Hormone therapy for trans teenagers is one of the most fought-over topics in health policy right now. In those fights, one word comes up again and again: regret.

A new study in JAMA Pediatrics asked the people who actually went through it. Most of them said they’d make the same call again.

What the study did

The paper, “Satisfaction, Regret, and Harm After Hormone Therapy in Youth From a Multidisciplinary Gender Clinic”, was published online on November 9. It’s led by psychologist Laura Kuper of UT Southwestern Medical Center in Dallas, with co-authors from Boston Children’s Hospital, Lurie Children’s Hospital in Chicago and UC San Diego.

The researchers surveyed former patients of a single US gender clinic for trans and gender-diverse youth, between October 2023 and October 2025. According to PsyPost’s breakdown of the paper:

  • 698 former patients who had agreed to long-term research were invited.
  • 376 who had started estrogen or testosterone as young people took part. They began hormones at 16 on average, and about 92% started at 17 or younger.
  • On average, they were surveyed 4.9 years after starting, at an average age of nearly 21.

They measured regret with the Decision Regret Scale, a standard questionnaire that has also been used for other medical decisions.

What it found

From the study abstract:

  • 96.8% (360 people) agreed or strongly agreed that starting hormone therapy was the right decision.
  • 2.7% (10 people) reported regret, and 1.9% (7) said they felt harmed.
  • The median regret score was 0 out of 100, and the average was 4.3. PsyPost notes that studies of other medical decisions using the same scale average about 16.5.
  • 82.7% were still on hormones; 17.3% had stopped.

Regret scores were higher among people who’d stopped hormones and among people who identify on the nonbinary spectrum, though the authors say regret stayed low in absolute terms for both groups. Even among those who’d stopped, 83% still said starting was the right decision.

The authors write that their findings “complement the literature documenting mental health benefits” of hormone therapy, “providing further support for existing standards of care for transgender and gender-diverse youth.” According to PinkNews, they also say the results “do not support efforts to categorically restrict or ban access” to it.

Why the people who regretted it matter too

The study didn’t just count regret; it asked about it. Nine people who reported regret or harm explained why in their own words. The most common reason (seven of the nine) was not feeling prepared: because of their age or maturity, mental health difficulties, or not enough support from parents or therapists. Others mentioned physical effects they didn’t want.

That’s useful for clinics, whatever side of the political debate you’re on. It points to better preparation and support, not to taking care away from the 96.8%.

What it can’t tell us

This is a strong study, and it has real limits. Researchers outside the team flagged several:

  • Non-response. Nearly 300 of the 698 people invited didn’t respond, PsyPost reports, so we don’t know how they feel. Prof Channa Jayasena of Imperial College London called it “a well-conducted and large study” but noted in comments to the Science Media Centre that “about 40% of those invited to complete the survey did not respond.”
  • One clinic, mostly white. More than 93% of participants were white, PsyPost reports, and the survey was run by clinicians from the clinic that treated them.
  • Follow-up. Nearly five years on average may be too short to catch regret that appears later.
  • Regret isn’t the whole picture. Psychologist Aleksandra M. Rogowska of the University of Opole in Poland, who wasn’t involved, told PsyPost that “low decisional regret is not the same as evidence of long-term benefit or safety,” and called for multi-site studies that actively follow people who stop treatment.

The bottom line

The biggest study of its kind found that almost everyone who started hormones as a teen still stands by the decision. It doesn’t settle every question, and no single study could. But at a time when access to this care is being restricted, it adds real data from the people whose lives are at the centre of the debate.

It’s out during Transgender Awareness Week, too. Listening to trans people about their own lives seems like the right way to mark it.