트랜스 정체성의 디트랜지셔너 82%가 외부 압력을 이유로 언급 - 그러나 더는 트랜스로 정체화하지 않는 사람은 제외

미국 트랜스젠더 및 성별 다양 사람들의 '디트랜지션'으로 이어지는 요인: 혼합 방법 분석

Authors: Jack L. Turban, Stephanie S. Loo, Anthony N. Almazan, Alex S. Keuroghlian
Journal: LGBT Health
Year: 2021
Source: https://doi.org/10.1089/lgbt.2020.0437

Summary

Using the 2015 U.S. Transgender Survey, the authors looked at why trans-identified adults said they had ever gone back to living as their birth sex. About 13% of those who had ever transitioned said yes. Most gave outside pressures such as family, harassment or work, while about 16% gave inner reasons such as doubts about their gender. Going back was more common among people born male, nonbinary or bisexual people, and those with unsupportive families. People who had never taken hormones or had surgery were much more likely to report it. The authors conclude that detransition is mostly driven by stigma. However, the survey only included people who still identified as trans, so it cannot describe people who stopped identifying as trans. It describes temporary or pressured detransition among people who remain trans, not detransition in general or regret.

Key findings

설문에 답한 27,715명 중 17,151명이 어떤 식으로든 전환한 적이 있었고, 이 중 2,242명(13%)이 일시적으로라도 디트랜지션한 적이 있다고 말했습니다.
디트랜지션한 사람의 83%는 적어도 하나의 외부 이유를 들었고, 가장 흔한 것은 가족의 압력과 사회의 낙인이었습니다.
16%는 성 정체성의 변화나 확신이 없다는 느낌 같은 내적 이유를 적어도 하나 들었으며, 이는 전환한 사람 전체의 2%입니다.
디트랜지션은 출생 시 남성(약 10퍼센트포인트 높음), 논바이너리, 양성애자, 지지하지 않는 가족이 있는 사람들에게서 더 흔했습니다.
디트랜지션한 사람은 호르몬을 쓴 적이 있을 가능성(26포인트 낮음)과 수술을 받은 적이 있을 가능성(17포인트 낮음)이 훨씬 낮았는데, 이는 많은 디트랜지션이 의학적이라기보다 사회적이었음을 시사합니다.
설문은 현재 트랜스로 정체화하는 사람만 포함했으므로 지금은 출생 성별로 정체화하는 디트랜지셔너를 포착할 수 없으며, 저자들도 이를 인정합니다.
서술 답변(800명)은 ‘디트랜지션’이 친척을 방문할 때 잠깐 출생 성별로 지내는 것을 포함해 여러 가지를 뜻함을 보여주었습니다.

Abstract

Purpose: There is a paucity of data regarding transgender and gender diverse (TGD) people who "detransition," or go back to living as their sex assigned at birth. This study examined reasons for past detransition among TGD people in the United States. Methods: A secondary analysis was performed on data from the U.S. Transgender Survey, a cross-sectional nonprobability survey of 27,715 TGD adults in the United States. Participants were asked if they had ever detransitioned and to report driving factors, through multiple-choice options and free-text responses. A mixed-methods approach was used to analyze the data, creating qualitative codes for free-text responses and applying summative content analysis. Results: A total of 17,151 (61.9%) participants reported that they had ever pursued gender affirmation, broadly defined. Of these, 2242 (13.1%) reported a history of detransition. Of those who had detransitioned, 82.5% reported at least one external driving factor. Frequently endorsed external factors included pressure from family and societal stigma. History of detransition was associated with male sex assigned at birth, nonbinary gender identity, bisexual sexual orientation, and having a family unsupportive of one's gender identity. A total of 15.9% of respondents reported at least one internal driving factor, including fluctuations in or uncertainty regarding gender identity. Conclusion: Among TGD adults with a reported history of detransition, the vast majority reported that their detransition was driven by external pressures. Clinicians should be aware of these external pressures, how they may be modified, and the possibility that patients may once again seek gender affirmation in the future.

Conclusion

Among TGD adults with a reported history of detransition, the vast majority reported that their detransition was driven by external pressures. Clinicians should be aware of these external pressures, how they may be modified, and the possibility that patients may once again seek gender affirmation in the future.

Methodological limitations

People most likely to have inner reasons were left out: The survey only included people who currently identified as trans or gender diverse. Anyone who detransitioned and stopped identifying as trans was excluded, so inner reasons such as realising one is not trans are badly under-counted. The authors admit this, and Cohn (Arch Sex Behav 2023) highlights it.
Loose definition: Detransition meant ever 'going back to living as your sex assigned at birth, at least for a while'. This includes briefly presenting as one's birth sex, such as when visiting family, and is not the same as stopping or reversing medical treatment.
Mostly non-medical transitions: Those who reported detransition were far less likely to have used hormones or had surgery. So the results say little about people who detransition after medical treatment.
Recruited through community groups, not at random: The survey recruited through more than 400 trans community and advocacy groups. People were younger, better educated, more often white and less often straight than in random samples, so the rates found may not apply more widely.
Old data: The data were collected in 2015, before the big rise in teenagers, mostly born female, seeking care. They may not apply to today's patients.
Pre-set answers and authors' sorting: Most reasons came from pre-set 'pressure' options plus 800 written answers sorted by the authors. 'It was just too hard for me' was counted as neither outside nor inner, and the authors' approach treats inner doubts as possibly caused by outside stigma.
Looking back, unchecked: Reasons were recalled at one point in time, with nothing to confirm them and no information on when or for how long people detransitioned.
Regret not measured: The authors stress that detransition is not the same as regret, but they did not measure regret. Their statement that regret is rare relies on other studies (e.g. Wiepjes 2018) that have their own problems with losing track of patients.
Authors' viewpoint: The authors are prominent doctors and researchers in gender-affirming care. They frame detransition mainly as a response to stigma that doctors can 'ameliorate', which shapes how inner reasons are sorted and understood.

detrans.ai

Summary

Key findings

Abstract

Conclusion