Largest “Transition Regret” Study Ever Finds It’s Incredibly Rare Up To 10 Years Later

The study contradicted some of the most prolific myths about transgender youth care.

Photo by yasmin peyman on Unsplash

An investigation published in JAMA Pediatrics marks the largest study ever examining regret rates among transgender people who transitioned as minors. What researchers found may not surprise you:

Transgender people vastly don’t regret transitioning as minors.

Published Monday, “Satisfaction, Regret, and Harm After Hormone Therapy in Youth From a Multidisciplinary Gender Clinic” sought to examine these factors among transgender and gender-diverse participants who started hormone therapy as youth. It also tracked whether demographic or clinical factors influenced outcomes.

They found that participants who received care at a single multidisciplinary clinic rarely regretted hormone replacement therapy, referenced in the study as HT or HRT. Rates of regret were only about 3%.

“Neither regret nor harm nor current HT status was associated with age at HT initiation or prepubertal gender diversity,” the study found.

Regret was also slightly higher in nonbinary patients, as opposed to binary trans men and trans women, although still low overall.

This has significant meaning for policymakers when it comes to gender-affirming care, researchers wrote. “Results provide support for existing standards of care rather than broad restrictions on youths’ access” to hormone therapy.

The exact breakdown of the study’s statistical findings and methods can be seen here:

An excerpt from JAMA Pediatrics.

Of the 372 participants, nearly all said that HRT was “the right decision”; only nine disagreed. Just three people said they had not been able to make an informed choice; four cited adverse side effects (vaginal atrophy, changes in emotional state); and six said they simply no longer desired the secondary sex characteristics that HRT induced, such as breast growth or facial hair.

Respondents had been taking HRT anywhere from one month to over 10 years; the average in the study was around 5 years on HRT. In other words, anti-trans activists often push the idea that people who transition young regret it later in life, but those in this study reported high satisfaction rates for years to come.

This is notable given GOP talking points that weaponize “ex-trans” narratives that stoke fervor against trans youth and their providers. Conservative lawmakers and activists have heralded a fictitious “wave” of transition regret. But that never materialized. They’ve also pearl-clutched about doctors reportedly rushing or pressuring youth into transition. The anti-trans movement has crafted a careful narrative to argue that patients and parents have been “kept in the dark” about their own care en masse, and that gender care is a surreptitious plot to trans children for financial gain.

In reality, accessing transition care—especially as a minor—is fraught with barriers, be they legal, financial, or interpersonal (such as a young person without a supportive family).

Studies like this strengthen the academic consensus that wholesale “detransition”—where a person who medically transitions stops identifying as trans and regrets receiving gender-affirming care—is rare. For those who do stop taking hormones or regret gender-affirming care, studies find the reasons cited are more likely to be financial, such as a lack of insurance; legal, with patients losing their care when states restricted it; or, most of all, a response to transphobia and violence upon coming out.

Still, the federal government has already successfully used legal threats to compel Texas Children’s Hospital to open a “detransition clinic.”

Researchers note that the existing literature overwhelmingly supports the benefits of allowing trans and gender diverse youth to access transition care. “However, concerns about potential regret and harm have intensified, leading to widespread efforts to prevent minors from accessing HT despite standards of care continuing to support its use,” they note. “Given recent increases in external barriers to accessing HT, rates of stopping treatment are likely increasing.”

The study was approved by the institutional review board at the University of Texas Southwestern Medical Center and peer-reviewed for publication in JAMA Pediatrics—indicators of scientific quality, an important hallmark as the anti-trans academic movement spends no small sum manufacturing academic literature to support it, often without these hallmarks of rigor.

Scott Leibowitz, a child and adolescent psychiatrist who serves on the board of the World Professional Association for Transgender Health (WPATH), told The Washington Post that this study “adds to the growing evidence base that demonstrates individualized gender-affirming care can be beneficial for a young person.”