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
- Seis adultos do Reino Unido nascidos do sexo feminino, de 21 a 32 anos, foram entrevistados. Todos haviam tomado testosterona por 1 a 5 anos, começando entre os 17 e os 24 anos, quatro haviam retirado as duas mamas, e haviam destransicionado de 2 meses a 5 anos antes.
- A transição médica tinha limites: hormônios e cirurgia não resolveram totalmente seu sofrimento de gênero nem as dificuldades de saúde mental subjacentes, e alguns sentiram mais sofrimento, ou sofrimento com o corpo modificado, após as mudanças físicas.
- Preocupações de saúde a longo prazo orientaram as decisões: a preocupação com os efeitos desconhecidos da testosterona em corpos femininos, como riscos para o coração, encolhimento do útero e infertilidade, ajudou a levar à destransição, e sentiram que não haviam sido devidamente informados antes.
- O sentimento de pertencimento mudou com o tempo: muitos descobriram que se sentiam mais eles mesmos ao se conectar com mulheres e comunidades lésbicas do que vivendo como homens, e alguns perceberam que ideias estreitas sobre o que é uma mulher haviam moldado sua primeira decisão de fazer a transição.
- A destransição foi complexa e contínua: trouxe luto, culpa e problemas práticos, como viver com uma aparência mais masculina, e a maioria encontrou outras formas, além do tratamento médico, de lidar com o sofrimento.
- O apoio era em grande parte insuficiente: descreveram necessidades não atendidas por médicos e terapeutas, e com frequência recorreram a comunidades online de destransição em busca de informações, conselhos práticos e apoio emocional.
- Quatro dos seis tinham diagnóstico de autismo (ou, em uma parte do artigo, autismo ou TDAH).
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.