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

• 女性として生まれた英国の成人6人（21～32歳）に聞き取りを行いました。全員が17～24歳で始めたテストステロンを1～5年使用しており、4人は両方の乳房を切除し、デトランジションしたのは2か月から5年前でした。
• 医学的トランジションには限界がありました。ホルモンや手術は、性別への苦痛や根底にあるメンタルヘルスの問題を完全には解決せず、身体的な変化の後に苦痛が強まった人や、変化した体への苦痛を感じた人もいました。
• 長期的な健康への不安が決断を左右しました。心臓のリスク、子宮の萎縮、不妊など、女性の体に対するテストステロンの未知の影響への懸念がデトランジションの一因となり、事前に十分な説明を受けていなかったと感じていました。
• 所属感は時間とともに変わりました。多くの人が、男性として生きるよりも、女性やレズビアンのコミュニティとつながるほうが自分らしいと感じ、女性とは何かという狭い考え方が最初のトランジションの決断を形づくっていたと気づいた人もいました。
• デトランジションは複雑で、続いていくものでした。悲しみ、罪悪感、より男性的な外見で暮らすことなどの現実的な問題を伴い、ほとんどの人は医学的治療以外の方法で苦痛に対処する道を見つけました。
• 支援はほとんど不足していました。医師やセラピストが応えてくれなかったニーズを語り、情報、実用的な助言、感情面の支えを求めてオンラインのデトランジションのコミュニティに頼ることが多くありました。
• 6人のうち4人は自閉症の診断を受けていました（論文の一部では、自閉症または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.