Evidence map›Paper›PMID 40906480›Full record

ArticleJAMA network open2025

Stability After Legal Gender Change Among Adults With Gender Dysphoria.

Kristen D Clark, Richard A White, Georgios Karamanis, Malin Indremo, Fatih Özel, Alkistis Skalkidou, Thomas Frisell, Fotios C Papadopoulos

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kristen D ClarkDepartment of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.
Richard A WhiteDepartment of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.
Georgios KaramanisDepartment of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.
Malin IndremoDepartment of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.
Fatih ÖzelDepartment of Organismal Biology, Uppsala University, Uppsala, Sweden.
Alkistis SkalkidouDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Thomas FrisellClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Fotios C PapadopoulosDepartment of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The number of people seeking treatment for gender dysphoria (GD) has risen in recent decades, yet data remain limited for understanding cases of detransition (ie, the reversal of social, medical, or legal transition). Legal gender change in national registers poses an opportunity to examine legal gender reversals, which may reflect an aspect of the detransition process, while also informing an understanding of the stability after a legal gender change. Objective: To determine the probability of obtaining a legal gender change and its stability over time among people diagnosed with GD in Sweden during a 10-year study period. Design, Setting, and Participants: In this population cohort study using data from Swedish national registers from January 1, 2013, to December 31, 2023, individuals who received their first International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), diagnosis code for GD during the study period were included. While participants may have received a GD ICD-10 code as youths, legal gender changes only occurred for adults (aged ≥18 years) based on legal requirements during the time of data collection. Exposure: Gender dysphoria. Main Outcomes and Measures: Legal gender change and its stability, that is, absence of legal gender reversal, as reported in the registry. Kaplan-Meier survival analysis was used to determine the probability of legal gender change and its stability during a 10-year study period. Results: A total of 7293 people with a GD diagnosis were included (36 025 person-years). Approximately one-third of the sample (n = 2467) obtained a legal gender change during the study period. The probability of legal gender change at 10 years following diagnosis was 58.3% (95% CI, 56.2%-60.4%). Twenty-one cases of legal gender reversal were identified. The probability of legal gender stability at 10 years following the initial change was 97.7% (95% CI, 96.3%-99.2%), with no differences by sex assigned at birth for either outcome. Conclusions and Relevance: In this cohort study using national population registry data, a significant proportion of participants with GD in Sweden obtained legal gender change within 10 years of follow-up. Despite significant growth of the population with GD, the probability of legal gender stability during the 10-year study period was high, at almost 98%. These results highlight that legal gender reversal was an infrequent occurrence in a national sample.

Indexed as

Gender DysphoriaAdolescentAdultCohort StudiesFemaleHumansMaleMiddle AgedRegistriesSwedenYoung Adult

Identifiers

PMID40906480
PMCPMC12411971

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.