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
- Bylo vyslechnuto šest dospělých ve Spojeném království narozených jako ženy ve věku 21 až 32 let. Všichni užívali testosteron 1 až 5 let, začali ve věku 17 až 24 let, čtyři měli odstraněna obě prsa a prošli detranzicí 2 měsíce až 5 let dříve.
- Lékařská tranzice měla meze: hormony a operace plně nevyřešily jejich genderovou tíseň ani základní duševní potíže a někteří po tělesných změnách pociťovali větší tíseň nebo tíseň z proměněného těla.
- Rozhodnutí řídily dlouhodobé obavy o zdraví: obavy z neznámých účinků testosteronu na ženská těla, například srdeční rizika, zmenšení dělohy a neplodnost, pomohly vést k detranzici a cítili, že nebyli předem řádně informováni.
- Pocit sounáležitosti se časem měnil: mnozí zjistili, že se cítí více sami sebou ve spojení se ženami a lesbickými komunitami než při životě jako muži, a někteří si uvědomili, že úzké představy o tom, co je žena, formovaly jejich původní rozhodnutí k tranzici.
- Detranzice byla složitá a probíhající: přinesla smutek, vinu a praktické problémy, například život s mužnějším vzhledem, a většina našla jiné způsoby než lékařskou léčbu, jak zvládat tíseň.
- Podpora většinou chyběla: popsali potřeby, které lékaři a terapeuti nesplnili, a často se obraceli na online komunity detranzicionistů pro informace, praktické rady a emocionální podporu.
- Čtyři ze šesti měli diagnózu autismu (nebo, v jedné části práce, autismu či ADHD).
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.