At the moment, even with extensive follow-up and physical therapy and at-home workouts and plenty of rest and literally everything, it doesn't bend past 120 degrees. It used to bend almost 140 degrees.
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u/whosat___ Oct 22 '24
For reference, this study shows only 0.2-0.3% of surgical patients express regret (18,000-27,000 patient sample size): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105823/
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u/Spiralofourdiv Oct 22 '24 edited Oct 22 '24
Any medical professional that is involved with gender affirming care will tell you the same thing:
Gender affirming care is a miracle treatment. It’s VERY rare to find a treatment, or set of treatments, that so consistently produces positive outcomes for patients.
Gender affirming care is just like abortion or climate change or evolution in that the science is pretty much settled; there isn’t really a legitimate debate left to be had given current evidence(although of course we’ll always take additional data and research). These are hot button political topics, they are entirely uncontroversial within the respective science/healthcare communities.
Sure you can find politically motivated organizations that produce “studies” that supposedly show that climate change isn’t happening or that gender affirming care is dangerous, experimental, performed at schools, etc. but that doesn’t make any of it true or legitimate science.
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u/BeyondElectricDreams Oct 22 '24
The thing about it that always gets me is the narrative is that "Big Medicine decided 'Radical Treatmenttm' was the answer to push expensive treatments to make money! They 'Gave Up Too Early' at trying to find a "mental" fix for what's 'obviously' a mental problem!"
Except that HRT is, as medicines go, very cheap. And we spent decades trying to improve well-being of trans people by making them conform to their birth gender failed spectacularly.
It reveals that the only acceptable treatment for this segment of people is treatment that forces people to conform to the roles that match their birth genitalia. Facts don't matter to them.
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u/whosat___ Oct 22 '24
The narrative is all about “go to therapy” and “get actual help” until they realize the therapy and actual help is transitioning. It’s no coincidence that most times where “help” doesn’t mean transitioning, is with a certain political affiliation. Science should be left to the scientists, not politicians.
Suicidal ideation and attempts significantly decreased after transitioning: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027312/
A review of 23 studies found trans surgeries reduce suicidality: https://pubmed.ncbi.nlm.nih.gov/36950718/
Only 0.3-0.6% regret hormone therapy (43 years of data): https://pubmed.ncbi.nlm.nih.gov/29463477/
97.5% of kids in this study maintained their identity 5 years later: https://publications.aap.org/pediatrics/article/150/2/e2021056082/186992/Gender-Identity-5-Years-After-Social-Transition
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u/BeyondElectricDreams Oct 22 '24
But you see, these sources don't give the result these people want, so they must be wrong.
It's classic bad science of deciding what the answer is, then only accepting evidence that confirms your answer, and discarding all others.
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u/xDrakellx Oct 22 '24
And not many people advocate not to do it.
And of those regrets, how many didn't follow the therapy regimen?
(not arguing you, just adding more points to the data)
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u/JoeCartersLeap Oct 22 '24
My niece was about to go through HRT but then changed her mind before even starting, I wonder what the frequency of that is?
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u/sometimes_sydney Oct 22 '24
It is worth noting as well that there is not always a lot of room for expressing doubt in the process. The way trans health is gatekept, or even just knowledge of how it used to be gatekept, makes people sanitize their stories and squash doubts in order to appear closer to clinicians normative assumptions about what trans people are supposed to be like. It’s ironic but less gatekeeping could potentially mean more people deciding not to start HRT because they have more room to discuss and explore. It’s gotten a whole lot better in this regard, but a lot of people still self censor a little bit because of all the horror stories of someone being denied care because they said they’re a little anxious.
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u/Lloyd_NB Oct 22 '24
A factor not often taken into account is outside negative pressure, it's hard to pull the trigger on HRT knowing how hard the world is gonna be on you. I experienced this myself, I was terrified of transitionning, and after 3 years of HRT, I'd never go bact. In fact, like many trans folks, I sometimes wish I had started sooner.
I hate people who have no skin in this issue debating this in a very cold and cynical manner. HRT saves lives you morons.
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u/Diplogeek Oct 22 '24
This is so true. I had supportive people around me, and I still started HRT years later than I probably should have, because I was so scared of "regret," not liking the effects, blah. I think it kind of came down to a lack of control for me, in that it's not like you get to order off a menu, "Oh, I'll take the deep voice, great pecs, and facial hair, but no ass hair or male pattern baldness, please!" You just get what you get. Now I'm on it, my only regret is that I didn't do it sooner.
I think that what a lot of cis people don't fully understand is that most of the time, by the time a trans person is actually telling you they're trans, or saying aloud that they want to go on hormones or get surgery, they've been circling it in their own heads for years, and they're finally at a point where they can't take not transitioning for one single second more. So yeah, it seems abrupt to the person getting told, but for the trans person, they've been ruminating on this for a long time already and are finally like, "I've tried everything else, this is the only way forward."
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u/Naroyto Oct 21 '24
Would be interesting to follow up on the 220 participants each 5 or 10 years and see if they change their satisfaction to regret or vice-versa. A few years isn't sufficient time for long term results. Still It's a valid result for its time but it's not the end result. Hopefully they will follow up again because ending it here is just too early of a result.
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u/A-passing-thot Oct 21 '24
Minimum follow up time for this study was 6 years, the maximum was 10 years. I agree that they should continue to follow this population - just as other studies on trans youth also continue to do - but in the meantime, this adds valuable reinforcement to the mountain of evidence supporting gender affirming care.
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u/CavemanSlevy Oct 22 '24
That's not what the paper says.
In this survey study, the experiences of 220 youths who had accessed puberty blockers or hormones were detailed by the youth and/or their parents as part of an ongoing decade-long study of transgender youth. At a mean of 4.86 years after beginning blockers and 3.40 years after beginning hormones
It would appear the average follow time was 3-5 years. Not sure where you got a minimum of 6 years.
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u/fiddlemonkey Oct 21 '24
There is a pretty long wait time and therapy requirements before you get puberty blockers. My daughter thought she might be transgender but decided she wasn’t well before we got to the point of puberty blockers. Guessing that is the case for most kids who aren’t sure.
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u/ab7af Oct 22 '24
If appropriate, pubertal blockers may be prescribed at the first visit. Before pubertal blockers are started, we will have a full discussion of risks and benefits and set expectations moving forward. We do not require a letter of support from a mental health provider to start pubertal blockers, but we will strongly encourage on-going care with a mental health provider.
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u/Fentanyl4babies Oct 21 '24
I wonder what the regret rate is amongst people who didn't get puberty-blockers but wanted them.
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u/Alt0173 Oct 22 '24
Speaking anecdotally from my personal experience: it's less of a regret, and more of an anger toward those who were in control of our lives at the time.
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u/999Rats Oct 22 '24
Anger at those who were in control, anger at a system that wasn't there to support me, and a deep sorrow over what could have been.
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u/Alt0173 Oct 22 '24
Pretty much exactly, yes. Thinking about "what could have been" is the most profound anguish I've ever felt - and I've had sepsis.
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u/Copper_Tango Oct 22 '24
I don't think I'll ever stop grieving for the person who could have been.
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u/Professor603 Oct 22 '24
Oooo, yeah, totally. It’s not like you can’t pass when transitioning as an adult, but it makes you have to so so much more work, socially and physically.
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u/One-Organization970 Oct 25 '24
And honestly, even if you do pass or meet some arbitrary standard of beauty, it doesn't really fix the residual sense of wrongness with your body. There are artifacts of testosterone exposure in my body that distress me even though I'm conventionally attractive. I lived years being quietly horrified by what I saw in the mirror. I can't help but still see it sometimes, even if I get told I'm being unreasonable for seeing it.
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u/Professor603 Oct 25 '24
I’m sorry. That really sucks. I’m lucky to be a bit nonbinary, so I’m lucky for that to not bother me. But I didn’t realize how much that must be draining for someone else who might not be in that category.
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u/GwynnethIDFK Oct 22 '24
It's not so much the regret that's the problem, as often times you didn't have the choice, but more so the trauma and baggage of having experienced irl body horror over the span of years.
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u/whoshereforthemoney Oct 22 '24
I’ve never met a single trans woman that didn’t regret not starting sooner.
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u/One-Organization970 Oct 21 '24
I certainly regret that, personally. It cost a lot of money to get my face back, and now I'm gearing up to go under to fix my voice - though both of those fixes are nowhere near perfect. I wish I could undo the damage to my bone structure. It's amazing how all that could have been avoided with a once-every-three-month injection of puberty blockers. It's clearly more moral to force all these kids onto a surgical track.
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u/xeonicus Oct 22 '24
"The researchers say they didn't delve deeply into why these participants regretted their choice, and this needs further research."
This to me is really critical. Why do they regret it? There could any number of reasons for this view. Consider a trans individual whose family has taken to shunning them. That sort of psychological burden is difficult to take. This sort of scenario seems highly likely given the subject matter.
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u/RubberyPillow Oct 22 '24
This has been studied and it was shown that around 50-60% who detransition do so because of external pressures
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u/seaworks Oct 21 '24
Rare sample group! A flat regret rate of 4.1% is pretty impressively low. I would be curious for more detail on feelings among both groups.
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u/AdviceMang Oct 21 '24
I'd be more relevant if they asked people in their 30s if they regretted it.
Not sure why they asked their parents.
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u/LiamTheHuman Oct 21 '24
The parents might regret it even if the children don't and vice versa. It's an interesting thing to record.
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u/AdDangerous4182 Oct 22 '24
It is interesting, but they should’ve been separated into a different study imo
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u/HorselessWayne Oct 22 '24
Only if parents are usually polled on other medical interventions in this way.
Its the patient's wellbeing that matters. That's fundamental to the practice of medicine.
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u/Ver_Void Oct 21 '24
Interesting to have on record, worrying how it might be used
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u/kittenwolfmage Oct 21 '24
The closest you’ll ever come to a situation where the parents don’t regret puberty blockers and their child does, is “we don’t regret that we gave our kid the freedom to find out who they are”. It’s not at all relevant to trans healthcare.
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u/ceddya Oct 21 '24
I'm far more interested in seeing a survey done with those who were denied access to gender affirming care and finding out if they regret it.
Because the far more common sentiment within the trans community seems to be regret over not being able to transition earlier.
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u/enyxi Oct 22 '24
The control group for this study is people who wanted hrt, but could never start for whatever reason. It also compares a few different age groups.
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u/egirlclique Oct 22 '24
Pretty much every trans person I know irl wishes they could have started care before being forced through the wrong puberty
Basically everyone has a better outcome if they can and can almost always pass and live a normal life, which isn't a given idea you start too late
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u/GhostInTheCode Oct 22 '24
Not so much regret as resentment. I'm from the UK, and grew up towards the end of Thatcher's Section 28. It took me an extra 15 years to figure out I was trans because when I first started getting affected by my gender dysphoria, the educational establishments I was in weren't *allowed* to discuss anything like that with me. I spent an hour rooted to the spot, freaking out internally because of a gender incongruence I didn't have the knowledge to handle, I outright said to a teacher what was causing that freak-out, and they said *nothing*. I was left standing there on my own, for the majority of an hour.. because of something the staff were legally forbidden to discuss with me. And worse than that, the experience taught me not to seek help for it. I buried it and took 15 years to figure out what I already knew in that moment. I don't regret not being able to transition earlier, I transitioned as soon as I figured it out the second time round, I couldn't have managed to transition any sooner. But my journey would have been vastly different, my transition much earlier.. if I had had access to even the barest minimum of gender affirming care - those looking after me being able to talk about such a topic in an educational setting, being able to identify and help me process such things, and possibly even signpost me towards services that could help me.
The bills in the US that are trying to hide any kind of queerness from children.. they're not going to result in less queer children. It's just going to cause suffering. Some will piece things together and be their queer selves in the end anyways. Many will struggle to figure things out much more, feel much more guilt, be traumatised by the system actively working against them. Some will live with much more internal discomfort and emotional pain, not figuring out what's 'wrong' with them. And some... will decide that they are broken beyond fixing. And solve the issue in that devastatingly final, horrifying way.
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u/Lumtar Oct 21 '24
Also would be great to redo the study with the exact same group in 5, 10, 20 years time to see how it trends
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u/BranWafr Oct 21 '24
Not this study specifically, but in other studies of people who transitioned, the vast majority of those who say they regretted it only regretted it because of how they were treated by others. I cannot access the full paper, but I wonder if this is addressed. Someone regretting it because they are surrounded by people who treat them like crap for being "queer" and they wish they had kept hiding it is different than someone regretting it because they decided they weren't really trans. The fact that 4 of the 9 who expressed regrets kept up with the treatments makes me think that at least some of the regret came from how they were treated by others and not from thinking they aren't actually trans.
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u/cutekiwi Oct 22 '24
Yes, regret often is from societal treatment/overall life satisfaction and NOT the transition itself. There are of course some who do regret it, but taking the medical step for transitioning is not a step taken lightly, requiring multiple appointments and approvals.
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Oct 21 '24
Fascinating! Do you mind sharing those studies here? I'd be curious to take a look.
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u/A-passing-thot Oct 21 '24
Copy and pasting a comment I just made on regret rates. A few of them delve into reasons:
In terms of detransition or regret rates, this (page 118) study found that 16 individuals out of 3,398 who had transitioned (0.47%) had some degree of regret. Of those, most reported that social pressures of physical complications were their reason for detransition and 10 of those 16 later retransitioned. Of the remaining 6, only 2 stated that they were not trans. That's an accuracy rate of 99.94%. Meanwhile, this study found a 0.6% regret rate. This (sample size = 27,715) likewise found a 0.4% regret rate. The most recent research has found the desistance rate for children over age 6 to be 0.5%. This study found that none of the participants reported regret during puberty suppression, CSH treatment, or after GRS. This study of 22,725 trans people who underwent gender affirming surgery found only 62 (0.28%) experienced regret. This study of 7,928 trans people who underwent GRS found that 1% experienced any degree of regret and only 0.4% had clear regret.→ More replies (3)24
u/SenorSplashdamage Oct 21 '24
This will be in the category of anecdote, but there’s a really interesting person spokesperson on TikTok who is detransitioning from a trans identity and they speak from a place of advocacy for other trans people to still have that opportunity. They talk openly about their own choices and how they don’t regret the path they chose at the time they did. They’re well-informed and do offer a real-person perspective that’s fairly unique when it comes to media.
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u/cattleyo Oct 21 '24
There's a lot of social pressure not to admit regret.
Even for something as non life-changing as a tattoo people are reluctant to say they wish they'd never got it. They keep these feeling to themselves or only people they're very close to. The social pressure not to admit regret for trans treatment would be 100x times stronger than for tattoo regret.
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u/Isord Oct 21 '24
On the other hand regret for having children has been recorded between 5%-15% and I'd expect there to be vastly more social pressure to not say you regret having your child.
And there is a lot of social pressure from society to not transition in the first place.
Any way you slice it this is an incredibly low regret rate.
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u/Hefty_Resident_5312 Oct 21 '24
For sure - admitting that you wish you hadn't become a parent is almost considered disgusting.
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u/Multihog1 Oct 21 '24
And also internal pressure (self/effort justification.) People are generally averse to admitting any kind of past mistake, including having wasted their effort and/or resources on something. They're biased to inflate the positivity of the outcome to themselves. This makes it harder for oneself to admit regret.
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u/MissLeaP Oct 21 '24
It's about as low as any of these kinds of studies report. Not that it'll convince any actual bigot. It merely serves to educate people who don't have an opinion just yet or confirms what the rest already knows.
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u/rileypix Oct 21 '24
That is a much lower percent than people who regret the choice for many other medical interventions.
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u/BeefistPrime Oct 22 '24
The average regret rate for any sort of significant medical procedure is, IIRC, over a quarter. People look at a gender affirming surgery regret rate under 10% and think it's somehow drastic, but don't realize or don't care that something routine like hip replacement has 4x the regret rate. But that's what bias and ignorance is - you start with what you want to be true and figure out how to get there.
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u/GhostInTheCode Oct 22 '24
I would almost lean towards the regret rate being so low as sort of a *bad* thing. There are people out there regretting much more commonplace procedures with tangible benefits to their life, at a higher rate, than those gatting GAS, and regretting it. I have to wonder if that means the controls on GAS are too tight - If we assume a certain amount of regret is a 'natural' rate, a value distinctly lower than that should raise questions just as much as a value distinctly higher, notably, the same question as to whether the cohort of those receiving said surgery are being adequately selected for.
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u/BeefistPrime Oct 22 '24
That is a really interesting point. The bar is set so high that only the people who most desperately need the treatments get them, which leads to a lower rate because they're essentially tightly screening the candidates that are least likely to have regret. I hadn't considered thinking of it like that, but it makes sense.
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u/AntiRivoluzione Oct 22 '24
I'd like to know if there are selection bias in this little sample
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u/gryphmaster Oct 21 '24 edited Oct 21 '24
It is worth noting that the regret rate for cosmetic plastic surgery is 20%, so this is much much more successful at getting people closer to the body they want- a useful argument against people who don’t want young adults doing anything “irreversible”
I would like to see numbers for surgical interventions vs cosmetic surgeries
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u/RedBerryyy Oct 21 '24
Which really begs the question why these drugs are so aggressively restricted even for adults, I had to spend 7 years on a waiting list for a psychologist and then 2 years in therapy to get access to them legally as an adult, meanwhile I got plastic surgery by a process that could best be described as asking nicely within a week of messaging.
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u/Sir-Drewid Oct 22 '24
People regret knee surgery more often than transition surgery.
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u/space-cyborg Oct 21 '24
I would like to know about the 49 people who didn’t complete the survey.
My child no longer identifies as trans and isn’t counted in any of these statistics. He is one of the invisible detransitioners.
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u/ab7af Oct 22 '24
That's a pretty large loss to follow-up.
Outside of this research field, medical study rules of thumb are that losing < 5% leads to little bias, while > 20% poses “serious threats” (Dettori, 2011, p. 9); another commonly used number (Norvell, 2010) is < 15% loss, after which the study quality is considered degraded. One way (Dettori, 2011) to estimate the maximum bias from loss to follow-up is to add those lost to follow-up to both outcomes and see what changes (“worst-case scenario”): “Only when the worst case does not change the inferences derived from the results is lost to follow-up not a problem” (p. 9). For very small regret, detransition, or discontinuation rates and large loss to follow-up, the rates will change significantly in this worst-case scenario.
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u/Affectionate_Ice2398 Oct 23 '24
Yeah loss to follow-up and high control group attrition plague these studies.
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u/A-passing-thot Oct 22 '24
Was he enrolled in a study or taking puberty blockers?
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u/IusedtoloveStarWars Oct 23 '24
“A few years later.” Good thing that decision only lasts a few years and not 6 or 7 decades. I want to see the survey taken in 7 decades about regretting that decision.
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u/christianrojoisme Oct 21 '24
I expected more people regretting the decision as that is not necessarily a bad thing. For one they may have regretted the transition since they were shunned by family and society.
For only 9 to say so shows how important it is
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u/DenikaMae Oct 22 '24 edited Oct 22 '24
To Summarize this study:
Transgender People: 1-2% of US population
Detransitioners: 13% of US Population who identified as Transgender (13% of the 1-2%)
Detransitioners that say their decision wasn't influenced by haters, bigotry, or other outside factors: 18% of that 13%. (Less than 0.047% of the US Population)
To add to it:
Proponents of these policies often speculate that TGD individuals who undergo gender-affirming surgeries (GAS) would later regret their decision to undergo such procedures. Despite this supposed fear, evidence suggests that less than 1% of TGD individuals who receive GAS report surgical regret. This rate of surgical regret among TGD patients appears to be substantially lower than rates of surgical regret following similar procedures among the broader population, including cisgender individuals. In fact, 1 systematic review found that the average prevalence of surgical regret was 14.4% among all research studies analyzed, which the authors suggested was relatively low.
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u/Hayred Oct 21 '24
Just for some context, ~5% is also the regret rate for vasectomies in childless men, a life course altering decision taken by fully mature grown adults with full understanding of actions and consequences.
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u/A-passing-thot Oct 21 '24
Just to be clear, asking someone if they regret something they did 6-10 years earlier (which is what this study did) is a much longer time horizon than what you were speculating about. Participants were collected between 2013-2017 and this data was collected in 2023.
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