Summary

Researchers interviewed six UK women who medically transitioned and later detransitioned, looking for shared themes. All had taken testosterone for 1 to 5 years, and four had had both breasts removed. Four themes emerged. First, hormones and surgery did not resolve their distress or change their sex. Second, they worried about the long-term health effects of testosterone. Third, their sense of belonging changed, and some felt more at home among women and lesbian communities. Fourth, detransition was an ongoing process, and their needs were mostly not met by health services. The authors call for careful whole-person assessment before transition, research on testosterone's long-term effects in women, and better support for people detransitioning. It gives a detailed picture of a few lives, but six similar, self-selected people cannot show how common this is.

Key findings

• أُجريت مقابلات مع ستة بالغين بريطانيين وُلدوا إناثاً، بأعمار 21 إلى 32. تناولوا جميعاً التستوستيرون لمدة 1 إلى 5 سنوات، بدءاً من أعمار 17 إلى 24، وأجرت أربعة منهم استئصال الثديين معاً، وتراجعوا عن التحول قبل شهرين إلى 5 سنوات.
• كان للتحول الطبي حدود: فلم تحل الهرمونات والجراحة كرْبهم الجندري ولا صعوباتهم النفسية الكامنة بالكامل، وشعر بعضهم بكرب أكبر، أو كرب بسبب جسدهم المتغير، بعد التغيرات الجسدية.
• دفعت المخاوف الصحية طويلة الأمد قراراتهم: فالقلق من الآثار المجهولة للتستوستيرون على أجساد الإناث، مثل مخاطر القلب وانكماش الرحم والعقم، ساعد على التراجع عن التحول، وشعروا أنهم لم يُبلَّغوا جيداً مسبقاً.
• تغير الانتماء مع الوقت: وجد كثيرون أنهم يشعرون بأنهم أنفسهم أكثر عند التواصل مع النساء ومجتمعات المثليات منه عند العيش كرجال، وأدرك بعضهم أن أفكاراً ضيقة عمّا تكونه المرأة شكّلت قرارهم الأول بالتحول.
• كان التراجع عن التحول معقداً ومستمراً: جلب الحزن والذنب ومشكلات عملية مثل العيش بمظهر أكثر ذكورة، ووجد معظمهم طرقاً غير العلاج الطبي للتعامل مع الكرب.
• كان الدعم ناقصاً في الغالب: وصفوا احتياجات لم يلبّها الأطباء والمعالجون، وكثيراً ما لجؤوا إلى مجتمعات التراجع عن التحول على الإنترنت للمعلومات والنصائح العملية والدعم العاطفي.
• كان لدى أربعة من الستة تشخيص بالتوحد (أو بالتوحد أو اضطراب فرط الحركة وتشتت الانتباه في أحد أجزاء الورقة).

Abstract

The visibility and presence of people who have detransitioned following a gender transition is growing, with an increase in research on the needs and experiences of this group. This study presents a thematic narrative analysis of interviews from six females (M = 25.5 yrs; range = 21–32 yrs). All detransitioned after having at least one gender-affirming medical or surgical treatment as part of a gender transition in the UK. Four narrative themes were developed to capture how they made sense of their detransition: (1) the limits of medical transition, (2) the longer-term health implications, (3) the social limits of transition, and (4) detransition as an ongoing process. Participants discussed a range of emotional, practical, and other support needs, largely unmet by healthcare or other services. These findings highlight the importance of ensuring that people have realistic expectations of transition as part of a holistic assessment process. Long-term health outcome research is also needed, addressing the impact of testosterone on female anatomy and health specifically. Further clinical implications with those considering transition or detransition are discussed.

Conclusion

This research adds an in-depth analysis to the previous literature on detransition. Participants detransitioned because they found medical transition had limits to resolve distress, or to change their sex. The ongoing health implications and associated risks were also a factor for most. Participant perception of social group belonging often shifted after transition, sometimes linked to feminist values, or perhaps reflecting the normal developmental experiences and trajectory of adolescence and early adulthood as young people explore their identities in different social contexts. It is also possible that the experience of the physical limits of transition to transform them, left the social aspects feeling hollow, increasing social dysphoria related to the new gender. Detransition was a complex and individual, ongoing process, with a range of needs expressed. Implications for clinical practice with people considering transition and detransition were discussed.