Finnish study: all nine detransitioners had a significant psychiatric history

Nine patients, nine cases of a psychiatric history that was not identified — or not identified sufficiently — when they began gender-related care. That is the core 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 that every one of them had trauma, mood disorders or dissociative symptoms that had been missed in the earlier diagnostic process.

What the study did

The researchers reassessed seven patients assigned female at birth and two assigned male at birth using structured clinical interviews (SCID-I and SCID-II), supplementary psychological testing and an assessment of attachment style. On average, seven years passed between the original diagnosis of gender dysphoria and the point at which someone sought detransition care — years during which they had used hormones and eight of the nine had undergone chest surgery. The study concerns adults; puberty blockers are not mentioned.

What the figures show

All nine patients were found to have at least one other psychiatric condition in addition to their diagnosis of gender dysphoria: mood disorders were present in everyone, anxiety disorders in two thirds, and eating-disorder symptoms in almost four out of five. Two patients had previously been diagnosed with borderline personality disorder, and the reassessment added three more diagnoses; almost 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. At the start of the initial assessment, 67 percent (six out of nine) were able to work or study full-time; by the start of the detransition assessment, that figure had fallen to 33 percent (three out of nine).

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 — an approach that aligns with Finnish policy since 2020. Why trauma is so often overlooked in gender dysphoria is explained at transplek.nl. The fact that the nine patients themselves later identified difficulties accepting their womanhood or manhood (in two thirds of cases), or their attraction to the same sex (in one of nine), as an underlying factor highlights how a purely “affirmative” approach can leave such underlying questions unaddressed. That is our interpretation of the findings, not a literal conclusion drawn by the authors — who explicitly do not discuss percentages for the population as a whole, but rather 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: it is not a representative sample and there is no control group. But the study fits a broader pattern that also emerged from the largest detransition study to date: regret and returning 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 regret rates than long assumed also fits this picture: where measurement is more careful, higher numbers emerge than the common 1-percent myth suggests. An overview of the studies can be found under detransition figures.

For people 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.