Vast majority of people with gender dysphoria continue using gender-affirming hormone treatment

Vast majority of people with gender dysphoria continue using gender-affirming hormone treatment

Amongst people handled at a gender identification clinic in The Netherlands, those that used puberty supressing therapy earlier than the age of 18 after which began gender-affirming hormones, 98% (704 out of 720) continued use at follow-up, in accordance with an observational examine revealed in The Lancet Youngster & Adolescent Well being journal.

Our examine checked out people handled at a gender identification clinic in The Netherlands, which has provided puberty suppression therapy adopted by gender-affirming hormones to transgender individuals for over 20 years, to grasp how many individuals continued to make use of hormone remedy. We discovered that the overwhelming majority of individuals continued utilizing gender-affirming hormones, which is reassuring within the context of current elevated public concern concerning remorse of transitioning.”

Marianne van der Loos, MD at Amsterdam UMC, Vrije Universiteit Medical Heart Amsterdam, The Netherlands

In 1998, The Netherlands was the primary nation to introduce a brand new therapy protocol for younger individuals identified with gender dysphoria who’re below the age of 18. After a radical diagnostic analysis, adolescents are provided reversible puberty suppression therapy (utilizing a gonadotropin-releasing hormone agonist). This pauses the bodily adjustments related to puberty that may be nerve-racking for adolescents with gender dysphoria and provides them time to discover their gender identification. Those that proceed to need to transition medically can subsequently start gender-affirming hormone therapy after age 15-16, which implies taking medicines (i.e. oestradiol or testosterone) to induce bodily feminization or masculinisation in a approach that aligns with their gender identification.

Nevertheless, puberty suppression and gender-affirming hormone therapy for individuals below 18 years previous has just lately turn out to be a topic of public debate and in some nations authorized measures have been taken to ban or restrict its use, reminiscent of within the USA and UK. [2,3] Though short-term research have demonstrated the useful results of puberty suppression therapy for adolescents’ psychological and bodily well being, long-term follow-up knowledge are missing.

The examine used medical data from a gender identification clinic in Amsterdam. People have been included in the event that they used puberty supressing therapy earlier than the age of 18 for no less than three months earlier than happening to make use of gender-affirming hormones. To analyze the proportion of those individuals who continued utilizing therapy at follow-up, the examine linked their data to the nationwide prescription registry to find out if people have been nonetheless receiving a prescription for gender-affirming hormones on the finish of knowledge assortment (December 2018). The follow-up intervals diversified by affected person, with the newest sufferers having the shortest follow-up interval. The authors stress that outcomes from sufferers with shorter follow-up intervals ought to be regarded with warning.

Included within the examine have been 720 individuals, of whom 31% (220) individuals have been assigned male at delivery (AMAB) and 69% (500) assigned feminine at delivery (AFAB). For AMAB individuals, the median age was 14 years previous when beginning puberty suppressing therapy and 20 years previous on the finish of follow-up. For AFAB individuals, the median age was 16 when beginning puberty blockers and 19 years previous on the finish of follow-up.

Out of 720 people within the examine, 704 continued utilizing gender-affirming hormones till observe up- amounting to 98% of people persevering with hormone remedy.
Concerning the two% (16 out of 720) of individuals not utilizing gender-affirming hormones, it stays unknown whether or not they stopped utilizing hormones as a result of they regretted transitioning or altering their gender. The authors stress there are a number of believable explanations, together with lack of expertise on the significance of continuous hormone therapy after gonadectomy (surgical elimination of both the testes or the ovaries), or contributors with non-binary gender identification solely wanting to make use of hormone therapy for a brief time frame. The authors advocate that future analysis ought to determine explanation why a small quantity of people that provoke this therapy as adolescents subsequently cease taking gender-affirming hormones.

The examine didn’t determine any components related to the next likelihood of stopping gender-affirming hormone therapy. The people’ age or the 12 months once they first visited the clinic, once they began puberty supressing therapy, once they began gender-affirming hormone therapy, and whether or not they had undergone a gonadectomy weren’t related to discontinuation.

A rise in referrals of AFAB people to this gender identification clinic after 2012 had been documented, so whether or not discontinuation charges have been totally different earlier than this 12 months in comparison with afterward was additionally investigated. The outcomes counsel that there is no such thing as a distinction between continuation charges earlier than 2012 in comparison with afterwards.

The authors notice a number of limitations of their examine. Gender-affirming hormones being prescribed doesn’t essentially imply a person is taking the treatment as prescribed, doubtlessly resulting in an overestimation within the variety of people persevering with use. However, prescriptions won’t have been recorded for anybody acquiring these medicines outdoors the common well being system, doubtlessly underestimating the variety of people persevering with use.


Journal reference:

Catharina van der Loos, M.A.T., et al. (2022) Continuation of gender-affirming hormones in transgender individuals beginning puberty suppression in adolescence: a cohort examine within the Netherlands. The Lancet Youngster & Adolescent Well being.

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