Summary

Writing in the BMJ, Kinnon MacKinnon, Pablo Expósito-Campos and W Ariel Gould argue that people who stop or reverse a gender transition have been ignored by research and care, partly because the topic has become political. Drawing on a few small studies of volunteers, they describe detransitioners as varied, but often female and young when they transitioned. Their reasons range from a change in identity and gender distress that didn't go away, to health worries and discrimination. Many have medical and mental health needs that aren't being met. The authors recommend following patients for at least 5 to 10 years and not assuming that people who drop out of studies (over 30% in some) are doing well. It is a sensible research plan, not new evidence. There was no formal search, and some claims rest on news reports or the authors' own studies.

Key findings

• Ini adalah artikel analisis, bukan tinjauan penelitian yang lengkap: artikel ini meringkas beberapa studi awal dan membuat rekomendasi, tanpa data baru.
• Studi yang dikutip (misalnya survei daring terhadap 237 orang yang berhenti transisi, 92% perempuan, dan studi wawancara Kanada terhadap 28 orang) menunjukkan bahwa banyak orang yang berhenti transisi terlahir perempuan dan bertransisi sebelum usia 25 tahun.
• Alasan berhenti transisi mencakup perubahan identitas, tekanan gender yang tidak diselesaikan oleh transisi, kekhawatiran kesehatan fisik atau mental, diskriminasi, dan tekanan batin yang disebabkan oleh perawatan itu sendiri ('disforia terbalik').
• Setelah berhenti transisi, banyak orang menggambarkan tekanan gender yang berlanjut, penyesalan, duka, atau perasaan campur aduk, kehilangan dukungan dari teman-teman LGBTQ+, dan menghindari dokter karena takut dihakimi.
• Para penulis mengatakan tindak lanjut 1 hingga 2 tahun terlalu singkat, karena berhenti transisi biasanya terjadi beberapa tahun setelah perawatan. Mereka merekomendasikan setidaknya 5 hingga 10 tahun.
• Mereka memperingatkan bahwa lebih dari 30% pasien keluar dari beberapa studi perawatan gender, dan bahwa peneliti tidak boleh berasumsi bahwa orang-orang ini masih mengidentifikasi diri sebagai trans atau tidak memiliki kebutuhan lebih lanjut.
• Mereka merekomendasikan memilih kelompok studi berdasarkan perawatan yang diterima orang daripada identitas mereka saat ini, memakai kata 'detrans' dan 'berhenti transisi', dan membangun perawatan berhenti transisi yang tidak menghakimi ke dalam layanan gender.

Abstract

Kinnon MacKinnon and colleagues call for robust, sensitive research to inform comprehensive gender care services for people who detransition

Conclusion

Rigorous and nuanced detransition research is indispensable. Investigating the experiences of people who detransition will provide a better understanding of the development of gender identity, as well as all health and psychosocial outcomes following gender care. This aligns with priorities identified by trans health experts. Unfortunately, ongoing debates and politicisation of gender care have resulted in the depiction of trans and detrans people as completely distinct groups with divergent needs and experiences, and who are doomed to conflict. However, we believe that trans and detrans people are more similar than different, and that detransition research holds value for advancing the healthcare of all those who transition, and for responsibly moving gender care research and practice forward.