Summary

Researchers surveyed 957 people in the US and Canada who said they had stopped, changed or reversed a gender transition, or wanted to. Most were born female and most described themselves as lesbian, bisexual or queer; 42% had at some point stopped and later restarted transition. Many reported poor care after detransitioning: about 43% said providers never seemed to know anything about detransition, and more than half sometimes or always avoided health care. People most often asked for clinicians who understand detransition, contact with other detransitioners, accurate advice on stopping hormones, help with reconstructive surgery, and therapy that takes trauma into account. Some stopped only because of cost, family rejection or losing access to care. The results show real unmet needs, but come from a self-selected online group and cannot show how common these experiences are.

Key findings

• 957 người được đưa vào (trong 1.377 khảo sát hoàn thành, sau khi loại bỏ bot và câu trả lời giả); 79% sinh ra là nữ và 74% sống ở Hoa Kỳ.
• Hầu hết là đồng tính nữ, đồng tính nam, song tính hoặc queer (45% song tính, 29% queer, 27% đồng tính nữ), và 42% đã ngừng rồi sau đó bắt đầu lại việc chuyển giới.
• Sau khi chuyển giới trở lại, 43% cho biết nhà cung cấp dịch vụ y tế của họ dường như không bao giờ biết về chuyển giới trở lại, và chỉ 7% cho biết các nhà cung cấp luôn biết.
• Tránh chăm sóc là phổ biến: 13% luôn và 45% đôi khi tránh các nhà cung cấp dịch vụ y tế khi cần chăm sóc, và 46% đôi khi hoặc luôn cần chăm sóc nhưng không nhận được.
• Trong 563 câu trả lời viết, các nhu cầu chưa được đáp ứng phổ biến nhất là hỗ trợ từ cộng đồng và những người cùng cảnh ngộ (29%), các nhà cung cấp hiểu về chuyển giới trở lại (29%), hỗ trợ cá nhân (22%) và chăm sóc sức khỏe tâm thần (16%).
• 46 câu trả lời yêu cầu lời khuyên về việc ngừng hormone an toàn, và một số mô tả bị từ chối phẫu thuật tái tạo, ví dụ bị bốn bác sĩ phẫu thuật từ chối.
• Một số mô tả bị buộc phải ngừng vì chi phí, mất khả năng tiếp cận chăm sóc hoặc sự từ chối của gia đình, và muốn được giúp bắt đầu lại việc chuyển giới.

Abstract

BACKGROUND: Detransition refers to stopping, shifting, or reversal of an initial gender transition. Some people detransition temporarily, and later re-start a transition process, or retransition. Despite calls for research and care surrounding detransition/retransition, these experiences remain poorly understood by care providers and LGBTQ2S+ community-serving organizations.

METHODS: Between December 2023-April 2024, a cross-sectional survey was administered to 957 individuals (aged 16 and older) living in the US or Canada who self-identified with experiences of detransition. Participants were recruited via advertisements across eight major social media platforms, direct emails sent to ∼1200 former research participants, and to >615 LGBTQ2S+ organizations and gender-affirming care providers. Mixed qualitative and quantitative data were collected and analyzed regarding participants' experiences and care needs during detransition and, if relevant, retransition. Data about care experiences and needs were analyzed descriptively using frequencies and percentages. Interpretive description was utilized to analyze qualitative responses.

RESULTS: Participants reported a wide range of current gender identities/expressions such as: woman (n = 386; 40.3%); gender nonconforming woman (n = 241; 25.2%); nonbinary (n = 238; 24.9%); and/or detrans woman; (n = 152; 22.5%). A majority of the sample were sexual minorities. A majority reported being bisexual (n = 429; 44.8%), queer (n = 277; 28.9%), and/or lesbian (n = 254; 26.5%). Qualitative analysis identified three key themes: (1) accessing detransition-related care needs within the gender-affirming care system; (2) detransition-related social/legal needs to navigate a second transition; and (3) detransition preventative and retransition needs. Each of these themes encompassed four subthemes, including access to detrans-knowledgeable care providers (n = 162; 28.8%); medical information (n = 62; 11.0%); mental healthcare and supports (n = 92; 16.3%); interpersonal supports (n = 124; 22.0%); and community supports (n = 163; 29.0%).

CONCLUSION: Greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.

Conclusion

The current study contributes to the limited body of work regarding the experiences and care needs of detrans people and other SGM people who report identity fluidity and detransition/retransition. Findings indicate that, like other SGM people, detransition may be inadequately understood by some LGBTQ2S+ serving and gender-affirming care practitioners. Future research and community-led research on detransition/retransition can ameliorate this knowledge gap. Importantly, given the potential for country-specific differences in detransition/retransition experiences, future research should be more sensitive to geopolitical and healthcare delivery dynamics. (Abstract conclusion: greater understanding and community-led care relating to detransition/retransition from an LGBTQ2S+-affirming lens can help to mitigate minority stressors and distress associated with these experiences.)