2024-02-16 18:08:18
By Aida Cerundolo.
Patients who have detransitioned wonder why, following receiving extensive medical support for gender transition, the medical establishment continues to ignore their detransition. There is no code to classify patients who regret it and, consequently, there is no mechanism to record the rate of detransition.
A patient should be more than a number, but those who detransition can’t even have that. Regret following transition Gender is so taboo that there is no way to document it in a medical record with an official diagnosis code.
FAIR in Medicine, where I collaborate, requested International Classification of Diseases diagnosis codes that represent detransition through the Centers for Disease Control and Prevention. Nine months later, subject matter experts appointed by the American Psychiatric Association (APA) and the American Academy of Pediatrics (AAP) are still reviewing our application.
International Classification of Diseases diagnosis codes label patients’ medical problems and transport them electronically through the U.S. healthcare system. They are combinations of letters and numbers that facilitate communication, help prevent medical errors, and indicate insurance companies to reimburse for treatments.
There are codes for patients “beaten by an orca” or that they have “problems in the relationship with his in-laws and even for those “sucked by [un] Motor to reaction”. However, detransition remains an unrecognized medical entity because it does not have a corresponding diagnosis code.
The codes tag conditions so that they are detectable in the CDC’s electronic database, allowing for better understanding through research. Although there are codes for documentary a transition to [disfrazar] birth sex, There is no code to classify patients who regret. Consequently, there is no mechanism to record the detransition rate, a possible indicator of the damage caused by the treatments patients receive when changing gender. This is unacceptable in an era of evidence-based medicine, especially when some treatments are irreversible.
Gender-affirming care uses hormones and surgeries to align the appearance of gender-nonconforming patients with their feelings of gender identity. Gender dysphoria, discomfort with one’s birth sex, is often a prelude to affirming a new gender identity and gender-affirming treatments. Gender incongruence resulting from a non-conforming identity with one’s own sex is presumed to be the cause of gender dysphoria and guides treatment.
In general, [en otras disciplinas] Patients undergo examinations to identify diagnoses and determine the appropriateness of treatments. But researching an individual’s gender dysphoria is considered stigmatizing to the gender non-conforming population and is considered a “control” of the care of transgender people.
However, more and more patients are coming out of gender-affirming treatments and realizing that their gender dysphoria was caused by more than just gender incongruence, joining a population known as detransitioners. Gender transition regret is described as uncommon, with reported rates ranging from 0,3 and the 3,8 percent, but some evidence suggests rates up to 30 percent.
Measuring detransition is difficult, as one study found that the 75 percent of people who abandoned their transition They did not notify their gender care doctor of their detransition. Still there is no estimate reliable detransition rate.
Meanwhile, gender transition is a booming industry in the US.with an estimate of more than 300 gender clinics in operation that treat minors (vs. zero in 2006) and a Nearly triple increase in gender-affirming surgeries between 2016 and 2019. All medical interventions carry risks, and detransition is one of the foreseeable outcomes if gender transition treatments do not achieve what patients expect. Detecting patients who suspend or reverse treatment helps evaluate the benefits of treatment.
The official publication of the American Psychiatric Association, “Gender Affirming Psychiatric Care”, advocates for gender-affirming care, but ignores detransition, except to describe older transgender people who detransition due to social pressure factors. This omission ignores the young people who are making the transition and putting demands that detail the damage that they have suffered, some facing a lifetime of physical alterations, sterilization and hormone replacement.
The APA-approved book even suggests that an evaluation for gender dysphoria that precludes gender-affirming treatments such as puberty suppression and hormone therapy “constitutes a form of GICE.” [terapia de conversión de identidad de género]”. The possibility of misdiagnosis is discussed, but only from the perspective of confusing a transgender identity with something else, and not the other way around.
The American Academy of Pediatrics similarly recommends gender-affirming care, although recently initiated a review systematic evidence. The results of this type of reviews in others countries have shown that the benefits do not outweigh the risks, leading to recommendations that move away from medicalization for gender-questioning youth.
The assumption that gender incongruence is always the cause of gender dysphoria leaves no room for the possibility that some patients may have other psychological stressors that contribute to their mental distress (leading to inappropriate gender transition). ) and lead to a future detransition. The acceptance that detransition exists calls into question the concept of immediate gender affirmation.
Medicine should accept the truth by recognizing the gender detransition in our health system. We hope the APA and AAP recognize this underserved cohort of patients and agree that safe medicine should always be a priority, regardless of gender identity.
Aida Cerundolo MD is a FAIR collaborator in Medicine at the Foundation Against Intolerance and Racism.
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#Medicine #ignores #detransition