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디트랜지셔너의 43%, 제공자가 디트랜지션에 대해 아는 것 같지 않았다고 말함: 북미 설문

'제공자들은 나를 어떻게 해야 할지 몰랐다': 성소수자 개인의 디트랜지션/재전환 지원, 진료, 정보 필요에 대한 혼합 방법 분석

설문 조사역전환과 후회역전환자 돌봄과 지원
Authors
Kirsty Rackliff, Pablo Expósito-Campos, Wren Ariel Gould, David J. Kinitz, Madeline Rosen, S. Rudd, June S. H. Lam, Annie Pullen Sansfaçon, Kinnon Ross MacKinnon
Journal
International Journal of Transgender Health
Year
2025
Source
https://doi.org/10.1080/26895269.2025.2538744

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

  • 957명이 포함되었습니다(완료된 설문 1,377건에서 봇과 가짜 답변을 제거한 후). 79%가 출생 시 여성이었고 74%가 미국에 살았습니다.
  • 대부분은 레즈비언, 게이, 양성애자 또는 퀴어였고(45%가 양성애자, 29%가 퀴어, 27%가 레즈비언), 42%는 전환을 중단했다가 나중에 다시 시작했습니다.
  • 디트랜지션 후 43%는 자신의 의료 제공자가 디트랜지션에 대해 전혀 모르는 것 같았다고 했고, 제공자가 항상 알았다고 한 사람은 7%뿐이었습니다.
  • 진료 회피가 흔했습니다. 진료가 필요할 때 13%는 항상, 45%는 때때로 의료 제공자를 피했고, 46%는 때때로 또는 항상 진료가 필요했지만 받지 못했습니다.
  • 563건의 서술 답변에서 가장 흔한 충족되지 않은 필요는 공동체와 또래 지원(29%), 디트랜지션을 이해하는 제공자(29%), 개인적 지원(22%), 정신 건강 진료(16%)였습니다.
  • 46건의 답변은 호르몬을 안전하게 중단하는 방법에 대한 조언을 요청했고, 일부는 재건 수술을 거절당한 경험을 설명했습니다. 예를 들어 외과의 네 명에게 거절당했습니다.
  • 일부는 비용, 진료 접근의 상실, 가족의 거부 때문에 중단하게 되었다고 설명하며 전환을 다시 시작하도록 도움받기를 원했습니다.

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.)