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43% от детранзитиралите: доставчиците никога не са изглеждали запознати с детранзицията (северноамериканска анкета)

„Доставчиците нямаха представа какво да правят с мен“: анализ със смесени методи на нуждите от подкрепа, грижа и информация при детранзиция/ретранзиция сред лица от сексуални и джендърни малцинства

АнкетиДетранзиция и съжалениеГрижи и подкрепа за детранзициониращи
Authors
Kirsty Rackliff, Pablo Expósito-Campos, Wren Ariel Gould, David J. Kinitz, Madeline Rosen, S. Rudd, June S. H. Lam, Annie Pullen Sansfaçon, Kinnon Ross MacKinnon
Journal
International Journal of Transgender Health
Year
2025
Source
https://doi.org/10.1080/26895269.2025.2538744

Summary

Researchers surveyed 957 people in the US and Canada who said they had stopped, changed or reversed a gender transition, or wanted to. Most were born female and most described themselves as lesbian, bisexual or queer; 42% had at some point stopped and later restarted transition. Many reported poor care after detransitioning: about 43% said providers never seemed to know anything about detransition, and more than half sometimes or always avoided health care. People most often asked for clinicians who understand detransition, contact with other detransitioners, accurate advice on stopping hormones, help with reconstructive surgery, and therapy that takes trauma into account. Some stopped only because of cost, family rejection or losing access to care. The results show real unmet needs, but come from a self-selected online group and cannot show how common these experiences are.

Key findings

  • Включени са 957 души (от 1377 попълнени анкети, след премахване на ботове и фалшиви отговори); 79% са родени като жени и 74% живеят в САЩ.
  • Повечето са лесбийки, гейове, бисексуални или куиър (45% бисексуални, 29% куиър, 27% лесбийки), а 42% са спрели и по-късно са възобновили трансизиция.
  • След детранзицията 43% казват, че здравният им доставчик никога не изглежда да знае за детранзицията, а само 7% казват, че доставчиците винаги са знаели.
  • Избягването на грижа е често: 13% винаги и 45% понякога са избягвали здравни доставчици, когато са се нуждаели от грижа, а 46% понякога или винаги са се нуждаели от грижа, но не са я получили.
  • В 563 писмени отговора най-честите неудовлетворени нужди са подкрепа от общността и връстници (29%), доставчици, които разбират детранзицията (29%), лична подкрепа (22%) и грижа за психичното здраве (16%).
  • 46 отговора искат съвет как да спрат хормоните безопасно, а някои описват отказ на възстановителна операция, например отказ от четирима хирурзи.
  • Някои описват, че са принудени да спрат заради цена, загуба на достъп до грижа или семейно отхвърляне, и искат помощ да възобновят трансизицията.

Abstract

BACKGROUND: Detransition refers to stopping, shifting, or reversal of an initial gender transition. Some people detransition temporarily, and later re-start a transition process, or retransition. Despite calls for research and care surrounding detransition/retransition, these experiences remain poorly understood by care providers and LGBTQ2S+ community-serving organizations.

METHODS: Between December 2023-April 2024, a cross-sectional survey was administered to 957 individuals (aged 16 and older) living in the US or Canada who self-identified with experiences of detransition. Participants were recruited via advertisements across eight major social media platforms, direct emails sent to ∼1200 former research participants, and to >615 LGBTQ2S+ organizations and gender-affirming care providers. Mixed qualitative and quantitative data were collected and analyzed regarding participants' experiences and care needs during detransition and, if relevant, retransition. Data about care experiences and needs were analyzed descriptively using frequencies and percentages. Interpretive description was utilized to analyze qualitative responses.

RESULTS: Participants reported a wide range of current gender identities/expressions such as: woman (n = 386; 40.3%); gender nonconforming woman (n = 241; 25.2%); nonbinary (n = 238; 24.9%); and/or detrans woman; (n = 152; 22.5%). A majority of the sample were sexual minorities. A majority reported being bisexual (n = 429; 44.8%), queer (n = 277; 28.9%), and/or lesbian (n = 254; 26.5%). Qualitative analysis identified three key themes: (1) accessing detransition-related care needs within the gender-affirming care system; (2) detransition-related social/legal needs to navigate a second transition; and (3) detransition preventative and retransition needs. Each of these themes encompassed four subthemes, including access to detrans-knowledgeable care providers (n = 162; 28.8%); medical information (n = 62; 11.0%); mental healthcare and supports (n = 92; 16.3%); interpersonal supports (n = 124; 22.0%); and community supports (n = 163; 29.0%).

CONCLUSION: Greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.

Conclusion

The current study contributes to the limited body of work regarding the experiences and care needs of detrans people and other SGM people who report identity fluidity and detransition/retransition. Findings indicate that, like other SGM people, detransition may be inadequately understood by some LGBTQ2S+ serving and gender-affirming care practitioners. Future research and community-led research on detransition/retransition can ameliorate this knowledge gap. Importantly, given the potential for country-specific differences in detransition/retransition experiences, future research should be more sensitive to geopolitical and healthcare delivery dynamics. (Abstract conclusion: greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.)