Summary

This study surveyed 78 American young adults, mostly born female, who had identified as trans, often taking medical steps, and later stopped. They reported high rates of mental health diagnoses, many from before they first identified as trans. Most said they had first mistaken mental health problems or trauma for gender distress. Their reasons for detransitioning were mostly internal, such as their own changing thinking, rather than pressure from family or discrimination. Most reported much less gender distress and self-harm, and feeling much better about life, after detransitioning. The authors conclude that for some people, detransition is both possible and helpful. But these were volunteers looking back once on their own experience. The study describes this group well, but cannot show how common detransition is, or that detransitioning caused the improvements.

Key findings

• Av 78 personer var 71 (91 %) födda som kvinnor. I genomsnitt identifierade de sig först som trans vid 17 års ålder och gjorde det i cirka 5 år.
• De flesta (83 %) hade tagit sociala transitionssteg och 68 % medicinska steg: 40 % bara hormoner, 23 % hormoner och kirurgi och 5 % bara kirurgi.
• Vid en tillbakablick mindes färre än 17 % könsrelaterat lidande i barndomen som uppfyllde dagens diagnos, medan 53 % kände att ‘snabbt debuterande könsdysfori’ (könsrelaterat lidande som dyker upp plötsligt i tonåren) beskrev dem.
• Psykiska problem var vanliga: 79 % hade någon gång skadat sig själva, däribland 71 % före, 64 % under och 23 % efter att de identifierade sig som trans.
• Det vanligaste skälet som angavs för att först identifiera sig som trans var att de förväxlat psykiska problem eller reaktioner på trauma med könsrelaterat lidande. Skälen till att sluta var oftare inre än yttre påtryckningar.
• Av dem som fick korskönshormoner kände 66,7 % att de inte blivit ordentligt informerade om riskerna, och bara en person sa att den fått information om andra alternativ.
• Bara 27,1 % av alla deltagare berättade för sin transitionsläkare att de hade detransitionerat.
• Författarna erkänner att deras studie inte kan visa hur vanlig detransition är eller vad som förutsäger den.

Abstract

Persons who have renounced a prior transgender identification, often after some degree of social and medical transition, are increasingly visible. We recruited 78 US individuals ages 18-33 years who previously identified as transgender and had stopped identifying as transgender at least six months prior. On average, participants first identified as transgender at 17.1 years of age and had done so for 5.4 years at the time of their participation. Most (83%) participants had taken several steps toward social transition and 68% had taken at least one medical step. By retrospective reports, fewer than 17% of participants met DSM-5 diagnostic criteria for Gender Dysphoria in Childhood. In contrast, 53% of participants believed that "rapid-onset gender dysphoria" applied to them. Participants reported a high rate of psychiatric diagnoses, with many of these prior to trans-identification. Most participants (N = 71, 91%) were natal females. Females (43%) were more likely than males (0%) to be exclusively homosexual. Participants reported that their psychological health had improved dramatically since detransi- tion/desistance, with marked decreases in self-harm and gender dysphoria and marked increases in flourishing. The most common reason given for initial trans-identification was confusing mental health issues or reactions to trauma for gender dysphoria. Reasons for detransition were more likely to reflect internal changes (e.g., the participants' own thought processes) than external pressures (e.g., pressure from family). Results suggest that, for some transgender individuals, detransition is both possible and beneficial.

Conclusion

We surveyed a sample of young adults who previously identified as transgender but had detransitioned or desisted. Most participants were born female. Mental health issues, including prior diagnoses and a history of self-harm, were especially common. A history of gender dysphoria during childhood was reported by a nontrivial minority of participants. A slight majority believed their histories were consistent with rapid-onset gender dysphoria. Factors most associated with detransition were internal factors, reflecting psychological change, rather than external factors, such as family or social pressure. Detransitioned participants reported that they had become much less gender dysphoric, and much happier, than they were during their period of trans-identification.