What surveys have contributed

Surveys are the main first-hand source on detransition, which clinic records largely miss: only 24% of 100 detransitioners had told their transitioning clinicians (Littman, 2021), and 27.1% in a later sample (Littman et al., 2024). Detransitioner respondents are mostly born female, and themes recur: many came to see their gender distress as linked to trauma or other mental health problems (38% in Littman, 2021; 70% in Vandenbussche, 2022), many felt inadequately assessed or informed about risks, and few felt supported afterward: only 18% did (Vandenbussche, 2022). A North American survey of 957 people found 43% said providers never seemed knowledgeable about detransition (Rackliff et al., 2025). Findings depend heavily on who is sampled. Among 2,242 currently trans-identified respondents who had ever detransitioned, 83% cited at least one external pressure and 16% an internal reason (Turban et al., 2021), but that survey excluded anyone who no longer identified as trans. Regret surveys are similarly divided: surgeons recalled 62 regret cases among an estimated 18,125 to 27,325 patients (Narayan et al., 2021), and a single-hospital mastectomy survey reported a typical regret score of zero (Bruce et al., 2023), whereas 39% of patients reported some regret about fertility choices after reproductive-organ removal (Johnson et al., 2024). Surveys have also documented pelvic and genital pain in testosterone users (Zwickl et al., 2023; Tordoff et al., 2023) and generated disputed hypotheses, from Blanchard's typology (Blanchard, 1985; Blanchard, 1989) to "rapid-onset gender dysphoria" (Littman, 2018).

Strengths and limits

Surveys capture reasons, needs and perceptions invisible to clinics, but their weaknesses are consistent. Almost all samples are self-selected, recruited through online communities, advocacy groups or partisan websites, so they cannot estimate how common any experience is. Most are one-time, retrospective and unverified against records, often use untested questionnaires and lack comparison groups, so they show associations rather than causes. Examples include chosen-name use and depression in 74 youth (Russell et al., 2018) and recalled family acceptance among 245 LGBT adults, only about 22 of them trans (Ryan et al., 2010). Response bias can run in either direction: 41% of mastectomy patients did not reply and 13 high-regret answers were excluded (Bruce et al., 2023), while detransitioner surveys may over-represent people with negative experiences. Definitions of detransition vary widely, and researchers' positions on either side of the debate shape question design and interpretation.