F Ashley et al, “Gatekeeping gender-affirming care is detrimental to detrans people” (2025)International Journal of Transgender Health
Abstract: Gender assessments are often required to access gender-affirming medical interventions. These assessments are typically defended as a way of preventing regret, offering a compromise between the interests of trans and detrans people. Whether they do is integral to ongoing debates about models of care in transgender health. Building on previous work demonstrating the inefficacy of gender assessments, this article explores the impact of gender assessments and argues that they are detrimental to detrans people. Assessments appear to be detrimental to detrans people because they disincentivize honesty and authenticity, inhibit gender exploration, increase shame and anger associated with detransition, foster transnormativity, hinder the development of a strong therapeutic alliance, and diminish the quality of informational disclosure. Given the detrimental consequences of gender assessments, clinicians should reconsider gatekeeping practices in favor of supporting patient decision-making and offering better care to people who detransition.