[foodlock]

> and having spent some time seeing their perspective they felt that transition would better resolve some internal tension

Thing is though, that during puberty there is a huge amount of internal tension as one's body goes through significant developmental changes. Especially for girls as they start to be sexualised by men. The idea that transition can be used to escape this makes for a tempting second option, and if there are peers who also think that way, it can be very encouraging.

We know that the number of detransitioners is on the rise, and their stories are very often along those lines. They became obsessively drawn to the idea of transitioning, often through social media and peers, and later, when they had the insights of adulthood and the obsession had faded, regretted what they'd done.

The problem is that transition isn't actually a change to the opposite sex, it just creates a poor facsimile at best, and the medical pathway of blocking puberty and taking cross-sex hormones causes irreversible harms to one's body. Loss of sexual function is a big problem. And of course, teenage girls who undergo mastectomy to affirm their idea that they should be boys, can't get those body parts back.

[chownie]

> We know that the number of detransitioners is on the rise, and their stories are very often along those lines

For some extra context on this comment "on the rise" still constitutes an absolute minority of those who transition, I believe somewhere between 5% and 8% -- and the most common reason given for detransition is due to lack of support, coercion or pressure from family and friends rather than transition regret.

"Of those who had detransitioned, 82.5% reported at least one external driving factor. Frequently endorsed external factors included pressure from family and societal stigma."

Turban JL, Loo SS, Almazan AN, Keuroghlian AS. Factors Leading to "Detransition" Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT Health

doi: 10.1089/lgbt.2020.0437

This article is useful because it explicitly mentions people often misconstrue detransition for regret, when that as a cause for detransition is considered uncommon compared to external pressure.

[foodlock]

The reasons given for detransition vary by survey. In these two papers, lack of support was a minor reason amongst those surveyed:

Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality, 69(9), 1602–1620. https://doi.org/10.1080/00918369.2021.1919479

> The most common reported reason for detransitioning was realized that my gender dysphoria was related to other issues (70%). The second one was health concerns (62%), followed by transition did not help my dysphoria (50%), found alternatives to deal with my dysphoria (45%), unhappy with the social changes (44%), and change in political views (43%). At the very bottom of the list are: lack of support from social surroundings (13%), financial concerns (12%) and discrimination (10%).

Littman L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of sexual behavior, 50(8), 3353–3369. https://doi.org/10.1007/s10508-021-02163-w

> The most frequently endorsed reason for detransitioning was that the respondent’s personal definition of male and female changed and they became comfortable identifying with their natal sex (60.0%). Other commonly endorsed reasons were concerns about potential medical complications (49.0%); transition did not improve their mental health (42.0%); dissatisfaction with the physical results of transition (40.0%); and discovering that something specific like trauma or a mental health condition caused their gender dysphoria (38.0%). External pressures to detransition such as experiencing discrimination (23.0%) or worrying about paying for treatments (17.0%) were less common.

One major problem in fully understanding this phenomenon is that there is currently inadequate follow-up by gender clinics to collect data on detransitioners.

As the Cass Review notes:

> 15.50 Estimates of the percentage of individuals who embark on a medical pathway and subsequently have regrets or detransition are hard to determine from GDC clinic data alone.

> There are several reasons for this:

> - those who do detransition may not choose to return to the gender clinic and are hence lost to follow-up

> - the Review has heard from a number of clinicians working in adult gender services that the time to detransition ranges from 5-10 years, so follow-up intervals on studies on medical treatment are too short to capture this

> - the inflection point for the increase in presentations to gender services for children and young people was 2014, so even studies with longer follow-up intervals will not capture the outcomes of this more recent cohort.

The Review also noted the problem of clinics not adequately sharing the data they do have:

> 15.55 An audit was undertaken at The Tavistock and Portman GDC on the characteristics of individuals who had detransitioned. Most papers on detransition are based on community samples, and questionnaire reports, but this was a case series of 40 patients who had all been examined by a psychiatrist.

> 15.56 Findings from the audit were discussed with the Review. The time for people to choose to detransition was 5-10 years (average 7 years). Common presenting features and risk factors such as high levels of adverse childhood experiences, alexithymia (inability to recognise and express their emotions) and problems with interoception (making sense of what is going on in their bodies) were identified in the audit, and this audit would be informative for clinicians assessing young people with a view to starting masculinising/feminising hormones. The Review asked to have access to this audit in order to understand some of the qualitative findings, but the trust did not agree to this.

[chownie]

There is a gulf between the quality of the sources we're looking at here and I want to highlight it so it's not hidden behind links.

My supplied source in the GP comment is an n=27,715 cross sectional survey supplied to any adult who has transitioned in the past, it's not detransition specific and it's sort of like a trans census taken yearly.

Your first source is an n=237 online survey on a detransition specific website which did make any effort to verify if any of the poll answerers were trans at any point.

Your second source is an n=100 anonymous poll posted on social media. This could well have been a strawpoll on twitter.

[foodlock]

The main discrepancy is that these have different survey populations.

Turban's study is based on an survey (which was also conducted online) of people who, for the most part, currently identify as trans, of which some had temporarily detransitioned in the past. Whereas Littman's and Vandenbussche's studies only surveyed detransitioners who no longer identify as trans.

What these suggest in aggregate is that these populations generally have quite different reasons for detransitioning.

[chownie]

The study I linked has 2200 detransitioners, an order of magnitude above the ~240 or the 100 you've referenced.

What the studies kind of suggest more is that if you pull your sample from somewhere like a detransition website you're likely to get a biased result which doesn't map to the sentiment of the larger population.

[foodlock]

No, the study you linked had ~2200 respondents who had temporarily detransitioned but later went back to identifying as trans.

[TaylorAlexander]

The Cass review is an unscientific hatchet job and should not be relied upon for any analysis.

[foodlock]

It's a carefully considered, in-depth and thorough evidence-based review of clinical policy from an independent expert group, led by an eminent paediatrician with decades of experience.

I'm baffled as to why you've decided it's an "unscientific hatchet job". Would you like to explain your reasoning?

[chownie]

Because they set an unrealistic bar by excluding all research which wasn't double blind, in the knowledge that there's barely any research you can perform on trans youth with that criteria that an ethics board will allow and there's barely any research anyone would attempt — because your blind is immediately nullified by the obvious continuing signs of puberty, or the obvious continuing signs of body produced hormones.

By doing this they have excluded the vast majority of the extant research, leaving what's essentially the most biased remaining sample.

Now add in the government of the UK's current attack angle on trans people, and Cass herself exclusively operating with anti-trans groups on social media.

[foodlock]

No, they did not do that. This is disinformation. As Cass herself says in this BBC News article:

https://www.bbc.co.uk/news/health-68863594

> Dr Cass was asked about particular claims spread online about her review - one that "98% of the evidence" was ignored or dismissed by her, and one that she would only include gold-standard "double-blind randomised control" trials in the review.

> She said the 98% claim was "completely incorrect".

> A total of 103 scientific papers were analysed by her review, with 2% considered high quality, and 98% not.

> "There were quite a number of studies that were considered to be moderate quality, and those were all included in the analysis," she said.

> "So nearly 60% of the studies were actually included in what's called the synthesis."

> And on the "double-blind" claim - where patients are randomly assigned to a treatment or placebo group, getting either medicine or nothing - she said "obviously" young people could not be blinded as to whether or not they were on puberty blockers or hormones because "it rapidly becomes obvious to them".

> "But that of itself is not an issue because there are many other areas where that would apply," she said.

> "If you were doing a trial, say, of acupuncture, people would know exactly what treatment that they were getting."

You can of course confirm this yourself by reading the report and the systematic reviews commissioned to inform it, rather than listening to social media bullshitters.

Also, Cass has talked to a variety of different groups with different views. For example, this is a Q&A she did with The Kite Trust, an LGBTQ+ charity: https://thekitetrust.org.uk/wp-content/uploads/2024/04/Cass-...

Please try harder not to spread such easily disprovable falsehoods.