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Stability After Legal Gender Change Among Adults With Gender Dysphoria.
Kristen D Clark1, Richard A White1,2, Georgios Karamanis1,3
1Department of Medical Sciences, Clinical Psychiatry, Uppsala University, Uppsala, Sweden.
JAMA Network Open
|September 4, 2025
Summary
Legal gender change is common for individuals with gender dysphoria (GD), with high stability rates. This study found nearly 98% of legal gender changes remained stable over ten years, indicating infrequent reversals.
Area of Science:
- Endocrinology and Metabolism
- Public Health and Epidemiology
- Psychiatry and Psychology
Background:
- Increasing prevalence of gender dysphoria (GD) diagnoses necessitates understanding transition outcomes.
- Limited data exists on detransition, particularly legal gender reversals.
- Legal gender change registries offer insights into transition stability.
Purpose of the Study:
- To determine the probability of obtaining legal gender change in individuals diagnosed with GD.
- To assess the long-term stability of legal gender changes.
- To analyze legal gender reversals as a potential indicator of detransition.
Main Methods:
- Population-based cohort study utilizing Swedish national registers (2013-2023).
- Inclusion of individuals with first-time ICD-10 diagnosis codes for GD.
- Kaplan-Meier survival analysis to calculate probabilities of legal gender change and stability.
Main Results:
- 7293 individuals with GD diagnosis included; 2467 (approx. one-third) obtained legal gender change.
- 10-year probability of legal gender change was 58.3%.
- 10-year probability of legal gender stability was high at 97.7%, with only 21 legal gender reversals identified.
Conclusions:
- A significant proportion of individuals with GD in Sweden undergo legal gender change.
- Legal gender change demonstrates high stability over a 10-year period.
- Legal gender reversal is infrequent in a national sample, suggesting robust legal gender change outcomes.
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