Boskey Elizabeth R, Scheffey Kathryn L, Pilcher Sarah, Barerra Ellis P, McGregor Kerry, Carswell Jeremi M, Kant Jessica D, Kremen Jessica
Division of Gynecology, Boston Children's Hospital, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts.
Department of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
J Adolesc Health. 2025 Apr;76(4):584-591. doi: 10.1016/j.jadohealth.2024.11.002. Epub 2025 Jan 16.
To understand the rate of, and reasons for, discontinuation of gender-affirming hormones (GAH) in transgender adolescents.
Retrospective cohort study of individuals starting GAH between January 2007 and December 2022. Individuals were included if they were diagnosed with gender dysphoria, were prescribed GAH, and took GAH continuously for a minimum of 6 months. Of 1,224 individuals who started GAH, 1,050 met the eligibility criteria for this analysis. The primary study outcome was the status of GAH use at last communication. We also assessed gender identity at the time of GAH discontinuation and reasons for discontinuation among individuals who discontinued GAH for periods of 3 months or longer.
Of 1,050 eligible individuals, 973 (93%) had been on GAH continuously at last contact, 20 (2%) had discontinued GAH for greater than 3 months then restarted hormones, and 37 (4%) had discontinued GAH without restarting hormones. Of those who discontinued hormones without restarting, 5 (0.5%) individuals did so because they reidentified with the gender associated with their sex assigned at birth. This represents less than 1 percent of the cohort.
In a large cohort of transgender adolescents seeking GAH, persistent discontinuation of hormones was rare and primarily reflected having accomplished gender expression goals or difficulties accessing or taking hormones - rather than individuals reaffirming a gender identity associated with their assigned sex at birth. It is important for future research on individuals who discontinue GAH to evaluate the reasons for discontinuation and not to make assumptions about detransition and/or regret.
了解跨性别青少年停用性别确认激素（GAH）的比例及原因。
对2007年1月至2022年12月开始使用GAH的个体进行回顾性队列研究。纳入标准为被诊断为性别焦虑症、已开具GAH处方且连续服用GAH至少6个月。在1224名开始使用GAH的个体中，1050名符合本分析的纳入标准。主要研究结局是最后一次随访时GAH的使用状态。我们还评估了GAH停用当时的性别认同情况，以及停用GAH达3个月或更长时间的个体的停药原因。
在1050名符合条件的个体中，973名（93%）在最后一次随访时仍在持续使用GAH，20名（2%）停用GAH超过3个月后重新开始使用激素，37名（4%）停用GAH后未重新开始使用。在那些停用激素后未重新开始使用的个体中，5名（0.5%）是因为重新认同了与出生时被指定的性别相关的性别。这占队列的比例不到1%。
在一大群寻求GAH的跨性别青少年中，持续停用激素的情况很少见，主要反映的是已经实现了性别表达目标，或者在获取或服用激素方面存在困难，而不是个体重新确认了与出生时被指定的性别相关的性别认同。对于未来关于停用GAH的个体的研究来说，评估停药原因很重要，而不应假设其为性别转变或后悔。
