Nine patients, nine psychiatric histories that did not come to light — or did not come to light sufficiently — when they began gender-related care. That is the central finding of a retrospective study by the gender clinic at Helsinki University Hospital, published in Archives of Sexual Behavior. The authors, including psychiatrist Katinka Tuisku, reassessed nine people who applied for detransition care between 2018 and 2019 and found trauma, mood disorders or dissociative symptoms in every case that had been missed in the earlier diagnostic process.

What the study did

The researchers reassessed seven patients born female and two born male using structured clinical interviews (SCID-I and SCID-II), additional psychological testing and an assessment of attachment style. On average, seven years elapsed between the original diagnosis of gender dysphoria and the point at which someone sought detransition care — years in which puberty blockers, hormones or surgical procedures had already taken place.

What the figures show

All nine patients were found to have at least one other psychiatric condition alongside their diagnosis of gender dysphoria: mood disorders were present in every case, anxiety disorders in two-thirds and eating-disorder symptoms in almost four out of five. The proportion diagnosed with borderline personality disorder rose from 22 to 33 percent, and nearly half reported psychotic symptoms. Two-thirds of the group had a history of sexual abuse or rape, and the researchers concluded that all nine patients had experienced a traumatic childhood. Their ability to work or study fell from 67 to 33 percent between the initial assessment and the point of detransition.

Distinguishing source from interpretation

The researchers themselves draw a cautious conclusion: they call for better screening for trauma, dissociative disorders and underlying psychiatric problems before someone begins medical transition care, as well as greater access to psychotherapy. The fact that, in retrospect, the nine patients themselves identified difficulty accepting their womanhood or manhood (in two-thirds of cases) or their attraction to the same sex (in one out of nine) as underlying factors highlights how a purely “affirmative” approach can leave such underlying questions unexplored. That is our interpretation of the findings, not a literal conclusion drawn by the authors — they explicitly do not speak of percentages for the population as a whole, but of a clinical signal from a single clinic.

A small study, but not an insignificant signal

Nine patients is a small number, and the authors acknowledge this themselves: the sample is not representative and there was no control group. But the study fits a broader pattern that also emerged from the largest detransition study to date: regret and reversal are rarely a straight line, and the path leading to them is often more complex than the initial diagnosis suggested. The finding that Nordic countries themselves report higher rates of regret than was long assumed also fits this picture: where measurement is more thorough, higher numbers emerge than the commonly cited 1-percent myth suggests.

For those struggling with the question of whether their own transition was the right step, or for parents wondering what else may be going on behind their child’s gender dysphoria, transspijt.nl brings together practical background information and stories about detransition.

Sources

Kettula, K., Puustinen, N., Tynkkynen, L., Lempinen, L. & Tuisku, K. (2025). Gender Dysphoria and Detransitioning in Adults: An Analysis of Nine Patients from a Gender Identity Clinic from Finland. Archives of Sexual Behavior, 54(5), 1981–1990. Open access via PubMed Central: pmc.ncbi.nlm.nih.gov/articles/PMC12162753.