Very few regret a legal gender change in Sweden

“We saw that the vast majority of people who go through the process to legally change their gender do not reverse this decision," says Kristen Clark, the study’s lead author.
Photo Credit: Tobias Sterner/Bildbyrån

Fewer than one per cent of people who have changed their legal gender choose to revert to the gender they were assigned at birth. This has been shown in a new study from Uppsala University in which the researchers looked at how stable a gender change is over time.

A new study based on national data from Sweden provides strong evidence that legal gender change in people diagnosed with gender dysphoria is stable over time. Reversal occurs in less than one per cent of cases.

“We saw that the vast majority of people who go through the process to legally change their gender do not reverse this decision. Of the 2,467 people included in the study who had applied for and obtained a change in their legal gender, only 21 changed it back to the gender they had been assigned at birth. The probability that a legal gender change will remain stable after 10 years is therefore estimated at close to 98 per cent,” says Kristen Clark, postdoc at Department of Medical Sciences and the study’s lead author.

Kristen Clark analysed data from all individuals who had received a gender dysphoria diagnosis and legally changed their gender between 2013 and 2023.
Photo Credit: Tobias Sterner/Bildbyrån

New knowledge in the detransition debate

The study is based on the Swedish population register and patient register and analyses data from the period 2013–2023. The researchers followed all the people during that period who had received a gender dysphoria diagnosis and were able to see who had obtained a legal gender change, and how many eventually reverted to the gender that had been registered for them at birth. During the entire period, only 21 people reversed their legal gender change.

To calculate the probability of a gender change remaining stable, the researchers used a Kaplan-Meier survival analysis. This is a statistical method that is often used when not all participants are followed for the same length of time. The analysis of the collected data showed that the probability of a legal gender change remaining stable after 10 years is almost 98 per cent.

“Although public and clinical debate on regret and detransition has grown in recent years, there have not been many studies to show how common that is. Our study contributes high-quality data and a better understanding of how stable a legal gender change actually is. The results suggest that it is unusual at the population level to reverse a legal gender change, and that it hasn’t become more common now compared to what was seen in older Swedish studies,” says Kristen Clark.

More research could capture the reasons why some do regret the change

According to the researchers, more studies are needed to find out more about the experiences of non-binary individuals, since the Swedish population registration system only offers binary gender options, either male or female. Therefore, it is unclear how the results of the study can be applied to the non-binary population. Further research is also needed to investigate the multi-faceted reasons behind the rare cases of reversal.

But the researchers believe that the study can help to provide transgender people with better healthcare.

“These results can provide valuable guidance for healthcare, in policy discussions and in conversations with patients, as they are based on reliable data on gender identity stability over time,” says Kristen Clark.

Published in journal: JAMA Open Network / Psychiatry

Title: Stability After Legal Gender Change Among Adults With Gender Dysphoria

Authors: Kristen D. Clark PhD, Richard A. White PhD, and Georgios Karamanis MD

Source/Credit: Uppsala University | Sandra Gunnarsson

Reference Number: psyc100625_01

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