A study published Monday in JAMA Pediatrics finds that transgender teenagers who have pursued medical interventions like puberty blockers and hormones are highly satisfied with their care.
“Regret was very rare,” says lead author Kristina Olson, a psychology professor at Princeton University.
It’s the latest research from the TransYouth Project, which Olson started in 2013, when transgender youth was a fairly obscure research area, far from the political limelight.
Back then, “our team was interested in recruiting a group of kids who were socially transitioning,” she explains, meaning they started using new pronouns and names and clothes in childhood, between age 3 and 12. They found 300 families, and have followed them since, to see “what their life would look like as they moved into adolescence and adulthood.”
The families enrolled in the program have participated in many research projects over the years, from gender development in childhood to mental health. The plan is to follow them for a total of 20 years.
The study on regret and satisfaction is based on a survey of 220 of those families. By now, the kids are teenagers — the average age of participants was 16 years old — and are several years into taking either puberty blockers or cross-sex hormones.
“What we found was that this group had very high levels of satisfaction,” she says. Olson knew from being in touch with the families that they seemed pretty happy with their care, but the results still surprised her. “I was pretty surprised at how satisfied they were — more than 50% [rated their satisfaction] a 7 on a 7-point scale.”
Only 4% of participants — nine kids — expressed regret with some aspect of their care. When the researchers asked more about these regrets, she says, “often the regrets they were expressing had to do with [wishing] they hadn't done blockers and they'd gone straight to hormones, or they maybe had a negative side effect related to the blockers.” For instance, having an implant that got irritated.
She adds that even though regret was very rare, it’s still important and needs to be better understood.
Four kids in the study who expressed regret continued their treatments, while four more chose to stop all gender-affirming medical care and one stated that they plan to stop.
“I don't think it's at all surprising that the researchers found a lower regret rate,” says Linsdey Dawson, who directs LGBTQ health policy for the nonprofit health research organization KFF. “This aligns with previous findings that gender affirming care is associated with low regret rates in both youth and adults.”
She says the findings in Olson’s study are important, and notes regret for gender affirming care is very low compared to other medical decisions, like gastric bypass surgery, which is also done on minors.
This new study comes at a time when transgender kids and their medical care is a hot topic politically — in former President Trump’s presidential campaign and in several key senate races, transgender issues are part of candidates’ closing arguments.
Earlier this year in a campaign video, Trump said “the left-wing gender insanity being pushed in our children is an act of child abuse — very simple,” and enumerated the ways he would use his executive power to prevent people from transitioning and to punish schools and hospitals that support transgender young people.
There’s also been a flurry of legislative action on this issue at the state level in recent years. Twenty-six states have now enacted laws banning the care the youth in this study received. Often, lawmakers speak of the prospect of children’s future regret as the reason why these bans are needed.
For instance, on the Wyoming state house floor in February, Republican Rep. Pepper Ottman explained why she was a co-sponsor of that state’s ban. “We need to protect these children from lifelong mistakes,” she said. “This is talking about physical changes that are not natural. These things are not good.”
Virtually all major U.S. medical organizations, including the American Medical Association and the American Academy of Pediatrics, support access to gender-affirming care for young people.
“Discourse around regret when it comes to gender affirming care has become a significant problem because it is inaccurate,” says Dawson. She points to a recent KFF analysis that found in September, the narrative that regret for gender affirming care was common was mentioned approximately 41,000 in posts, articles and comments.
Discussion of regret for trans-related care “has become a common form of misinformation in debate and policymaking and in the courts,” Dawson says.
The Supreme Court will hear arguments about whether the state bans on gender affirming care are constitutional in the coming weeks.
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