Overview

Many people who transition hope it will relieve a distress that has dominated their lives. That distress might be gender dysphoria (persistent discomfort with one's sexed body or with being seen as one's sex), or depression, anxiety and self-hatred that they have come to understand through the lens of gender. A recurring theme in detransition accounts is that this relief did not last, or never came. Some felt better at first and then watched the improvement fade. Others found their dysphoria moving from one body part to the next, or getting worse the more they changed. Many found that the depression, anxiety and loneliness they had before transition were still there afterwards.

This page looks at that experience: the early "honeymoon", the dysphoria that persisted or grew, the moving goalposts of "one more step", and the realisation some people come to that the problem was never their body. It also sets out what research says about mental health after transition, including studies that report benefit, and how trans-identified people who feel helped describe their experience. For the psychiatric conditions that often come before transition, see mental health and gender dysphoria. For what people found was driving their distress instead, see reframing dysphoria.

The honeymoon period

What people describe

In detransition communities the word "honeymoon" is used for the first months or years of transition, when everything feels possible. Accounts describe excitement at each new change, relief at being seen in a new way, and a strong sense of having found the answer. Several people give rough timelines: a few months for some, "six months to a year" for one woman, and up to five years for another before she began to question everything (Sonderosity, detrans female; pipanpi, detrans).

One detransitioned woman described what happens when it ends:

But after a while reality starts to set in, the euphoria wears off, you realize that you have to decide whether or not the feelings of being a fraud, the persistent dysphoria despite transition, all these other things the euphoria covered up or you hoped would go away as you started to pass more, are worth looking like the opposite sex… —lacroicsz5, detrans female

Why the early lift happens

Detransitioners offer several explanations for the early lift, and they overlap.

• A drug effect. Testosterone is an anabolic steroid with energising and mood-lifting effects. Several women say they mistook this for proof that they were on the right path. "I felt great when I first started testosterone… Over the years I instead had increased anxiety and other mental health problems," one wrote (purplebicycles, detrans female). Testosterone can also suppress the menstrual cycle, which can mask conditions like premenstrual dysphoric disorder (PMDD), a severe cyclical mood disorder (Takeshold, detrans female). See testosterone in females.
• Expectation. People who have been told a treatment will finally let them feel authentic tend to feel better on it, at least at first. One woman noted that the placebo effect is stronger when a treatment is painful or expensive and comes with glowing testimonials (calloutfolly, detrans female).
• Novelty and validation. A dramatic change brings attention, a new community and a fresh start. A detrans man compared it to the lift "when they move cities or move to a new country" (Master_Glass_5297, detrans male).
• Visible progress. The first bodily changes are exciting. After a couple of years they slow down, and disappointment can follow if someone had hoped for more (calloutfolly, detrans female).

The psychology of fading relief

Psychology has well-studied names for these patterns. Hedonic adaptation is the tendency to return to a baseline level of happiness after major life changes. In a classic 1978 study, people who had won large lottery prizes were not happier than controls some time later, and took less pleasure in everyday events (Brickman et al. 1978). Affective forecasting research by Timothy Wilson and Daniel Gilbert finds that people reliably overestimate how strongly and how long a future event will affect their feelings, an error they call the impact bias (Wilson & Gilbert 2005). One reason is "focalism": imagining the change in isolation, and forgetting everything else in life that will stay the same.

These findings apply to everyone, not just to transition. But they help explain a pattern in these accounts. If transition is pictured as the event that will finally make life bearable, the gap between expectation and reality can be large. The unchanged parts of life (work, family, relationships, old wounds) are exactly what focalism leaves out.

Dysphoria that persisted or got worse

Dysphoria that moves

A striking theme in these accounts is that dysphoria did not shrink as the body changed. It moved. Women describe how testosterone made their breasts feel more out of place; how top surgery (a double mastectomy) shifted their focus to their hips or genitals; and how every resolved feature revealed the next one. One summarised it:

Lots of trans guys who got mastectomies say they then began to have more bottom dysphoria, or to feel self conscious about their hips. When you fix one part, your focus shifts to the next part that needs work. Eventually you run out of parts you can realistically change. —calloutfolly, detrans female

Some describe hormones creating dysphoria they had not had before. One woman said testosterone "really put rockets on my sense of maleness" and brought "severe genital dysphoria I hadn't previously had" (DapperDhampir, detrans female). Another put it in a single line: she started testosterone because of dysphoria and stopped it because it gave her dysphoria (throwavent154, detrans female).

There are several possible mechanisms. Each change makes the remaining sexed features stand out more by contrast. Constant attention to the body, through selfies, timelines and comparison with others, tends to increase body-focused distress. And spending time in communities where people talk about the body parts they hate can, as one woman put it, "rub off on you" (calloutfolly, detrans female).

Moving goalposts

The phrase "moving goalposts" comes up often. The next step (hormones, then top surgery, then bottom surgery on the genitals, then facial surgery) is always the one that will finally make it enough. One woman described the realisation that stopped her:

That the goalpost would just keep shifting and there's no guarantee that any of these "steps" would alleviate my distress or make me better. —DetransIS, detrans female

Several women draw a direct comparison with eating disorders:

Believing that I'll be happy if I cut my tits off is just as stupid as believing I'll be happy when I just lose another 10 pounds. It will never be enough. —imbibitionn, detrans female

That comparison has some research behind it. In body dysmorphic disorder (BDD), an intense preoccupation with perceived flaws in appearance, cosmetic procedures rarely help. In one study only about 2% of procedures led to a longer-term improvement in overall BDD symptoms, and clinicians report that preoccupation often shifts to other body areas after treatment (Crerand, Menard & Phillips 2010; International OCD Foundation). Gender dysphoria and BDD are classified as different conditions, and many trans-identified people reject the comparison. But the pattern some detransitioners describe (relief, then a new target) looks a lot like the BDD pattern. See body dysmorphia and eating disorders.

Passing and never feeling "enough"

Passing means being consistently seen as the sex one is presenting as. For many, it became a goal in itself, and a source of constant anxiety. "Attempting to pass made me all too aware of every way I was failing to do so," one woman wrote (Same_Bee_4061, detrans female).

But not passing is not the only problem in these accounts. Many say that passing did not help either. They passed and still weren't satisfied, because what they wanted was to be the other sex, not to be taken for it:

Transition never cured my dysphoria- no matter how well I passed. It was never enough. Because I wanted to be a man- not a trans man. —L82Desist, detrans female

This is perhaps the deepest version of the "never enough" problem. Transition can change appearance, hormones and how others see someone. It can't change sex. For people whose distress was about not being the other sex, every success in appearance can sharpen awareness of what remains out of reach. "There was no escaping my female skeletal structure," one woman wrote, describing how she had considered surgery on her brow, jaw and even her height (Souf1duh, detrans female). People who live stealth (without others knowing they transitioned) describe a related pressure. The closer a "normal" life seems, the harsher the self-scrutiny becomes (DetransIS, detrans female).

Depression and anxiety that stayed

A second strand concerns everything other than dysphoria. Many people say they believed transition would fix their depression, anxiety, loneliness or self-hatred, often because they had come to see these as symptoms of being trans. When the honeymoon ended, these problems were still there. Some say they were worse, now with added health worries, social costs and, for some, regret about permanent changes.

One theme is that the trans identity worked as a single explanation for everything. A male detransitioner described it this way:

In some ways I feel transition can be a way to compartmentalize and deny your own depression, like you just lump it all into 'dysphoria' and don't think of it in any greater context than you just failing to be the sex you want to be, but when you aren't transitioned and have those same feelings, you have nothing else to blame it on. —NeighborhoodFit2786, detrans male

This matches survey findings. In Lisa Littman's survey of 100 detransitioners, 42% said a reason for detransitioning was that transition did not improve their mental health. More than half (51%) believed transitioning had delayed or prevented them from dealing with trauma or a mental health condition (Littman 2021; Genspect summary).

"The problem wasn't my body"

For many detransitioners the turning point is a change in how they understand their distress. The body stops looking like the cause and starts looking like the place where something else was being expressed. A woman who had lived as a man for nearly ten years wrote simply: "Changing the outside didn't solve the unsolved issues I had inside" (pipanpi, detrans). Another said therapy for sexual assault (SA) did what transition hadn't:

I experienced really bad gender dysphoria and transition didn't really help it was never enough. I went to therapy and started dealing with the SA and that is what treated my gender dysphoria. —Odd-Associations, detrans female

This is not always a sudden insight. It often comes after the honeymoon has ended, after a surgery that brought no relief, or after the last available step has been taken. One woman, five years on testosterone, had top surgery and "felt nothing, no euphoria, no relief" (Odd-Associations, detrans female). In Elie Vandenbussche's survey of 237 detransitioners, the most common reason for detransitioning was realising their gender dysphoria was related to other issues (70%), and half (50%) said transition did not help their dysphoria (Vandenbussche 2022).

Philosophically, this is a shift from treating the body as a mistake to be corrected to treating it as the place where a person's history shows up. Some detransitioners describe it in terms of trauma or misogyny, others in terms of obsession, autism or a search for a fresh start. The different causes people found are covered in reframing dysphoria. What they share is the conclusion that the body was not the source of the problem.

In detransitioners' words

Female detransitioners

Women's accounts often centre on testosterone's early lift and its later costs, on dysphoria spreading after top surgery, and on never feeling male enough. Some describe a lasting aftereffect: years of believing their female body was wrong can leave a deeper discomfort than they started with.

Even now I dislike being female more than I ever did before transitioning. I spent so long believing that the sexed parts of my body were fundamentally wrong, that mindset is hard to move past when you've spent years stewing in it. —Quiet-County-9236, detrans female

Some women describe a long, apparently "successful" transition that still did not work. One said she passed well and liked how she looked as a man, but that her body distress "is just not actual dysphoria", and that the better she looked, the harder it was to let go of the fantasy of literally becoming a man (Werevulvi, detrans female). Others came to see the whole process differently in hindsight:

On the surface, I felt some relief to be flat, but it took me a couple of years to mature and realise what I'd done was a deeper act of self-hate. —claudescy, detrans female

These themes match a 2025 interview study of women who detransitioned. Participants found that hormones and surgery did not fully resolve their dysphoria or their underlying mental health struggles, and some described intensified distress after physical changes (Lomax & Butler 2025).

Male detransitioners

Men's accounts more often describe estrogen and testosterone blockers deepening low mood, fatigue and anxiety rather than lifting them, and a struggle with passing that is harder for most males because of bone structure, height and voice. See estrogen and testosterone blockers in males.

I would say my honeymoon phase was very short, a couple of months or so where I felt some brain fog lifting and becoming more connected to the world. The lowered libido also probably made me feel calmer generally. But I quickly went back to feeling dissociated but now with the addition of having even less energy. —christa-paffgen, detrans male

But throughout my life on estrogen I felt like I was an emotional dumpster fire, I feel like estrogen took everything I was already struggling with -- including my internalized unprocessed trauma which made me mistakenly believe I was trans in the first place -- and magnified it by a million. —dysphoric_leaf, detrans male

Several men say that passing, when they managed it, did not resolve anything:

I was passable and I still detransitioned because it just felt wrong and I realized that I had an addiction to chasing the fantasy of being a woman and it would never feel right. —AlviToronto, detrans male

That underlying fakeness to your life starts out as small cracks until they spread and the whole thing shatters. —verytiredcatto, detrans male

Others describe the same wish as the women above: to be the other sex rather than a trans person. "My dysphoria is to be female, not a person who transitioned. Didn't get what I wanted out of transition," one wrote (DeepSeaSasha, detrans male). Another said he "got everything I ever wanted & realized it left me empty inside" (will-I-ever-Be-me, detrans). A third, who had lived a fairly stable life before, said he "was never as mentally unstable or broken" as after transition, while acknowledging other traumatic events may have played a part (stupidstories, detrans male).

A young male detransitioner pointed to a problem with how improvement is measured:

it seriously muddies the water if we can't tell whether relief from depression comes from "fixing" gender incongruence or is just a direct effect of injecting hormones. —TheDrillKeeper, detrans male

What the research says

The research on mental health after medical transition is large but weak. Different studies point in different directions, and most can't separate the effect of treatment from other influences such as therapy, antidepressants, family support, or simply growing older. The main national evidence reviews are covered in detail on evidence reviews.

Studies reporting improvement

• Chen et al. 2023. In a prospective study of 315 young people in the United States, published in the New England Journal of Medicine, depression and anxiety scores fell and life satisfaction rose over two years on cross-sex hormones (Chen et al. 2023). The changes were small: depression fell by about 1.3 points a year on a 63-point scale. There was no control group, and two participants died by suicide during the study, which a letter in the same journal argued was a high rate (NEJM correspondence 2023).
• Tordoff et al. 2022. A 12-month study of 104 young people at a Seattle clinic reported 60% lower odds of moderate or severe depression and 73% lower odds of suicidality among those receiving puberty blockers or hormones (Tordoff et al. 2022). Journalist Jesse Singal pointed out that the treated group's mental health did not significantly improve: the difference came from comparison with an untreated group that had shrunk to very few participants by the end (Singal 2022).
• Baker et al. 2021. A Johns Hopkins systematic review of 20 studies found hormone therapy was associated with better quality of life and less depression and anxiety. The authors added that certainty was limited by high risk of bias, small samples and confounding, and that no conclusions could be drawn about suicide (Baker et al. 2021).
• Taylor et al. 2024. The University of York's systematic review of hormones in adolescents, done for the Cass Review, found "moderate-quality evidence" that mental health may improve during treatment, mainly from before-and-after studies with 12 months of follow-up, but said robust research was still needed (Taylor et al. 2024).

Studies and reviews finding persistent or worsening distress

• Dhejne et al. 2011. A Swedish national study of 324 people who had sex reassignment surgery found nearly three times the rate of psychiatric hospitalisation and about 19 times the rate of suicide compared with the general population. The authors concluded that surgery, "although alleviating gender dysphoria, may not suffice as treatment" (Dhejne et al. 2011). The comparison was with the general population, not with untreated people with gender dysphoria, so it cannot show whether surgery helped or harmed.
• Bränström & Pachankis correction, 2020. A widely publicised 2019 Swedish study claimed surgery reduced mental health treatment. After reanalysis, the American Journal of Psychiatry published a correction stating that the results "demonstrated no advantage of surgery" for mood or anxiety-related care or suicide-attempt hospitalisations (AJP correction 2020; study page).
• Ruuska et al. 2026. A Finnish national register study of 2,083 young people referred to gender services found that psychiatric treatment needs rose after medical transition, most sharply among those receiving feminising treatment. The authors wrote that in some individuals medical transition "appears to be linked to deterioration in mental health" (Ruuska et al. 2026).
• Straub et al. 2024. A large US health-records study found people who had gender surgery had much higher rates of suicide attempts, self-harm and post-traumatic stress disorder (PTSD) than matched controls. It shows association, not cause (Straub et al. 2024).
• Miroshnychenko et al. 2025. A systematic review of hormone therapy in people under 26 rated the evidence for gender dysphoria, depression and suicide as low or very low certainty, meaning neither benefit nor harm can be ruled out (Miroshnychenko et al. 2025).
• The Cass Review (2024). The independent review of England's youth gender services found the evidence base for hormones weak, and called for comprehensive assessment of co-occurring mental health conditions (Cass 2024).

What detransition research adds

Studies of people who detransitioned consistently find that persisting distress was part of why they stopped. Alongside Littman's 42% and Vandenbussche's 50% figures above, a Finnish clinic study of nine adult detransitioners found very high rates of mood disorders (89%) and anxiety disorders (78%), and on average about seven years passed before regret emerged (Kettula et al. 2025). That delay matters, because most outcome studies follow people for only one or two years, well within the honeymoon period many detransitioners describe.

In a 2024 survey of 78 people who stopped identifying as trans, participants reported large decreases in gender dysphoria and self-harm, and more wellbeing, after detransition (Littman et al. 2024). These samples are self-selected and recruited partly through detransition communities. They show that persisting distress is a real and repeated experience, not how common it is.

Assessment

Both sides of this debate can point to real data. Short-term studies often find modest improvements in mood on hormones, and many trans-identified people report feeling much better. But those studies rarely have control groups, rarely follow people beyond two years, often lose many participants, and can't separate a drug's direct mood effect from relief of dysphoria. Long-term register studies show high psychiatric need persisting, or increasing, after transition, though they can't show that transition caused it. Detransition accounts suggest some people improve at first and then decline, which short studies would record as success. Given this, the honest conclusion is that nobody yet knows how often transition relieves distress in the long term, or for whom.

What the detrans.ai data shows

The detrans.ai stats cohort contains about 3,094 r/detrans users' stories of people who transitioned in some form (2,344 female, 750 male). Figures are AI-extracted from self-selected public posts. They describe this sample, not rates in any wider population.

• Primary reason for detransitioning. Realising that an underlying mental health condition was driving the transition was the main reason in roughly 270 female accounts (about 12%) and 96 male accounts (about 13%). A related category, where the reality of transition did not match the fantasy or the person became exhausted by performing a role, was the main reason in about 180 female (8%) and 80 male (11%) accounts. Being unable to pass was the main reason in a small share: about 2% of female and 4% of male accounts. These are model-estimated, so the counts are approximate (detrans.ai stats).
• Mental health in the cohort. Depression is described in 960 accounts (31%) and anxiety in 1,245 (40%). Suicidality during transition is described in 214 accounts (7%) and suicidality since detransition in 267 (9%) (detrans.ai stats).
• After detransition. Of the 3,094 accounts, 2,109 (68%) are rated as showing somewhat or much better mental health since detransitioning, 676 (22%) about the same, and 309 (10%) somewhat or much worse (detrans.ai stats). Ratings of "about the same" include accounts that say little about later mental health. People who are doing well may also be more likely to keep posting.

Trans perspectives

Many trans-identified people say transition greatly improved their mental health, and their accounts deserve to be taken seriously. Some describe the lift as lasting for years.

I celebrate 10 years on HRT tomorrow, and my quality of life is so much better in general, period. I haven't thought about harming myself since starting HRT, and honestly, I haven't looked back. —presentingmaddi, trans woman (MTF)

One trans woman said that after a while on hormones she no longer needed the antidepressant escitalopram (Select-Pudding-1137, trans woman (MTF)).

Trans commenters are often frank about the limits. Several draw a line between dysphoria and other problems:

HRT helps people who are depressed as a result of gender dysphoria. Unfortunately, depression isn't content to just claim one area of your life and one alone-- chances are there are other areas of your life that you are depressed about, like most people, and E won't rid you of all your depression. —lvl99_noob, trans woman (MTF)

Some describe their own version of the honeymoon ending, low mood "once the initial excitement… wore off". They respond by taking further transition steps rather than stopping (Illustrious_Pen_5711, trans woman (MTF)). A trans man noticed that after top surgery "some other dysphorias I had started getting stronger", and found it helped to remember that many non-trans men feel the same about height or voice (Aware-Rain9401, trans man (FTM)). Another trans man with a personality disorder and trauma history said his gender identity no longer troubled him, even though his other mental health struggles continued (Natural-Priority-977, trans man (FTM)).

These accounts and the detrans accounts above often describe similar experiences: the early lift, the shifting dysphoria, the problems that stay. They differ in how people interpret them. For one group these are hurdles on the right path; for the other, signs that the path was wrong. Many detransitioners say they once spoke exactly like the satisfied commenters. That doesn't mean those commenters are mistaken. It does mean that how someone feels in the early years is a poor guide to how they will feel later. The real harm comes when permanent interventions are given without fully informed consent and without first exploring other causes of distress.

Why this matters

This page does not give medical advice. The accounts above suggest some practical lessons that detransitioners themselves raise again and again:

• Treat early relief with caution. A lift in the first months of hormones can come from a drug effect, expectation or novelty, and may fade.
• Watch for moving goalposts. If each step creates the need for the next, some detransitioners say that is worth stopping to examine before going further.
• Address the rest of life directly. Depression, anxiety, trauma, eating disorders and loneliness have their own treatments. Many detransitioners wish these had been looked at first. Gender exploratory therapy is one non-directive option.
• Expect a hard period on stopping. Coming off cross-sex hormones often brings a difficult few months. See healing and recovery, testosterone cessation and estrogen cessation.

The support directory lists detrans support groups and gender-exploratory therapists. For suicidality and the "transition or suicide" narrative, see suicide and transition. For regret itself, see transition regret.

Related pages

• Mental health and gender dysphoria
• Reframing dysphoria
• Transition regret
• Suicide and transition
• Evidence reviews
• Gender dysphoria
• Top surgery regret

References

• Baker, K. E., Wilson, L. M., Sharma, R., Dukhanin, V., McArthur, K., & Robinson, K. A. (2021). Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review. Journal of the Endocrine Society, 5(4), bvab011. source.
• Bränström, R., & Pachankis, J. E. (2020). Correction to Bränström and Pachankis. American Journal of Psychiatry, 177(8), 734. source; study page.
• Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident victims: Is happiness relative? Journal of Personality and Social Psychology, 36(8), 917–927. source.
• Cass, H. (2024). Independent review of gender identity services for children and young people: Final report. study page, source.
• Chen, D. et al. (2023). Psychosocial Functioning in Transgender Youth after 2 Years of Hormones. New England Journal of Medicine, 388, 240–250. source; correspondence, NEJM 389, 1536–1540: source.
• Crerand, C. E., Menard, W., & Phillips, K. A. (2010). Surgical and minimally invasive cosmetic procedures among persons with body dysmorphic disorder. Annals of Plastic Surgery. Reported by ScienceDaily; summary by the International OCD Foundation: source.
• Dhejne, C. et al. (2011). Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS ONE 6(2): e16885. study page, source.
• Kettula, K., Puustinen, N., Tynkkynen, L., Lempinen, L., & Tuisku, K. (2025). Gender Dysphoria and Detransitioning in Adults: An Analysis of Nine Patients from a Gender Identity Clinic from Finland. Archives of Sexual Behavior. study page, source.
• Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. study page, source; summary by Genspect (advocacy organisation): source.
• 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.
• Miroshnychenko, A. et al. (2025). Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis. Archives of Disease in Childhood. study page, source.
• Ruuska et al. (2026). Psychiatric Morbidity Among Adolescents and Young Adults Who Contacted Specialised Gender Identity Services in Finland in 1996–2019: A Register Study. Acta Paediatrica. study page, source.
• Singal, J. (2022). Researchers Found Puberty Blockers And Hormones Didn't Improve Trans Kids' Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. Singal-Minded (Substack). source.
• Straub, J. J. et al. (2024). Risk of Suicide and Self-Harm Following Gender-Affirmation Surgery. Cureus. study page, source.
• Taylor, J., Mitchell, A., Hall, R., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Masculinising and feminising hormone interventions for adolescents experiencing gender dysphoria or incongruence: a systematic review. Archives of Disease in Childhood. source.
• Tordoff, D. M. et al. (2022). Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Network Open, 5(2), e220978. source.
• Vandenbussche, E. (2022). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. study page, source.
• Wilson, T. D., & Gilbert, D. T. (2005). Affective Forecasting: Knowing What to Want. Current Directions in Psychological Science, 14(3), 131–134. source.
• detrans.ai statistics: primary detransition reason, mental health features and after-detransition panels. source.