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

• Von 100 Detransitionierten waren 69 % weiblich und 31 % männlich geboren. Im Durchschnitt hatten sie 3,9 Jahre transitioniert gelebt und waren 26, als sie sich zur Detransition entschlossen.
• Die häufigsten Gründe waren, sich mit dem Geburtsgeschlecht wohler zu fühlen (60 %), Sorge vor möglichen medizinischen Komplikationen (49 %) und die Entscheidung, dass ihr Geschlechtsleidensdruck durch etwas Bestimmtes verursacht war, etwa Trauma, Missbrauch oder eine psychische Erkrankung (38 %).
• Diskriminierung war für 23 % ein Grund. Weitere 23 % sagten, Scham über das Schwulsein oder Schwierigkeiten, lesbisch, schwul oder bisexuell zu sein, hätten bei der Transition und dann der Detransition eine Rolle gespielt.
• 55 % hatten das Gefühl, ein Arzt oder eine psychotherapeutische Fachkraft habe sie vor der Transition nicht richtig beurteilt. Fast die Hälfte sagte, die Beratung sei zu positiv über den Nutzen und nicht ehrlich genug über die Risiken gewesen.
• Etwa 80 % empfanden etwas Reue, und etwa die Hälfte (49,5 %) empfand starke oder sehr starke Reue. Manche sagten, die Transition habe ihnen geholfen, und sie hätten nur wegen Druck oder medizinischer Probleme aufgehört.
• Nur 24 % hatten den Behandelnden, die ihnen bei der Transition geholfen hatten, gesagt, dass sie eine Detransition gemacht hatten, daher sind Detransitionsraten auf Grundlage von Klinikakten wahrscheinlich zu niedrig.
• Weiblich Geborene waren jünger und hatten kürzer transitioniert gelebt als männlich Geborene (durchschnittlich 3,2 gegenüber 5,4 Jahre).

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.