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
- Au fost intervievați șase adulți din Marea Britanie născuți de sex feminin, cu vârste între 21 și 32 de ani. Toți luaseră testosteron timp de 1 până la 5 ani, începând la vârste între 17 și 24 de ani, patru aveau ambii sâni îndepărtați și făcuseră detranziție cu 2 luni până la 5 ani înainte.
- Tranziția medicală avea limite: hormonii și chirurgia nu și-au rezolvat pe deplin suferința legată de gen sau problemele de sănătate mintală de fond, iar unii au simțit mai multă suferință, sau suferință legată de corpul schimbat, după schimbările fizice.
- Îngrijorările privind sănătatea pe termen lung au influențat deciziile: grija față de efectele necunoscute ale testosteronului asupra corpului feminin, precum riscurile pentru inimă, micșorarea uterului și infertilitatea, a contribuit la detranziție, iar ei au simțit că nu fuseseră informați corespunzător în prealabil.
- Sentimentul de apartenență s-a schimbat în timp: mulți au constatat că se simțeau mai ei înșiși legându-se de femei și de comunitățile lesbiene decât trăind ca bărbați, iar unii au realizat că ideile înguste despre ce este o femeie le-au influențat prima decizie de a face tranziția.
- Detranziția a fost complexă și continuă: a adus durere, vinovăție și probleme practice, precum trăitul cu un aspect mai masculin, iar majoritatea au găsit alte modalități decât tratamentul medical de a gestiona suferința.
- Sprijinul a lipsit în mare parte: au descris nevoi neacoperite de medici și terapeuți și s-au îndreptat adesea spre comunitățile online de detranziție pentru informații, sfaturi practice și sprijin emoțional.
- Patru dintre cei șase aveau un diagnostic de autism (sau, într-o parte a lucrării, autism sau 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.