Tampere University, Faculty of Medicine and Health Techonolgy, Tampere University Hospital and Vanha Vaasa Hospital, Tampere, 33014, Finland.
Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University, Faculty of Social Sciences, Tampere, Finland.
BMC Psychiatry. 2024 Aug 19;24(1):566. doi: 10.1186/s12888-024-06005-6.
With increasing numbers of people seeking medical gender reassignment, the scientific community has become increasingly aware of the issue of detransitioning from social, hormonal or even surgical gender reassignment (GR). This study aimed to assess the proportion of patients who discontinued their established hormonal gender transition and the risk factors for discontinuation.
A nationwide register-based follow-up was conducted. Data were analysed via cross-tabulations with chi-square statistics and t tests/ANOVAs. Multivariate analyses were performed via Cox regression, which accounts for differences in follow-up times.
Of the 1,359 subjects who had undergone hormonal GR in Finland from 1996 to 2019, 7.9% discontinued their established hormonal treatment during an average follow-up of 8.5 years. The risk for discontinuing hormonal GR was greater among later cohorts. The hazard ratio was 2.7 (95% confidence interval 1.1-6.1) among those who had accessed gender identity services from 2013 to 2019 compared with those who had come to contact from 1996 to 2005. Discontinuing also appeared to be emerging earlier among those who had entered the process in later years.
The risk of discontinuing established medical GR has increased alongside the increase in the number of patients seeking and proceeding to medical GR. The threshold to initiate medical GR may have lowered, resulting in a greater risk of unbalanced treatment decisions.
TRIAL REGISTRATION NUMBER (TRN): Not applicable (the paper does not present a clinical trial).
随着寻求医学性别重置的人数不断增加，科学界越来越关注从社会、激素甚至手术性别重置（GR）中退出的问题。本研究旨在评估停止既定激素性别转换的患者比例以及停药的风险因素。
进行了全国范围内基于登记的随访。通过卡方检验和 t 检验/方差分析进行交叉表分析。通过 Cox 回归进行多变量分析，该分析考虑了随访时间的差异。
在 1996 年至 2019 年间在芬兰接受激素 GR 的 1359 名受试者中，7.9%在平均 8.5 年的随访期间停止了既定的激素治疗。较晚的队列中停止激素 GR 的风险更高。与 1996 年至 2005 年相比，2013 年至 2019 年接受性别认同服务的患者中断激素 GR 的风险比为 2.7（95%置信区间 1.1-6.1）。在较晚年份进入该过程的患者中，中断的时间似乎也更早出现。
随着寻求和接受医学 GR 的患者数量的增加，停止既定医学 GR 的风险也有所增加。启动医学 GR 的门槛可能已经降低，导致治疗决策不平衡的风险增加。
注册号（TRN）：不适用（本文未呈现临床试验）。
