Summary

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

Key findings

• Kirjoittaja erottaa kolme usein ”detransitioksi” niputettua ajatusta: detransitioitumisen teko, identifioituminen detransitioituneeksi ja huono kokemus korjauksesta.
• Essee lajittelee olemassa olevan tutkimuksen ”detransin estämiseen” (sen yleisyyden ja syiden tutkiminen) ja ”detransin tukemiseen” (itse kokemuksen tutkiminen hoidon parantamiseksi).
• Ruotsalaisessa aineistossa (Dhejne ym., 2014) leikkauksen peruutuspyynnöt tulivat tyypillisesti noin 8 vuotta leikkauksen jälkeen. Joten 0,3 %:n luku vuosille 2001–2010 voi olla liian matala yksinkertaisesti siksi, ettei aikaa ollut kulunut tarpeeksi; tuo ajanjakso pois jättäen 14 ihmistä 321:stä (4,4 %) pyysi peruutusta.
• Klinikoiden tuntemia katumustapauksia (esimerkiksi 0,1 % kyselyssä klinikoille, jotka aloittavat hormonit pelkän suostumuksen perusteella) kutsutaan ”merkittävästi virheellisiksi”, koska monet detransitioituneet lopettavat käymisen sen sijaan, että kertoisivat klinikalleen.
• Tuohon aikaan detransitiolle ei ollut lääketieteellistä ohjeistusta ja lähes ei lainkaan tutkimusta detransitiosta ihmisillä, jotka ottivat hormoneja ilman leikkausta.
• Kirjoittaja vaatii haastatteluihin perustuvaa tutkimusta detransitioituneiden kanssa sekä lääketieteellistä tutkimusta siitä, miten hormonit lopetetaan turvallisesti.

Abstract

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

Conclusion

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