Summary

This essay by a sociology doctoral student reports no new data. It argues that "detransition" covers three different things: stopping or reversing a transition, identifying as a detransitioner, and having a bad experience of transition. Studies often blur them. The author says most research has tried to count or predict detransition in order to prevent it, which does little for people who have already detransitioned. Regret studies have weak spots: requests to reverse surgery come years later, many people just stop going to clinics, and counting lawsuits or "known cases" misses most experiences. The author calls for interview-based research with detransitioners to build care plans, including guidance on stopping hormones. It is an openly transfeminist position paper; its views are argued, not tested.

Key findings

• The author separates three ideas often lumped together as "detransition": the act of detransitioning, identifying as a detransitioner, and having a bad experience of transition.
• The essay sorts existing research into "preventing detrans" (studying how often it happens and why) and "supporting detrans" (studying the experience itself to improve care).
• In Swedish data (Dhejne and others, 2014), requests to reverse surgery typically came about 8 years after surgery. So the 0.3% rate for 2001 to 2010 may be too low simply because not enough time had passed; leaving out that period, 14 of 321 people (4.4%) asked for reversal.
• Regret cases known to clinics (for example 0.1% in a survey of clinics that start hormones on consent alone) are called "significantly flawed", because many detransitioners stop going rather than tell their clinic.
• At the time, there was no medical guidance for detransition and almost no research on detransition in people who took hormones without surgery.
• The author calls for interview-based research done with detransitioners, and for medical research on how to stop hormones safely.

Abstract

Detransition is tied to three related but distinct concepts – the act of detransitioning, the 'detransitioner' identity, and the negative transition experience – which I refer to collectively using the umbrella term 'detrans'. Detrans research is inevitably political and value-laden, but different methodologies and research questions lend themselves to divergent goals. Drawing on work in the feminist philosophy of science and transfeminist scholarship, I draw a conceptual distinction between research aligned with the goals of 'preventing detrans' vs. 'supporting detrans'. Existing research has constructed detransition as a negative clinical outcome to be prevented because it has been focused on the causes of detrans and the detrans rate. Research associated with the goal of supporting detrans is defined by its focus on the experience and process of detrans itself. Research on preventing detrans constructs detrans as a divisive issue of zero-sum clinical risk, and it is not oriented toward helping people who detransition or who have a negative transition experience. Research on supporting detrans, in contrast, constructs detrans as an issue of inclusion and can be used to improve the medical and mental health care that detrans people receive. I argue that there is an urgent need for qualitative sociological research involving detrans people. I conclude with some broad guidelines for researchers studying detrans.

Conclusion

The author recommends that researchers be precise about which aspect of detrans they study (the act, the identity, or the negative experience), how their measures relate to it, and how the study is described to participants, and that they consult potential participants throughout. Qualitative, interview-based research with online detransition communities is described as feasible and urgently needed whether detransition is rising or not, without "rising epidemic" or "contagion" rhetoric, and detransitioners' calls for medical research on safely stopping hormones are endorsed. Qualitative work should not be used for broad causal claims. Detransitioners should be treated as more than "canaries" signalling a wider risk: their experiences are real, distinct and worth studying in their own right.