Summary

This study surveyed 78 American young adults, mostly born female, who had identified as trans, often taking medical steps, and later stopped. They reported high rates of mental health diagnoses, many from before they first identified as trans. Most said they had first mistaken mental health problems or trauma for gender distress. Their reasons for detransitioning were mostly internal, such as their own changing thinking, rather than pressure from family or discrimination. Most reported much less gender distress and self-harm, and feeling much better about life, after detransitioning. The authors conclude that for some people, detransition is both possible and helpful. But these were volunteers looking back once on their own experience. The study describes this group well, but cannot show how common detransition is, or that detransitioning caused the improvements.

Key findings

• Af 78 personer var 71 (91 %) født som kvinder; i gennemsnit identificerede de sig første gang som trans i en alder af 17 og gjorde det i omkring 5 år.
• De fleste (83 %) havde taget sociale transitionsskridt og 68 % medicinske skridt: 40 % kun hormoner, 23 % hormoner og kirurgi og 5 % kun kirurgi.
• Set i bakspejlet huskede færre end 17 % kønslidelse i barndommen, der opfyldte nutidens diagnose, mens 53 % følte, at ‘rapid-onset gender dysphoria’ (kønslidelse, der dukker pludseligt op i teenageårene) beskrev dem.
• Psykiske problemer var almindelige: 79 % havde nogensinde selvskadet, heraf 71 % før, 64 % under og 23 % efter at have identificeret sig som trans.
• Den mest almindelige angivne årsag til først at identificere sig som trans var at forveksle psykiske problemer eller reaktioner på traumer med kønslidelse; årsager til at stoppe var oftere indre end pres udefra.
• Af dem, der fik krydskønshormoner, følte 66,7 %, at de ikke var ordentligt informeret om risiciene, og kun én person sagde, at vedkommende var blevet informeret om andre muligheder.
• Kun 27,1 % af alle deltagere fortalte deres transitionslæge, at de havde detransitioneret.
• Forfatterne indrømmer, at deres studie ikke kan vise, hvor almindelig detransition er, eller hvad der forudsiger den.

Abstract

Persons who have renounced a prior transgender identification, often after some degree of social and medical transition, are increasingly visible. We recruited 78 US individuals ages 18-33 years who previously identified as transgender and had stopped identifying as transgender at least six months prior. On average, participants first identified as transgender at 17.1 years of age and had done so for 5.4 years at the time of their participation. Most (83%) participants had taken several steps toward social transition and 68% had taken at least one medical step. By retrospective reports, fewer than 17% of participants met DSM-5 diagnostic criteria for Gender Dysphoria in Childhood. In contrast, 53% of participants believed that "rapid-onset gender dysphoria" applied to them. Participants reported a high rate of psychiatric diagnoses, with many of these prior to trans-identification. Most participants (N = 71, 91%) were natal females. Females (43%) were more likely than males (0%) to be exclusively homosexual. Participants reported that their psychological health had improved dramatically since detransi- tion/desistance, with marked decreases in self-harm and gender dysphoria and marked increases in flourishing. The most common reason given for initial trans-identification was confusing mental health issues or reactions to trauma for gender dysphoria. Reasons for detransition were more likely to reflect internal changes (e.g., the participants' own thought processes) than external pressures (e.g., pressure from family). Results suggest that, for some transgender individuals, detransition is both possible and beneficial.

Conclusion

We surveyed a sample of young adults who previously identified as transgender but had detransitioned or desisted. Most participants were born female. Mental health issues, including prior diagnoses and a history of self-harm, were especially common. A history of gender dysphoria during childhood was reported by a nontrivial minority of participants. A slight majority believed their histories were consistent with rapid-onset gender dysphoria. Factors most associated with detransition were internal factors, reflecting psychological change, rather than external factors, such as family or social pressure. Detransitioned participants reported that they had become much less gender dysphoric, and much happier, than they were during their period of trans-identification.