43% of Detransitioners Say Providers Never Seemed Knowledgeable About Detransition, North American Survey Finds

"Providers had no idea what to do with me": A mixed-methods analysis of detransition/retransition support, care, and information needs among sexual and gender minority individuals

Surveys Detransition & regret Detransitioner care & support

Authors: Kirsty Rackliff, Pablo Expósito-Campos, Wren Ariel Gould, David J. Kinitz, Madeline Rosen, S. Rudd, June S. H. Lam, Annie Pullen Sansfaçon, Kinnon Ross MacKinnon
Journal: International Journal of Transgender Health
Year: 2025
Source: https://doi.org/10.1080/26895269.2025.2538744

Summary

Researchers surveyed 957 people in the US and Canada who said they had stopped, changed or reversed a gender transition, or wanted to. Most were born female and most described themselves as lesbian, bisexual or queer; 42% had at some point stopped and later restarted transition. Many reported poor care after detransitioning: about 43% said providers never seemed to know anything about detransition, and more than half sometimes or always avoided health care. People most often asked for clinicians who understand detransition, contact with other detransitioners, accurate advice on stopping hormones, help with reconstructive surgery, and therapy that takes trauma into account. Some stopped only because of cost, family rejection or losing access to care. The results show real unmet needs, but come from a self-selected online group and cannot show how common these experiences are.

Key findings

957 people were included (out of 1,377 completed surveys, after removing bots and fake answers); 79% were born female and 74% lived in the US.
Most were lesbian, gay, bisexual or queer (45% bisexual, 29% queer, 27% lesbian), and 42% had stopped and later restarted a transition.
After detransitioning, 43% said their health provider never seemed to know about detransition, and only 7% said providers always did.
Avoiding care was common: 13% always and 45% sometimes avoided health providers when they needed care, and 46% sometimes or always needed care but did not get it.
In 563 written answers, the most common unmet needs were community and peer support (29%), providers who understand detransition (29%), personal support (22%) and mental health care (16%).
46 answers asked for advice on stopping hormones safely, and some described being refused reconstructive surgery, for example being turned down by four surgeons.
Some described being forced to stop by cost, losing access to care or family rejection, and wanted help to restart transition.

Abstract

BACKGROUND: Detransition refers to stopping, shifting, or reversal of an initial gender transition. Some people detransition temporarily, and later re-start a transition process, or retransition. Despite calls for research and care surrounding detransition/retransition, these experiences remain poorly understood by care providers and LGBTQ2S+ community-serving organizations.

METHODS: Between December 2023-April 2024, a cross-sectional survey was administered to 957 individuals (aged 16 and older) living in the US or Canada who self-identified with experiences of detransition. Participants were recruited via advertisements across eight major social media platforms, direct emails sent to ∼1200 former research participants, and to >615 LGBTQ2S+ organizations and gender-affirming care providers. Mixed qualitative and quantitative data were collected and analyzed regarding participants' experiences and care needs during detransition and, if relevant, retransition. Data about care experiences and needs were analyzed descriptively using frequencies and percentages. Interpretive description was utilized to analyze qualitative responses.

RESULTS: Participants reported a wide range of current gender identities/expressions such as: woman (n = 386; 40.3%); gender nonconforming woman (n = 241; 25.2%); nonbinary (n = 238; 24.9%); and/or detrans woman; (n = 152; 22.5%). A majority of the sample were sexual minorities. A majority reported being bisexual (n = 429; 44.8%), queer (n = 277; 28.9%), and/or lesbian (n = 254; 26.5%). Qualitative analysis identified three key themes: (1) accessing detransition-related care needs within the gender-affirming care system; (2) detransition-related social/legal needs to navigate a second transition; and (3) detransition preventative and retransition needs. Each of these themes encompassed four subthemes, including access to detrans-knowledgeable care providers (n = 162; 28.8%); medical information (n = 62; 11.0%); mental healthcare and supports (n = 92; 16.3%); interpersonal supports (n = 124; 22.0%); and community supports (n = 163; 29.0%).

CONCLUSION: Greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.

Conclusion

The current study contributes to the limited body of work regarding the experiences and care needs of detrans people and other SGM people who report identity fluidity and detransition/retransition. Findings indicate that, like other SGM people, detransition may be inadequately understood by some LGBTQ2S+ serving and gender-affirming care practitioners. Future research and community-led research on detransition/retransition can ameliorate this knowledge gap. Importantly, given the potential for country-specific differences in detransition/retransition experiences, future research should be more sensitive to geopolitical and healthcare delivery dynamics. (Abstract conclusion: greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.)

Methodological limitations

Self-selected group: People were found through social media ads, LGBTQ groups, gender clinics and past research studies, so the survey cannot show how common any experience is among people who detransition.
Very broad definition of detransition: Anyone who had ever stopped, changed or reversed a transition, or wanted to but felt unable to, could take part. This mixes people who now identify with their birth sex, people who remain trans or nonbinary, and people who later restarted transition (42%).
No medical history: The paper does not say how many people had used hormones or had surgery, so care needs cannot be linked to what was being reversed.
Very different groups lumped together: People who stopped because their understanding of their gender changed, and people forced to stop by cost or family pressure, are analysed together. This blurs very different care needs.
Simple counts only: The numbers are percentages from four rating questions, with no comparison group and no analysis of what was linked to poorer care.
Many 'does not apply' answers: 36% and 39% answered 'not applicable' to the questions about providers' knowledge and comfort. So the 43% 'never knowledgeable' figure is a share of everyone, not of those who actually talked to a provider about detransition.
Untested questions based on memory: The care questions were written for this study and rely on people remembering past events.
Written answers from one optional question: Themes come from short answers to a single open question (563 of 957 answered), which limits depth.
Risk of fake answers: 31% of completed surveys were removed as bots, scams or ineligible. Screening reduces, but cannot fully remove, fake responses.
Researchers' viewpoint: The study was described as led by the LGBTQ community and analysed from an "LGBTQ2S+-affirming lens", and most of those coding answers were LGBTQ or gender diverse. This shapes how themes were read and may have put off detransitioners who reject that view.
Numbers don't agree: The summary gives 152 people (22.5%) as 'detrans woman', but the results table gives 215 (22.47%).
Timing and setting: Data were collected in late 2023 and early 2024 in the US and Canada only, during rapid policy change. The authors note US restrictions may since have caused more interrupted transitions.

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Summary

Key findings

Abstract

Conclusion