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
- Intervjuvanih je bilo šest odraslih iz Združenega kraljestva, rojenih kot ženske, starih od 21 do 32 let. Vsi so jemali testosteron od 1 do 5 let, začeli pa so pri starosti od 17 do 24 let, štirje so imeli odstranjeni obe prsi, detranzicionirali pa so 2 meseca do 5 let prej.
- Medicinska tranzicija je imela omejitve: hormoni in operacije niso popolnoma rešili njihove spolne stiske ali spodaj ležečih težav z duševnim zdravjem, nekateri pa so po telesnih spremembah občutili več stiske ali stisko zaradi spremenjenega telesa.
- Dolgoročne zdravstvene skrbi so vodile odločitve: skrb zaradi neznanih učinkov testosterona na ženska telesa, na primer tveganja za srce, krčenje maternice in neplodnost, je pripomogla k detranzicij in čutili so, da jih pred tem niso ustrezno obvestili.
- Pripadnost se je sčasoma spremenila: mnogi so ugotovili, da se pri povezovanju z ženskami in lezbičnimi skupnostmi počutijo bolj sami kot pri življenju kot moški, nekateri pa so spoznali, da so ozke predstave o tem, kaj je ženska, oblikovale njihovo prvo odločitev za tranzicijo.
- Detranzicija je bila zapletena in stalna: prinesla je žalovanje, krivdo in praktične težave, na primer življenje z bolj moškim videzom, večina pa je našla druge načine kot medicinsko zdravljenje za obvladovanje stiske.
- Podpore je večinoma primanjkovalo: opisali so potrebe, ki jih zdravniki in terapevti niso zadovoljili, in se pogosto obračali na spletne skupnosti detranzicionarjev za informacije, praktične nasvete in čustveno podporo.
- Štirje od šestih so imeli diagnozo avtizma (ali, v enem delu članka, avtizma ali 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.