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Detransition figures
How many people detransition after a gender transition? The low figure of around 1 percent that was cited for decades does not hold up to critical reading. Those figures rested on outdated clinical cohorts, short follow-up and a narrow definition of regret. More recent research consistently points to substantially higher percentages — and provides strong indications that the actual scale is still being underestimated.
Why the old figures (~1%) do not stand up
The well-known figure of about 1 percent comes from older clinical follow-up studies, especially from the Netherlands and Sweden, based on cohorts from the 1980s and 1990s. Those studies had structural limitations:
- They counted only people who formally returned to the treating clinic with a statement of regret — a high threshold most detransitioners do not meet.
- The follow-up was often short (a few years), while detransition on average only takes place 4 to 8 years after transition.
- Loss to follow-up was high. Those who left were counted as "satisfied" or omitted from the analysis.
- The treatment population at that time — predominantly adult men with early, persistent dysphoria — differs fundamentally from the current population, in which teenage girls and young women without childhood dysphoria dominate.
In other words: the old figures are not simply "cautious estimates" — they measure something different from what we now understand by detransition.
What more recent research shows
Littman (2021) surveyed 100 detransitioners in a targeted survey. Many respondents never reported back to their original doctor: they stopped hormones themselves, sought help elsewhere or withdrew from care. That explains why clinical registrations systematically produce too-low figures.
Vandenbussche (2021) reported comparable findings in a study of 237 detransitioners: a majority felt they had been inadequately supported and indicated that underlying problems (trauma, autism, internalised misogyny, homophobia) had not been recognised.
British data from the years around the Cass Review point to a discontinuation rate in young people far above the old 1%. An American study on military insurance data (Roberts et al., 2022) showed that around 30% of young people stopped hormone treatment within four years of starting — not all detransitioners in the strict sense, but a much larger signal than the mainstream narrative acknowledges.
Why the actual figures are likely higher
Three systematic effects contribute to underestimation:
- Late detransition. On average it takes years before someone acknowledges regret and takes steps back. Short follow-up misses this group entirely.
- Shame and isolation. Detransitioners almost unanimously describe how difficult it is to express themselves — both within the trans community, which often feels rejected by their story, and with original care providers.
- Disappearing from clinical care. Many detransitioners break off contact with the treating clinic. They do not appear in clinical figures, at most in self-report surveys or online communities.
The current patient population — predominantly adolescent girls and young women with co-morbid psychological problems, often without childhood dysphoria — differs fundamentally from the cohorts on which the reassuring old figures are based. It is not scientifically defensible to project the 1% figures of that era onto this population today.
Dutch context
For the Netherlands large, representative detransition studies are lacking. Amsterdam UMC (formerly VUmc) has for decades operated as virtually the only specialised clinic, but did not publish a complete long-term follow-up of all treated patients. The figures that are cited — low, reassuring — come from the same clinic that performs the treatments. Independent verification is lacking. The Cass Review has explicitly criticised that the same methodological weaknesses recur in much Western gender care: short follow-up, high loss to follow-up, no control groups.
Interpretation
Whether the actual detransition rate is 5%, 10% or 30% depends on population, definition and follow-up duration. What is certain: the old reassurance of "less than 1 percent regret" is no longer tenable in the current care climate. Even on cautious assumptions this means that thousands of people in the Netherlands face lasting physical consequences of a treatment they later regret. That is not a marginal phenomenon.