84% Desist Rate

Last updated: January 2, 2023

This is an important one to cover. There is a lot of misinformation about the desist rate (those who de-transition). The 84% desist myth is one of the more enduring and incorrect “statistic” that has been used against the transgender community. It has been around for some time and has been used in many cases where the anti-transgender individuals try to formulate a watchful waiting ^[1] situation to try to stop positive, evidence based medical and mental health treatment. A couple of years ago in Utah, we had a Conversion Therapy Ban administrative rule hearing at the Department of Public Licensing (DOPL). Those that were there, listened to one anti-transgender individual after another state that we should wait as more than 84% of youth desist and that this fact was in the WPATH Standards of Care^[2]. Even today we are seeing announcements from the Eagle Forum that “The number of children who change their mind is EXTREMELY HIGH. According to the DSM-5 manual, up to 88% of the girls who identify during childhood as boys and up to 97.8% of the boys who identify as girls change their mind if they do not receive puberty blockers, cross-sex hormones or surgery. “^[3] It is pretty slick to take a document that is not easily available and misrepresent it. I have read the Gender Dysphoria section twice and the wording on persistence is the closest thing to this and these are not the numbers in the DSM. Likewise, lack of persistence does not equal desistance. The be transgender, you have to evaluate to being persistent, insistent, and consistent. Therefore, the numbers in the DSM are related to people who are being evaluated on whether they are transgender or not and do not apply to those who are already diagnosed as transgender.

So where does this study come from. Its roots are in a study by Dr Steensma^[4]. This study took a selection of youth with varying degrees of gender confusion. But it didn’t fulfill the standard from the DSM-V guidelines of feeling their gender identity persistently, insistently, and consistently. Instead it was a much looser standard from the DSM-IV that a didn’t measure intensity or identity feelings. In fact, the study was reviewed and several concerns were raised including 45.3% of the study group did not return and were placed in the desist category without any contact or information on why they didn’t return^[5]. Ultimately, one of the main concerns is that youth displaying gender non-conforming behavior cannot be equated to being gender dysphoric per the DSM-V. 

One of the largest supporters of this desistance theory was Dr Kenneth Zucker, who I may cover more in a separate writing. Dr Zucker was known to subscribe to reparative therapy methods and was fired for not performing affirming care and had his clinic closed^[6]. His support of this desistance theory presumably contributed to the inclusion of this study to a previous WPATH Standards of Care revision, which they have moved from and all major medical organizations now affirm the transgender community. 

So do we have better data? The Australian Family Court once found “96 per cent of all patients who were assessed and received a diagnosis of Gender Dysphoria by the 5th intervenor from 2003 to 2017 continued to identify as transgender or gender diverse into late adolescence. No patient who had commenced stage 2 treatment had sought to transition back to their birth assigned sex. No longitudinal study is yet available. “^[7]

The UK Gender Identity Clinic found “This research by Prof. Dr P. T. Cohen-Kettenis, VU University Medical Centre, Department of Medical Psychology, shows that of 162 trans adults, only 1 reported they would choose not to transition again. Another had some regrets but would choose to transition again (0.6% regret rate) Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals”^[8]

In this study, not only are the detransition rates shown as low, but those who detransition include those who are doing it for social or medical reasons. “Of the 3398 patients who had appointments during this period, 16 (0.47%) expressed transition-related regret or de-transitioned. Of these 16, one patient expressed regret but was not considering detransitioning, two had expressed regret and were considering detransitioning, three had detransitioned, and ten had detransitioned temporarily. The reasons stated by patients for their regret or detransition included: social factors, reporting physical complications, and changing their mind about their gender identity and identifying as their gender assigned at birth. The 16 patients consisted of 11 trans women, two trans men, two cis men, and one person assigned male at birth who said their gender identity was “trans”. “^[9]. Note that it states two cis men which quantified those who are desisters that aren’t transgender. Out of 3398 (.00059). 

Finally, this Swedish study resulted in a finding 2.2% regret rate with regret declining over time. ^[10]

The 84% desistance myth is an argument we will be fighting against for the foreseeable future. The roots of it are embedded with those who believed that being transgender was not a characteristic present from birth. We continue to see evidence to the opposite and evidence that desistance is rare and generally found to be in the 1-4% range, depending on the study. For now we will need to pull the data and show the error in past studies and presumptions.

Finally, this Swedish study resulted in a finding 2.2% regret rate with regret declining over time. ^[11]

The 84% desistance myth is an argument we will be fighting against for the foreseeable future. The roots of it are embedded with those who believed that being transgender was not a characteristic present from birth. We continue to see evidence to the opposite and evidence that desistance is rare and generally found to be in the 1-4% range, depending on the study. For now we will need to pull the data and show the error in past studies and presumptions.

Footnotes

^[1] http://sueinut.com/watchful-waiting/
^[2] https://www.wpath.org/publications/soc
^[3] https://www.utaheagleforum.org/eagle-eye-blog/utah-children-getting-dangerous-hormone-therapy-and-surgery#
^[4] https://www.ncbi.nlm.nih.gov/pubmed/21216800
^[5] https://gidreform.wordpress.com/2014/02/25/methodological-questions-in-childhood-gender-identity-desistence-research/
^[6] https://thinkprogress.org/infamous-reparative-therapy-clinic-for-transgender-youth-set-to-close-bd4e960519c3/
^[7] https://www.humanrights.gov.au/sites/default/files/Re%2BKelvin%2B30%2BNovember%2B2017.pdf
^[8] https://www.gendergp.com/evidenced-research-on-detransition-regret-newsnight/
^[9] https://epath.eu/wp-content/uploads/2019/04/Boof-of-abstracts-EPATH2019.pdf#page=139
^[10] https://www.researchgate.net/publication/262734734_An_Analysis_of_All_Applications_for_Sex_Reassignment_Surgery_in_Sweden_1960-2010_Prevalence_Incidence_and_Regrets
^[11] https://psychcentral.com/lib/there-is-no-evidence-that-rapid-onset-gender-dysphoria-exists?fbclid=IwAR1OlIUvUgbkfNWqtPBCcy-H3SkfO1Lu6WSS3acIPndjRMU2bxDKhtrfhYg#1

Additional Articles and Studies