The Actual Numbers

A meta analysis of 28 studies published in Clinical Endocrinology showed that after sexual reassignment surgery, “80% of individuals with GID reported significant improvement in gender dysphoria; 78% reported significant improvement in psychological symptoms; 80% reported significant improvement in quality of life; and 72% reported significant improvement in sexual function”.

A similar European study revealed a 2.2% regret rate for SRS. For context, the regret rate for vasectomies is 7.4%. That’s over 3 times the regrets for a simple 15 minute procedure! But we’re not making them get therapist approval first, are we? 

A meta analysis by Cornell University of 73 studies “found a robust international consensus in the peer-reviewed literature that gender transition, including medical treatments such as hormone therapy and surgeries, improves the overall well-being of transgender individuals.” The report goes on to say that “The literature also indicates that greater availability of medical and social support for gender transition contributes to better quality of life for those who identify as transgender.”

That last part is so important. In fact, let’s read it again! In BOLD this time: “Greater availability of medical and social support for gender transition contributes to better quality of life” (emphasis mine, obviously).

So then is the answer to make it harder on people?

Why Some People Desist

But okay, sure. Obviously there are some people who desist in their transition journeys. So let’s talk about some of those reasons.

• Societal Pressure: Since trans people encounter higher levels of employment and housing discrimination and therefore homelessness as well, and are more likely to be disowned by family and kicked out of their homes (also leaving them faced with homelessness), you can imagine how easy it could be for us to become discouraged from living our truths. I’ve seen so many of my friends quit HRT and start dressing as their birth genders just to gain employment or to get into shelters or to appease their families. But while yes, that’s detransitioning, it’s not evidence of desisting from their trans identities.
• Nonbinary and Gender Nonconforming Identities: Nonbinary and GNC folk will sometimes get lumped in with “detransitioners” since they might be taken off of HRT for not conforming to a socially acceptable binary transition, or they may no longer need or desire HRT for their transition.
• Desire to Fit into “Normal” Heterosexual Roles: An extreme example of this would be Iran, where it’s perfectly legal to be trans, but illegal to be gay. This has lead some gay Iranians to transition either after being outed as gay or to prevent themselves from being outed. But naturally, since they weren’t really trans and were just trying to avoid social and legal persecution, they of course winded up not enjoying the process. Nevertheless, I wouldn’t be surprised if their stories were included in some detransition “stats”.

Keep in mind that it’s also perfectly possible for one to detransition for whatever personal reasons (societal pressure, inability to afford HRT, etc) and then to later retransition once they’re in a better place in life for it. Yet, retransitioners are rarely included in discussions and statistics relating to detransitioners. According to the 2015 US Transgender Survey, 62% of those who had detransitioned later retransitioned. That’s evidence that “detransitioning” isn’t necessarily indicative of desistance. It’s just sometimes unfortunately what we have to do to survive.

Not only that, but the definition of “desistance” is different for every study. This study counted anyone who didn’t return to their original gender clinic or didn’t respond to follow-up surveys with the researchers as desisters. By that logic, I’m a “detransitioner” because I switched HRT providers.

As you can understand, this is a complicated issue with so many moving parts. So it’s difficult to making sweeping generalizations based on such often vague statistics – so don’t.

My Story

I very nearly became one of these “detransitioners”. Not because I suddenly didn’t feel like a woman anymore. But because I lost insurance coverage and went a few months without hormones and feared that I would never again be seen as a woman. My facial and body hair grew back thicker and darker than ever and no amount of shaving would remove the shadow and the stubble. Most of my clothes were low cut and I couldn’t wear them anymore for that reason. My emotions were going haywire and I was getting nonstop headaches from the hormonal fluctuations. On top of that, I was unemployed and needing to support my family so I decided (very much against my wishes) to interview for a job as a Corrections Officer. I didn’t go through with it, but I did cut my hair and dress masculinely so that my potential employers would take me seriously in the hypermasculine world of corrections with all it’s distinct gender divisions. I definitely still was a woman then. I just knew in those moments that there was no way I could live as who I was. Not if I wanted to eat.

My story isn’t unique. After all, the transgender community suffers from one of the highest homeless and unemployment rates. So many of us come out only to be kicked out of our homes and lose employment. And meanwhile, people are telling us that we must be on hormones and trying to “pass” as our identified genders in order to be taken seriously – even by other trans people! The stigma comes from every angle. And when we lose access to care, it can be really hard to keep going. But that’s not a “detransitioner” problem. It’s a societal problem.

Detransition stories are always far more complicated than clickbait media will have you think. They make good clickable headlines that make a few cishet people very wealthy, but they are absolutely not representative of what we actually go through. So sit down and have a conversation with an actual trans person rather than passing sweeping judgement on our behalfs without knowing even half the story.

Related: Informed Consent and Why it Matters

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References:

Murad, et al. “Hormonal therapy and sex reassignment: a systematic review and meta‐analysis of quality of life and psychosocial outcomes”. Clinical Endocrinology. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265.2009.03625.x

Dhejne C, et al. “An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets”. Center for Psychiatric Research, Department of Clinical Neuroscience. https://www.ncbi.nlm.nih.gov/pubmed/24872188

Vice News. “Dispelling the Myths About Trans People ‘Detransitioning’”. https://www.vice.com/en_us/article/kwxkwz/dispelling-the-myths-around-detransitioning

Cornell University. “What does the scholarly research say about the effect of gender transition on transgender well-being?” https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Steensma TD, et al. “Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study”. J Am Acad Child Adolesc Psychiatry. 2013;52(6):582-590. doi:10.1016/j.jaac.2013.03.016 https://pubmed.ncbi.nlm.nih.gov/23702447/

National Center for Transgender Equality. “2015 US Trans Survey”. http://www.ustranssurvey.org/reports