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Detransition is the cessation or reversal of a transgender identification or gender transition, whether by social, legal, or medical means. Some individuals detransition on a temporary basis.
Desistance is a related term used to describe the cessation of transgender identity or gender dysphoria and has a higher occurrence.
Direct, formal research of detransition is lacking. Professional interest in the phenomenon has been met with contention.
Transition is the process of a transgender person changing their gender presentation and/or sex characteristics to accord with their internal sense of gender identity.Transition commonly involves social changes (such as clothing, personal name, and pronouns), legal changes (such as legal name and legal gender), and medical/physical changes (such as hormone replacement therapy and sex reassignment surgery).
Detransition (sometimes called retransition) is the process of halting or reverting a transgender identification or gender transition.Like transition, detransition is not a single event. Methods of detransitioning can vary greatly among individuals, and can involve changes to one's gender expression, social identity, legal identity documents, and/or anatomy. Desistance is a general term for any cessation, and it is commonly applied specifically to the cessation of transgender identity or gender dysphoria. Those who undertake detransition are known as detransitioners. Detransition is commonly associated with transition regret, but regret and detransition do not always coincide.
Formal studies of detransition have been few in number,of disputed quality, and politically controversial. Frequency estimates for detransition and desistance vary greatly, with notable differences in terminology and methodology. Detransition is more common in the earlier stages of transition, particularly before surgeries. It is estimated that the number of detransitioners ranges from less than one percent to as many as five percent. A 2015 survey of transgender people in the United States found that eight percent had detransitioned at some point, with the majority of those later living as a gender other than the one assigned to them at birth.
Studies have reported higher rates of desistance among young children. A 2016 review of 10 prospective follow-up studies from childhood to adolescence found desistance rates ranging from 61% to 98%, with evidence suggesting that they might be less than 85% more generally.However, the methodology for many of these studies has been criticized, particularly for counting as "desistance" cases where the child would never have been diagnosed with gender dyphoria based on current criteria, established in the Diagnostic and Statistical Manual in 2013. Research prior to 2000 might report inflated numbers of desistance, as gender-nonconforming children without gender dysphoria might have been included in studies. Most childhood desisters go on to identify as cisgender and gay or lesbian.
A 2019 poster presentation examined the records of 3398 patients who attended a UK gender identity clinic between August 2016 and August 2017. Davies and colleagues searched for assessment reports with keywords related to regret or detransition. They identified 16 individuals (0.47%) who expressed regret or had detransitioned. Of those 16, 3 (0.09%) had detransitioned permanently.10 (0.29%) had detransitioned temporarily, to later retransition.
A 2019 clinical assessment found that 9.4% of patients with adolescent-emerging gender dysphoria either ceased wishing to pursue medical interventions or no longer felt that their gender identity was incongruent with their assigned sex at birth within an eighteen-month period.
A 2003 German study found evidence for an increase in the number of demands for detransition, blaming poor practice on the part of "well-meaning but certainly not unproblematic" clinicians who—contrary to international best practices—assumed that transitioning as quickly as possible should be the only correct course of action.
According to social worker Lisa Marchiano, detransitioners commonly cite trauma, isolation, dissociation, inadequate mental healthcare, and social pressure as motivations for pursuing transition.Informed consent and affirmation of self-diagnosis (both newer but increasingly employed models for transgender healthcare) have been criticized for failing to meet the needs of those who eventually detransition. Based on blog posts by detransitioners, Marchiano states that transition can magnify, rather than remedy, gender dysphoria. Sufferers may fixate on passing (being perceived as their preferred gender), says Marchiano, leading them to pursue further steps in medical transition.
Criticisms have been made regarding the "persistence-desistance" dichotomy as ignoring reasons why a person's gender identity may desist outside of simply being cisgender in the first place. For example, an assertion of a cisgender identity may be treated with validity and as an invalidation of a previously stated transgender identity; however, an assertion of a transgender identity may only be treated with the same validity if it is held throughout one's life. An individual may repress or realize their identity at any point in their life for a variety of reasons; some individuals' gender identities are fluid and/or may change throughout their lifetime, and some individuals' whose identities are non-binary are effectively excluded due to the studies' assumption of a gender binary.
Motives for detransitioning may include the realization that gender dysphoria was due to other issues, health concerns, feeling that transitioning did not help alleviate dysphoric feelings, finding other ways of dealing with dysphoric feelings, being unhappy with social changes, and changing political views.Motives also may include financial barriers to transition, social rejection in transition, depression or suicidality due to transition, and discomfort with sexual characteristics developed during transition. Additional motives include concern for lack of data on long-term effects of hormone replacement therapy, concern for loss of fertility, complications from surgery, and changes in gender identity. Some people detransition on a temporary basis, in order to accomplish a particular aim, such as having biologically related children, or until barriers to transition have been resolved or removed. Transgender elders may also detransition out of concern for whether they can receive adequate or respectful care in later life. A qualitative study comparing child desisters to persisters (those with persisting gender dysphoria) found that while persisters related their dysphoria primarily to a mismatch between their bodies and their identity, desisters' dysphoria was more likely to be, at least retroactively, related to a desire to fulfill the other gender role.
Mike Penner, a sportswriter for the Los Angeles Times , publicly identified as transsexual in April 2007 under the name Christine Daniels and wrote of his experience with transition until October 2008, when he resumed his male identity. He killed himself in November 2009.
Since 2011, Walt Heyer has written several books and a USA Today editorial on his experience of regret and detransition.
Carey Callahan began speaking openly about her detransition in 2016. Callahan identified as trans for four years. Her employment at a gender clinic led her to seek alternatives to transition. She advocates for detransitioners and gender-nonconforming people while working as a licensed therapist. She was profiled by The Atlantic in 2018.
Longtime New York performance artist Brian Belovitch (formerly known as Tish Gervais) transitioned in 1972, following social pressure to conform his feminine personality to binary gender norms. He lived as a trans woman for fifteen years before "retransitioning", as he terms it, in 1987. Belovitch cites his changed views on his own gender identity (referring to himself now as "genderqueer or gender nonconforming") for prompting his reversal. He was profiled by Paper magazine in 2018; he published his memoir later that year.
In March 2019, James Shupe, the first American to win legal recognition of having a nonbinary gender, criticized his transition and publicly re-identified as a man. Shupe had lived as a trans woman for two years and as a nonbinary person for three.
In 2020 in the United Kingdom, 23-year-old Keira Bell joined a lawsuit against the NHS Gender Identity Development Service.Bell was prescribed puberty blockers at age 16 and testosterone a year later, and had her breasts removed before stopping hormone treatments and reidentifying as a woman. She states that she should have been "challenged more" by the gender clinic, criticising the lack of therapy or questioning she received before being prescribed the puberty blockers. The High Court ruled "It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers", also "It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers" and "In respect of young persons aged 16 and over, the legal position is that there is a presumption that they have the ability to consent to medical treatment".
The 2015 U.S. Transgender Survey collected responses from individuals who identified as transgender at the time of the survey. 8% of those who had transitioned reported having ever detransitioned; 62% of that group were living as a gender other than the one assigned to them at birth at the time of the survey.About 36% reported having detransitioned due to pressure from parent, 33% because it was too difficult, 31% due to discrimination, 29% due to difficulty getting a job, 26% pressure from family members, 18% pressure from a spouse, and 17% due to pressure from an employer.
Marissa Dainton surgically transitioned to a woman in 1993. Four years after that, she had joined an evangelical church, and decided to resume a male identity, because she viewed her first transition as sinful. When she married a woman from the congregation, she had her surgically-constructed vagina removed, leaving her without genitalia. However, she continued to crossdress in secret, and in 2003 decided to transition again. She obtained breast implants, but decided against constructing a new vagina due to possible complications from the type of procedure it would require the second time.
Sam Kane surgically transitioned to a woman in 1997, but seven years later had found life as a woman "shallow" and stated that men did not take her seriously in business as a woman. She transitioned back to a male gender role and had a new penis surgically constructed in 2004. She did not consider herself to have successfully returned to being a man, and stated, "Having become Samantha, I should have stayed Samantha." She again transitioned into a female gender role, this time non-surgically, in 2017.
Ky Schevers transitioned to male in college, but later detransitioned and documented the process under the name CrashChaosCats. She was interviewed for The Outline in 2016 and The Stranger in 2017.She later began to identify as transmasculine and in a 2021 Slate interview compared her experiences in detransition communities to the ex-gay movement.
There are no legal, medical, and psychological guidelines on the topic of detransition.The Standards of Care by the World Professional Association for Transgender Health (WPATH) do not mention detransition, though 37 WPATH surgeons have expressed a desire for detransition guidelines to be included, and former WPATH president and longtime chair of WPATH's SOC revision team, Eli Coleman, has listed detransition among the topics that he would like to see included in the eighth edition.
Some researchers perceive there to be an atmosphere of censorship around studying the phenomenon.Detransitioners say they have been harassed, and that they have been treated as a political threat to transgender rights. A study in 2021 involving detransitioners found that many of them felt they lost support from the LGBT+ community and friends.
Controversy surrounding detransition within trans activism primarily arises from how the subject is framed as a subject of moral panic in mainstream media and right-wing politics.Detransition has attracted interest from both social conservatives on the political right and radical feminists on the political left. Activists on the right have been accused of using detransitioners' stories to further their work against trans rights. On the left, radical feminists see detransitioners' experiences as further proof of patriarchal enforcement of gender roles and medicalized erasure of gays and lesbians. This attention has elicited in detransitioners mixed feelings of both exploitation and support.
In August 2017, the Mazzoni Center's Philadelphia Trans Health Conference, which is an annual meeting of transgender people, advocates, and healthcare providers, canceled two panel discussions on detransition and alternate methods of working with gender dysphoria.The conference organizers said, "When a topic becomes controversial, such as this one has turned on social media, there is a duty to make sure that the debate does not get out of control at the conference itself. After several days of considerations and reviewing feedback, the planning committee voted that the workshops, while valid, cannot be presented at the conference as planned."
In September 2017, Bath Spa University revoked permission for James Caspian, a Jungian psychotherapistwho works with transgender people and is a trustee of The Beaumont Trust, to research regret of gender-reassignment procedures and pursuit of detransition. Caspian alleged the reason for the university's refusal was that it was "a potentially politically incorrect piece of research, [which] carries a risk to the university. Attacks on social media may not be confined to the researcher, but may involve the university. The posting of unpleasant material on blogs or social media may be detrimental to the reputation of the university." The university stated that Caspian's proposal "was not refused because of the subject matter, but rather because of his proposed methodological approach. The university was not satisfied this approach would guarantee the anonymity of his participants or the confidentiality of the data." In May 2017, he took the matter to the High Court, which concluded his application for a judicial review was "totally without merit". The outcome was also considered by the Office of the Independent Adjudicator for Higher Education, who determined the university's conclusion was reasonable. Caspian appealed to the High Court for judicial review again in 2019; the judge ruled against him, saying, "I entirely accept that there are important issues of freedom of expression. I just do not accept that, on the facts of this particular case, there is an arguable case made out," and adding that the application was too late. Caspian claimed that he was "refused permission for a Judicial Review on points of procedure" and that the judge "was clearly sympathetic to the case but felt that his hands were tied by legal procedure;" in February 2021, he appealed to the European Court of Human Rights.
Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity and their sex assigned at birth. The diagnostic label gender identity disorder (GID) was used until 2013 with the release of the DSM-5. The condition was renamed to remove the stigma associated with the term disorder.
Sex reassignment surgery (SRS), also known as gender reassignment surgery (GRS) and several other names, is a surgical procedure by which a transgender person's physical appearance and function of their existing sexual characteristics are altered to resemble those socially associated with their identified gender. It is part of a treatment for gender dysphoria in transgender people.
The Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People are international clinical protocols outlining the recommended assessment and treatment for gender non-conforming individuals across the lifespan or transgender or transsexual people who wish to undergo social, hormonal or surgical transition to the other sex. Clinicians' decisions regarding patients' treatment are often influenced by this standard of care (SOC). They are most widespread SOC used by professionals working with transsexual, transgender, or gender variant people. However, other sets of SOCs, protocols and guidelines do exist, especially outside the United States.
Sex reassignment therapy is the medical aspect of gender transitioning, that is, modifying one's sex characteristics to better suit one's gender identity. It can consist of hormone therapy to modify secondary sex characteristics, sex reassignment surgery to alter primary sex characteristics, and other procedures altering appearance, including permanent hair removal for trans women.
A trans man is a man who was assigned female at birth. The label of transgender man is not always interchangeable with that of transsexual man, although the two labels are often used in this way. Transgender is an umbrella term that includes different types of gender variant people. Many trans men choose to undergo surgical or hormonal transition, or both, to alter their appearance in a way that aligns with their gender identity or alleviates gender dysphoria.
Gender transitioning is the process of changing one's gender presentation and/or sex characteristics to accord with one's internal sense of gender identity – the idea of what it means to be a man or a woman, or to be non-binary or genderqueer. For transgender and transsexual people, this process commonly involves reassignment therapy, with their gender identity being opposite that of their birth-assigned sex and gender. Transitioning might involve medical treatment, but it does not always involve it. Cross-dressers, drag queens, and drag kings tend not to transition, since their variant gender presentations are (usually) only adopted temporarily.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
Blanchard's transsexualism typology is a proposed psychological typology of gender dysphoria, transsexualism, and fetishistic transvestism, created by Ray Blanchard through the 1980s and 1990s, building on the work of prior researchers, including his colleague Kurt Freund. Blanchard categorized trans women into two groups: homosexual transsexuals who are attracted exclusively to men, and who seek sex reassignment surgery because they are feminine in both behavior and appearance; and autogynephilic transsexuals who are sexually aroused at the idea of having a female body.
Transgender people have a gender identity or gender expression that differs from the sex that they were assigned at birth. Some transgender people who desire medical assistance to transition from one sex to another identify as transsexual. Transgender, often shortened as trans, is also an umbrella term; in addition to including people whose gender identity is the opposite of their assigned sex, it may also include people who are non-binary or genderqueer. Other definitions of transgender also include people who belong to a third gender, or else conceptualize transgender people as a third gender. The term transgender may be defined very broadly to include cross-dressers.
Transsexual people experience a gender identity that is inconsistent with their assigned sex and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance to help them align their body with their identified sex or gender.
Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, transgender youth face different challenges compared to adults. Professional medical associations state that appropriate care may include supportive mental health care, social transition, and puberty blockers, which delay puberty and the development of secondary sex characteristics to give children time to make decisions about more permanent courses of action. Most children with gender dysphoria end up identifying with their biological sex after reaching puberty, though if gender dysphoria does continue into adolescence it is far more likely to persist into adulthood. However, the evidence offered to support this has been disputed.
A trans woman is a woman who was assigned male at birth. Trans women may experience gender dysphoria and may transition; this process commonly includes hormone replacement therapy and sometimes sex reassignment surgery, which can bring relief and resolve feelings of gender dysphoria. Trans women may be heterosexual, bisexual, homosexual, asexual, or identify with other terms.
Puberty blockers, also called puberty inhibitors, are drugs used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which inhibit the release of sex hormones, including testosterone and estrogen. In addition to their various other medical uses, puberty blockers are used off-label for transgender children to delay the development of unwanted sex characteristics, with the intent to provide transgender youth more time to explore their identity. The use of puberty blockers in transgender youth has been challenged on ethical and medical grounds, causing controversy over the morality and legality of their use.
Transgender hormone therapy, also sometimes called cross-sex hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is feminization or masculinization:
The real-life experience (RLE), sometimes called the real-life test (RLT), is a period of time in which transgender individuals live full-time in their identified (discovered) gender role. The purpose of the RLE is to confirm that a given transgender person can function successfully as a member of said gender in society, as well as to confirm that they are sure they want to live as said gender for the rest of their life. A documented RLE is a requirement of some physicians before prescribing hormone replacement therapy (HRT), and a requirement of most surgeons before performing genital reassignment surgery (GRS).
Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as sex reassignment therapies, for transgender individuals. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world.
Debra W. Soh is a Canadian science columnist, author, political commentator, and former academic sex researcher.
Rapid onset gender dysphoria (ROGD) is a controversial proposed socially mediated subtype of gender dysphoria. Brown University School of Public Health assistant professor Lisa Littman created the term to describe surveyed parents' accounts of their teenage children suddenly manifesting symptoms of gender dysphoria and self-identifying as transgender simultaneously with other children in their peer group. Littman speculated that rapid onset of gender dysphoria could be a "social coping mechanism" for other disorders. ROGD is not recognized by any major professional association, with Littman noting that it is "not a formal mental health diagnosis at this time".
Transmedicalism is broadly defined as the belief that being transgender is contingent upon experiencing gender dysphoria or undergoing medical treatment in transitioning. Transmedicalists believe that individuals who identify as transgender but who do not experience gender dysphoria or have no desire to undergo a medical transition—through methods such as sex reassignment surgery or hormone replacement therapy—are not genuinely transgender. They may also exclude those whose gender is non-binary from being trans. Transmedicalists are sometimes referred to, by others or by themselves, as truscum, a term coined by a Tumblr user meaning true transsexual scum. The counterpart term for those who believe that gender dysphoria is not required to be transgender is tucute, meaning too cute to be cisgender.
Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, by Regnery Publishing. The book endorses the contentious concept of rapid onset gender dysphoria, which is not recognized as a medical entity by any major professional institution. Shrier states that there was a "sudden, severe spike in transgender identification" among teenagers assigned female at birth during the 2010s. She attributes this to a social contagion among "high-anxiety, depressive girls who, in previous decades, fell prey to anorexia and bulimia or multiple personality disorder". Shrier also criticizes gender-affirming psychiatric support, hormone replacement therapy and sex reassignment surgery as treatment for gender dysphoria in young people.
Expert estimates of the number of transitioners who abandon their new gender range from fewer than one per cent to as many as five per cent.
Evidence from the 10 available prospective follow-up studies from childhood to adolescence (reviewed in the study by Ristori and Steensma 28) indicates that for ~80% of children who meet the criteria for GDC, the GD recedes with puberty. Instead, many of these adolescents will identify as non-heterosexual.
As is shown in Table 1 there is much variation in the reported persistence rates between the studies, ranging from 2% to 39%. ", " Based on this information, it seems reasonable to conclude that the persistence of GD may well be higher than 15%. However, desistence of GD still seems to be the case in the majority of children with GD.
Due to such shifting diagnostic categories and inclusion criteria over time, these studies included children who, by current DSM-5 standards, would not likely have been categorized as transgender (i.e., they would not meet the criteria for gender dysphoria) and therefore, it is not surprising that they would not iden- tify as transgender at follow-up. Current criteria require identification with a gender other than what was assigned at birth, which was not a necessity in prior versions of the diagnosis.