Detransitioned Women Report Unmet Needs: Medical Transition Failed to Resolve Dysphoria

Narratives of Adults Registered Female at Birth who Started a Medical Transition and Later Detransitioned

Interviews & qualitative research Detransition & regret Detransitioner care & support

Authors: Jane Lomax, Catherine Butler
Journal: Archives of Sexual Behavior
Year: 2025
Source: link.springer.com/article/10.1007/s10508-025-03083-9#ref-CR61

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

Six UK adults born female, aged 21 to 32, were interviewed. All had taken testosterone for 1 to 5 years, starting at ages 17 to 24, four had had both breasts removed, and they had detransitioned 2 months to 5 years earlier.
Medical transition had limits: hormones and surgery did not fully resolve their gender distress or underlying mental health struggles, and some felt more distress, or distress about their changed body, after physical changes.
Long-term health worries drove decisions: concern about unknown effects of testosterone on female bodies, such as heart risks, shrinking of the womb and infertility, helped lead to detransition, and they felt they had not been properly informed beforehand.
Belonging changed over time: many found they felt more themselves connecting with women and lesbian communities than living as men, and some realised that narrow ideas of what a woman is had shaped their first decision to transition.
Detransition was complex and ongoing: it brought grief, guilt and practical problems such as living with a more masculine appearance, and most found ways other than medical treatment to manage distress.
Support was mostly lacking: they described needs not met by doctors and therapists, and often turned to online detransition communities for information, practical advice and emotional support.
Four of the six had a diagnosis of autism (or, in one part of the paper, autism or 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.

Methodological limitations

Very small group: Six people is suitable for in-depth interviews, but cannot show how common these experiences are among detransitioners, let alone among everyone who transitions.
Very similar people: All were White and UK-born, lesbian, bisexual or asexual/lesbian, had at least started university, and were aged 21 to 32. Four had an autism (or, in one part of the paper, autism or ADHD) diagnosis. Results may not carry over to people born male, older people, ethnic minorities or straight detransitioners.
People chose to take part through detransition networks: They were found via Twitter, the r/detrans forum on Reddit, a Facebook 'gender discourse' group and the UK Detransition Advocacy Network. People active in these spaces may hold particular views of transition, and the authors note their group may resemble those in Littman (2021) and Vandenbussche (2022).
One interview, looking back: Each story was told once (in 2021) and may be shaped by how people now make sense of their lives. The authors note experiences may be reinterpreted or left out as people's sense of themselves changes.
Medical history not checked: Diagnoses, treatments, timing and what they were told before treatment all rely on what people said, with no check of medical records.
Dates not recorded: The years of transition and detransition were not collected, so experiences cannot be linked to particular UK clinic rules or periods.
Researchers' influence: One interviewer (the first author) did all the interviews, and the authors admit that being women who do not identify as trans, and the interview relationship, will have shaped the stories told.
Little checking with the interviewees: Summaries and themes sent to the six interviewees for checking got no replies. The person with lived experience who reviewed materials was also found via Reddit and may share their views.
Other paths to detransition left out: Detransitioners born male, people who transitioned again, and people who detransitioned for outside reasons such as stigma or lack of access were not included. The authors also did not look closely at changing gender identity.
No comparison group: Without interviewing people who continued to transition, the study cannot say which experiences (such as health worries or changing sense of belonging) are specific to those who detransition.

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Summary

Key findings

Abstract

Conclusion