Evan Urquhart

The lack of uniformity across data sets and the narrow inclusion criteria are potential sources of underestimation of the data. 4/12

Second, many studies report a considerable amount of patients LOST TO FOLLOW-UP. Therefore, detransition rates are based only on those who go back to their gender clinics, and we know that many detransitioners don't. 5/12

In addition, many studies use limited follow-up intervals, which are incapable of capturing the experiences of those who decide to detransition several years after they began their medical treatments. 6/12

The third problem is NOT taking into account how the landscape of transgender healthcare has changed in recent years. 7/12

Many of the outcome studies are based on older (i.e., stricter) treatment protocols. Patients selected for hormonal/surgical procedures were thoroughly assessed on different domains (usually for a period of several months) before making any decision. 8/12

Protocols also included a pre-requisite (now extinct) called the “real-life experience”, in which patients needed to live full time as members of the opposite sex before undergoing medical treatments. 9/12

Thus, individuals who underwent medical transition were those whom clinicians considered would be more likely to benefit from it (after careful screening). It is not difficult to see how this might have contributed to reducing the potential rates of regret/detransition. 10/12

In recent years, however, many gender clinics have adopted an informed consent model of care in which psychological assessments are not requisite for the initiation of medical interventions. 11/12