60 % blev komfortable med deres fødselskøn: Undersøgelse af 100 personer, der stoppede deres transition, afslører hvorfor de stoppede

Personer behandlet for kønsdysfori med medicinsk og/eller kirurgisk overgang, som derefter stoppede deres overgang: En undersøgelse af 100 personer

Spørgeskemaundersøgelser Detransition & fortrydelse Omsorg og støtte til detransitionerede

Authors: Lisa Littman
Journal: Archives of Sexual Behavior
Year: 2021
Source: pubmed.ncbi.nlm.nih.gov/34665380/

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

Af 100 detransitionister var 69 % født som kvinder og 31 % født som mænd. I gennemsnit havde de levet transitioneret i 3,9 år og var 26, da de besluttede at detransitionere.
De mest almindelige årsager var at blive mere tryg ved deres fødselskøn (60 %), bekymring for mulige medicinske komplikationer (49 %) og at beslutte, at deres kønslidelse skyldtes noget specifikt, såsom traumer, overgreb eller en psykisk tilstand (38 %).
Diskrimination var en årsag for 23 %. Yderligere 23 % sagde, at skam over at være homoseksuel eller vanskeligheder ved at acceptere at være lesbisk, bøsse eller biseksuel spillede en rolle i at transitionere og derefter detransitionere.
55 % følte, at en læge eller psykolog ikke havde vurderet dem ordentligt før transition. Næsten halvdelen sagde, at rådgivningen var for positiv om fordelene og ikke ærlig nok om risici.
Omkring 80 % følte en vis fortrydelse, og omkring halvdelen (49,5 %) følte stærk eller meget stærk fortrydelse. Nogle sagde, at transition havde hjulpet dem, og at de kun stoppede på grund af pres eller medicinske problemer.
Kun 24 % havde fortalt de behandlere, der hjalp dem med at transitionere, at de havde detransitioneret, så detransitionsrater baseret på klinikjournaler er sandsynligvis for lave.
Dem født som kvinder var yngre og havde været transitioneret i kortere tid end dem født som mænd (3,2 mod 5,4 år i gennemsnit).

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.

Methodological limitations

Volunteers found mostly through detransition networks: The survey was posted on detransition blogs, a private detransition forum, a closed Facebook group, Tumblr, Twitter and Reddit, as well as professional mailing lists (WPATH, APA Division 44 and SEXNET). Many people heard about it through detransition blogs, so those with bad experiences and ties to those groups are probably over-represented.
Nothing could be checked: The survey was anonymous, didn't record IP addresses, and relied only on what people reported. Who they were, what treatment they had, their diagnoses and timelines couldn't be checked, as the author admits.
Small and similar group: There were 100 people, 90% White, 98% non-Hispanic and mostly from the US. That limits how far the results apply to others.
Looking back, at one point in time: People described their reasons and feelings from years earlier, after about 4 years of transition on average. The author notes that bad experiences may have 'colored some of the responses', and this design can't show what caused what.
Home-made questionnaire: The 115-question survey was written by the author with two detransitioned people. No tested questionnaires were used for gender distress, regret or mental health, and wording such as whether gender distress was 'caused by something specific (ex. trauma, abuse, mental health condition)' may nudge people toward certain answers.
No comparison group: Without people who continued transitioning, we can't know whether features like poor assessment, social media influence or past trauma are special to detransitioners.
Can't say how common detransition is: The author says the study wasn't designed to measure this. The 24% who told their clinicians shows clinics undercount, but not by how much.
Old data: The survey ran from December 2016 to April 2017 but was published in October 2021. Clinical practice, the sites used to recruit and the people detransitioning may have changed since.
Questions shaped by the author's earlier idea: The author had earlier proposed 'rapid-onset gender dysphoria' (Littman 2018), the idea that gender distress can appear suddenly under social influence. The survey included questions testing that idea, such as on social media and friends, which may have shaped what was asked and how answers were read.
Who paid: The author works for The Institute for Comprehensive Gender Dysphoria Research, which also paid the publishing fees. There was no outside funding and no conflicts were declared.
Written answers sorted by one person: The author alone read and sorted people's written answers, with no second person checking that they'd sort them the same way.

detrans.ai

Summary

Key findings

Abstract

Conclusion