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 人中有 71 人（91%）出生時為女性；他們平均在 17 歲時首次認同為跨性別，並持續約 5 年。
• 多數人（83%）採取了社會性過渡步驟，68% 採取了醫療步驟：40% 只使用荷爾蒙，23% 使用荷爾蒙並接受手術，5% 只接受手術。
• 回顧起來，不到 17% 回憶童年時的性別困擾符合今天的診斷，而 53% 覺得「快速發作性別焦慮」（在青少年時期突然出現的性別困擾）描述了他們。
• 心理健康問題很常見：79% 曾經自傷，包括認同為跨性別之前的 71%、期間的 64% 和之後的 23%。
• 首次認同為跨性別最常見的原因，是把心理健康問題或對創傷的反應誤認為性別困擾；停止的原因更常是內在因素，而不是外在壓力。
• 在使用跨性別荷爾蒙的人中，66.7% 覺得沒有被適當告知風險，只有一人表示被告知過其他選項。
• 所有參與者中只有 27.1% 告訴過協助他們過渡的醫師自己已經去過渡。
• 作者承認，他們的研究無法顯示去過渡有多常見，也無法顯示什麼可以預測它。

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.