Summary

This paper suggests splitting detransition into two types. In 'core' detransition, a person stops identifying as transgender and identifies with their birth sex again. In 'non-core' detransition, a person stops or reverses transition but still identifies as trans, because of things like discrimination, health worries or being unhappy with results. The author argues this would clear up confusion, since 'detransition' is used to mean both. He gives advice for clinicians: thorough mental health assessment, honest consent about benefits, risks and unknowns, offering talking therapy alongside medical options, long-term follow-up, and guidelines for both groups. It is a useful way to think about the topic, but it is based on stories and opinion rather than data, and nobody has yet tested whether the types work in practice.

Key findings

• 논문은 두 유형을 제안합니다. ‘핵심’ 또는 일차 디트랜지션(더 이상 트랜스젠더로 정체화하지 않고 다시 출생 성별로 정체화)과 ‘비핵심’ 또는 이차 디트랜지션(여전히 트랜스로 정체화하면서 전환을 중단하거나 되돌림)입니다.
• 핵심 디트랜지션의 이유에는 전환이 성별 고통을 덜어 주지 않았다는 발견, 그리고 그 고통이 트라우마, 동성애에 대한 내면의 수치심, 성차별, 다른 정신 건강의 어려움과 관련되어 있었음을 알게 된 것이 포함됩니다.
• 비핵심 디트랜지션의 이유에는 의학적 문제, 결과에 대한 불만, 차별, 돈이나 지원의 부족, 가족의 압력, 아이를 원하거나 생식 능력을 지키고 싶은 것이 포함됩니다.
• 유형은 고정되어 있지 않습니다. 비핵심 디트랜지션이 나중에 핵심 디트랜지션이 될 수 있고, 일부는 출생 성별로 다시 정체화하기 전에 한동안 논바이너리로 정체화합니다.
• 저자는 일반 인구보다 디트랜지셔너에서 자폐가 더 흔하다는 비공식적 보고가 있지만 이에 대한 연구가 필요하다고 말합니다.
• 그는 철저한 정신 건강 평가, 이점과 위험과 알려지지 않은 것을 다루는 솔직한 동의, 의학적 선택지와 함께 탐색적 대화 치료 제공, 장기 추적을 권고합니다.
• 디트랜지션이 항상 후회인 것은 아닙니다. 그는 임상의가 판단하지 않고 대응하고 두 집단 모두를 위한 임상 지침을 작성할 것을 요청합니다.

Abstract

Gender detransition, i.e., the process of reidentifying with one's birth sex after having undergone a gender transition, has captured the attention of the scientific community, the media, and the public in the last few years. Despite not being a genuinely novel phenomenon from a historical perspective—psychiatrist Harry Benjamin described one such case in his 1966 book The Transsexual Phenomenon—, research on detransition has been absent from the academic literature until recently. As a consequence, our understanding of this issue is still limited and primarily based on anecdotal evidence, which comes from a variety of sources such as personal testimonies shared on the internet, parent reports, informal surveys carried out by detransitioners, media outlets, support groups, documentaries, case studies, and the experiences of clinicians who work with this cohort. Gender detransition is as scientifically fascinating as socially controversial, for it poses significant professional and bioethical challenges for those clinicians working in the field of gender dysphoria. However, the scarcity of information, along with the lack of formal recognition of detransitioners and their experiences, has contributed to a state of things in which we fall short of a shared and scientifically consolidated language to approach detransition. This gap has favored the proliferation of inconsistent usages of the concept, thus adding to the confusion and unclarity. The term 'detransition' has been used to describe two types of situations. In the first, a person stops identifying as transgender after having socially, legally, or medically transitioned. In the second, a person stops transitioning due to health concerns, lack of societal/familial support, or dissatisfaction with the results—but does not cease to identify as transgender. This article proposes a typology of gender detransition based on the cessation or continuation of a transgender identity, distinguishing between core (primary) and non-core (secondary) detransitions, and discusses its implications for healthcare providers working with gender dysphoric patients.

Conclusion

Gender detransition is an emerging yet poorly understood phenomenon in our society, which poses significant professional and bioethical challenges for clinicians working in the field of GD. The absence of systematic research around detransition has given rise to inconsistencies in its conceptual use and application, adding to the unclarity and confusion. A typology of gender detransition based on the cessation or the continuation of a transgender identity could address these issues, while offering clinicians a framework to reflect on their therapeutic endeavor when treating patients with GD. Furthermore, recognizing the disparities between core and non-core detransitioners could also help develop clinical guidelines, thus assisting healthcare providers to accommodate their different needs and demands. The conducting of comprehensive exploratory assessments can prove to be a useful tool to ensure thoughtful decision-making and prevent any potential harm associated with the experience of detransition. In conclusion, detransitioners are an underserved population whose experiences we need to listen to and understand if we truly aim to improve healthcare for people with GD. This will require extensive research to learn more about their unique experiences, motivations, needs, and demands.