Detransition and regret
Detransition means stopping or reversing a gender transition: stopping hormones, having surgery to reverse changes, or going back to living as the sex assigned at birth, for a while or for good. People take different paths. Some stop because of pressure, cost or danger and still identify as transgender, some come to identify with their birth sex, and some identify as nonbinary. Stopping and regret are separate questions.
What drives it
Both sides of the wider argument use detransition. One side points to it as proof that young people are moved too fast, the other to low rates as proof the worry is overblown. The studies so far can’t carry either claim far, because each reaches only part of the people involved. For identification the useful step is to ask which kind of stopping this is, pushed from outside, a change in how the person understands themselves, or something else, since the needs that follow are different.
How it shows
Work
Explaining a second name change to HR. Colleagues who supported the first transition unsure what to say now. Going back to a former name at work while still unsure of it in private.
Relationships
Some describe losing friends in a trans community after stopping, and finding little welcome among people who opposed the transition either. A parent who says ‘I told you so’ when help was what was needed. Telling a new partner about changes that can’t be undone.
Self
Notice what you feel when you think about the step you stopped: relief, grief, anger at the people who advised you, or a mix. Notice whose reaction you fear most if you speak about it.
What tells it apart
Gender minority stress and resilience (Testa): When someone stops because of harassment, family pressure or the cost of being visible, and still describes the same gender, minority stress may be the driver. In Turban’s data most people who had detransitioned gave at least one outside reason.
Internalized homophobia (internalized stigma): In Littman’s sample 23% said difficulty accepting themselves as lesbian, gay or bisexual was a reason for transitioning and then detransitioning. That may be part of the picture when shame about same-sex attraction comes up as the person retells their story.
Trauma (big T and small t): Some in Littman’s sample came to see their dysphoria as caused by trauma, abuse or a mental health condition. That may fit when distress about gender rose and fell with the effects of a trauma, and it is a reading the person reaches about their own life.
A test
Ask what led to the change, in the person’s own words, and whether it came mainly from outside pressure, a change in self-understanding, health worries or something else. The answers may point to very different needs, and no statistic settles which one applies to this person.
Questions to carry
- When I decided to stop, whose voice was loudest in my head?
- What do I need people to understand about my reasons that they keep getting wrong?
How strong the research is
mixed. Estimates differ widely because studies ask different questions of different people. In the 2015 US Transgender Survey, 13.1% of 17,151 respondents who had pursued gender affirmation said they had ever gone back to living as their sex assigned at birth, ‘at least for a while’, and 82.5% of them named at least one outside reason, such as family pressure or stigma (Turban and colleagues, LGBT Health, 2021). As the authors note, that survey reached only people who still identified as transgender, so it can say nothing about those who no longer do. Littman (Archives of Sexual Behavior, 2021) surveyed 100 people recruited online who had stopped or reversed medical transition: 60% said they had become more comfortable identifying as their birth sex, 38% that their dysphoria was caused by something specific such as trauma or a mental health condition, 55% that they had not been assessed adequately before starting, and only 24% had told their clinicians. She wrote that her convenience sample cannot show how common detransition is. In US military health records (Roberts and colleagues, 2022), 70.2% of 952 people who started hormones were still on them four years later. In an Amsterdam clinic cohort (van der Loos and colleagues, 2022), 98% of 720 people who began puberty suppression in adolescence were still taking hormones at follow-up, at a median age of about 20. Prescription records show who stopped and can’t show why. A York review for the Cass Review found that reasons for stopping were rarely reported and follow-up was often too short or unclear.
Where it comes from
No single origin. Littman wrote in 2021 that the visibility of people who detransition is new, and that as recently as 2014 it was hard for one to find another. Two of the larger studies: Jack Turban, Sari Loo, Anthony Almazan and Alex Keuroghlian, LGBT Health, 2021, and Lisa Littman, Archives of Sexual Behavior, 2021