Study draws attention to insufficient clinical care and support for those who discontinue or seek to reverse prior gender-affirming interventions

TORONTO, July 25, 2022 鈥� Medical education, research and clinical guidelines are all available to support the initiation of gender-affirming care for transgender people, but a 91亚色-led qualitative study has found these resources are sparse when patients discontinue or reverse gender-affirming medical or surgical interventions 鈥� referred to as detransition.

The study results published today in the journal indicate that individuals detransition for various reasons including physical and mental health concerns or an evolving gender identity, such as shifting from trans men or trans women, to non-binary or re-identifying with their birth sex.

鈥淎 majority of respondents reported little decisional regrets regarding prior gender-affirming interventions, however participants frequently discussed stopping gender-affirming hormones 鈥榗old turkey鈥� without medical supervision, facing provider stigma, and experiencing clinicians who lacked detransition-related clinical knowledge,鈥� says , lead author of the study.

鈥淚 actually just stopped talking to them [clinicians]鈥� I felt like they were going to be mad at me [for detransitioning],鈥� said one study participant who quit taking testosterone and seeing her therapist. 鈥淚 had like almost no supports when that was happening.鈥� Although during her initial medical transition she had positive relationships with her healthcare providers and therapist, she felt guilt and shame about detransitioning, and was worried that her clinicians would misinterpret her initial transition as a mistake and subsequent detransition as regret.

鈥淩ather than relying on clinicians who were often a source of distrust, many turned instead to online detransition networks and social media. Often, they did not have a clear understanding of what health implications to expect when stopping gender-affirming hormones,鈥� points out MacKinnon.

Medical detransition was often experienced as physically and psychologically challenging. Some individuals initiated the process after gonadectomies or lower surgeries, which meant switching from masculinizing to feminizing hormones or vice-versa.  

鈥淭he first doctor I went to 鈥� and the second doctor 鈥� both didn't have a clue what was going on 鈥� I feel like more information [is needed] around specifically people who need to get off testosterone to go back onto another [hormone],鈥� said another study participant who now identifies as female. In her initial transition process as a transgender young person, her gender dysphoria had been treated with testosterone and both oophorectomy and hysterectomy. However, when she was seeking medical support to detransition and switch from testosterone to estrogen, she felt her medical providers were unprepared to meet her needs.

Aside from physical and mental health concerns, factors motivating detransition included surgical complications and post-operative pain, unsupportive parents or romantic partners, and employment discrimination. In the last two years, the COVID-19 pandemic and related lockdowns was an additional impediment, causing difficulty accessing clinical appointments or gender-affirming surgeries.

For the study, 28 adults between the ages of 20-53 鈥� the majority of whom were assigned female at birth 鈥� were interviewed about their experiences of detransition, including their healthcare encounters when discontinuing or reversing gender-affirming medical or surgical care.

MacKinnon and other researchers from Simon Fraser University, University of British Columbia, University of Michigan, and University of Toronto who worked on this study, conclude that further research and clinical guidance is required to address the unmet needs of those who discontinue or seek to reverse prior gender-affirming interventions.

91亚色 is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change and prepare our students for success. 91亚色's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. 91亚色鈥檚 campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future.

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Gloria Suhasini, 91亚色 Media Relations, 647-463-4354, suhasini@yorku.ca

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Everyday legal problems such as consumer disputes, debt, employment issues and relationship breakdowns are straining Canadians鈥� personal finances and their mental and physical health, as well as increasing social and health care costs, according to a new study by the Canadian Forum on Civil Justice (CFCJ).

The CFCJ is a national not-for-profit organization established by the Canadian Bar Association and affiliated with 91亚色鈥檚 Osgoode Hall Law School.

The found that within a three-year period, almost half of Canadian adults 鈥� approximately 11.4 million people 鈥� experience at least one civil or family justice problem that they consider serious and difficult to resolve. 听They range from employment issues and discrimination to divorce and support payments, and from disputes with neighbours to cell phone contracts.

It is estimated that Canadians spend approximately $7.7 billion annually on everyday legal problems. Furthermore, it is estimated that legal problems cost the state a combined total of $799 million annually: $248 million for social assistance; $450 million for employment insurance; and $101 million for health care. These additional costs stem directly from the physical, emotional, and psychological consequences of experiencing everyday legal problems.

The study, which surveyed more than 3,000 Canadians across Canada, is the first of its kind to measure legal problems not just in dollars, but in time and opportunity costs, costs to physical and mental health, and costs to livelihood.

鈥淲e think this is an issue of major national importance: people haven't been thinking about or studying these costs issues, and the public needs to become much more aware of these issues, if anything is going to change in the context of our current access-to-justice crisis,鈥� says Trevor Farrow, associate dean of Osgoode Hall Law School and Chair of the Canadian Forum on Civil Justice. 鈥淯ntil we can get this issue into our everyday conversations in the same way that health, nutrition and education have become part of dinner table and coffee shop conversations 鈭� which in turns sees these issues become of real interest to politicians 鈭捥� I fear we won鈥檛 significantly move the dial on these justice-related issues.鈥�

The research team, led by Farrow, includes: Ab Currie, a senior research fellow at CFCJ; Les Jacobs, professor of Law & Society and Political Science at 91亚色, Director of 91亚色鈥檚 Institute for Social Research, and a senior CFCJ research fellow;听 Nicole Aylwin, assistant director of the Winkler Institute for Dispute Resolution and a CFCJ research fellow; David Northrup, Director, Survey Research of 91亚色鈥檚 Institute for Social Research; and Lisa Moore, operations director and research coordinator at the CFCJ. The project is funded by a $1 million grant from the Social Sciences and Humanities Research Council of Canada.

91亚色 has always been known for championing new ways of thinking that drive teaching and research excellence. Our 52,000 students receive the education they need to create big ideas that make an impact on the world. Meaningful and sometimes unexpected careers result from cross-discipline programming, innovative course design and diverse experiential learning opportunities. 91亚色 students and our 283,000 alumni worldwide push limits, achieve goals and find solutions to the world鈥檚 most pressing social challenges, empowered by a strong community that opens minds. 91亚色 U is an internationally recognized research university 鈥� our 11 faculties and 25 research centres have partnerships with 200+ leading universities worldwide.

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Janice Walls, Media Relations, 91亚色, 416 736 2100 ext. 22101 / wallsj@yorku.ca

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