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人が含まれました（完了した調査1,377件から、ボットや偽の回答を除いたもの）。79%が女性として生まれ、74%が米国に住んでいました。
• 大半がレズビアン、ゲイ、バイセクシュアル、またはクィアで（バイセクシュアル45%、クィア29%、レズビアン27%）、42%がトランジションをやめて後に再開していました。
• デトランジションの後、43%が医療提供者はデトランジションについてまったく知らないようだったと答え、提供者が常に知っていたと答えたのは7%だけでした。
• ケアを避けることは一般的で、ケアが必要なときに医療提供者を避けたのが、常にが13%、ときどきが45%で、46%はケアが必要だったのにときどき、またはいつも受けられませんでした。
• 563件の記述式の回答で、最も多かった満たされないニーズは、コミュニティと仲間の支援（29%）、デトランジションを理解する提供者（29%）、個人的な支援（22%）、メンタルヘルスケア（16%）でした。
• 46件の回答がホルモンを安全にやめる方法についての助言を求めており、再建手術を拒否された例（たとえば4人の外科医に断られた）を述べた人もいました。
• 費用、ケアへのアクセスの喪失、家族からの拒絶のために、やめざるを得なかったと述べ、トランジションを再開する手助けを望んだ人もいました。

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.)