Evan Urquhart

Numbers about detransition are legitimately hard to find. The best numbers we have suggest that rates of detransition are extremely low. However, there are few enough studies and low enough sample sizes that a rational person could wonder if they tell the whole story.

A critique of this study could fairly say: 1. It only looks at post-surgery patients, not those who went on hormones, made a legal name change, or other big steps. 2. It's based on provider reports, so detransitioners who didn't tell a doctor their regrets were missed.

Those arguments are valid enough that I would agree that studies have under counted detransitioners, more likely than not. But then, I would encourage you to ask: By how much have they undercounted, do we think?

Forget study methods for a minute, and come with me to a place I like to call The Real World. In The Real World, patients get prescribed a medication or undergo medical procedures, and doctors follow up to a greater or lesser extent.

In The Real World, doctors don't see most patients throughout their whole lives, and are more likely to see them when there is a problem. Studies are helpful in quantifying if there are more complications than docs realize, or results are less favorable than they hoped.

What studies DON'T generally show is a massive numbers of patients who were extremely dissatisfied with a procedure, to the point of blaming the doctor who performed it, while the doctor remained totally unaware that there were any problems at all.

It is perfectly sensible to say, okay, the data shows less than 1% of patients detransition... but maybe it's something more like 2-3%.