Summary

This study surveyed 78 American young adults, mostly born female, who had identified as trans, often taking medical steps, and later stopped. They reported high rates of mental health diagnoses, many from before they first identified as trans. Most said they had first mistaken mental health problems or trauma for gender distress. Their reasons for detransitioning were mostly internal, such as their own changing thinking, rather than pressure from family or discrimination. Most reported much less gender distress and self-harm, and feeling much better about life, after detransitioning. The authors conclude that for some people, detransition is both possible and helpful. But these were volunteers looking back once on their own experience. The study describes this group well, but cannot show how common detransition is, or that detransitioning caused the improvements.

Key findings

• De 78 personas, 71 (91 %) habían nacido mujer; de media se identificaron como trans por primera vez a los 17 años y lo hicieron durante unos 5 años.
• La mayoría (83 %) había dado pasos de transición social y el 68 % pasos médicos: el 40 % solo hormonas, el 23 % hormonas y cirugía, y el 5 % solo cirugía.
• Mirando atrás, menos del 17 % recordaba un malestar de género en la infancia que cumpliera el diagnóstico actual, mientras que el 53 % sintió que la 'disforia de género de inicio rápido' (malestar de género que aparece de repente en la adolescencia) los describía.
• Los problemas de salud mental eran comunes: el 79 % se había autolesionado alguna vez, incluido el 71 % antes, el 64 % durante y el 23 % después de identificarse como trans.
• El motivo más común dado para identificarse como trans por primera vez fue confundir problemas de salud mental o reacciones a un trauma con malestar de género; los motivos para parar eran más a menudo internos que presión externa.
• De quienes recibieron hormonas del sexo opuesto, el 66,7 % sintió que no se les informó adecuadamente de los riesgos, y solo una persona dijo que se le habló de otras opciones.
• Solo el 27,1 % de todos los participantes dijo a su médico de transición que había hecho detransición.
• Los autores admiten que su estudio no puede mostrar lo común que es la detransición ni qué la predice.

Abstract

Persons who have renounced a prior transgender identification, often after some degree of social and medical transition, are increasingly visible. We recruited 78 US individuals ages 18-33 years who previously identified as transgender and had stopped identifying as transgender at least six months prior. On average, participants first identified as transgender at 17.1 years of age and had done so for 5.4 years at the time of their participation. Most (83%) participants had taken several steps toward social transition and 68% had taken at least one medical step. By retrospective reports, fewer than 17% of participants met DSM-5 diagnostic criteria for Gender Dysphoria in Childhood. In contrast, 53% of participants believed that "rapid-onset gender dysphoria" applied to them. Participants reported a high rate of psychiatric diagnoses, with many of these prior to trans-identification. Most participants (N = 71, 91%) were natal females. Females (43%) were more likely than males (0%) to be exclusively homosexual. Participants reported that their psychological health had improved dramatically since detransi- tion/desistance, with marked decreases in self-harm and gender dysphoria and marked increases in flourishing. The most common reason given for initial trans-identification was confusing mental health issues or reactions to trauma for gender dysphoria. Reasons for detransition were more likely to reflect internal changes (e.g., the participants' own thought processes) than external pressures (e.g., pressure from family). Results suggest that, for some transgender individuals, detransition is both possible and beneficial.

Conclusion

We surveyed a sample of young adults who previously identified as transgender but had detransitioned or desisted. Most participants were born female. Mental health issues, including prior diagnoses and a history of self-harm, were especially common. A history of gender dysphoria during childhood was reported by a nontrivial minority of participants. A slight majority believed their histories were consistent with rapid-onset gender dysphoria. Factors most associated with detransition were internal factors, reflecting psychological change, rather than external factors, such as family or social pressure. Detransitioned participants reported that they had become much less gender dysphoric, and much happier, than they were during their period of trans-identification.