91��ɫ

Detransition and gender fluidity: Deeper understanding can improve care and acceptance

If you have been following recent coverage about gender-affirming health care, . From   to transgender , many have taken an interest in people who underwent a medical gender transition and chose to return to their former identity.

The  of gender transitioning and detransitioning has also come with a helping of sensationalization and . But a divided media landscape that presents detransitioners as either “” or victims of “” hurts all gender-diverse people, including those who are detransitioning.

We are  and   who study gender-affirming health care, and we are among a  who are  (detrans, for short — a label adopted by some with this lived experience). We also know many people who have detransitioned personally, whose first-hand perspectives have helped us to improve how we approach this topic.

Detransition is not new, but we are seeing new gender-diverse experiences

Detransition is not new. Providers of gender-affirming medicine have long been aware of adults who medically transitioned and later returned to live in their former “gender role” or showed signs of regret.

Dr. Harry Benjamin, the endocrinologist who was among the first to offer gender-affirming medical interventions in the United States, wrote about one such case in his 1966 book, .

In 1992, German clinicians Friedemann Pfäfflin and Astrid Junge published a  of followup studies published over the previous 30 years, reporting 25 cases of “role reversal” or regret among adults who had undergone surgery. Later, in 1998, Dutch clinicians Abraham Kuiper and Peggy Cohen-Kettenis published a  of 10 adults who returned to their original “gender role” or expressed feelings of regret after surgery.

Pioneers of gender medicine were interested in understanding these stories because regret, along with suicide, was considered an outcome  at all costs.

The logic of  was part of what inspired  practices and the requirement that : male-to-female or female-to-male. Using strict measurement criteria, they estimated that detransition was rare:  to .

But today, gender is no longer thought of as binary. And while there is evidence that  has  in , debates about numbers can distract from a more delicate conversation about the real need for LGBTQ+ communities, organizations and gender-affirming care providers to develop a .

Although detransition may not be new, what is new is a small but emerging gender-diverse population in our society who  and/or medically as  or  who are now  with their , or moving from a binary trans identity (trans man or woman) .

Understanding detransition can help us to enrich gender care

We have long known that  for some LGBTQ+ people. New  shows that it is not uncommon for trans and  young people to report  over time — dynamically moving between binary trans girls or trans boys, to non-binary, or to . In some cases, these identity-shift patterns can influence .

However, when a person’s gender identity or their desire for how they want to express their gender changes after already completing medical or surgical interventions, this may contribute to feelings of decisional regret. This poses  for providers of gender-affirming medical interventions.

Many people who detransition are . But because detransition and regret are being  about trans people and gender-affirming health care, organizations and care providers serving sexual minorities and gender-diverse communities may feel that offering outward support for detransitioners is politically risky.

But if organizations and care systems fail to offer formal recognition and support, where can detransitioners turn to for help?

Discussion of anything but positive outcomes from gender-affirming hormonal or  was long  in mainstream culture and in the trans community. As a result, regret went underground, to online social media networks and . Apart from a small number of therapists working privately with this population, there are few support services.

Detransitioners’ voices

Some detrans people have decided to go public and tell their , to  and to . As social scientists who study gender-affirming health care, we understand what motivates these pursuits: a desire to be understood, and to seek validation and justice.

Detransitioners’ voices, though, may be strategically positioned toward , rather than to improve research or to develop comprehensive detransition-related care services. This positioning may further contribute to stigma and division between trans and detrans people.

It is our view that detransition should be rigorously studied to build a more robust understanding of gender identity development, and to improve gender care — so that nobody’s needs or lived experiences are neglected.

We wrote about some of these ideas and recommendations in the medical journal , including what we know about detransition so far. We also developed an  to communicate the most up-to-date research and care guidance.

Identity evolution and detransition are LGBTQ+ experiences

In our own emerging research with detransitioning people, we have observed that these experiences  and the broader LGBTQ+ community. Indeed, some who understand themselves as detrans may also identify as , bisexual, queer, butch, gay, ; and many continue to experience .

Some might only  due to , external pressures and transphobia, and re-affirm a trans identity in the future.

Regardless, detransition can bring about , . &�Բ�����;—&�Բ�����; — detransitioners experience regret over past medical interventions. Other feelings may be present as well, including .

Identity shifts can be hard to predict. However, in hindsight, some detransitioners do feel that they were influenced by their cultural environment to  and behaviours through the  or to  without considering alternatives. At the same time, some detrans people recount that environments that suppressed or  only meant that later on, in detransition, it was hard to disclose to loved ones and care providers that their identity had changed.

In any case, gender fluidity does not negate the reality of detrans people’s authenticity in their own gender-diversity. While we understand that some of this information is new and may be uncomfortable to embrace, a gender-affirmative stance must hold space for the full breadth of gender diversity being reflected in our society today.

Rigorous, on-going research that is inclusive of these experiences is fundamental to being gender-affirming. Gender fluidity and detransition deserve further understanding and formal care services, not controversy.

Co-written by Assistant Professor , School of Social Work, 91��ɫ, Professor of Social Work , and Université de Montréal, Predoctoral researcher in Psychology , Universidad del País Vasco / Euskal Herriko Unibertsitatea.

This article is republished from .