Summary
Researchers interviewed six UK women who medically transitioned and later detransitioned, looking for shared themes. All had taken testosterone for 1 to 5 years, and four had had both breasts removed. Four themes emerged. First, hormones and surgery did not resolve their distress or change their sex. Second, they worried about the long-term health effects of testosterone. Third, their sense of belonging changed, and some felt more at home among women and lesbian communities. Fourth, detransition was an ongoing process, and their needs were mostly not met by health services. The authors call for careful whole-person assessment before transition, research on testosterone's long-term effects in women, and better support for people detransitioning. It gives a detailed picture of a few lives, but six similar, self-selected people cannot show how common this is.
Key findings
- Enam orang dewasa Inggris yang terlahir perempuan, berusia 21 hingga 32 tahun, diwawancarai. Semuanya telah memakai testosteron selama 1 hingga 5 tahun, mulai pada usia 17 hingga 24 tahun, empat orang telah menjalani pengangkatan kedua payudara, dan mereka berhenti transisi 2 bulan hingga 5 tahun sebelumnya.
- Transisi medis memiliki keterbatasan: hormon dan operasi tidak sepenuhnya menyelesaikan tekanan gender atau masalah kesehatan mental yang mendasari, dan sebagian merasa lebih tertekan, atau tertekan oleh tubuh mereka yang berubah, setelah perubahan fisik.
- Kekhawatiran kesehatan jangka panjang mendorong keputusan: kekhawatiran tentang efek testosteron yang tidak diketahui pada tubuh perempuan, seperti risiko jantung, penyusutan rahim, dan ketidaksuburan, ikut mengarah pada berhenti transisi, dan mereka merasa tidak diberi informasi yang layak sebelumnya.
- Rasa memiliki berubah seiring waktu: banyak yang merasa lebih menjadi diri sendiri saat terhubung dengan perempuan dan komunitas lesbian daripada hidup sebagai laki-laki, dan sebagian menyadari bahwa gagasan sempit tentang apa itu perempuan telah membentuk keputusan awal mereka untuk bertransisi.
- Berhenti transisi itu kompleks dan berkelanjutan: hal ini membawa duka, rasa bersalah, dan masalah praktis seperti hidup dengan penampilan yang lebih maskulin, dan sebagian besar menemukan cara selain perawatan medis untuk mengelola tekanan batin.
- Dukungan sebagian besar kurang: mereka menggambarkan kebutuhan yang tidak dipenuhi oleh dokter dan terapis, dan sering beralih ke komunitas berhenti transisi daring untuk informasi, saran praktis, dan dukungan emosional.
- Empat dari enam orang memiliki diagnosis autisme (atau, di satu bagian makalah, autisme atau ADHD).
Abstract
The visibility and presence of people who have detransitioned following a gender transition is growing, with an increase in research on the needs and experiences of this group. This study presents a thematic narrative analysis of interviews from six females (M = 25.5 yrs; range = 21–32 yrs). All detransitioned after having at least one gender-affirming medical or surgical treatment as part of a gender transition in the UK. Four narrative themes were developed to capture how they made sense of their detransition: (1) the limits of medical transition, (2) the longer-term health implications, (3) the social limits of transition, and (4) detransition as an ongoing process. Participants discussed a range of emotional, practical, and other support needs, largely unmet by healthcare or other services. These findings highlight the importance of ensuring that people have realistic expectations of transition as part of a holistic assessment process. Long-term health outcome research is also needed, addressing the impact of testosterone on female anatomy and health specifically. Further clinical implications with those considering transition or detransition are discussed.
Conclusion
This research adds an in-depth analysis to the previous literature on detransition. Participants detransitioned because they found medical transition had limits to resolve distress, or to change their sex. The ongoing health implications and associated risks were also a factor for most. Participant perception of social group belonging often shifted after transition, sometimes linked to feminist values, or perhaps reflecting the normal developmental experiences and trajectory of adolescence and early adulthood as young people explore their identities in different social contexts. It is also possible that the experience of the physical limits of transition to transform them, left the social aspects feeling hollow, increasing social dysphoria related to the new gender. Detransition was a complex and individual, ongoing process, with a range of needs expressed. Implications for clinical practice with people considering transition and detransition were discussed.