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

• 78人中，71人（91%）出生时为女性；平均而言，他们在17岁时首次认同为跨性别者，持续了约5年。
• 大多数人（83%）采取过社会性过渡的步骤，68%采取过医学步骤：40%仅使用激素，23%使用激素加手术，5%仅做手术。
• 回顾起来，不到17%的人回忆起符合当今诊断的童年性别痛苦，而53%觉得“快速发作性别焦虑”（在青少年时期突然出现的性别痛苦）描述了他们。
• 心理健康问题很常见：79%曾有过自伤，其中认同为跨性别者之前为71%，期间为64%，之后为23%。
• 首次认同为跨性别者最常给出的原因是把心理健康问题或对创伤的反应误认为性别痛苦；停止的原因更多是内在的，而不是外部压力。
• 在获得跨性别激素的人中，66.7%觉得自己没有被恰当地告知风险，只有一个人说被告知了其他选择。
• 所有参与者中，只有27.1%告诉了他们的过渡医生自己已经去过渡。
• 作者承认，他们的研究无法说明去过渡有多常见，也无法说明什么可以预测它。

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.