Study finds detransition often reflects evolving identities, highlighting the need for flexible, trauma-informed care

As access to gender-affirming care has expanded in recent years, public and clinical understandings of gender transition and detransition have remained limited and highly politicized. Anecdotal reports of detransition have become a flashpoint in culture war debates and international policy battles, while the actual experiences of people who have stopped, shifted, or reversed an initial gender transition remain under-researched.

A groundbreaking new study led by 91亚色 Professor , , emphasizes the need for a nuanced, evidence-informed understanding of detransition experiences among 2SLGBTQ+ individuals. Drawing on survey data from 957 participants in the U.S. and Canada, the research reveals that detransition is far from a homogenous experience.

鈥淭his particular topic is very contentious and debated along political lines. People with these experiences tend to feel marginalized and misrepresented by both sides,鈥� says MacKinnon, a social scientist at 91亚色鈥檚 School of Social Work. 鈥淥ur study aimed to build knowledge that was more empirically driven, to try to understand from people鈥檚 own knowledge how they experienced gender transition, and their ongoing care needs.鈥�

Funded by the Social Sciences and Humanities Research Council and co-authored by Naail Khan and Katherine Newman, 91亚色 PhD candidates in the Department of Psychology, the DARE (Detransition Analysis, Representation, and Exploration) study identifies four distinct pathways of detransition and offers a more nuanced framework for understanding why people decide to detransition. These findings may not be generalizable to the larger TGD population, especially those who do not detransition. Detransition is a minority experience within the TGD community, currently estimated at between one to 30 per cent.

鈥淚n Canada and the United States, there has been very little robust research into detransition in the last 30 years,鈥� says MacKinnon. 鈥淭his is one of the first large-scale, community efforts to study detransition and gender fluidity since gender-affirming health care was widely scaled up about 10 to 15 years ago.鈥�

Understanding the study

Data collection for the SSHRC Insight Grant-backed study began in December 2023. Over the following year, 957 individuals were surveyed and 42 interviewed. Participants ranged from 16 to 74 years old. The average age was 26. The mean age at which most began to identify as TGD was around 15. A large majority (78.8 per cent) were assigned female at birth (AFAB), and nearly three-quarters were based in the U.S.

Participants had all detransitioned or retransitioned after a social and/or medical gender transition. The time between initially realizing a TGD identity and starting to detransition ranged from several months to over a decade. While reasons for detransition varied, the study found that gender identity and expression can be fluid over time, particularly for 2SLGBTQ+ youth. Some described their transitions and detransitions not as mistakes, but as part of a longer developmental journey. Others felt let down by gender-affirming health care or accessed care that may have deviated from recommended standards of care.

Four distinct detransition pathways

Survey results offer new insights into socio-demographic profiles and characteristics of individuals who have detransitioned or retransitioned (resumed transitioning after a temporary detransition). Using self-reported reasons, MacKinnon and co-authors identified four distinct pathways using Latent Class Analysis (LCA).

Class A (33 per cent of participants): Predominantly young, AFAB (89.87 per cent) individuals, who began transition early and later reported high decisional regret, mental health challenges and dissatisfaction with care. Most (85.4 per cent) no longer identified as TGD at the time of the survey. Participants in this group had the highest average number of lifetime gender identities, reported high adverse childhood experiences (ACEs) and strong decisional regret with transition. Over half of those who accessed gender-related surgery as minors were in this group; fewer than half reported receiving decision-making supports before they started to transition.

Class B (19.5 per cent): Participants whose gender identity evolved with little to no regret, and who expressed satisfaction with transition and care received. Most (62.3 per cent) still identified as TGD but had evolved in their gender identity/expression after their initial gender transition.

Class C (19 per cent): This group experienced a combination of internal struggles (neurodivergence, mental health, trauma and identity shifts) and external pressures (discrimination, romantic rejection, lack of support). Participants in this group reported high adverse childhood experiences (ACEs), moderate regret and mixed satisfaction with care. In this class, 29 per cent reported wanting to detransition but were feeling unable to take steps.

Class D (28.5 per cent): Detransition was involuntary, driven primarily by external pressures like discrimination, family rejection, difficulty with accessing gender-related treatments, and more. About 95 per cent reported a current TGD identity, and most (71 per cent) had retransitioned, suggesting this group had a temporary detransition. This group reported high treatment satisfaction and the lowest decisional regret, with a majority reporting access to decision-making supports prior to starting to transition. Best conceptualized as an 鈥渋nterrupted鈥� transition. Trans women were more often in this group.

Beyond regret: gender fluidity, social context and complexity

Survey findings show that detransition can occur with or without decisional regret. While roughly half of those who accessed gender-related medical treatments reported decisional regret or ambivalence, many expressed ongoing satisfaction. For some, detransition reflected changing identity; for others, it was a forced interruption due to external or systemic barriers. A significant number retransitioned, illustrating that treatment needs can evolve across time and context.

Recent longitudinal research found that 20 to 79 per cent of gender-diverse young people experience shifts in gender identity over time. These changes are not necessarily signs of regret or pathology but may reflect typical child and adolescent identity developmental processes. This underscores the importance of care models that are responsive to evolving identities and the dynamic ways young people can experience gender. 

More resources are required from health-care funders to improve high-quality research and ensure that gender care delivery follows recommended standards of care, particularly for gender-diverse children and youth. This would include training clinicians on the diversity of TGD experiences, including detransition and retransition, and updating guidelines like the World Professional Association for Transgender Health (WPATH) Standards of Care to reflect evolving research.

Gender-affirming care must be flexible, compassionate, trauma-informed and evidence-based. Providers must adopt non-stigmatizing, informed practices that reflect the reality that gender identity and treatment needs can evolve. By better understanding gender dysphoria, gender fluidity, and detransition, clinicians and health-care systems can offer safer, more comprehensive supports. Integrating a nuanced view of gender fluidity into care models will improve patient trust, reduce harm and ensure inclusivity across the full spectrum of 2SLGBTQIA+ experiences.

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A 91亚色-led study aims to support positive social and economic change for 2SLGBTQ+ communities

While municipal and provincial poverty-related studies offer glimpses, there is no national measure for how widespread or persistent poverty is within 2SLGBTQ+ communities in Canada. A research project housed at 91亚色 looks to fill those gaps by conducting the first national study addressing poverty in 2SLGBTQ+ communities.

"We will produce an evidence-based portrait of poverty," says , director of the 2SLGBTQ+ Poverty in Canada Project, which launched its national survey during Pride Month. Part of the 2SLGBTQ+ Poverty in Canada: Improving Livelihood and Social Wellbeing study, the survey has been rolling out across the country, province-by-province, territory-by-territory over the summer months. That survey is now open to residents of Nunavut, the Northwest Territories and Yukon.

Mul茅, professor in the Faculty of Liberal Arts and Professional Studies cross-appointed to the Faculty of Health at 91亚色, says a motivating factor driving the research was hearing from community organizations that advocacy work was hitting roadblocks when policymakers and governments would ask for evidence. The project is dedicated to producing high-impact, policy-relevant knowledge. It aims to meet the need for nationally representative data to inform policy, funding, and programming decisions in government, academia and at the community level.

The findings from our comprehensive survey represent an exciting opportunity to add precision and nuance to our understanding of the varied experiences of poverty among 2SLGBTQ+ community members

Nick Mul茅

"We hope to produce outputs that will be helpful to the community, that they can use, and that we will use as researchers to advocate for change," says Mul茅, adding that the United States is eight to 10 years ahead of Canada with this type of data collection.

The comprehensive survey covers individual and household incomes, employment, education levels, housing stability, food security, access to health care and social support, experiences of discrimination and more. This critical information will allow for reliable comparisons between 2SLGBTQ+ people and the general population. The survey also allows respondents to indicate whether they would be interested in participating in individual interviews, a focus group, or both.

Residents of the territories 16 years or older who are members of 2SLGBTQ+ communities are encouraged to contribute to the research by . For more information about the national survey or the 2SLGBTQ+ Poverty in Canada Project, read the full media release or visit the study's website.

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A 91亚色-led study aims to support positive social and economic change for 2SLGBTQ+ communities

How widespread 鈥� and persistent 鈥� is poverty within 2SLGBTQ+ communities in Canada? Municipal and provincial 2SLGBTQ+ poverty-related studies offer some glimpses but there is no national measure. Through conducting the first national study addressing poverty in 2SLGBTQ+ communities, a research project housed at 91亚色 looks to fill that gap.

Led by , 91亚色 professor in the Faculty of Liberal Arts and Professional Studies cross-appointed to the Faculty of Health, the 2SLGBTQ+ Poverty in Canada: Improving Livelihood and Social Wellbeing study launched a national survey in June, which is being rolled out across the country, province-by-province, territory-by-territory. Today that survey opens to residents of New Brunswick, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island.

Mul茅, who is also the director of the 2SLGBTQ+ Poverty in Canada Project, says a motivating factor driving the research was hearing from community organizations that their advocacy was hitting roadblocks when policymakers and governments would ask for evidence. Recognizing this need for nationally representative data to inform policy, funding, and programming decisions in government, academia and at the community level, the project is dedicated to producing high-impact, policy-relevant knowledge.

鈥淲e hope to produce outputs that will be helpful to the community, that they can use, and that we will use as researchers to advocate for change,鈥� says Mul茅. The project was awarded $2.5 million in funding from the Social Sciences and Humanities Research Council of Canada.

Residents of Atlantic Canada 16 years or older and who are members of 2SLGBTQ+ communities are encouraged to contribute to this research by .

The comprehensive survey covers individual and household incomes, employment, education levels, housing stability, food security, access to health care and social support, experiences of discrimination and more. This critical information will allow for reliable comparisons between 2SLGBTQ+ people and the general population. The survey also allows respondents to indicate whether they would be interested in participating in individual interviews, a focus group, or both.

For more information about the national survey or the 2SLGBTQ+ Poverty in Canada Project, read the full media release or visit the study's website.

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91亚色 U-led project aims to drive social and economic change in support of 2SLGBTQ+ communities

TORONTO, June 27, 2024 鈥� Just how widespread 鈥� and persistent 鈥� is poverty within 2SLGBTQ+ communities in Canada? Municipal and provincial 2SLGBTQ+ poverty-related studies offer glimpses but there is no national measure. Research led by 91亚色 and launched during Pride Month looks to fill that gap.

鈥淭he goals of our project reflect mounting and disturbing evidence that members of our community cannot take the time to celebrate, as some are deprived of basic necessities such as food and shelter,鈥� says , professor in the Faculty of Liberal Arts and Professional Studies cross-appointed to the Faculty of Health, and director of the 2SLGBTQ+ Poverty in Canada Project. Housed at 91亚色, the project is conducting the first national study addressing poverty in 2SLGBTQ+ communities.

鈥淚t鈥檚 one thing to experience poverty, whether they were born into it, grew up in it, or fell into it,鈥� says Mul茅, who teaches at both 91亚色鈥檚 School of Social Work and School of Gender, Sexuality and Women鈥檚 Studies, 鈥渂ut when you鈥檙e a member of these communities issues become compounded with regards to discrimination, with regards to stigmatization, lack of self-esteem, difficulty accessing education, getting work, retaining work.鈥�

In celebration of Pride, the 2SLGBTQ+ Poverty in Canada: Improving Livelihood and Social Wellbeing study launched with a national survey, which is rolling out across the country, province-by-province, territory-by-territory, throughout the summer.

Led by Mul茅, the study aims to advance social and economic change in support of 2SLGBTQ+ communities. Mul茅 says a motivating factor driving the research was hearing from community organizations that their advocacy work would hit roadblocks when policymakers and governments would ask for evidence. Recognizing this need for nationally representative data to inform policy, funding, and programming decisions in government, academia and at the community level, the project is dedicated to producing high-impact, policy-relevant knowledge.

鈥淲e will produce an evidence-based portrait of poverty,鈥� says Mul茅, adding that the United States is eight to 10 years ahead of Canada with this type of data collection.

The project was awarded $2.5 million in funding from the Social Sciences and Humanities Research Council of Canada. The comprehensive survey covers individual and household incomes, employment, education levels, housing stability, food security, access to health care and social support, experiences of discrimination and more. The survey will also allow respondents to indicate whether they would be interested in participating in individual interviews, a focus group or both.

鈥淲e are looking at the extent and experiences of poverty amongst the 2SLGBTQ+ community,鈥� explains Mul茅. 鈥淲e will also look at the effects of poverty in the lives of people from these communities.鈥�

This critical information will allow for reliable comparisons between 2SLGBTQ+ people and the general population. 鈥淲e hope to produce outputs that will be helpful to the community, that they can use, and that we will use as researchers to advocate for change,鈥� says Mul茅.

Launching the survey during Pride was significant for the researchers. 鈥淓very June, public institutions, civil society organizations, and leaders from many sectors share in celebrating Pride, positioning themselves as stewards of the hard-fought progress made in recognizing the human rights of 2SLGBTQ+ people in Canada,鈥� says Mul茅. 鈥淒espite this progress, for 2SLGBTQ+ communities, Pride is a time of deep reflection, community mobilization, and an opportunity to draw attention to the socio-economic disparities affecting our collective well-being and our differing abilities to celebrate Pride.鈥�

Members of 2SLGBTQ+ communities across Canada who are 16 years or older are encouraged to contribute to this research by .

The project is co-directed by Maryam Dilmaghani, professor of economics in the Sobey School of Business at Saint Mary鈥檚 University. Leading the quantitative and qualitative data gathering are Todd Coleman, assistant professor in the Department of Health Sciences at Wilfrid Laurier University and co-chair of the project鈥檚 quantitative research team; and Andrea Daley, professor in the School of Social Work, Renison University College at the University of Waterloo and co-chair of the project鈥檚 qualitative research team.

For more information about the national survey or the 2SLGBTQ+ Poverty in Canada Project, visit the study's website.

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