How common is detransition among people who used puberty blockers?
Executive summary
Published reviews and cohort studies report that detransition after any medical step (including puberty blockers or later hormones) is uncommon in the studied samples — typically in the low single digits, with systematic reviews summarizing prevalence estimates roughly 0.5–7.3% when focused on changes, doubts, or cessation of transgender identity around the start of hormones (which in some studies includes puberty blockers) [1]. Large clinic cohorts and recent retrospective analyses report discontinuation or detransition rates generally below 5% for youth who accessed blockers or hormones [2] [3].
1. What the numbers in the literature actually measure: identity change, discontinuation, or “detransition”
Studies and reviews use different endpoints: some count a shift in gender identity, some count stopping hormones, and others count seeking reversal of surgical steps. A critical review reported a range of prevalence estimates of 0.5–7.3% when focusing on identity change, doubts, or stopping treatment at or before hormonal therapy — and that review explicitly grouped puberty blockers with later hormones under “hormonal treatment” for analytic purposes [1]. That mixed definition means any single percentage must be read against what outcome the study recorded [1].
2. Clinic and cohort evidence: low percentages but limited follow‑up
Large retrospective clinic cohorts and cohort studies report low rates of discontinuation or detransition. A multisite retrospective cohort found that only a small portion of those who discontinued gender‑affirming hormones were doing so in association with returning to the sex assigned at birth; one cited study noted 2.8% who started hormones later discontinued during follow‑up, and another prospective cohort that included some children prescribed puberty blockers reported detransition in less than 5% of social‑transitioned preadolescents [2]. Systematic reviews and meta‑analyses similarly register low single‑digit estimates [3] [1].
3. Major caveats: definitions, sample bias, and the time window matter
Authors and reviewers repeatedly warn that study design limits interpretation. Many studies are single‑center, use convenience samples, or follow participants for only a few years; definitions of “detransition” vary; and some reviews explicitly downgrade certainty because of bias and imprecision [3] [4]. The critical review notes heterogeneity in terminology (e.g., “desistance,” “discontinuation,” “primary” vs. “secondary” detransition) that changes prevalence estimates depending on which events are counted [1]. These methodological differences are the primary reason reported rates vary across papers [1] [3].
4. Where puberty blockers specifically fit into the evidence
Several reviews and cohort studies include puberty blockers within the category of “hormonal treatment” or consider them alongside later gender‑affirming hormones, which complicates isolating a detransition rate for blockers alone [1] [3]. Available systematic reviews have noted the overall evidence base for puberty blockers is limited — many studies are observational, single‑arm, and short‑term — so direct, high‑certainty estimates of long‑term detransition after blockers specifically are not strongly established in the literature cited [3] [5].
5. Competing perspectives in the field and policy responses
Clinical reviews and cohort studies emphasize benefits reported by many treated youth and low observed detransition or discontinuation rates in clinical samples [6] [2]. At the same time, critical commentaries and policy bodies in some countries have urged caution, called for more trials, or recommended restricting blockers to research settings — these policy moves reflect concerns about weak evidence on long‑term outcomes rather than consistent high rates of detransition [7] [8]. Advocacy groups for detransitioners have also amplified individual experiences, which policymakers cite when recommending more conservative approaches [8] [7].
6. Bottom line for readers seeking clarity
Available peer‑reviewed syntheses and clinical cohorts report detransition or discontinuation in the low single digits for samples that include people who received puberty blockers or later hormones (commonly cited ranges center below 5% and up to about 7% in some measurements) [1] [2] [3]. However, the literature does not provide a single, high‑confidence percent that isolates long‑term detransition after puberty blockers because of mixed definitions, short follow‑up in many studies, and sample limitations; systematic reviews explicitly rate certainty down for these reasons [3] [5].
Limitations of this summary: sources differ in definitions and scope; some group puberty blockers with later hormones; and long‑term, large‑scale, multi‑center prospective data isolating puberty‑blocker recipients remain limited in the cited literature [1] [3].