Overview

Families of someone who transitions often describe what happens to them as grief. Nobody has died, but a name, a set of pronouns, a body and an expected future have gone. Detransitioners describe grief too, running the other way: for breasts, fertility, a voice, years of their youth, and sometimes for the trans self they had built. When a person detransitions, their family can find themselves grieving a second time.

This page sets out the two theories most often used to make sense of these losses. The first is ambiguous loss, the family therapist Pauline Boss's term for a loss that has no clear ending. The second is disenfranchised grief, the thanatologist Kenneth Doka's term for grief that others do not recognise. The page then looks at the argument over whether "grief" is the right word at all, at grief after detransition, and at the coping ideas the research offers. (A thanatologist studies death, dying and bereavement.)

The emotional side for parents (shock, guilt, estrangement) is covered in parents' experiences, and for husbands and wives in partners and spouses. This page goes deeper into the theory and into what helps.

Ambiguous loss

Two kinds of unclear loss

Pauline Boss, now professor emeritus of family social science at the University of Minnesota, coined the term "ambiguous loss" in the 1970s (APA 2022). She began with fathers who were at home but emotionally absent, and with families of airmen missing in action in Vietnam. Her book Ambiguous Loss: Learning to Live with Unresolved Grief brought the idea to a general readership (Boss 1999). In its chapter titles she names two types of loss: "Leaving without Goodbye" and "Goodbye without Leaving".

• Physical absence with psychological presence. The person is gone but may still be alive, such as a soldier missing in action, a kidnapped child, or an adult child who has cut off contact.
• Physical presence with psychological absence. The person is still there, but the person you knew seems gone, as in dementia, addiction, or a brain injury.

Boss's central claim is that the ambiguity itself is what does the damage. With a death there is a body, a funeral, and a shared agreement that grieving has begun. With an ambiguous loss there is none of that, so grief "freezes". People swing between hope and despair, and the stuck grief is easily mistaken for depression or for a personal failing. She places the cause outside the family, in a situation that cannot be clarified, rather than in a weakness of the people grieving (Boss & Yeats 2014).

Boundary ambiguity

Behind the theory sits an older idea from family stress research, boundary ambiguity. Boss defined it as a family not knowing who is in and who is out of the system (Boss & Greenberg 1984). It also covers uncertainty about roles: who is the daughter, who will be the bride at the wedding, who carries the family name. Boss argues that the more ambiguous the boundary, the more a family struggles to function.

This maps closely onto what families describe after a transition. A household may disagree about whether the child is still a daughter, whether old photos stay on the wall, and whether to correct a grandmother who slips. Each disagreement is a dispute about the boundary.

The myth of closure

Boss rejects the idea that grief should end in closure. In a 2022 interview she said that what people really want is "certainty of what that loss was" rather than closure itself (APA 2022). Her later book, The Myth of Closure, argues that chasing closure for a loss that cannot be clarified leaves people more anxious, angry and depressed (Salzman 2022, review).

Both/and thinking and resilience

Boss's alternative is both/and thinking: holding two opposing ideas at once instead of forcing a choice. A wife of a man with dementia might say "he is both here and gone". The book Loss, Trauma, and Resilience is her guide for therapists, built around not "going for closure" and instead building tolerance for ambiguity (Boss 2006). Its six guidelines, which she says are not sequential steps, are:

1. Finding meaning: making some sense of the loss, often through naming it.
2. Tempering mastery (later "adjusting mastery"): accepting that some things cannot be controlled, while acting on those that can.
3. Reconstructing identity: working out who you are now, in a changed family.
4. Normalising ambivalence: accepting that mixed feelings, including anger at the person, are normal.
5. Revising attachment: keeping the bond while accepting it has changed.
6. Discovering hope: finding new hopes that do not depend on the loss being reversed.

(NCFR; Salzman 2022)

Resilience in this framework does not mean bouncing back to where you were. It means being able to live well without an answer.

Disenfranchised grief

Kenneth Doka introduced the idea of disenfranchised grief in 1989. He defined it as the grief people feel when they suffer a loss that is "not or cannot be openly acknowledged, publicly mourned, or socially supported" (Doka 1989, p. 4, as quoted in a 2022 bereavement study). In his later edited volume he described how society's unwritten "grieving rules" decide whose losses count (Doka 2002).

In Doka's account, grief is disenfranchised in three main ways:

• The loss isn't recognised. Others don't see that anything has been lost.
• The relationship isn't recognised. The griever isn't seen as entitled to mourn.
• The griever isn't recognised. Others assume the person cannot or should not grieve.

Gender transition and detransition can produce all three. A parent who grieves a child's transition may be told that nothing has been lost, or that grieving is itself transphobic. A detransitioner who grieves a mastectomy may be reminded that they asked for it. Family therapists working with caregivers of trans-identified youth have noted that this grief often goes unrecognised by the caregivers themselves, and is hard to reconcile with their love for the child (Canitz & Haberstroh 2022).

Applying the theory to transition

Grieving a child who is alive

Family researchers began applying ambiguous loss to transition about a decade ago. The communication scholar Kristen Norwood's 2013 study of family members was titled "Grieving gender" (Norwood 2013). The psychologist Jeni Wahlig argued that parents may grieve "the child they thought they had" (Wahlig 2015). In a study of 18 parents in Italy, Spain and the US, Ines Testoni and Manuela Pinducciu identified three themes: a mourning orientation to the loss, the disenfranchisement of that mourning, and an orientation to restoration (Testoni & Pinducciu 2019). Those themes echo the dual process model of bereavement described below.

Here the loss is physical presence with psychological absence. The child is at the dinner table, but the son or daughter the parent knew, with that name and that expected future, seems to have gone. The uncertainty is often real as well. A parent cannot know whether the new identity will last, and neither can the child. One mother on r/detrans described the weight of that uncertainty, writing to a young woman whose own mother had reacted coldly to her detransition:

The waffling of... is she gone... is she back.... could she decide to disappear (trans herself) again in the future... is probably too much to bare. —sara7147, parent

That is boundary ambiguity in a single sentence. A questioning commenter on r/detrans made a related point about why the grief is not a lack of love:

Love has nothing to do with the grieving, and at the same time the grieving is because of that love. —SomedayImGonnaBeFree, questioning own gender transition

Names, pronouns and photographs

The concrete triggers of this grief are small and everyday. In ethnographic fieldwork with a parents' support group in the US Midwest, the researcher Mel Constantine Miseo found that what they called "gendered mourning" centred on the child's changing name and body, fear of the child living in a hostile world, and fears of losing the child (Constantine Miseo 2022).

A name is often the first thing a parent gave a child. Some trans-identified people recognise this. On r/ftm, one man said he feels guilty towards his parents because "one of them has a tattoo of my birth name" (holographiccd, ftm). The word deadname, used in trans communities for a person's birth name, itself frames the change as a death. Some detransitioners say the imagery looks very different in hindsight:

Even the term "deadname" has some really dark fucked up implications IMO. Especially when you introduce detransition to the conversation, the whole "death and rebirth" metaphor starts to look very sinister —DavidGjam, detrans

Photographs are a sharper version of the same problem. Parents must decide whether childhood photos stay on display, and some trans-identified young people destroy them. A detransitioned woman remembered doing so:

I also threw out all childhood photos that had me in them. I feel so guilty for that one, my mother was absolutely gutted. —NopetraintoNope, detrans female

Another detransitioned woman wrote that she was "glad my mom only ever packed away those photos, regardless of my protest at the time" (Purpletomb, detrans female). The parent who kept the photos, against the child's wishes, kept a bridge back. For more on the practical side of names, see names and pronouns.

Siblings, grandparents and the wider family

Boss's theory is about family systems, not just parents. Siblings can lose a brother or sister in a role sense, such as an older sister who was going to be a bridesmaid, as well as in an emotional sense. They can also be pulled into the transition. One desisted woman wrote that both her younger siblings came to identify as trans after she did, and that her desistance opened a gap:

But there is this chasm now, cutting off our bond and our ability to be honest with each other. —novaskyd, desisted female

The loss can also run the other way. One detransitioned woman said her sister, a strong advocate for trans people, "stopped talking to me and now is uncomfortable around me" after she detransitioned (jackolantern717, detrans female). Grandparents can struggle too: one woman's "Oma" (grandmother) asked whether she could keep using the male name (Oak_Tree22, detrans female). Siblings are covered more fully on their own page.

When one spouse transitions, the loss for the other can be more total. The person they married is physically present, but the husband or wife seems gone, and the relationship's sexual basis may be too. See partners and spouses.

When contact is cut off

Estrangement turns the loss into the other type, physical absence with psychological presence. The child is alive but unreachable. One parent wrote on r/detrans:

Unfortunately he has cut off communication with his entire family. Our hearts ache for him everyday. He only associates with trans identified people. We wait for his return. —Criticalmode3, parent

"We wait for his return" is the stance Boss describes in families of the missing: unable to mourn, unable to stop hoping.

The contested framing

"I'm not dead"

Many trans-identified people object strongly to the idea that their families are grieving. In their view nothing has been lost. The child is the same person, now seen more accurately. A thread on r/MtF titled "cis mourning" collected many such reactions:

Like, girl, I'm not dead, I'm the same person who's just living authentically now. It's like mourning a caterpillar for the butterfly - it doesn't make any sense. —hypatia163, mtf

Others in the same thread read parental grief as grief for the parents' own expectations, "pretty much like if you told them you don't wanna go to college" (Bac0n0clast, mtf).

There is also a research version of this objection. In a 2025 survey of 319 trans and nonbinary youth aged 13 to 22, those who were aware that their families grieved their identity reported more anxiety and depression and were more likely to have attempted suicide (Toomey et al. 2025). The authors advise clinicians to reduce their use of a grief-and-loss lens with families. The study shows an association, not a cause. Families whose children are already struggling may grieve more, and open grieving may go together with outright rejection.

Ambiguous loss used constructively

Researchers who support transition do not all reject the grief framing. Several have used ambiguous loss as a tool to help parents accept a transition. Wahlig proposed it as a way to validate parents' grief so they could move through it towards support (Wahlig 2015). Deborah Coolhart and colleagues found in interviews that some parents of trans-identified adolescent girls experienced ambiguous loss and others did not, and drew practical advice for therapists from the parents' own coping (Coolhart et al. 2018). Jenifer McGuire and colleagues, writing in a special issue on ambiguous loss theory, applied Boss's resilience processes to the whole family. They also argued that the trans person may experience an ambiguous loss of their own when family members become emotionally absent or deny the transition (McGuire et al. 2016).

What these writers share is a view that the loss is real but its cause is social. In their account, cisnormativity (the assumption that everyone's sex and gender identity match) sets parents up to expect a cisgender child and then to experience transition as a loss (McGuire et al. 2016; Constantine Miseo 2022). Constantine Miseo explicitly rejected the "oversimplification" that grieving a trans child is simply transphobic.

Assessing the debate

Both camps agree that parents feel something like grief. Where they differ is over what is lost and whether the loss is legitimate. The affirming literature mostly treats the lost thing as an expectation, something the parent should let go of so that the child can flourish. On that view, the goal of therapy is acceptance.

That is not the only reading. The affirming accounts assume the new identity is a settled truth. For many adolescents it may not be. The Cass Review, the 2024 independent review of England's youth gender services, found that the evidence for medical transition in young people was weak, and that identities in adolescence can change (Cass 2024). If a parent is grieving a healthy body, fertility and a likely future, and those are given up because of an identity the child may later drop, then the grief is not only about the parent's expectations. Boss's theory doesn't take sides on this. What it explains is why the grief is so hard to resolve: the loss is unclear, and it may be reversed.

Read this way, the framework's real value is both/and thinking. A parent can both love the child in front of them and mourn what is being given up. They can both stay close and keep doubts about the medical path. The Toomey findings are a reason to be careful about how grief is voiced to a distressed teenager. They are not a reason to deny that it exists. For guidance on staying close without signing up to every step, see when a child says they are trans.

Grief in the other direction

Bodies, function and fertility

For many detransitioners the clearest loss is physical, and it is not ambiguous at all. A mastectomy, a hysterectomy or a voice deepened by testosterone are permanent. On r/detrans, grief over a mastectomy is one of the most frequently described losses, and posters often compare it to bereavement:

It makes sense to mourn your loss, as I'm sure many women who've had masectomies due to breast cancer do. A loss of a body part is traumatic, regardless of why it was lost. —toobertpoondert, desisted female

The first published case report of a detransitioned woman grieving her inability to breastfeed described a lack of understanding from maternity staff, and noted that breastfeeding is missing from consent guidance for chest masculinisation surgery (Gribble et al. 2023). The grief over fertility often arrives years later, with a partner or with age:

I'm still dealing with the grief of knowing that I can never become pregnant or enter parenthood how I would like to. Writing and talking to a therapist has helped a little, but I think I'll always be at least a little upset with myself for having a hysto. —MangoProud3126, detrans female

Detransitioned men describe the same kind of loss. One wrote that "saying goodbye to sex was so hard for me" (OFF-WORLDOBSERVER, detrans male). Another, almost a decade after surgery:

not a day goes by that I don't feel some type of grief or loss. Whilst it hasn't gone away for me it has become somewhat easier to deal with, either it has diminished or I've just gotten used to it I'm not quite sure which one it is. —Hedera_Thorn, detrans male

See also fertility, top surgery regret and wanting children.

Lost time

Some losses are not bodily. Many posters mourn years: a youth spent in a binder, friendships that never deepened, teenage milestones they skipped because they didn't want to take part "as a guy" (Dissposabletag). One woman wrote that she has "so much grief and anger regarding the decade+ of my life wasted on this", but can only talk about it in a few niche online communities (pigeon-feather, detrans female).

The person they became

The most ambiguous loss of all is the trans self. This is a person who, in a sense, never existed, but who was lived as real for years. Some detransitioners describe a double death:

This is how I said it, "I murdered my past self, and the man who I thought I was also died". Felt like I was grieving two people. —iscrewedup888, detrans female

Others miss what the trans identity gave them rather than the identity itself. One detransitioned woman said "disguising myself as a man felt like becoming my own protector" (furbysaidburnthings, detrans). A detransitioned man missed "the carefree feeling of freedom and wonder that came with not knowing I was on a path that would harm me" (UniquelyDefined, detrans male). Others say there is nothing to mourn. One woman called the trans man she used to be "a persona. A mask. A fictional character" (Space-A1ien, detrans female).

There is also grief for a self that might have been: the woman a detransitioner could have grown into, or, as one detransitioned man put it, the "proud gay man" he could have been (Beautiful_Trip_6714, detrans male). This is a loss of an imagined future, much like the parent's.

Disenfranchised twice

Detransitioners' grief fits Doka's definition closely. The loss is often not recognised, since others point out that it was chosen. The griever's right to mourn is questioned, because some trans people say they were "never really trans". Support can be hard to find. In a survey of 237 detransitioners, respondents reported strong psychological needs around regret and a major lack of support, with many negative experiences from medical and mental health services and from the LGBT+ community (Vandenbussche 2022). One commenter named the problem and the remedy:

As with all grief, I think the pain may never go away. This is a part of our experience now. And it is disenfranchised grief so it can be harder to process and people aren’t understanding... Creating personal rituals can be helpful for acknowledging the loss. —a deleted account, r/detrans

Families can add to the disenfranchisement without meaning to. One detransitioned woman said that when relatives remind her "remember how much you wanted it", it "devalues my current pain" (thistle_ev, detrans female). See backlash against detransitioners.

Families grieving again

When a child detransitions, parents can feel relief and a fresh grief at the same time. They may mourn the body or the fertility their child lost, and feel guilty for having agreed to it. Some describe the reunion itself as a kind of restoration. One detransitioned woman said her mother's first words were "I'm so happy to have my daughter back" (Korgsson, detrans female). A detransitioned man said his mother hugged him and told him "you will always be my baby boy" (David43432, detrans male).

Grieving together can help both sides:

She will grieve with you, but that may just be what you need right now. I've cried with my mother and it was one of the best things I could have done in my detransition. —Shifty-Fang, detrans female

For practical help, see supporting a detransitioning child.

Coping, drawn from the literature

Nothing here is a treatment. These are ideas from grief research and from people's own accounts, which families and detransitioners have found useful.

Naming the loss

Boss argues that the first step is simply naming the loss as ambiguous. Doing so moves the blame from the person to the situation. A parent who knows they are facing an ambiguous loss can stop asking why they can't "get over it". A detransitioner who knows their grief is disenfranchised can stop waiting for permission to feel it. One woman described how changing a single word helped:

I recently stopped referring to it as a top surgery. I don’t know why, exactly, but it was something I no longer wanted to associate with. It just felt too painful. I started calling it my mastectomy. And that word felt capable of holding all of the grief I was feeling. —radiantgrace, detrans female

Rituals

Ambiguous and disenfranchised losses lack the rituals that structure grief after a death, so people make their own. Boss's clinical work encourages family rituals that can hold both presence and absence (Boss 2006). In detransitioners' accounts, rituals include writing letters to an earlier self, talking to the lost body part, and, in one suggestion, "mastectomy memorial tattoos" (icantastethecolors, desisted female). For families, a ritual might be choosing which photographs to keep out, or marking the day a child takes back their birth name.

Meaning-making

Finding meaning is the first of Boss's guidelines. Detransitioners describe several kinds. Some reframe their earlier self with compassion: "the person I was when I underwent surgery was someone who was suffering and looking for solutions and was pointed in the wrong direction" (ivyspiders, detrans female). Others find meaning in faith, or in warning others. For detransitioners, see healing and recovery.

Holding contradiction

Both/and thinking is useful in both directions. A detransitioner can both regret a surgery and refuse to hate the younger self who chose it. A parent can be both relieved by a detransition and angry about the years lost. One woman found a way to hold the never-transitioned version of herself without being destroyed by her:

I think of the version of me who never transitioned as essentially an alternate universe me. I can’t meet her, she can’t meet me, I’ll never know for sure what she’s like, how her life is, or if she’s even happy. I can’t change the decisions I made that lead me here. Somehow this helps me. —detransitionb4death, socially trans, regrets entire transition

Oscillation between loss and restoration

The dual process model of Margaret Stroebe and Henk Schut describes healthy grieving as a back-and-forth. People alternate between facing the loss and turning to rebuild ordinary life, and taking breaks from grief is part of coping, not a failure of it (Stroebe & Schut 1999). One desisted woman gave a vivid version of the same idea. Grief doesn't shrink, she wrote; instead, "the sphere of your life grows larger, so the loss and its grief take up less and less of the sphere over time" (quendergestion, desisted female).

Continuing bonds

Older grief theory said mourners should "let go". The continuing bonds school argues that keeping an inner relationship with the lost person is normal and often healthy (Klass, Silverman & Nickman 1996). For detransitioners, the "lost person" may be their own younger self. Several posters advise against erasing that past:

I don't think it's generally a good idea to try and forget your past. Usually not everything about that time is unhappy so you'd be losing out on the good memories too. I do find it strange how different I used to look. That person was still me, despite everything I was doing. —oldtomboy, detrans

Time

Many posters say the worst of the grief eased with time, and they often give a timescale of one to three years. One woman said it took "maybe 18 months or so" to process the grief over her mastectomy, helped by journaling, trusted listeners and a support group (handygal-DIY, detrans female). That matches survey findings that psychological health often improves markedly after detransition, even where losses remain (Littman et al. 2024). Grief and recovery can happen at the same time.

When to seek help

Grief is not an illness, but it can tip into one. It may be time to seek professional help if:

• grief is not easing at all after many months, or is getting worse;
• you can't work, sleep, eat or look after yourself (one mother on r/detrans only realised she was depressed when her husband pointed out she had stopped showering and eating, as she described);
• there are thoughts of suicide or self-harm, whether yours or your child's;
• anger or blame is breaking up the family;
• a detransitioner is also dealing with medical complications or trauma.

Look for a therapist who will take the loss seriously without telling you how to feel about the transition, whichever direction it went. Interviews with detransitioned women in the UK found that many of their emotional support needs were not met by health or other services (Lomax & Butler 2025). Peer groups can fill some of that gap. In a qualitative review of detransition studies, recommendations for therapy included emotional validation, attention to personal strengths and meanings, and building social networks (qualitative metasummary, 2024).

See support and resources for parent groups, detransitioner peer groups and therapists, with each organisation's orientation labelled. Crisis lines and other help are on the support page. For the wider family picture, see the parents and families hub.

References

• American Psychological Association (2022). Speaking of Psychology: Ambiguous loss and the "myth of closure," with Pauline Boss, PhD (episode 181). source.
• Boss, P. (1999). Ambiguous Loss: Learning to Live with Unresolved Grief. Harvard University Press. publisher.
• Boss, P. (2006). Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss. W. W. Norton. publisher.
• Boss, P. (2022). The Myth of Closure: Ambiguous Loss in a Time of Pandemic and Change. W. W. Norton. Reviewed by Salzman, H. (2022), Family Medicine. review.
• Boss, P., & Greenberg, J. (1984). Family boundary ambiguity: a new variable in family stress theory. Family Process. source.
• Boss, P., & Yeats, J. R. (2014). Ambiguous loss: a complicated type of grief when loved ones disappear. Bereavement Care. source.
• National Council on Family Relations. Helping families learn to live with ambiguous loss (webinar with Pauline Boss). source.
• Canitz, S. N., & Haberstroh, S. (2022). Navigating loss and grief and constructing new meaning: therapeutic considerations for caregivers of transgender youth. Journal of Child and Adolescent Counseling, 8(3), 168–180. doi.
• Cass, H. (2024). Independent review of gender identity services for children and young people: final report. study page.
• Constantine Miseo, M. (2022). Grieving the transgender (assumed-cisgender) child. Bulletin of Applied Transgender Studies, 1(3–4). source.
• Coolhart, D., Ritenour, K., & Grodzinski, A. (2018). Experiences of ambiguous loss for parents of transgender male youth: a phenomenological exploration. Contemporary Family Therapy, 40, 28–41. doi.
• Doka, K. J. (Ed.) (1989). Disenfranchised Grief: Recognizing Hidden Sorrow. Lexington Books. catalogue record. Definition (p. 4) as quoted in In dialogue: how writing to the dead and the living can increase self-awareness in those bereaved by addiction (2022). source.
• Doka, K. J. (Ed.) (2002). Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice. Research Press. catalogue record.
• Gribble, K. D., Bewley, S., & Dahlen, H. G. (2023). Breastfeeding grief after chest masculinisation mastectomy and detransition: a case report with lessons about unanticipated harm. Frontiers in Global Women's Health. study page, source.
• Klass, D., Silverman, P. R., & Nickman, S. L. (Eds.) (1996). Continuing Bonds: New Understandings of Grief. Taylor & Francis. publisher.
• Littman, L., O'Malley, S., Kerschner, H., & Bailey, J. M. (2024). Detransition and desistance among previously trans-identified young adults. Archives of Sexual Behavior. study page, source.
• Lomax, J., & Butler, C. (2025). Narratives of adults registered female at birth who started a medical transition and later detransitioned. Archives of Sexual Behavior. study page, source.
• McGuire, J. K., Catalpa, J. M., Lacey, V., & Kuvalanka, K. A. (2016). Ambiguous loss as a framework for interpreting gender transitions in families. Journal of Family Theory & Review, 8(3), 373–385. doi.
• Norwood, K. (2013). Grieving gender: trans-identities, transition, and ambiguous loss. Communication Monographs, 80(1), 24–45. doi.
• A qualitative metasummary of detransition experiences with recommendations for psychological support (2024). International Journal of Clinical and Health Psychology. source.
• Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: rationale and description. Death Studies, 23(3), 197–224. doi.
• Testoni, I., & Pinducciu, M. A. (2019). Grieving those who still live: loss experienced by parents of transgender children. Gender Studies, 18(1), 142–162. doi.
• Toomey, R. B., Trujillo, L., Abreu, R. L., Rios Garza, A., Hainsworth, S., & Zhao, Z. (2025). The potential harm of loss and grief narratives among families of transgender and nonbinary youth. Journal of Counseling Psychology, 72(3), 201–210. doi.
• Vandenbussche, E. (2022). Detransition-related needs and support: a cross-sectional online survey. Journal of Homosexuality. study page, source.
• Wahlig, J. L. (2015). Losing the child they thought they had: therapeutic suggestions for an ambiguous loss perspective with parents of a transgender child. Journal of GLBT Family Studies, 11(4), 305–326. doi.