Nearly 97% Surveyed Say Starting Gender-Affirming Hormones Was the Right Decision

Nearly 97% of respondents in a study of 376 transgender people who began hormone therapy in their youth said starting treatment was the right decision for them. About 3% reported regret, including about 2% who said they both regretted starting hormones and felt they had been harmed by the treatment.

The study, published in JAMA Pediatrics, surveyed patients who had received care at the same clinic. Respondents ranged from 14 to 28 years old when surveyed, and most had started hormones at 17 or younger. On average, they answered the survey about five years after beginning treatment.

Most respondents were still taking hormones. Among the 65 who had stopped, a majority still said starting treatment had been the right decision for them. Researchers did not ask why those patients stopped or measure satisfaction with specific effects of hormone therapy.

Nearly 300 other patients initially agreed to participate but never completed the final survey, leaving researchers without information about their experiences. Kinnon R. MacKinnon, a York University researcher who was not involved in the study, said patients who stop treatment or experience regret may be reluctant to stay in contact with the clinic.

Nine respondents gave details about regret or harm. Some said they no longer wanted the physical changes brought on by treatment. Others reported unwanted side effects or said they had felt unprepared to make an informed decision. The authors said clinicians should make clear that patients can pause or stop treatment and encourage young people and their families to raise concerns.

The findings come amid a fight over access to gender-affirming care for minors. Republicans and the Trump administration have cited accounts of regret and harm in support of restrictions. The study’s authors said their findings support existing standards of care from the Endocrine Society and the World Professional Association for Transgender Health.