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
- Sono stati intervistati sei adulti britannici nati femmine, di età compresa tra 21 e 32 anni. Tutti avevano assunto testosterone per 1-5 anni, iniziando tra i 17 e i 24 anni, quattro avevano subito l'asportazione di entrambi i seni e avevano fatto detransition da 2 mesi a 5 anni prima.
- La transizione medica aveva dei limiti: ormoni e chirurgia non avevano risolto completamente il loro disagio di genere né le difficoltà di salute mentale di fondo, e alcuni provavano più disagio, o disagio per il proprio corpo cambiato, dopo i cambiamenti fisici.
- Le preoccupazioni per la salute a lungo termine hanno guidato le decisioni: la preoccupazione per gli effetti sconosciuti del testosterone sul corpo femminile, come rischi cardiaci, restringimento dell'utero e infertilità, ha contribuito a portare alla detransition, e sentivano di non essere state informate adeguatamente in precedenza.
- Il senso di appartenenza è cambiato nel tempo: molte hanno scoperto di sentirsi più se stesse legandosi alle donne e alle comunità lesbiche che vivendo come uomini, e alcune si sono rese conto che idee ristrette su cosa sia una donna avevano influenzato la loro prima decisione di fare la transizione.
- La detransition era complessa e in corso: ha portato lutto, senso di colpa e problemi pratici come vivere con un aspetto più mascolino, e la maggior parte ha trovato modi diversi dal trattamento medico per gestire il disagio.
- Il sostegno mancava per lo più: descrivevano bisogni non soddisfatti da medici e terapeuti, e spesso si sono rivolte alle comunità online sulla detransition per informazioni, consigli pratici e sostegno emotivo.
- Quattro delle sei avevano una diagnosi di autismo (o, in una parte dell'articolo, di autismo o 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.