"Some adolescents or adults who take gender-affirming hormones subsequently elect to stop treatment. Most adults who stop gender-affirming hormones report doing so for reasons unrelated to a change in gender identity, such as pressure from family, difficulty obtaining employment, or discrimination. Also, discontinuation of gender-affirming hormones does not necessarily represent a failure in treatment or initial decision-making. Some TGD adolescents and adults who start and then discontinue gender-affirming hormones experience use of hormones as an important part of consolidating their gender identity and experience no regret over the use of hormones despite some permanent effects. However, a portion of TGD individuals who pursue gender-affirming medical or surgical affirmation do express regret over the permanent effects of treatment. In a metanalysis of 7928 TGD individuals who had gender confirmation surgery, 1% expressed regret after surgery. The most prevalent reason for regret was psychosocial circumstances, particularly from a lack of social support or negative reactions from family and employers."