Kvinder, der er gået i detransition, rapporterer uopfyldte behov: Medicinsk transition løste ikke dysfori

Fortællinger fra voksne registreret som kvinder ved fødslen, der startede en medicinsk transition og senere gik i detransition

Authors
Jane Lomax, Catherine Butler
Journal
Archives of Sexual Behavior
Year
2025

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

  • Seks britiske voksne født som kvinder i alderen 21 til 32 år blev interviewet. Alle havde taget testosteron i 1 til 5 år og begyndt i en alder af 17 til 24 år, fire havde fået begge bryster fjernet, og de havde detransitioneret 2 måneder til 5 år tidligere.
  • Medicinsk transition havde grænser: hormoner og kirurgi løste ikke fuldt ud deres kønslidelse eller underliggende psykiske problemer, og nogle følte mere lidelse, eller lidelse over deres forandrede krop, efter de fysiske ændringer.
  • Bekymringer om langsigtet helbred drev beslutninger: bekymring for ukendte effekter af testosteron på kvindekroppe, såsom hjerterisici, svind af livmoderen og infertilitet, var med til at føre til detransition, og de følte ikke, at de var blevet ordentligt informeret på forhånd.
  • Tilhørsforhold ændrede sig over tid: mange fandt, at de følte sig mere sig selv i forbindelse med kvinder og lesbiske fællesskaber end ved at leve som mænd, og nogle indså, at snævre forestillinger om, hvad en kvinde er, havde formet deres første beslutning om at transitionere.
  • Detransition var kompleks og igangværende: den medførte sorg, skyld og praktiske problemer såsom at leve med et mere maskulint udseende, og de fleste fandt andre veje end medicinsk behandling til at håndtere lidelsen.
  • Støtte manglede for det meste: de beskrev behov, som læger og terapeuter ikke mødte, og søgte ofte til online detransitionsfællesskaber for information, praktiske råd og følelsesmæssig støtte.
  • Fire af de seks havde en autismediagnose (eller i en del af artiklen autisme eller 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.