Summary

Canadian researchers interviewed 20 young people aged 16 to 25, nearly all born female, from seven countries. All had started and then stopped a gender transition, and were asked about the whole journey. How they saw their gender changed over time, and rarely settled into a simple return to their birth sex. Same-sex attraction, sometimes with shame about being gay, was part of why many had transitioned. Body discomfort often eased during transition. Afterwards it could ease, come back, or turn into distress about permanent changes such as a deeper voice. The authors conclude that paths are too varied to predict how things will turn out. They say care should look at the whole of life, including sexuality and possible loss. This is early, exploratory work. The group was small and volunteered, accounts look back in time, and the analysis openly comes from a gender-affirming viewpoint.

Key findings

• Tyve personer i alderen 16 til 25 år fra Canada, USA, Frankrig, Belgien, Indonesien, Skotland og Finland blev interviewet i 2020; 19 af de 20 var født som kvinder.
• Alle havde transitioneret socialt; 13 havde også transitioneret medicinsk (12 tog hormoner, 8 havde mindst én operation, 2 tog pubertetsblokkere), men kun 3 af de 13 begyndte på medicinsk transition før 18-årsalderen.
• Efter at have stoppet varierede kønsidentiteterne: nogle omfavnede deres fødselskøn igen, andre kaldte sig ikke-binære eller flydende eller brugte ingen etiket, og nogle beholdt deres transitionsnavn eller pronominer.
• Mere end halvdelen af dem, der talte om seksualitet, havde været tiltrukket af deres eget køn før transition, og flere forbandt deres transition med skam over at være homoseksuel.
• De fleste følte sig bedre tilpas i deres krop under transition, men nogle fandt, at ændringerne ikke var nok, fik komplikationer eller følte pres for at fortsætte til det næste ‘skridt’.
• Efter at have stoppet blev tre kropsoplevelser beskrevet: at føle sig nogenlunde tilpas, at den oprindelige lidelse vendte tilbage, eller ny lidelse over permanente ændringer såsom stemme eller ansigtsbehåring.
• Forfatterne fandt ingen fælles træk, der kunne forudsige, hvem der ville stoppe, og anbefaler, at informeret samtykke dækker seksualitet, mulige tab og fremtidige udfordringer gennem en persons liv.

Abstract

Background: Detransition is frequently covered in the media as a return to a cis identity after transition. Detransition is often studied in isolation and fails to examine it in context of various stages leading to detransition. Aim: To present the perspectives and reflections of youth who have detransitioned on their journey from early transition to discontinuation, focusing on three key dimensions: gender modalities, sexual modalities, and dysphoria experiences, and their evolution during this journey. Method: We drew from 20 in-depth interviews with young people aged 16 to 25 who have discontinued a transition and examined various stages of the gender journey from early transition to detransition. Youth narratives were analyzed thematically and longitudinally. Results: We developed three main themes related to the gender journey: nonlinear gender modalities, navigating sexual modalities along with gender modalities, and coping with dysphoria and body discomfort. We found a great diversity of experiences with regard to these within each participant and across the sample. Discussion: Transition and detransition trajectories are nonlinear and heterogeneous, without any identified commonalities that enable the prediction of outcomes after transitions. However, transnormativity may influence how people who detransition are expected to conform to a certain narrative despite the diversity of experiences present in this community.

Conclusion

Youth who discontinue a transition undergo diverse gender journeys and changes across gender modalities, sexual modalities and experiences of dysphoria. Transition and detransition trajectories are nonlinear and heterogeneous, with no identified commonalities that allow outcomes after transition to be predicted, and transnormativity may push people who detransition to fit an expected narrative. Future research should examine these experiences prospectively, for example by following youth from the moment they question their transition and examining how heteronormativity and transnormativity affect decisions to transition or detransition. Providers should look critically at media narratives, take a life-course approach that offers support beyond transition care, help youth understand how transition may affect their gender and sexual modalities, and discuss possible ambiguous loss, in order to strengthen informed consent and support youth whatever direction their gender journey takes.