Centre LGBT+: Transition and gender-affirming care is well-documented medical fact

Centre LGBT+ is concerned about an anti-transgender activist visiting our community who espouses a dangerous narrative about trans people and “de-transitioning.”

We would like to present a research-supported look at the experiences of transgender people, their medical care, and why some de-transition.

Gender affirming care — which ranges from social transition that includes calling someone by their correct name and pronouns, to medical treatments including hormone replacement therapies and surgery — is medical fact validated by every major medical association. The American Medical Association, American Academy of Pediatrics and many more recognize gender affirming care as medically necessary, life-saving treatment.

It is important to clarify that transness itself is not an issue that requires “fixing.” Gender affirming care treats “dysphoria” by helping trans people align their bodies with who they truly are. Many trans people prefer to focus on gender “euphoria”— a feeling of joy and correctness that comes with their true gender. Every individual’s transition experience and needs will vary, but transitioning is universally recognized as the appropriate care for transgender people.

Research has consistently found extremely high rates of satisfaction with gender affirming medical care, including hormone replacement therapies and surgery.

The 2022 U.S. Transgender Study, with over 92,000 respondents, found that 98% of individuals receiving hormone replacement therapy report their transition has made them more satisfied with their life.

Research published in 2022 from the Stanford University School of Medicine explicitly found that starting hormone treatment in adolescence is linked to better mental health than waiting until later in adulthood.

A review of 27 scientific studies, published in 2021 in the Journal of the American Society of Plastic and Reconstructive Surgery, found that the regret rate for gender affirming surgery is 1%. As an illustrative comparison, regret for knee replacement surgery ranges as high as 30%.

Gender affirming care for youth almost exclusively takes the form of social transitioning and hormone treatments, with surgeries rarely performed. A 2023 study published in JAMA found that about 92% of gender affirming surgeries are performed on individuals who are 18 or older, with less than 8% performed on those younger than 18.

So with gender affirming care being associated with extremely high satisfaction and improved mental health, why do some transgender people de-transition?

Most don’t.

The U.S. Transgender Survey found that only 8% of people detransition, and that the majority of those who do later resume their transition.

Those who de-transition do so because society is not very kind to transgender people. The top reasons reported were 1) pressure from a parent, 2) transitioning was too hard, 3) they faced too much harassment and discrimination, and 4) they had trouble getting a job.

Similarly, a 2021 study found that over 82% of individuals who de-transitioned did so because of external pressure, lack of acceptance, social stigma and violence and harassment.

Gender affirming care is overwhelmingly associated with positive outcomes and greater life satisfaction. The extremely small number of individuals who de-transition and remain de-transitioned for reasons other than being treated poorly for being trans represent the smallest possible sliver of trans experience.

Despite this, “de-transitioners” like the speaker visiting our community wield an outsized influence on public discourse — often spearheading or supporting attempts to restrict or ban gender-affirming care.

Centre LGBT+ encourages all members of the transgender, nonbinary and gender nonconforming communities (as well as their allies, friends and families) to find community through the resources we offer. We offer support groups for LGBTQ+ people and their families, social groups for LGBT+ folk of all identities, and trainings for businesses and organizations who want to learn more.

Please visit centrelgbtplus.org or reach out to us at info@centrelgbtqa.org to learn more about the resources we offer and how you can help support our local LGBT+ community.

Dr. Pia Smal, Susan Q. Port, Susan Marshall, Kerry Wiessmann, Katie Nurmi, Kevin Kassab, Fermin Almeida, Rafael Alvarado, Michel Lee Garrett, Sharon Dixon-Brytczuk, Dr. Dempsey Young are members of the Centre LGBT+ board.