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 年訪談了來自加拿大、美國、法國、比利時、印尼、蘇格蘭和芬蘭、年齡 16 至 25 歲的 20 人；20 人中有 19 人出生時為女性。
• 所有人都進行過社會性過渡；13 人也進行過醫療過渡（12 人使用荷爾蒙，8 人至少做過一次手術，2 人使用青春期阻斷劑），但 13 人中只有 3 人在 18 歲以前就開始醫療過渡。
• 停止後，性別認同各不相同：有些人再次接納自己的出生性別，有些人稱自己為非二元性別或流動性別，或不使用任何標籤，有些人保留了過渡時的名字或代名詞。
• 在談到性的人當中，超過一半在過渡前就被同性所吸引，數人將自己的過渡與對身為同志的羞恥聯繫起來。
• 多數人在過渡期間覺得身體感覺更好，但有些人發現這些改變不夠、出現併發症，或感受到壓力要繼續邁向下一個「步驟」。
• 停止後，描述了三種身體經驗：感覺相當自在、原本的痛苦再度出現，或對聲音或臉部毛髮等永久改變產生新的痛苦。
• 作者沒有發現可以預測誰會停止的共同特徵，並建議知情同意應涵蓋性、可能的失去，以及人一生中未來的挑戰。

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.