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

• 2020年访谈了来自加拿大、美国、法国、比利时、印度尼西亚、苏格兰和芬兰的20名16至25岁的人；20人中有19人出生时为女性。
• 所有人都进行过社会性过渡；13人还进行过医学过渡（12人使用激素，8人至少做过一次手术，2人使用过青春期阻断剂），但这13人中只有3人在18岁之前开始医学过渡。
• 停止之后，性别认同各不相同：有些人再次接纳自己的出生性别，另一些人称自己为非二元性别或流动性别，或不使用任何标签，还有些人保留了过渡时的名字或代词。
• 谈到性取向的人中，超过一半在过渡之前就被同性所吸引，几个人把自己的过渡与对同性恋身份的羞耻联系起来。
• 大多数人在过渡期间对身体感觉更好，但有些人发现这些变化不够，出现了并发症，或感到要继续走向下一个“步骤”的压力。
• 停止之后，描述了三种身体体验：感觉相当自在、原来的痛苦又回来，或对嗓音或面部毛发等永久性变化产生新的痛苦。
• 作者没有发现可以预测谁会停止的共同特征，并建议知情同意应涵盖性取向、可能的丧失以及人一生中未来的挑战。

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.