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Detransitioned Women Report Unmet Needs: Medical Transition Failed to Resolve Dysphoria

Narratives of Adults Registered Female at Birth Who Started a Medical Transition and Later Detransitioned

mental healthdetransitionnarrative analysisgender dysphoriaqualitative researchautism
Authors
Jane Lomax, Catherine Butler
Year
2025
Journal
Archives of Sexual Behavior

Methodological Limitations

  • Small, homogeneous sample size (n=6) with limited demographic diversity: all participants were White, UK-born, registered female at birth, lesbian or bisexual, four diagnosed with autism, all had started university, and aged 21–32 years, which severely restricts generalizability and transferability of findings.
  • Self-selected convenience sampling from online detransition communities (Twitter, r/detrans subreddit, Facebook gender discourse group, UK Detransition Advocacy Network) likely introduces selection bias toward individuals with negative transition experiences or particular ideological perspectives.
  • No data collected on year of transition or detransition, which the authors acknowledge as potentially relevant given the rapidly changing cultural context; this temporal ambiguity limits understanding of how healthcare policy changes may have influenced experiences.
  • Single time-point data collection captures narratives at one moment in an evolving process, with no longitudinal follow-up; participants may reinterpret or omit experiences as part of ongoing narrative identity development.
  • Potential interviewer influence and power dynamics: the first author conducted all interviews, and while reflexivity is discussed, the authors acknowledge that their identities as cisgender women and the interview context likely influenced the stories told.
  • No responses received when individual narrative outlines and developing themes were shared with participants for member checking, undermining participant validation of findings.
  • Expert by experience recruited via Reddit may share similar viewpoints to participants, potentially reinforcing rather than challenging interpretive biases.
  • The study explicitly excludes detransitioned men and those who retransitioned, limiting understanding of the full spectrum of detransition experiences; the authors acknowledge results may have differed with a more diverse sample.
  • Payment of participants (£15) and recruitment through potentially ideologically-aligned online communities may attract individuals motivated by financial incentive or particular advocacy agendas.
  • The life history approach, while participant-centered, may allow participants to construct coherent retrospective narratives that rationalize current identities rather than accurately represent past decision-making processes.
  • The authors cite and rely upon controversial sources including Littman (2021) and Vandenbussche (2022), whose methodologies and sampling approaches have been criticized, potentially propagating similar methodological limitations through citation.
  • No exploration of shifts in gender identity or the shifting meaning of gender in depth, which the authors identify as an emerging important theme in recent literature that this study failed to adequately address.

Key Findings

  • Medical transition had limits: Participants found that hormones and surgery did not fully resolve their gender dysphoria or underlying mental health struggles, with some experiencing intensified distress or 'reverse dysphoria' after physical changes.
  • Long-term health concerns drove decisions: Anxiety about unknown long-term effects of testosterone on female bodies—such as cardiovascular risks, uterine atrophy, and infertility—contributed to detransition, with participants feeling inadequately informed beforehand.
  • Social belonging shifted over time: Many discovered they felt more authentic connecting with women and lesbian communities rather than living as men, with some realizing narrow stereotypes of womanhood had influenced their initial decision to transition.
  • Detransition is complex and ongoing: The process involved grief, guilt, and practical challenges like navigating a masculinized appearance, with most finding alternative ways to manage distress rather than through medical intervention.
  • Support systems are largely inadequate: Participants reported unmet needs from healthcare providers and therapists, often turning to online detransition communities for information, practical guidance, and emotional support instead.

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.

Summary

This qualitative study presents a thematic narrative analysis of interviews with six UK females who medically transitioned and later detransitioned, identifying four key themes: the limits of medical transition in resolving dysphoria, long-term health concerns about testosterone use, social challenges including shifting identity and political views, and detransition as an ongoing process with largely unmet support needs. The authors emphasize the importance of holistic assessment before transition, the need for better long-term health research on testosterone effects in females, and improved clinical support for those considering or undergoing detransition.

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.