Gender Dysphoria -- Transitioning, Detransitioning, Retransitioning

"The mainstream gender-affirming  care system largely presumes that gender identity/expression is immutable and that TGD [transgender and gender-diverse] people will engage in only one gender transition."

"While this may be the reality for many TGD people, this presumption can create environments in which multiple transitions, gender fluidity, and detransitions are misunderstood or even stigmatized."

"[Detransition] has been conceptualized as stopping, shifting or reversing aspects of an initial gender transition, often motivated by a shift in how one understands their sex/gender [although there is no universally agreed-upon definition]."

"Some people who detransition may self-label as 'detrans' for short."

"Irrespective of their current gender identity, those undergoing a detransition often retain 'atypical' sex characteristics from prior hormonal and surgical treatments, leading to vulnerability to gender minority stressors and, potentially, an experience of 'reverse dysphoria'." 

York University research team 

A woman who wished to keep her identity hidden de-transitioned after years of testosterone therapy she started at age 15, and a double mastectomy she had at 18. She's experienced "a lot of pain and regret." Photo by Michelle Berg /Saskatoon StarPhoenix

 

"I feel so alienated now, and super-isolated from the rest of the queer community" reported one of the study's subjects. Another said: "I lost every adult and friend in my life when I chose to detransition. I lost everything I had socially." It is obviously a very lonely journey to be  taken.

 

"Conservatives want us to speak to them to 'prove' that transitioning is 'evil'. Liberals want to silence us for fear that we'll somehow 'influence' trans people to detransition", said another.  "We're in a horrible space and it's nearly more painful detransitioning for me than it was just suffering through an identity that didn't fix my problems like everyone said it would."

 

A new form of stigma -- detransphobia -- is being exposed through the largest study of detransitioners in Canada and the United States in decades, revealing that the medical community is abandoning people who had undergone transition and in time made a decision to reverse that gender journey, finding themselves ignored by the very surgeons who had altered their bodies, while the communities that once embraced them, now choose to ostracize them. 

 

 Close to 1,000 people were included in the survey, to reveal that many who halt or reverse a gender transition end up feeling disappointingly poorly supported by LGBTQ groups and gender-affirming care practitioners, leaving them wistfully regretting their doctors' distancing themselves, wishing instead that they "took a more neutral approach to care".  The study was published in the International Journal of Transgender Health and funded by the Social Sciences and Humanities Research Council.

 

The ritual of name changing and pronouns, the halting of hormone therapy or seeking out reversal surgeries like breast reconstruction following a double mastectomy for masculinizing female-to-male chest surgery are difficult decisions to make in a total makeover of what had preceded that detransitioning process. Findings from earlier research are inconsistent with estimates for detransition ranging from less than one percent to as high as 30 percent. 

 

For some individuals, detransitioning may lead to a reversal - retransition -- particularly if their detransition was 'involuntary, forced' as a result of family pressure, discrimination or "the climate of fear around trans people". In other instances, the pressures are internal; a shift in identity of a realization that their gender dysphoria was related to some other issues "such as trauma or internalized homophobia".  

"According to the detransphobia model, individuals who shift their gender after an initial transition may encounter social rejection and barriers to accessing support within SGM [sexual and gender minority] communities due to misrecognition, gender identity fluidity and detransition-related stigma."

"Many shifted from  transgender to gender non-confirming lesbian, gay or detrans identities, and, in hindsight, wished they had access to providers who took a more neutral approach to care."

"[That backs previous research] and carries implications for gender-affirming care delivery."

York University research team 

The research team itself was comprised of a majority of LGBTQ researchers who stated that no formal health-care guidelines exist that would be of assistance to address the medical and psychological needs to detrans individuals when stigma from LGBTQ communities can also occur. The study is that of an anonymous survey taking place between 2023 and 2024, of 957 individuals from ages 16 and up in the U.S. (704)  and Canada (253) self-identifying, with experiences of detransition -- along with one-on-one interviews with 42 selected participants.

 

Gender detransitioning - going back to living as the gender one was assigned at birth, or identifying differently - is generating more and more headlines these days. Nouvelles Montreal

 

79 percent of participants were born female, a reflection of the surge in biological girls referred to gender clinics. Another Canadian study found that of 174 youth aged 15 and younger who were referred for puberty blocks to 10 gender clinics in the country, 82 percent were born female. Some 42 percent of the total reported a history of discontinuing, then later resuming transition.

 

Challenges to access medial care or financial support to cover detransition procedures such as voice training in response to voice deepening or laser hair removal for body and facial hair;  side-effects from testosterone therapy used in female-to-male transitions were mentioned by many of the study participants. "I was turned down by four surgeons and ghosted by the one who did the mastectomy", one participant said of the search for a breast reconstruction surgeon.

  

Some participants spoke of a wish to secure the services of "non-trans-affirming care providers" on the basis of past therapists appearing too eager to encourage their transition in the first place, or to retransition following detransitioning, "despite no expressed desire to do so". "I had no confidence in my providers when I stopped transitioning" , explained one study participant. 

 

A new research website launched by a multidisciplinary team led by York University Professor Kinnon MacKinnon aims to provide resources, support and data-driven information about gender detransition/retransition. York U Yfile