Summary

Lisa Littman surveyed 100 detransitioners about why they transitioned and why they stopped. Most were found through detransition blogs, forums and social media, and some through professional mailing lists. Reasons varied: 60% had become comfortable with their birth sex, 49% worried about medical complications, 38% came to see their gender distress as rooted in trauma or mental illness, and 23% mentioned discrimination. About half felt strong regret. 55% felt they were not properly assessed before transition, and only 24% told their clinicians they had detransitioned. That suggests clinic records miss many detransitioners. The study gives a voice to a hidden group, but the people chose to take part, their answers couldn't be checked, and it is a one-time snapshot from 2016 to 2017. It cannot show how common detransition is or what causes it.

Key findings

• От 100 детрансишънъри 69% са родени като жени и 31% като мъже. Средно са живели в трансизиция 3,9 години и са били на 26 години, когато решават да направят детранзиция.
• Най-честите причини са по-голямо удобство с биологичния им пол (60%), тревога за възможни медицински усложнения (49%) и решението, че половият им дистрес е причинен от нещо конкретно, като травма, насилие или психично състояние (38%).
• Дискриминацията е причина за 23%. Още 23% казват, че срамът от това да си гей или трудността да приемат, че са лесбийки, гейове или бисексуални, е изиграла роля при трансизицията и след това при детранзицията.
• 55% смятат, че лекар или специалист по психично здраве не ги е оценил подобаващо преди трансизицията. Почти половината казват, че консултирането е било твърде позитивно за ползите и недостатъчно честно за рисковете.
• Около 80% чувстват известно съжаление и около половината (49,5%) чувстват силно или много силно съжаление. Някои казват, че трансизицията им е помогнала и са спрели само заради натиск или медицински проблеми.
• Само 24% са казали на клиницистите, които са им помогнали с трансизицията, че са направили детранзиция, така че честотите на детранзиция, основани на клинични записи, вероятно са твърде ниски.
• Родените като жени са по-млади и са останали в трансизиция за по-кратко време от родените като мъже (средно 3,2 срещу 5,4 години).

Abstract

The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then detransitioned by discontinuing medications, having surgery to reverse the effects of transition, or both. Recruitment information with a link to an anonymous survey was shared on social media, professional listservs, and via snowball sampling. Sixty-nine percent of the 100 participants were natal female and 31.0% were natal male. Reasons for detransitioning were varied and included: experiencing discrimination (23.0%); becoming more comfortable identifying as their natal sex (60.0%); having concerns about potential medical complications from transitioning (49.0%); and coming to the view that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition (38.0%). Homophobia or difficulty accepting themselves as lesbian, gay, or bisexual was expressed by 23.0% as a reason for transition and subsequent detransition. The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned. There are many different reasons and experiences leading to detransition. More research is needed to understand this population, determine the prevalence of detransition as an outcome of transition, meet the medical and psychological needs of this population, and better inform the process of evaluation and counseling prior to transition.

Conclusion

This study described individuals who, after transitioning with medications or surgery, have detransitioned. The prevalence of detransitioning after transition is unknown but is likely underestimated because most of the participants did not inform the doctors who facilitated their transitions that they had detransitioned. There is no single narrative to explain the experiences of all individuals who detransition and we should take care to avoid painting this population with a broad brush. Some detransitioners return to identifying with their birth sex, some assume (or maintain) a nonbinary identification, and some continue to identify as transgender. Some detransitioners regret transitioning and some do not. Some of the detransitioners reported experiences that support the ROGD hypotheses, including that their gender dysphoria began during or after puberty and that mental health issues, trauma, peers, social media, online communities, and difficulty accepting themselves as lesbian, gay, or bisexual were related to their gender dysphoria and desire to transition. Natal female and natal male detransitioners appear to have differences in their baseline characteristics and experiences and these differences should be further delineated. Future research about gender dysphoria and the outcomes of transition should consider the diversity of experiences and trajectories. More research is needed to determine how best to provide support and treatment for the long-term medical and psychological well-being of individuals who detransition. Findings about detransition should be used to improve our understanding of gender dysphoria and to better inform the processes of evaluation, counseling, and informed consent for individuals who are contemplating transition.