Summary

This essay by a sociology doctoral student reports no new data. It argues that "detransition" covers three different things: stopping or reversing a transition, identifying as a detransitioner, and having a bad experience of transition. Studies often blur them. The author says most research has tried to count or predict detransition in order to prevent it, which does little for people who have already detransitioned. Regret studies have weak spots: requests to reverse surgery come years later, many people just stop going to clinics, and counting lawsuits or "known cases" misses most experiences. The author calls for interview-based research with detransitioners to build care plans, including guidance on stopping hormones. It is an openly transfeminist position paper; its views are argued, not tested.

Key findings

• Författaren skiljer mellan tre idéer som ofta slås ihop som ‘detransition’: handlingen att detransitionera, att identifiera sig som detransitionerare och att ha en dålig erfarenhet av transition.
• Essän sorterar befintlig forskning i ‘förebygga detrans’ (att studera hur ofta det sker och varför) och ‘stödja detrans’ (att studera själva upplevelsen för att förbättra vården).
• I svenska data (Dhejne med flera, 2014) kom begäranden om att vända kirurgi typiskt cirka 8 år efter operationen. Så andelen på 0,3 % för 2001 till 2010 kan vara för låg helt enkelt för att det inte gått tillräckligt med tid. Om man utesluter den perioden bad 14 av 321 personer (4,4 %) om att vända.
• Fall av ånger som är kända för kliniker (till exempel 0,1 % i en enkät bland kliniker som påbörjar hormoner enbart på samtycke) kallas ‘betydligt bristfälliga’, eftersom många detransitionerare slutar gå dit i stället för att berätta för sin klinik.
• Vid den tiden fanns ingen medicinsk vägledning för detransition och nästan ingen forskning om detransition hos personer som tog hormoner utan kirurgi.
• Författaren efterlyser intervjubaserad forskning gjord tillsammans med detransitionerare, och medicinsk forskning om hur man säkert slutar med hormoner.

Abstract

Detransition is tied to three related but distinct concepts – the act of detransitioning, the 'detransitioner' identity, and the negative transition experience – which I refer to collectively using the umbrella term 'detrans'. Detrans research is inevitably political and value-laden, but different methodologies and research questions lend themselves to divergent goals. Drawing on work in the feminist philosophy of science and transfeminist scholarship, I draw a conceptual distinction between research aligned with the goals of 'preventing detrans' vs. 'supporting detrans'. Existing research has constructed detransition as a negative clinical outcome to be prevented because it has been focused on the causes of detrans and the detrans rate. Research associated with the goal of supporting detrans is defined by its focus on the experience and process of detrans itself. Research on preventing detrans constructs detrans as a divisive issue of zero-sum clinical risk, and it is not oriented toward helping people who detransition or who have a negative transition experience. Research on supporting detrans, in contrast, constructs detrans as an issue of inclusion and can be used to improve the medical and mental health care that detrans people receive. I argue that there is an urgent need for qualitative sociological research involving detrans people. I conclude with some broad guidelines for researchers studying detrans.

Conclusion

The author recommends that researchers be precise about which aspect of detrans they study (the act, the identity, or the negative experience), how their measures relate to it, and how the study is described to participants, and that they consult potential participants throughout. Qualitative, interview-based research with online detransition communities is described as feasible and urgently needed whether detransition is rising or not, without "rising epidemic" or "contagion" rhetoric, and detransitioners' calls for medical research on safely stopping hormones are endorsed. Qualitative work should not be used for broad causal claims. Detransitioners should be treated as more than "canaries" signalling a wider risk: their experiences are real, distinct and worth studying in their own right.