Detransitioneerde vrouwen melden onvervulde behoeften: Medische transitie loste dysforie niet op

Verhalen van volwassenen die bij de geboorte als vrouw zijn geregistreerd, een medische transitie zijn begonnen en later detransitioneerd zijn

Authors
Jane Lomax, Catherine Butler
Journal
Archives of Sexual Behavior
Year
2025

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

  • Zes Britse volwassenen die als vrouw geboren waren, van 21 tot 32 jaar, werden geïnterviewd. Allen hadden 1 tot 5 jaar testosteron gebruikt, begonnen op 17 tot 24 jaar, vier hadden beide borsten laten verwijderen, en ze waren 2 maanden tot 5 jaar eerder gedetransitioneerd.
  • Medische transitie had grenzen: hormonen en operaties losten hun genderklachten of onderliggende psychische problemen niet volledig op, en sommigen voelden na lichamelijke veranderingen meer nood, of nood over hun veranderde lichaam.
  • Zorgen over gezondheid op lange termijn bepaalden beslissingen: zorgen over onbekende effecten van testosteron op vrouwelijke lichamen, zoals hartrisico's, krimp van de baarmoeder en onvruchtbaarheid, droegen bij aan detransitie, en ze vonden dat ze vooraf niet goed waren geïnformeerd.
  • Het gevoel erbij te horen veranderde in de tijd: velen merkten dat ze meer zichzelf waren in contact met vrouwen en lesbische gemeenschappen dan als man leven, en sommigen zagen in dat beperkte ideeën over wat een vrouw is hun eerste besluit om te transitioneren hadden gevormd.
  • Detransitie was complex en doorlopend: het bracht verdriet, schuldgevoel en praktische problemen met zich mee, zoals leven met een mannelijker uiterlijk, en de meesten vonden andere manieren dan medische behandeling om met nood om te gaan.
  • Steun ontbrak grotendeels: ze beschreven behoeften waaraan artsen en therapeuten niet voldeden, en wendden zich vaak tot online detransitiegemeenschappen voor informatie, praktisch advies en emotionele steun.
  • Vier van de zes hadden een diagnose autisme (of, in één deel van het artikel, autisme of 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.