Summary

Canadian researchers interviewed 20 young people aged 16 to 25, nearly all born female, from seven countries. All had started and then stopped a gender transition, and were asked about the whole journey. How they saw their gender changed over time, and rarely settled into a simple return to their birth sex. Same-sex attraction, sometimes with shame about being gay, was part of why many had transitioned. Body discomfort often eased during transition. Afterwards it could ease, come back, or turn into distress about permanent changes such as a deeper voice. The authors conclude that paths are too varied to predict how things will turn out. They say care should look at the whole of life, including sexuality and possible loss. This is early, exploratory work. The group was small and volunteered, accounts look back in time, and the analysis openly comes from a gender-affirming viewpoint.

Key findings

• Tjugo personer i åldern 16 till 25 från Kanada, USA, Frankrike, Belgien, Indonesien, Skottland och Finland intervjuades 2020. 19 av de 20 var födda som kvinnor.
• Alla hade transitionerat socialt. 13 hade också transitionerat medicinskt (12 tog hormoner, 8 hade genomgått minst en operation, 2 tog pubertetsblockerare), men bara 3 av de 13 började medicinsk transition före 18.
• Efter att ha slutat varierade könsidentiteterna: vissa omfamnade åter sitt biologiska kön, andra kallade sig icke-binära eller fluida eller använde ingen etikett, och vissa behöll sitt namn eller sina pronomen från transitionen.
• Mer än hälften av dem som pratade om sexualitet hade varit attraherade av sitt eget kön före transitionen, och flera kopplade sin transition till skam över att vara homosexuell.
• De flesta mådde bättre i sina kroppar under transitionen, men vissa tyckte att förändringarna inte räckte, fick komplikationer eller kände press att fortsätta till nästa ‘steg’.
• Efter att ha slutat beskrevs tre kroppsliga upplevelser: att känna sig ganska bekväm, att det ursprungliga lidandet kom tillbaka eller att känna nytt lidande över permanenta förändringar som röst eller ansiktsbehåring.
• Författarna fann inga gemensamma drag som kunde förutsäga vilka som skulle sluta, och rekommenderar att informerat samtycke omfattar sexualitet, möjlig förlust och framtida utmaningar under en människas liv.

Abstract

Background: Detransition is frequently covered in the media as a return to a cis identity after transition. Detransition is often studied in isolation and fails to examine it in context of various stages leading to detransition. Aim: To present the perspectives and reflections of youth who have detransitioned on their journey from early transition to discontinuation, focusing on three key dimensions: gender modalities, sexual modalities, and dysphoria experiences, and their evolution during this journey. Method: We drew from 20 in-depth interviews with young people aged 16 to 25 who have discontinued a transition and examined various stages of the gender journey from early transition to detransition. Youth narratives were analyzed thematically and longitudinally. Results: We developed three main themes related to the gender journey: nonlinear gender modalities, navigating sexual modalities along with gender modalities, and coping with dysphoria and body discomfort. We found a great diversity of experiences with regard to these within each participant and across the sample. Discussion: Transition and detransition trajectories are nonlinear and heterogeneous, without any identified commonalities that enable the prediction of outcomes after transitions. However, transnormativity may influence how people who detransition are expected to conform to a certain narrative despite the diversity of experiences present in this community.

Conclusion

Youth who discontinue a transition undergo diverse gender journeys and changes across gender modalities, sexual modalities and experiences of dysphoria. Transition and detransition trajectories are nonlinear and heterogeneous, with no identified commonalities that allow outcomes after transition to be predicted, and transnormativity may push people who detransition to fit an expected narrative. Future research should examine these experiences prospectively, for example by following youth from the moment they question their transition and examining how heteronormativity and transnormativity affect decisions to transition or detransition. Providers should look critically at media narratives, take a life-course approach that offers support beyond transition care, help youth understand how transition may affect their gender and sexual modalities, and discuss possible ambiguous loss, in order to strengthen informed consent and support youth whatever direction their gender journey takes.