Summary

This paper suggests splitting detransition into two types. In 'core' detransition, a person stops identifying as transgender and identifies with their birth sex again. In 'non-core' detransition, a person stops or reverses transition but still identifies as trans, because of things like discrimination, health worries or being unhappy with results. The author argues this would clear up confusion, since 'detransition' is used to mean both. He gives advice for clinicians: thorough mental health assessment, honest consent about benefits, risks and unknowns, offering talking therapy alongside medical options, long-term follow-up, and guidelines for both groups. It is a useful way to think about the topic, but it is based on stories and opinion rather than data, and nobody has yet tested whether the types work in practice.

Key findings

• 論文提出兩種類型：「核心」或初級去過渡（不再認同為跨性別，並重新認同出生性別），以及「非核心」或次級去過渡（停止或逆轉過渡，但仍認同為跨性別）。
• 核心去過渡的原因包括發現過渡並沒有減輕性別困擾，並逐漸認為這種困擾與創傷、對自己是同志的內在羞恥、性別歧視或其他心理健康困難有關。
• 非核心去過渡的原因包括醫療問題、對結果不滿意、歧視、缺乏金錢或支持、家人的壓力，以及想要孩子或保護生育能力。
• 這些類型並非固定：非核心去過渡之後可能變成核心去過渡，有些人在重新認同出生性別之前，會有一段時間認同為非二元性別。
• 作者指出，有非正式的報告顯示去過渡者中自閉症比一般人口更常見，但他說這需要研究。
• 他建議進行完整的心理健康評估、涵蓋益處、風險和未知事項的誠實同意、除了醫療選項外也提供探索性的談話治療，以及長期追蹤。
• 去過渡並不總是後悔：他要求臨床人員不帶評判地回應，並為這兩個群體撰寫臨床指引。

Abstract

Gender detransition, i.e., the process of reidentifying with one's birth sex after having undergone a gender transition, has captured the attention of the scientific community, the media, and the public in the last few years. Despite not being a genuinely novel phenomenon from a historical perspective—psychiatrist Harry Benjamin described one such case in his 1966 book The Transsexual Phenomenon—, research on detransition has been absent from the academic literature until recently. As a consequence, our understanding of this issue is still limited and primarily based on anecdotal evidence, which comes from a variety of sources such as personal testimonies shared on the internet, parent reports, informal surveys carried out by detransitioners, media outlets, support groups, documentaries, case studies, and the experiences of clinicians who work with this cohort. Gender detransition is as scientifically fascinating as socially controversial, for it poses significant professional and bioethical challenges for those clinicians working in the field of gender dysphoria. However, the scarcity of information, along with the lack of formal recognition of detransitioners and their experiences, has contributed to a state of things in which we fall short of a shared and scientifically consolidated language to approach detransition. This gap has favored the proliferation of inconsistent usages of the concept, thus adding to the confusion and unclarity. The term 'detransition' has been used to describe two types of situations. In the first, a person stops identifying as transgender after having socially, legally, or medically transitioned. In the second, a person stops transitioning due to health concerns, lack of societal/familial support, or dissatisfaction with the results—but does not cease to identify as transgender. This article proposes a typology of gender detransition based on the cessation or continuation of a transgender identity, distinguishing between core (primary) and non-core (secondary) detransitions, and discusses its implications for healthcare providers working with gender dysphoric patients.

Conclusion

Gender detransition is an emerging yet poorly understood phenomenon in our society, which poses significant professional and bioethical challenges for clinicians working in the field of GD. The absence of systematic research around detransition has given rise to inconsistencies in its conceptual use and application, adding to the unclarity and confusion. A typology of gender detransition based on the cessation or the continuation of a transgender identity could address these issues, while offering clinicians a framework to reflect on their therapeutic endeavor when treating patients with GD. Furthermore, recognizing the disparities between core and non-core detransitioners could also help develop clinical guidelines, thus assisting healthcare providers to accommodate their different needs and demands. The conducting of comprehensive exploratory assessments can prove to be a useful tool to ensure thoughtful decision-making and prevent any potential harm associated with the experience of detransition. In conclusion, detransitioners are an underserved population whose experiences we need to listen to and understand if we truly aim to improve healthcare for people with GD. This will require extensive research to learn more about their unique experiences, motivations, needs, and demands.