Kettula Kaisa, Puustinen Niina, Tynkkynen Lotta, Lempinen Liisa, Tuisku Katinka
Gender Identity Clinic, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.
The Doctoral Programme in Clinical Research, University of Helsinki, Helsinki, Finland.
Arch Sex Behav. 2025 May 20. doi: 10.1007/s10508-025-03176-5.
The aim of this study was to analyze the pathways of detransitioning, which is a rare, but serious complication of gender-affirming treatments (GATs). The patient group consisted of all patients who were referred to the Helsinki University Hospital's Gender Identity Clinic (GIC) wanting medical treatment for detransition from 2018 to 2019. A new assessment was made systematically and retrospective data were collected. The sample consisted of nine patients originally diagnosed with gender identity disorder (F64.0). Seven of them were assigned female at birth and two were assigned male at birth. All seven females at birth had "major" regret and both males at birth had "minor" regret. All patients except one male assigned at birth wanted their previous GAT to be reversed. The mean regret time (i.e., time from the first diagnosis of F64.0 to the beginning of the new evaluation period) was seven years. The detransitioners had a high number of psychiatric diagnoses. Childhood trauma, sexual abuse or rape, eating disorder symptoms, borderline personality, and psychotic symptoms were common among detransitioners. Retrospectively, the patients reported that the need for transitioning in the first place was not the transgender identity or gender dysphoria, but reasons related to the maturation process and unresolved psychological stressors. An assessment made by the psychologist at the GIC revealed childhood trauma and severe challenges in parenting and attachment. It is important to acknowledge, support, and evaluate those regretting treatments and/or detransition, and to learn from them.
本研究的目的是分析去转型的途径，这是性别确认治疗（GATs）中一种罕见但严重的并发症。患者组包括2018年至2019年期间转诊至赫尔辛基大学医院性别认同诊所（GIC）寻求去转型医疗治疗的所有患者。进行了系统的新评估并收集了回顾性数据。样本包括9名最初被诊断为性别认同障碍（F64.0）的患者。其中7名出生时被指定为女性，2名出生时被指定为男性。所有7名出生时为女性的患者都有“严重”的后悔情绪，2名出生时为男性的患者都有“轻微”的后悔情绪。除1名出生时被指定为男性的患者外，所有患者都希望撤销他们之前的性别确认治疗。平均后悔时间（即从首次诊断F64.0到新评估期开始的时间）为7年。去转型者有大量的精神科诊断。童年创伤、性虐待或强奸、饮食失调症状、边缘性人格和精神病症状在去转型者中很常见。回顾性来看，患者报告说，最初需要转型的原因不是跨性别身份或性别焦虑，而是与成熟过程和未解决的心理压力源相关的原因。GIC的心理学家进行的评估揭示了童年创伤以及养育和依恋方面的严重挑战。认识、支持和评估那些对治疗和/或去转型感到后悔的人，并从中吸取教训很重要。
