Detransition rates are low
Few kids detransition and those who do mostly do so before any medical interventions. Kristina R. Olson, PhD; Lily Durwood, PhD; Rachel Horton, BS; Natalie M. Gallagher, PhD; Aaron Devor, PhD, “Gender Identity 5 Years After Social Transition”, Pediatrics, American Academy of Pediatrics, July 13, 2022
Maria Anna Theodora Catharina van der Loos, MD, Sabine Elisabeth Hannema, PhD, Daniel Tatting Klink, PhD, Prof Martin den Heijer, PhD, Chantal Maria Wiepjes, PhD, “Continuation of gender-affirming hormones in transgender people starting puberty suppression in adolescence: a cohort study in the Netherlands”, The Lancet, October 20, 2022
98% of kids who start blockers and/or HRT as kids continue on them into adulthood Bauer, Sydney, “Transgender Teens Don’t Abandon Hormone Therapy as Adults, Study Finds” The Daily Beast, October 22, 2022 (cites Lancet study above)
General Regret Rates are Low
Filip Timotija, Politifact: 1% or 85% Two numbers before SCOTUS purport to show trans youth "regret" rates. Which is it? December 17, 2024.
Surgical Regret Rates are Low
Surgical regret rates: Bustos, Valeria P.;Bustos, Saymd S;, et al.,Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence Plastic and Reconstructive Surgery Global Open, March 19, 2021
Surgical regret rates: breast augmentation: Isha Sijben, Floyd W. Timmermans, Oren Lapid, Mark-Bram Bouman, Wouter B. van der Sluis, Long-term Follow-up and Trends in Breast Augmentation in 527 Transgender Women and Nonbinary Individuals: A 30-year experience in Amsterdam - Journal of Plastic, Reconstructive & Aesthetic Surgery April 19, 2021
Reduces depression and suicidality
Kerry McGregor Psy.D., John L. McKenna Ph.D., Coleen R. Williams Psy.D., Ellis P. Barrera, Elizabeth R. Boskey Ph.D., M.P.H., M.S.S.W. Association of Pubertal Blockade at Tanner 2/3 With Psychosocial Benefits in Transgender and Gender Diverse Youth at Hormone Readiness Assessment Journal of Adolescent Health, December 13, 2023
Arjee Javellana Restar Gender Affirming Care is Preventative Care The Lancet Regional Health Americas, June 24 2023
Gender confirming care reduces suicidality: Diana M. Tordoff, MPH; Jonathon W. Wanta, MD; Arin Collin, BA; et al,
Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care | Pediatrics | JAMA Network Open February 25 2022; alternate point of access: Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care - PMC
Gender affirming hormone therapy reduces depression and suicidality among trans and non-binary youth: Amy E. Green, Ph.D.; Jonah P. DeChants, Ph.D.; Myeshia N. Price, Ph.D.; Carrie K. Davis, M.S.W:
Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth - Journal of Adolescent Health December 14, 2021
More on gender affirming care & effects on depression and suicidality
Green, Amy E.; DeChants, Jonah P.; Price, Myesha N.; Davis, Carrie K. Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth - Journal of Adolescent Health Journal of Adolescent Health, December 14, 2021
Depression, anxiety, and suicidality rates for trans children whose gender identities are supported are no different than their cis peers:Kristina R. Olson, PhD; Lily Durwood, BA; Madeleine DeMeules, BA; Katie A. McLaughlin, PhD, Mental Health of Transgender Children Who Are Supported in Their Identities, Pediatrics, March, 2016
What does the scholarly research say about the effect of gender transition on transgender well-being?, What We Know, The Public Policy Research Portal, Cornell University. “We conducted a systematic literature review of all peer-reviewed articles published in English between 1991 and June 2017 that assess the effect of gender transition on transgender well-being. We identified 55 studies that consist of primary research on this topic, of which 51 (93%) found that gender transition improves the overall well-being of transgender people, while 4 (7%) report mixed or null findings. We found no studies concluding that gender transition causes overall harm. As an added resource, we separately include 17 additional studies that consist of literature reviews and practitioner guidelines.”
Jack L. Turban, MD, MHS; Dana King, ALM; Jeremi M. Carswell, MD; Alex S. Keuroghlian, MD, MPH, Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation Pediatrics, February 1, 2020.
See also: History of Gender Affirming Medical Care for Minors
Puberty Blockers:
Puberty Blockers: Experimental? (no) Giordano, Simona; Holm, Soren; Full article: Is puberty delaying treatment ‘experimental treatment’?, International Journal of Transgender Health, April 11, 2020
They were developed first for cisgender children experiencing precocious puberty with research begun in the 1960s, resulting in the use of current GnRHa's by the early 1980s for cisgender children. These became the preferred class of medication for this purpose both because of their efficacy, their lack of side effects, and because they are fully reversable. They began to be used in the late 80s in Denmark for transgender teens and began to be recommended to be used after the onset of puberty (Tanner stage 2) in the 1998 version of the Standards of Care, the primary professional guidelines for medical treatment of trans people and all subsequent revisions including the most recent SOC 8.
This is both an extensive article and an enormous list of sources on the science of gender affirming care: Serano, Julia Gender-Affirming Care for Trans Youth Is Neither New nor Experimental: A Timeline and Compilation of Studies, May 16, 2023
Gill-Peterson, Jules Histories of the Transgender Child, University of Minnesota Press, Minneapolis, Minnesota 2018
In the 1960s, Harry Benjamin would routinely demur when minors would write his practice seeking prescription or surgical advice, essentially telling them to wait until they were adults. However, his was not the only perspective of the era.
Hormone therapy for minors
Dr. Lawrence Newman of the Gender Identity Research Clinic at UCLA in the 1960s aimed to use psychotherapy essentially as conversion therapy to make kids as young as five, presenting as trans become cisgender. This typically failed by adolescence and he then began prescribing hormone therapy. Jules Gill-Peterson refers to one such patient, a trans girl who socially transitioned by 15 and whom Newman prescribed hormone therapy at that age. (Gill-Peterson pp. 148-9)
Surgery for minors:
Dr. John Money of the then new Gender Identity Clinic at Johns Hopkins in 1965 successfully lobbied for long term patient, and then criminal defendant G.L. to be a surgical patient for gender affirming surgery while they were 17, under the belief that their accused criminal behavior was due to their “transsexualism” and would cease following such surgery. Delays in parental permission lead to G.L. running away prior to any surgery being realized (Gill-Peterson p. 130)
Dr. Money again in 1973, writing to consult about a 15 year old trans boy, that, he should do a two year real life test before any hysterectomy or ovariectomy, [thus having them around age 17 or 18] but that ‘I am willing to consent to mastectomy much earlier, because it does make occupational adjustment as a male much easier.” and he went on to note the availability of breast implants in case of later regret and recommending starting hormone therapy early. (Gill-Peterson)
Anti-trans legislation harms kids’ increasing depression, etc. Staloch, Laura “The passage of anti-transgender legislation increases internet searches for “suicide” and “depression”, PsyPost, January 23, 2023
More: Novotny, Amy ‘The young people feel it in their bones’: A look at the mental health impact of antitrans legislation The American Psychological Association, June 29, 2023
Thurston, Andrew, How Will Anti-Trans Laws Impact Transgender and Gender-Diverse Youth Mental Health? | The Brink | Boston University March 24, 2023
Rates of Distress, Depression Have Doubled Among Transgender Americans Since 2014, NonStop Local Billings, June 24, 2024.
Carl G. Streed Jr, MD, Kellan E. Baker, PhD, MPH, Arjee Javellana Restar, PhD, MPH, Association of Political Assaults With the Health of Transgender and Nonbinary Persons, JAMA Internal Medicine, June 24, 2024.
Michael Liu, MPhil; Vishal R. Patel, MD, MPH; Sari L. Reisner, ScD; et al, Health Status and Mental Health of Transgender and Gender-Diverse Adults, JAMA Internal Medicine, June 24, 2024.
There have been trans teen boys 16-19 since the late 1960s, recommended by doctors to have masculinizing chest surgeries to help make their social transitions in school easier.
This is not experimental
There are about the same number of elective cosmetic surgeries for cisgender minors per person as medically necessary gender affirming surgeries for trans minors.
Numbers first, then the math, then the sources.
Cisgender teens under 17 years of age have elective, cosmetic plastic surgery procedures at a rate of 25 per 100,000 cis teens per yr
Transgender teens under 17 years of age have medically necessary gender affirming surgeries at a rate of 26 per 100,000 trans teens per yr
The math:
These data are for the U.S. primarily between the years 2019 and 2021.
In 2021, Gallup survey results indicated 2.1 % of the U.S. GenZ population is trans.
The U.S. census indicates that in 2021 the U.S. population of 6-17 year olds was 54.8 million.
With the Gallup data that means about 1.15 million trans GenZ minors between 6-17.
In 2021, there were about 300 gender affirming surgeries trans teens between the ages of 13-17 in the U.S., mostly top surgeries for 17 year old trans boys.
That's 0.026% of trans teens or 26 per 100,000 trans teens per year.
Respaut, Robin and Terhune, Chad, Putting numbers on the rise in children seeking gender care, Reuters, October 6, 2022
Most of the data I could find for cisgender cosmetic surgeries for teens were for teens 13-19, and were around 65,000 annually with an additional 165,000 non-surgical cosmetic procedures.
eg:
2017 Plastic Surgery Statistics Report
For 2019 cisgender cosmetic surgery for teens between 13-17 give numbers closer to 13,400. Those procedures include breast augmentation for girls, breast reduction, rhinoplasty, ear tucks & lipo.
That's about 0.025% or 25 out of 100,000 cis teens
aesthetic plastic surgery national databank - statistics
My total population numbers had included all U.S. kids from 6-17.
Revising to the 13-17 numbers as with the surgery data:
* 1 in 2000 minor cis teens/year have elective cosmetic surgery
* 1 in 2000 minor trans teens/year have gender affirming surgeries, mostly top surgery
Arguments against GAC for minors have included the notion that the brain isn’t fully developed until age 25. This is a misunderstanding.
The myth that the brain is so unfinished in its development prior to age 25 that youth are especially vulnerable to outside influence and poor decision making has been weaponized by the anti-trans movement to extend age restrictions beyond minors.
The Myth of the 25-Year-Old Brain
And it's especially frustrating when sources propagate this notion without understanding the damage that they are inadvertently supporting. (Including Picard Season 3 Episode 9)
Among minors
Respaut, Robin and Terhune, Chad, Putting numbers on the rise in children seeking gender care, Reuters, October 6, 2022
Headline above may be misleading. Even with the reported rise, such numbers after the rise are just reaching being in line with comparable cisgender interventions for that age group including elective cisgender ones.
“In 2017, when gender-affirming medical care was included in the list of TRICARE benefits for about one year, at least 2500 children actively sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities, and 900 received GnRH-a or gender-affirming hormones.” https://pmc.ncbi.nlm.nih.gov/articles/PMC9932380/
Comparison for rates among cisgender minors of similar medical interventions
Breast reduction for cisgender male teens with gynecomastia. American Society of Plastic Surgeons: “Briefing Paper: Plastic Surgery for Teenagers”, Connect (Data from 2015)
Dannie Dai, BS1; Brittany M. Charlton, ScD2; Elizabeth R. Boskey, PhD3; et al, Prevalence of Gender-Affirming Surgical Procedures Among Minors and Adults in the US, JAMA Netw Open. 2024;7(6):e2418814. doi:10.1001/jamanetworkopen.2024.18814, June 27, 2024 - most gender affirming surgeries on minors are breast reductions for cisgender males.
Social contagion and rapid onset gender dysphoria are bogus:
Serano, Julia, All the Evidence against Transgender Social Contagion. February 13, 2023
Among adults or Among All
Comparison for rates among cisgender people of all ages of similar medical interventions
Among those considered aesthetic plastic surgery
The Aesthetic Society, Aesthetic Plastic Surgery National Databank Statistics 2019
Focus on care of minors
Gill-Peterson, Jules Histories of the Transgender Child, University of Minnesota Press, Minneapolis, Minnesota 2018
Serano, Julia Gender-Affirming Care for Trans Youth Is Neither New nor Experimental: A Timeline and Compilation of Studies, May 16, 2023
Meredithe McNamara, MD MSc, Assistant Professor of Pediatrics, Yale School of Medicine, et al. An Evidence-Based Critique of "The Cass Review" on Gender-affirming Care for Adolescent Gender Dysphoria