Study Finds Low Detransition Rates Among Canadian Teens Receiving Gender-Affirming Care
A new Canadian study suggests that adolescents who receive gender-affirming medical care after comprehensive psychosocial assessment are highly likely to maintain their gender identity over the short to medium term. The research, published in the Journal of Adolescent Health, followed 445 youth diagnosed with gender dysphoria across four specialized pediatric gender clinics in Vancouver, Calgary, Ottawa, and Halifax.
Key Findings
Over an average follow-up period of 2.4 years, only 2.9 percent of participants reverted to a gender identity aligned with their sex assigned at birth. Of the 353 teens who began gender-affirming hormone therapy, just 1 percent discontinued treatment. Notably, no participant who initially identified as non-binary reverted to a binary gender matching their birth sex.
The study authors emphasized that these results demonstrate “adolescent gender identity is highly stable” in a clinical context with thorough assessment and support. Lead author Dr. Daniel Metzger stated that for many youth, access to appropriate care correlates with improved well-being and mental health outcomes.
Study Limitations and Criticism
However, critics argue the findings present an incomplete picture. Dr. Laura Targownik, a physician and professor of medicine at the University of Toronto, noted the follow-up period may be too short to establish true detransition rates. The study cannot account for outcomes after youth transitioned to adult care.
“We don’t know what happened after they moved into adult care,” Targownik said. “It could be that many continue to do well, or we could reach out and they say, ‘I quit when I was 22.'”
The research also included patients seen between 2012 and 2017, before a significant surge in cases and demographic shifts. Doctors now primarily treat biological females, many with complex mental health issues who identify as non-binary—a population not fully represented in the study cohort.
Broader Context
The number of children and adolescents seeking gender-inclusive care nearly tripled in Canada and the United States between 2017 and 2020, according to the study authors. While major medical organizations support gender-affirming care, some government agencies continue questioning access.
Recent Canadian studies echo findings from a large British study that led to restrictions on puberty blockers, noting “significant uncertainty” about treatment benefits for children. Reported detransition rates vary widely across research, ranging from 1 percent to 30 percent depending on the population studied.
The science on detransition remains developing. Other research indicates people who complete transition typically do so after five to seven years, suggesting longer follow-up periods may yield different results.
Methodology Considerations
The study relied on medical records from specialized clinics, excluding youth who sought care elsewhere, did not pursue medical interventions, or lacked parental support. Researchers acknowledged this approach risks missing relevant social and psychological factors influencing treatment decisions.
Lead author Dr. Margaret Lawson defended the study’s methodology as “extremely sound,” while acknowledging that opponents of gender-affirming care may seek reasons to question the results.