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Nearly all individuals with gender dysphoria who initiated hormone treatment as adolescents continued that treatment into adulthood, a Dutch observational study found.

Among 720 people who started puberty suppressing hormones prior to the age of 18, 704 (98%) continued to use gender-affirming hormones after turning 18, reported Chantal Wiepjes, PhD, of Vrije Universiteit Amsterdam in the Netherlands, and colleagues.

Out of the 16 individuals who stopped using prescription gender-affirming hormones by the end of the study at an average age of 19 to 20, nine were assigned male at birth (4% of 220) and seven were assigned female at birth (1% of 500).

A total of 12 of these 16 individuals (75%) underwent gonadectomy during this follow-up period, the group wrote in .

No single variable significantly predicted discontinuation of hormone use, including age at first visit, year of first visit, age and puberty stage at start of gonadotropin-releasing hormone agonist (GnRHa) treatment, age at start of gender-affirming hormone treatment, year of start of gender-affirming hormone treatment, or gonadectomy.

"Our study looked at individuals treated at a gender identity clinic in The Netherlands, which has offered puberty suppression treatment followed by gender-affirming hormones to transgender people for over 20 years, to understand how many people continued to use hormone therapy," co-author Marianne van der Loos, MD, also of Vrije Universiteit Medical Center Amsterdam, explained in a statement.

The findings were "reassuring in the context of recent increased public concern regarding regret of transitioning," van der Loos added.

While 2% of individuals didn't have a prescription found for gender-affirming hormones after the age of 18, the researchers noted that it wasn't certain that they stopped hormones.

"There are several plausible reasons for discontinuation of treatment," they said. "There might be a lack of knowledge on the importance of continued hormone treatment after gonadectomy, or the side-effects of medication could have led to stopping of medication."

They also mentioned that individuals with a non-binary gender identity may only require short-term treatment.

"No prescriptions for any kind of sex hormones (ie, neither for the sex assigned at birth or the experienced gender) were found, suggesting that people might not have stopped treatment because of regret of transition or change of gender identity," Wiepjes' group explained, adding "if people who had gonadectomy regretted their transition they might have started treatment with sex hormones of their sex assigned at birth."

These findings fall right in line with a study published in Pediatrics earlier this year, which also found most youth stuck with the new gender identity. This study of U.S. kids found only 7.3% of 317 transgender children altered their gender identification -- or retransitioned -- over a 5-year follow-up period. And of this group, only 0.5% of those who transitioned at age 6 or older retransitioned.

For the current study, the researchers compared data in the Dutch nationwide prescription registry. They looked at individuals who started medical treatment in adolescence with a GnRHa to suppress puberty before the age of 18 years and used GnRHa for a minimum of 3 months prior to the addition of gender-affirming hormones.

The median age at the start of GnRHa therapy was 14.1 for those assigned male at birth and 16 for those assigned female at birth.

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