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

• Sur 78 personnes, 71 (91 %) étaient nées femmes ; en moyenne, elles se sont identifiées comme trans pour la première fois à 17 ans et l'ont fait pendant environ 5 ans.
• La plupart (83 %) avaient pris des mesures de transition sociale et 68 % des mesures médicales : 40 % hormones seules, 23 % hormones et chirurgie, et 5 % chirurgie seule.
• Rétrospectivement, moins de 17 % se souvenaient d'une détresse de genre dans l'enfance répondant au diagnostic actuel, tandis que 53 % estimaient que la « dysphorie de genre à début rapide » (détresse de genre qui apparaît soudainement à l'adolescence) les décrivait.
• Les problèmes de santé mentale étaient courants : 79 % s'étaient déjà automutilés, dont 71 % avant, 64 % pendant et 23 % après leur identification comme trans.
• La raison la plus courante donnée pour s'être d'abord identifié comme trans était d'avoir pris des problèmes de santé mentale ou des réactions à un traumatisme pour une détresse de genre ; les raisons d'arrêt étaient plus souvent internes que dues à une pression extérieure.
• Parmi ceux qui ont reçu des hormones du sexe opposé, 66,7 % estimaient ne pas avoir été correctement informés des risques, et une seule personne a dit qu'on lui avait parlé d'autres options.
• Seuls 27,1 % de l'ensemble des participants avaient dit à leur médecin de transition qu'ils avaient détransitionné.
• Les auteurs reconnaissent que leur étude ne peut pas montrer la fréquence de la détransition ni ce qui la prédit.

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.