Overview

For some people, the decision to detransition starts in the body, not in a change of belief. A blood test comes back with dangerous numbers, pelvic pain stops going away, erections don't come back, or a scar keeps hurting years after a "good result". In surveys of detransitioners, health concerns are among the most common reasons given for stopping. In first-person accounts on /r/detrans, a physical complication is often the moment that turns a quiet doubt into a decision.

This page looks at how physical problems lead people to detransition: which problems people describe, how they make sense of them, the point where health starts to outweigh identity, how clinicians respond, and what surveys and this site's own statistics show. It does not list the risks of each treatment. For those, see hormones, iatrogenic harm (harm caused by medical treatment itself) and surgery.

Three kinds of health reason

"Health reasons" covers at least three different experiences, and surveys often lump them together.

• Anticipated harm: worry about long-term risks that haven't happened yet, such as heart disease, cancer, bone loss, or what decades of hormones might do. Lisa Littman's 2021 survey of 100 detransitioners asked about "concerns about potential medical complications". The word potential matters there (Littman 2021).
• Experienced complications: a specific side effect or surgical problem that has already happened, such as thick blood, vaginal atrophy, erectile dysfunction or chronic nerve pain.
• Cumulative burden: no single crisis, but the slow weight of lifelong medication, injections, blood tests, follow-up procedures and a body that needs managing indefinitely.

These often overlap in one person's story. Someone may start with a lab result, read more, and then become frightened of risks they had never thought about. The difference still matters. Anticipated harm is a judgement about the future. An experienced complication is evidence the person has collected on their own body.

What people describe

The complications reported on /r/detrans follow the known effects of each hormone and surgery. This is a short orientation. The linked pages cover mechanisms and evidence in more detail.

In female accounts

Women who took testosterone most often describe:

• Genital and pelvic problems: vaginal atrophy (thinning and drying of vaginal tissue when estrogen is suppressed), cramping, pain during or after orgasm, frequent urinary tract infections (UTIs), incontinence, and in some accounts pelvic organ prolapse.
• Blood and heart markers: high haemoglobin or haematocrit (erythrocytosis or polycythaemia, meaning too many red blood cells, which thickens the blood and raises clot risk), high blood pressure, high cholesterol and palpitations.
• Hair loss, acne, weight gain, and in some accounts autoimmune or endocrine problems that got worse.
• Surgical after-effects, especially chronic pain and numbness after mastectomy, and complications of phalloplasty and hysterectomy.

See testosterone in females and mastectomy.

In male accounts

Men who took estrogen and anti-androgens (testosterone blockers such as spironolactone) more often describe:

• Sexual dysfunction: erectile dysfunction, lost libido and testicular atrophy, sometimes lasting years after stopping (see sexual function).
• Weakness, fatigue, weight gain and mood changes, which they often notice most clearly after stopping.
• Bone loss after orchiectomy (removal of the testes) when hormone levels are not kept up.
• Clotting, liver and blood-pressure concerns, and complications of vaginoplasty.

See estrogen and testosterone blockers in males.

What the clinical literature says, briefly

The research shows these effects are real, but how often they happen is disputed and depends on the study. In a long-term Amsterdam cohort, about 11% of trans-identified females on testosterone developed erythrocytosis (haematocrit above 0.50), and the risk kept rising with years of exposure (Madsen et al. 2021). A 2024 analysis of 6,670 patients in the Journal of Clinical Endocrinology & Metabolism found a lower figure, 8.4% at a haematocrit of 50% or more, and called severe erythrocytosis rare (JCEM 2024). A small online survey of 68 trans-identified females on testosterone in Brazil reported pelvic floor symptoms in 95% (da Silva et al. 2024). By contrast, the much larger US PRIDE Study (a national cohort of sexual and gender minority adults) found that current testosterone use was linked to less chronic pelvic pain overall, though about half of those reporting pain after starting testosterone had new-onset pain (Tordoff et al. 2025). In males taking estrogen, a Kaiser Permanente cohort found higher rates of venous thromboembolism (blood clots in the veins) and stroke than in matched comparison groups (Getahun et al. 2018).

These numbers come from people who stayed in clinic care. People who stopped and left the clinic are often missing from them. That is the group this page is about.

The body "pushing back"

How people interpret a complication is as important as the complication itself. A recurring theme in these accounts is that the body is no longer treated as the problem to be corrected. It becomes a witness with something to say.

Straight up – I started having medical problems from hormones. … So that was the catalyst – After I realized this wasn't healthy for me, I thought "How can this be my true self if it's going to hurt me to be this way?" —ButchPeace274, detrans female

Health complications primarily. It felt like my body was fighting my medical transition. HRT raised my cortisol, BP, and HGB to very high levels regardless of dose, and exacerbated symptoms of an endocrine disorder I have. —dappermantra, detrans female

The gender-identity framework (see gender as an explanatory framework) gives the inner sense of self authority over the body. The mind is the true self, and the body is wrong and must be brought into line. A complication turns that around. The body now seems to resist the project, and it is hard to argue with a haematocrit result or a prolapse.

Phenomenology, the philosophical study of lived experience, offers a useful idea here. The philosopher Drew Leder argued that a healthy body mostly "disappears" from awareness and only comes forward, or dys-appears, when it malfunctions or hurts (Leder 1990). Gender dysphoria already makes the sexed body painfully visible. In these accounts, complications make the body visible a second time, now as something fragile that can be harmed rather than something to be fixed. Some people describe this as a shift from treating the body as an object of correction to living it as a self that needs care (see embodiment).

The medical sociologist Michael Bury called the onset of chronic illness a biographical disruption: an event that breaks the story a person expected their life to follow and forces them to rethink who they are (Bury 1982). Transition is itself a planned new life story. A lasting complication disrupts that new story, and for some people this is the opening through which they look again at why they transitioned at all.

Not everyone reads the body this way. Dappermantra, quoted above, does not regret transition and describes detransition as a long-term health choice, not a change of identity. Others reject the "body as signal" idea and see their complications as bad luck or poor clinical care. Both readings appear on /r/detrans, and neither describes everyone.

The tipping point

Many accounts describe a cost-benefit judgement that slowly changes until it tips. While dysphoria feels unbearable, side effects seem worth it. As dysphoria eases, or the side effects pile up, the balance shifts.

I am also one of those people, but at this point I think the medical complications are starting to outweigh the benefits of dysphoria relief. —watching_snowman, detrans female

Often one concrete event forces the decision:

I had annual bloodwork done and found out my labs were a disaster. I took care of my body and thought I was healthy, but my cholesterol was awful, blood pressure was awful, RBC was awful, resting heart rate was awful. My doctor (a trans specialist) wanted me to either go on statin drugs or go off T, and really encouraged me to go off T. I wasn't going on statin drugs at 29, so I decided to go off T. —graybutch, butch ♀, detrans'd after ~10 years

I started getting bad vaginal atrophy around 10 months after starting T, which my endo swore they hadn’t seen in someone as young & been on as little time as me. She offered a cream & said that I would most likely need a hysterectomy within the next year or so. That got me to start thinking about whether or not the inevitable outcome was worth it to me in the end. —easier_2_run, detrans female

Three patterns stand out.

Health first, rethinking second

In many stories, the health problem comes before any change in belief about gender, and the rethinking follows:

I "detransitioned" due to health concerns, but when I began the process, I did a lot of thinking and realized everything I thought about the process, about "being transgender", everything was illogical. —OnceBitten8240, detrans female

I was a trans woman/ on hrt for over 3 years and chose to stop due to medical risks of hormones. I thought I would stop and need to just struggle with the dysphoria afterwards, but it inevitably became a process that involved dealing with the issues that caused me to transition in the first place. —sentientmassofenergy, detrans male

This matters for research. Someone who stopped for health reasons and later decided their dysphoria came from trauma or internalised homophobia might tick both boxes in a survey, even though one caused the other. See reframing dysphoria.

Health as an acceptable explanation

Health is also a reason that other people find easy to accept. Saying "my doctor told me to stop" avoids the questioning and accusations that "I no longer think I'm trans" can bring (see backlash against detransitioners).

I explained to anyone who needed to know that I stopped T because it was causing health problems, which was true but meant I didn't have to launch into a difficult personal explanation about transition doubts. —DapperDhampir, detrans female

This does not make health reasons less real. It does mean that how often health is given as a reason partly reflects which reasons are socially safe to give.

The weight of dependence

Some people are moved less by any one complication than by the prospect of lifelong medical dependence:

It became not worth putting my body through so much stress when I wasn't going to be satisfied with passing. … I'd rather be healthy and not medically dependent than keep chasing something I can never achieve. —oldtomboy, detrans female

How clinicians respond

Dismissal and "it's rare"

A common complaint is that symptoms were played down, treated as normal, or put down to something other than the hormones:

I got polycythemia on T which is a somewhat common side effect and very dangerous, my blood was so thick that I was told to immediately stop taking the T, take blood thinners AND to go donate blood because I was at close risk of a blood clot, heart attack or stroke. —throwawayeffoff, detrans female

The same commenter says a later "trans affirming" doctor told her the first doctor had overreacted and that polycythaemia was no big deal. Her conclusion:

Thay is just insane to me and showed me clearly that these people do not have a good enough grasp on this to be trusted with my physical health. —throwawayeffoff, detrans female

I have had people tell me that this is not the fault of the trans medical industry, because that does not happen to most females who take testosterone, but from my perspective, it is their fault, because without testosterone, it would not have happened to me. —DetransLaura, detrans female

Male detransitioners more often describe being dropped from care altogether, or having persistent symptoms judged not worth treating:

Clomid is pretty much the only hope I’ve got at this point, my gender clinic cut me off years ago when I started doubting my transition, and I went to endocrinology just for them to tell me that because my T is in the lower end of acceptable they refused to do anything. I guess being in your early 20s and sexually compromised is fine to doctors now. —MythicalDawn, detrans male

In a Canadian interview study of 28 people who stopped or reversed transition, participants often described avoiding healthcare, stigma from clinicians, and clinicians who knew little about detransition. Some stopped hormones "cold turkey" without medical supervision (MacKinnon et al. 2022). In Elie Vandenbussche's survey of 237 detransitioners, many needed medical help with complications but described negative experiences with healthcare providers, and only 18% felt they had enough support (Vandenbussche 2022).

The mirror image: "trans broken arm syndrome"

Trans-identified patients often report the opposite. Their clinicians blame every symptom on hormones, a pattern known informally as "trans broken arm syndrome": a provider attributes unrelated complaints to the patient's trans status or treatment (Grace & Doan 2024).

I went to the er cus an ovarian cyst ruptured and got horribly infected. The doctor was like " your platelet count is stupidly high. You need to get off your hormones or they could kill you" and I was too physically weak to resist so I went off them for the month I was in the hospital but they kept blaming my t? —RandomBlueJay01, ftm

I just can't handle having to explain over and over again that no, this is really not something testosterone does and even if it did, going off testosterone would be the absolute last resort option after trying every other possible treatment there is. —Cerealuean, ftm

Putting the two complaints side by side is revealing. Both groups face the same uncertainty about whether a symptom is caused by the hormones, and the long-term data to settle it are thin. That uncertainty tends to get resolved in favour of whatever the person in the room already believes. A patient committed to transition reads "it's the hormones" as prejudice. A patient who is doubting reads "it's not the hormones" as denial. Clinicians can lean either way depending on their own views. None of this shows who is right in a particular case. It does show why careful, unbiased assessment of symptoms matters to both groups.

Informed consent in hindsight

Many accounts return to consent. Most people did sign forms. The question they raise is whether they could really take in the risks at the time:

We might have signed the paperwork. Someone may have gone over a list of side effects with us. What did we think at the time, especially if we were young and had other mental illnesses we were dealing with? We thought: “This will never happen to me. That hasn’t happened to anyone I know, so it’ll probably be ok. And even if it does happen to me, I can take it. I really want this! I’ll risk it.” —squidapedoyt, questioning own gender transition

In Littman's survey, nearly half said counselling before transition was too positive about benefits and not negative enough about risks (Littman 2021). In a UK study of six women who detransitioned, worry about the unknown long-term effects of testosterone, and a feeling that they had not been properly informed, were central themes (Lomax & Butler 2025). See informed consent critique.

What surveys show

Vandenbussche's figures come from a summary of the survey (SEGM, an organisation critical of youth gender medicine). Littman's breakdown is from the published results (Littman 2021).

Three caveats apply. First, Littman and Vandenbussche recruited through online detrans communities, which overrepresent people who stopped identifying as trans and who have strong views about their care. Second, MacKinnon's 2024 sample was recruited from trans and gender-diverse young people, many of whom still identified as trans. That health reasons led the list there too suggests the pattern is not just an artefact of detrans spaces. Third, the categories are broad. "Health concerns" can mean anything from a pulmonary embolism to a general unease, and none of these surveys measured how common complications are among everyone who transitions.

Pablo Expósito-Campos's typology of detransition is useful here. It separates core detransition (stopping because one no longer identifies as trans) from non-core detransition (stopping for other reasons, such as health problems or discrimination, while still identifying as trans) (Expósito-Campos 2021). Health complications can lead to either.

What this site's statistics show

The detrans.ai stats cohort contains about 3,094 /r/detrans stories from people who transitioned in some way (2,344 female, 750 male). The features below were extracted by AI and counted at a conservative ≥0.8 probability threshold. This is a self-selected online sample. These are counts of stories, not rates among people who transition.

• Primary reason for detransition: "regret after surgery or significant medical complications/side effects" was the single most important reason in 300 stories (about 10%). By comparison, trauma realisation was the main reason in 450, acceptance of the sexed body in 384, and mental-health realisation in 378. By sex (probability-weighted), it was the primary reason in roughly 9% of female and 11% of male stories.
• Medical complications of any kind were described in 1,007 stories (33%): 783 female (33%) and 224 male (30%). A further 875 stories were uncertain.
• A medical scare, meaning a specific incident, complication or health scare that prompted re-evaluation, appeared in 182 stories (6%): 132 female and 50 male. Ninety per cent of these also described medical complications.
• Severity: on a 0–3 scale from "no complications" to "severe, permanent, or life-altering harm", 531 stories scored at the severe end (2.7 or higher).
• Ongoing medical needs linked to transition (monitoring, medication, corrective procedures) appeared in 734 stories, and dissatisfaction with how clinicians handled care in 936 (detrans.ai stats).

These numbers suggest that complications are much more common in these stories than as the main reason for stopping. Many people mention a complication, but fewer present it as the deciding factor. This fits the pattern above, where health is often one part of a wider rethinking.

In their own words

Female accounts

This was exactly why I detransitioned to begin with. Before even deconstructing ideas and past experiences, it was all the medical fallout. Same experience as you, within the first year or two I had the hair thinning, excessive hot flashes and sweating, atrophy, pelvic floor issues, developed hypothyroidism, red blood cell issues, umanagably high cholesterol, i could go on. It was in no way sustainable and the providers that put me on it at 17 didn't warn me about almost any of it. So much for "informed consent". —greyysxnn, detrans female

That testosterone would cause me to develop atrophy and a pelvic organ prolapse that I would be dealing with for the rest of my life, which prevents me from lifting anything heavy. I thought testosterone would make me stronger, and it did for a while, but then it made me permenantly weaker. —DetransLaura, detrans female

I had a very easy recovery from my mastectomy, with no complications, and by all metrics had a “good result” aesthetically. … I expected loss of sensation, not frazzled nerves. I was not truly informed and my surgery happened only 1 month after the consultation. —detrans-throwaway7, detrans female

Male accounts

The main reason to detransition was for my health. Low testosterone increases your risk of osteoporosis, depression, infertility etc. I developed a lot of health issues that I ignored on HRT. —loveincautionn, detrans male

In my case I detransitioned because I felt worse seeing estrogen changes and I had painful side effects. My dysphoria convinced me transition was a good idea. However, it was never a major problem for me and the damage that estrogen did to me was far worse than anything I ever experienced from dysphoria. —UniquelyDefined, detrans male

It all started 2 years ago, when I suddenly developed a crazy dizziness which lasted for a few months. I felt so weak and sick. I had time to think through everything and finally accepted that SRS was wrong and a crazy, traumatizing experience. … Also that HRT and transitioning did have a negative impact on my physical and mental health and that this dizziness was a warning sign that I couldn't move on like this. —Felina11, detrans male

I took spiro for 3-4 years, then had an orchi (which was the right decision for me) stayed with HRT and I rapidly became fat, weak and stupid. I could not get my current endo to understand I hated what was happening to my body, but did not want to go all the way back. —Mindless_Low_1047, detrans male

It was related to my auto immune diseases, and hormones werent exactly helping so it was recommended I stop hrt after we tested several different hrt methods, none of which made any difference and for the sake of my liver i had to stop —Severe_Cranberry5657, detrans male

I was on E for nine years. Had an orchi too. I quit E for a couple years, nearly died, been on T now for a couple years. —joliphotia, detrans male

When health doesn't end in re-identification

Stopping for health reasons does not always mean stopping identifying as trans. Some people stop hormones and still feel the same way about their identity:

Here’s the secret. I’m definitely still “trans” or have gender dysphoria or whatever, and I still regret it. —PeregrinePanic, detrans female

Trans-identified people also describe stopping for medical reasons:

I had to leave T cuz it was damaging my kidneys and my body got rid of low dosis due to my already high hormonal level. —Vicvir, ftm

In MacKinnon's interview study, most participants did not regret their earlier treatment, even though many had stopped for health or other reasons (MacKinnon et al. 2022). People who stop for health reasons but stay trans-identified are probably underrepresented on /r/detrans. See external pressures and retransition.

After stopping

Recovery after stopping varies a great deal. Some people describe blood pressure, cholesterol and pain going back to normal within months. Others live with permanent effects. Graybutch later reported that her blood pressure had fallen to 100/70. Split_skunk, by contrast, wrote:

Most people are luckier and fully recover their sexual function within a couple months. I still have persistent erectile dysfunction and libido issues. —split_skunk, detrans male

People who have had their gonads removed face a different situation. Without testes or ovaries, the body cannot make its own sex hormones, so stopping all hormones can lead to bone loss and other problems. Some male detransitioners describe that happening. For what is known about stopping, see testosterone cessation, estrogen cessation and detransition healthcare. For support, see healing and recovery and the support directory.

Limits of the evidence

• No population rates. No study cited here shows how often complications lead to detransition among everyone who transitions. Most detransitioners do not tell their clinics: only 24% in Littman's survey had told their clinicians (Littman 2021). Loss to follow-up means clinic data undercount both complications and stopping.
• Self-selected samples. Surveys recruited through detrans communities, and this site's /r/detrans stories, overrepresent people with negative experiences.
• Attribution is hard. A person cannot easily tell whether a symptom was caused by hormones, an existing condition, or something unrelated. Both detransitioners and trans-identified patients report clinicians getting this wrong, in opposite directions.
• AI-extracted statistics. The /stats figures come from AI analysis of public posts. They depend on how each story was written, not on medical records.

Related pages

• Hormones and Surgery
• Iatrogenic harm, Sexual function and Fertility
• Detransition healthcare
• Transition regret
• Distress persisted, Wanting children and Realisation moments

References

• 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.
• Vandenbussche, E. (2022). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. study page, source. Summary figures via SEGM (advocacy organisation).
• MacKinnon, K. R., et al. (2022). Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments. JAMA Network Open. source.
• MacKinnon, K. R., et al. (2024). Discontinuation of Gender-Affirming Medical Treatments: Prevalence and Associated Features in a Nonprobabilistic Sample of Transgender and Gender-Diverse Adolescents and Young Adults in Canada and the United States. Journal of Adolescent Health. 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.
• Expósito-Campos, P. (2021). A Typology of Gender Detransition and Its Implications for Healthcare Providers. Journal of Sex & Marital Therapy. study page.
• Madsen, M. C., et al. (2021). Erythrocytosis in a Large Cohort of Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years. Journal of Clinical Endocrinology & Metabolism. source.
• Erythrocytosis Is Rare With Exogenous Testosterone in Gender-Affirming Hormone Therapy (2024). Journal of Clinical Endocrinology & Metabolism 109(5). source.
• da Silva, L. M. B., et al. (2024). Pelvic Floor Dysfunction in Transgender Men on Gender-affirming Hormone Therapy: A Descriptive Cross-sectional Study. International Urogynecology Journal. source.
• Tordoff, D. M., et al. (2025). Chronic pelvic pain among transgender men and gender diverse adults assigned female at birth. Andrology. source.
• Getahun, D., et al. (2018). Cross-sex hormones and acute cardiovascular events in transgender persons: A cohort study. Annals of Internal Medicine. source.
• Grace, M. K., & Doan, L. (2024). Medical Authority, Trans Exceptionalism, and Americans’ Willingness to Believe Claims of Inadequate Training as Justification for the Denial of Care to Trans People. Socius. source.
• Leder, D. (1990). The Absent Body. University of Chicago Press. publisher page.
• Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health & Illness, 4(2), 167–182. source.
• detrans.ai (2026). Detransition statistics from /r/detrans stories. stats page.