(145) Dropout Among Patients with Gender Incongruence: Causes and Consequences

Introduction Gender-affirming treatment aims to align secondary sex characteristics with gender identity and can substantially improve quality of life for transgender and non-binary individuals. Despite these benefits, a subset of patients disengages from clinical pathways. Discontinuation may reflect a wide range of experiences, including satisfaction with achieved changes, logistical barriers, minority stress, a lack of social support, or reconsideration of one's gender identity. Understanding these factors is crucial to enhancing support and avoiding unintended dropout. Objective To investigate reasons for discontinuation from gender-affirming care and examine demographic, psychosocial, and treatment-related predictors of dropout. Methods A total of 703 adults who had been previously referred for gender-affirming care but were not currently engaged in treatment were contacted via secure email and invited to complete an online questionnaire. Responses were received from 105 participants. For a subgroup of 75, a systematic review of medical records is being performed to determine initiation and discontinuation of gender-affirming hormone therapy (GAHT), timing of disengagement, and any documented reasons. Statistical analyses will assess dropout trajectories and associations with age, assigned sex at birth, psychosocial vulnerabilities, and treatment course. Results Early observations suggest heterogeneous pathways to dropout, including dissatisfaction with attained bodily changes, practical or geographical obstacles, and stressors related to stigma or a lack of relational support. Analyses will further clarify which individual and contextual factors are most strongly associated with treatment disengagement. Conclusions By identifying diverse patterns and determinants of discontinuation, this study will contribute to more responsive and person-centred treatment pathways for transgender and gender-diverse individuals, enabling care providers to tailor support and information to minimise unintended dropout. Disclosure No