Summary

Researchers surveyed 957 people in the US and Canada who said they had stopped, changed or reversed a gender transition, or wanted to. Most were born female and most described themselves as lesbian, bisexual or queer; 42% had at some point stopped and later restarted transition. Many reported poor care after detransitioning: about 43% said providers never seemed to know anything about detransition, and more than half sometimes or always avoided health care. People most often asked for clinicians who understand detransition, contact with other detransitioners, accurate advice on stopping hormones, help with reconstructive surgery, and therapy that takes trauma into account. Some stopped only because of cost, family rejection or losing access to care. The results show real unmet needs, but come from a self-selected online group and cannot show how common these experiences are.

Key findings

• 957 embert vettek be (az 1377 kitöltött felmérésből, a botok és hamis válaszok eltávolítása után); 79% nőként született és 74% az Egyesült Államokban élt.
• A legtöbben leszbikusok, melegek, biszexuálisak vagy queerek voltak (45% biszexuális, 29% queer, 27% leszbikus), és 42% abbahagyta, majd később újrakezdte az átmenetet.
• A detransition után 43% mondta, hogy az egészségügyi szolgáltatója sosem tűnt tudni a detransitionről, és csak 7% mondta, hogy a szolgáltatók mindig tudtak.
• Az ellátás elkerülése gyakori volt: 13% mindig és 45% néha kerülte az egészségügyi szolgáltatókat, amikor ellátásra volt szüksége, és 46%-nak néha vagy mindig szüksége volt ellátásra, de nem kapta meg.
• Az 563 írásos válaszban a leggyakoribb kielégítetlen igények a közösségi és kortárs támogatás (29%), a detransitiont értő szolgáltatók (29%), a személyes támogatás (22%) és a mentális egészségügyi ellátás (16%) voltak.
• 46 válasz a hormonok biztonságos abbahagyásáról kért tanácsot, és néhányan elutasított helyreállító műtétet írtak le, például négy sebész általi elutasítást.
• Néhányan azt írták le, hogy költség, az ellátáshoz való hozzáférés elvesztése vagy családi elutasítás kényszerítette őket az abbahagyásra, és segítséget kértek az átmenet újrakezdéséhez.

Abstract

BACKGROUND: Detransition refers to stopping, shifting, or reversal of an initial gender transition. Some people detransition temporarily, and later re-start a transition process, or retransition. Despite calls for research and care surrounding detransition/retransition, these experiences remain poorly understood by care providers and LGBTQ2S+ community-serving organizations.

METHODS: Between December 2023-April 2024, a cross-sectional survey was administered to 957 individuals (aged 16 and older) living in the US or Canada who self-identified with experiences of detransition. Participants were recruited via advertisements across eight major social media platforms, direct emails sent to ∼1200 former research participants, and to >615 LGBTQ2S+ organizations and gender-affirming care providers. Mixed qualitative and quantitative data were collected and analyzed regarding participants' experiences and care needs during detransition and, if relevant, retransition. Data about care experiences and needs were analyzed descriptively using frequencies and percentages. Interpretive description was utilized to analyze qualitative responses.

RESULTS: Participants reported a wide range of current gender identities/expressions such as: woman (n = 386; 40.3%); gender nonconforming woman (n = 241; 25.2%); nonbinary (n = 238; 24.9%); and/or detrans woman; (n = 152; 22.5%). A majority of the sample were sexual minorities. A majority reported being bisexual (n = 429; 44.8%), queer (n = 277; 28.9%), and/or lesbian (n = 254; 26.5%). Qualitative analysis identified three key themes: (1) accessing detransition-related care needs within the gender-affirming care system; (2) detransition-related social/legal needs to navigate a second transition; and (3) detransition preventative and retransition needs. Each of these themes encompassed four subthemes, including access to detrans-knowledgeable care providers (n = 162; 28.8%); medical information (n = 62; 11.0%); mental healthcare and supports (n = 92; 16.3%); interpersonal supports (n = 124; 22.0%); and community supports (n = 163; 29.0%).

CONCLUSION: Greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.

Conclusion

The current study contributes to the limited body of work regarding the experiences and care needs of detrans people and other SGM people who report identity fluidity and detransition/retransition. Findings indicate that, like other SGM people, detransition may be inadequately understood by some LGBTQ2S+ serving and gender-affirming care practitioners. Future research and community-led research on detransition/retransition can ameliorate this knowledge gap. Importantly, given the potential for country-specific differences in detransition/retransition experiences, future research should be more sensitive to geopolitical and healthcare delivery dynamics. (Abstract conclusion: greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.)