Summary

Researchers interviewed six UK women who medically transitioned and later detransitioned, looking for shared themes. All had taken testosterone for 1 to 5 years, and four had had both breasts removed. Four themes emerged. First, hormones and surgery did not resolve their distress or change their sex. Second, they worried about the long-term health effects of testosterone. Third, their sense of belonging changed, and some felt more at home among women and lesbian communities. Fourth, detransition was an ongoing process, and their needs were mostly not met by health services. The authors call for careful whole-person assessment before transition, research on testosterone's long-term effects in women, and better support for people detransitioning. It gives a detailed picture of a few lives, but six similar, self-selected people cannot show how common this is.

Key findings

• 研究訪談了六名英國出生時為女性的成人，年齡 21 至 32 歲。他們都使用過睪固酮 1 至 5 年，開始時為 17 至 24 歲，四人切除了雙乳，並在 2 個月至 5 年前去過渡。
• 醫療過渡有其侷限：荷爾蒙和手術並沒有完全解決他們的性別困擾或潛在的心理健康困難，有些人在身體改變後感到更痛苦，或對改變後的身體感到痛苦。
• 對長期健康的擔憂推動了他們的決定：擔心睪固酮對女性身體的未知影響，例如心臟風險、子宮萎縮和不孕，促成了去過渡，而且他們覺得事前沒有得到充分的告知。
• 歸屬感隨時間改變：許多人發現與女性和女同志社群相處，比以男性身分生活更能做自己，有些人意識到，對女性狹隘的想像影響了他們最初決定過渡。
• 去過渡是複雜且持續進行的：它帶來悲傷、罪惡感，以及實際的問題，例如要以較男性化的外貌生活，而且多數人找到了醫療以外的方式來處理痛苦。
• 支持大多不足：他們描述了醫師和治療師沒有滿足的需求，並常轉向網路上的去過渡社群，尋求資訊、實用建議和情感支持。
• 六人中有四人被診斷有自閉症（或在論文的某一部分中為自閉症或ADHD）。

Abstract

The visibility and presence of people who have detransitioned following a gender transition is growing, with an increase in research on the needs and experiences of this group. This study presents a thematic narrative analysis of interviews from six females (M = 25.5 yrs; range = 21–32 yrs). All detransitioned after having at least one gender-affirming medical or surgical treatment as part of a gender transition in the UK. Four narrative themes were developed to capture how they made sense of their detransition: (1) the limits of medical transition, (2) the longer-term health implications, (3) the social limits of transition, and (4) detransition as an ongoing process. Participants discussed a range of emotional, practical, and other support needs, largely unmet by healthcare or other services. These findings highlight the importance of ensuring that people have realistic expectations of transition as part of a holistic assessment process. Long-term health outcome research is also needed, addressing the impact of testosterone on female anatomy and health specifically. Further clinical implications with those considering transition or detransition are discussed.

Conclusion

This research adds an in-depth analysis to the previous literature on detransition. Participants detransitioned because they found medical transition had limits to resolve distress, or to change their sex. The ongoing health implications and associated risks were also a factor for most. Participant perception of social group belonging often shifted after transition, sometimes linked to feminist values, or perhaps reflecting the normal developmental experiences and trajectory of adolescence and early adulthood as young people explore their identities in different social contexts. It is also possible that the experience of the physical limits of transition to transform them, left the social aspects feeling hollow, increasing social dysphoria related to the new gender. Detransition was a complex and individual, ongoing process, with a range of needs expressed. Implications for clinical practice with people considering transition and detransition were discussed.