The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in Prevalence, Treatment, and Regrets
Article InfoTo view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect.
Figure 1
Number of people and median age for each year, stratified for transwomen and transmen and for children (<12 years), adolescents (12–18 years), and adults (≥18 years). Age is defined as age at the 1st visit to the VU University Medical Center, Amsterdam. From 1987 through 2002, children and adolescents were seen at the Utrecht University Medical Center and then at the VU University Medical Center only if they could begin medical treatment.
Figure 2
Top panel shows percentage of transgender adults beginning gender-affirming HT within 5 years after the 1st visit, stratified for transwomen and transmen. Bottom panel shows percentage of transgender adults with occurrence of gonadectomy within 5 years after starting HT for each year, stratified for transwomen and transmen. Year is defined as the year of the 1st visit. HT = gender-affirming hormonal treatment.
Abstract
Background
Over the past decade, the number of people referred to gender identity clinics has rapidly increased. This raises several questions, especially concerning the frequency of performing gender-affirming treatments with irreversible effects and regret from such interventions.
Aim
To study the current prevalence of gender dysphoria, how frequently gender-affirming treatments are performed, and the number of people experiencing regret of this treatment.
Methods
The medical files of all people who attended our gender identity clinic from 1972 to 2015 were reviewed retrospectively.
Outcomes
The number of (and change in) people who applied for transgender health care, the percentage of people starting with gender-affirming hormonal treatment (HT), the estimated prevalence of transgender people receiving gender-affirming treatment, the percentage of people who underwent gonadectomy, and the percentage of people who regretted gonadectomy, specified separately for each year.
Results
6,793 people (4,432 birth-assigned male, 2,361 birth-assigned female) visited our gender identity clinic from 1972 through 2015. The number of people assessed per year increased 20-fold from 34 in 1980 to 686 in 2015. The estimated prevalence in the Netherlands in 2015 was 1:3,800 for men (transwomen) and 1:5,200 for women (transmen). The percentage of people who started HT within 5 years after the 1st visit decreased over time, with almost 90% in 1980 to 65% in 2010. The percentage of people who underwent gonadectomy within 5 years after starting HT remained stable over time (74.7% of transwomen and 83.8% of transmen). Only 0.6% of transwomen and 0.3% of transmen who underwent gonadectomy were identified as experiencing regret.
Clinical Implications
Because the transgender population is growing, a larger availability of transgender health care is needed. Other health care providers should familiarize themselves with transgender health care, because HT can influence diseases and interact with medication. Because not all people apply for the classic treatment approach, special attention should be given to those who choose less common forms of treatment.
Strengths and Limitations
This study was performed in the largest Dutch gender identity clinic, which treats more than 95% of the transgender population in the Netherlands. Because of the retrospective design, some data could be missing.
Conclusion
The number of people with gender identity issues seeking professional help increased dramatically in recent decades. The percentage of people who regretted gonadectomy remained small and did not show a tendency to increase.
Wiepjes CM, Nota NM, de Blok CJM, et al. The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in Prevalence, Treatment, and Regrets. J Sex Med 2018;15:582–590.
To access this article, please choose from the options below
Purchase access to this article
Claim Access
If you are a current subscriber with Society Membership or an Account Number, claim your access now.
ISSM Members
Login with your issm.org username.
Subscribe to this title
Purchase a subscription to gain access to this and all other articles in this journal.
Institutional Access
Visit ScienceDirect to see if you have access via your institution.
Conflicts of Interest: The authors report no conflicts of interest.
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
