What evidence exists for gender-affirming medical protocols?
Detransitioners and their allies argue that the evidence base for these protocols is weak and potentially harmful. They repeatedly cite four independent systematic reviews—UK NICE, Sweden SBU, Finland THL, and Florida AHCA—which all conclude that the certainty of benefits from pediatric gender-affirming care is “low” and the risk of bias “high.”

Long-term data is central to their critique. The 2011 Swedish cohort study (Dhejne et al.) is highlighted as showing that, 10–15 years after sex-reassignment surgery, suicide rates were up to 20 times higher than in matched peers, and cancer and cardiovascular mortality were also elevated.

Childhood desistance figures are used to question the necessity of early medical steps. Peer-reviewed studies indicate that 60–90 % of children with gender dysphoria naturally desist by adulthood if not socially transitioned or given puberty blockers, with most becoming gay or lesbian adults. Detrans voices note that nearly 100 % of children placed on puberty blockers proceed to cross-sex hormones, suggesting these interventions may interrupt natural resolution.

Case reports such as Malone et al. (Baylor College) document adolescents whose dysphoria and suicidality worsened under affirmation-only protocols, reinforcing concerns that medical transition can lock individuals into persistence rather than allow natural desistance.

Overall, detransitioners present these systematic reviews, long-term outcome data, desistance studies, and documented clinical cases as evidence that the current evidence base for gender-affirming medical protocols is inadequate and may worsen rather than improve long-term mental and physical health.