Are more people detransitioning?
To answer this question, we need to reflect on the origins and categorical boundaries of this concept
“Are more people detransitioning?”
This is a question we have often asked (and have been asked) as detransition researchers in formal and informal settings.
The short answer is… Probably. Or at least so that seems, given the increasing number of detransition stories being shared in mainstream media and on social media.
Now, for a longer answer… Probably yes. And here is what we think about it.
First, we should clarify that neither of us is especially interested in studies of prevalence or figuring out how frequently detransition occurs. It is important, but such studies say nothing meaningful about the experience of detransitioning. In addition, they can have the consequence of minimizing the significance and impact of this experience on people’s lives. As Hildebrand-Chupp has argued, a transfeminist approach to detransition research focuses more on understanding and providing support.
Not only that, but the question of prevalence is very tricky and, as it has been framed in scholarly and media discussions, it comes with a hidden catch: its estimate completely depends on what we mean when we say “detransition” and how we define its categorical boundaries.
In other words: restrictive definitions, like pursuing a reversal/reconstructive surgery, will yield very low detransition estimates, whereas more expansive definitions will yield higher figures.
But more importantly, we have observed an interesting phenomenon amid these discussions: while wide definitions of “trans” have been socially championed and implemented in all kinds of research, the same hasn’t hold true for detransition. Why?
To understand this, we need to go back several decades, to the second half of the 20th century.
The historical emergence of detransition and regret
From a purely historical point of view, detransition experiences are not new. In its early days, transgender medicine clinicians were already aware of adults who medically transitioned and later reversed course (or at least attempted to do so).
Back then, and reflecting the gender binary way of thinking, this was typically referred to as “gender role reversal” or “regret.” Yes, what we often think about today in terms of detransitioning was simply referred to as “regret” by older clinicians (even if the patient did not express feelings of regret).
For example, Dr. Harry Benjamin, the endocrinologist who was among the first to offer transition-related medical interventions in the US, wrote about one such case in his 1966 book, The Transsexual Phenomenon.
In Europe, German clinicians Drs. Friedmann Pfäfflin and Astrid Junge wrote in 1992 a comprehensive review of follow-up 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 Drs. Abraham Kuiper and Peggy Cohen-Kettenis published a qualitative study of 10 adults who returned to their original “gender role” or expressed feelings of regret after surgery.
But clinicians were not alone in reporting these experiences, as individuals with a lived experience of detransition also shared their stories. In 1980, for instance, American transgender activist and author Diane Leslie Feinberg wrote about their own transition and detransition, publishing a creative work titled the Journal of a Transsexual. Feinberg wrote:
I am a very masculine woman. Perhaps that is the easiest way to introduce myself. I lived convincingly as a man for four years on a sex-change program before leaving that program… I am a woman. I am the way I am. It is a fine way to be.
Feinberg’s writing also indicates that detransition was not at all uncommon at the time.
In this older literature, detransition was understood as a binary and linear process of returning to a pre-transition state and gender identity, and often through the lens of regret—even in the absence of a clear utterance of this feeling from patients themselves.
Put another way: detransition was just returning to (or attempting to return to) cisgender and (potentially) feeling regret about having medically transitioned.
Although some clinicians, like Kuiper and Cohen-Kettenis, were aware of substantively different manifestations within what they called “regret,” the term and its underlying assumptions stuck.
The word “detransition” did not exist back then. According to the Oxford English Dictionary, the first documented use of this term was in 2004, and a quick search in Google Trends shows that didn’t come into broad circulation until 2016.
But today, our understanding of detransition has shifted in very significant ways. This is, in part, thanks to social media, mainstream media, detrans content creators, as well as the research that we and our colleagues have conducted in the last few years!
Contemporary detrans research and ontological double standards
In a 2021 edited collection of trans studies articles, sociologist Rowan Hildebrand-Chupp introduced a way of describing detransition as three related but conceptually distinct parts: the act of detransitioning, the detransitioner identity, and the negative transition experience.
For Hildebrand-Chupp, these three potentially discrete experiences comprised “detrans” as an umbrella term.
In a way, this is similar to how the category of “trans” was expanded to include not only transsexuals who pursued medical transition, but also genderqueer people, cross-dressers (called transvestites back then), and other gender nonconforming individuals.
In part, this trend reflected a gradual favouring of poststructuralism and multiple truths, which worked its way from its breeding ground—the humanities and the social sciences—into some academic medicine circles by the mid-2000s. In addition, community-engaged research and patient and public involvement brought communities of people with lived experience into the academic knowledge production process over the last couple of decades. LGBTQ+ organizations also conducted their own studies, introducing more community knowledge into academic scholarship.
One example of a community study was the ground-breaking 2011 National Center for Transgender Equality survey, taken by over 6,000 American participants. They set their study eligibility criteria to include:
… those who transition from one gender to another (transsexuals), and those who may not, including genderqueer people, cross-dressers, the androgynous, and those whose gender non-conformity is a part of their identity.
The authors of the survey go on to explain their rationale for including gender nonconforming lesbian, gay, and bisexual people in the survey:
Because the term “transgender” is understood in various ways that may or may not include these groups of people, we chose to use broader gender non-conforming language to ensure broad participation in the survey.
At the time, this survey set the stage for future community-based research studies to include this broad range of self-identities, which in turn expanded the boundaries of “trans” and increased the sample sizes significantly.
Today, the category of “trans” has virtually no boundaries outside of self-identity (or identifying with a different gender than the one assigned at birth). It is a definition that includes multiple truths, multiple realities, all equally valid. Its edges and characteristics are blurred.
Even more, gender nonconforming is still included under the trans umbrella in a recent representative national sample showing a dramatic growth of trans identities in the US.
Collapsing gender nonconformity and transness is an increasingly relevant (and prevalent) social phenomenon unfolding in real time.
However, it is especially curious when you compare this to the way that detransition is often studied. That is, under extremely restrictive conditions that reflect the same binary understanding of gender and transitioning that gender clinicians espoused fifty years ago.
Take, for example, a 2022 British study that found 5.3% of youth “reverted to their birth gender” after initiating a medical transition. Or a recent Australian study that found only 1% of patients “reidentified with their birth gender” after medically transitioning.
Forget that these studies employed relatively short data collection periods that would miss identity shifts that can occur 10 years or more after an initial gender transition.
The key aspect is that they do not take into account people who may reidentify from binary transgender to nonbinary, or still understand their identities along the spectrum of gender diversity, or identify themselves as detrans but continue to take transition-related medical treatments, or even reject the notion of gender and gender identity altogether.
This is the complex reality of detransition that we have seen in our own research and in the wider culture—but it is not showing up in the medical sciences when estimating prevalence!
What seems to be happening is that two discrete ontological realities are being applied to the study “trans” versus “detrans.” The former applies a poststructural understanding of the concept, and the latter follows a positivist and behavioral tradition.
When a wide and expansive net is cast around “trans” such that the term has virtually no boundaries, being even inclusive of non-transitioning, gender nonconforming people (and even relatively gender conforming folks, too), why is the bar set for defining detransition so extremely high?
What if a more community-based, poststructural understanding of “detrans” was applied?
If gender is fluid and one can transition through endless conditions and forms, why is detransition reduced to a simplistic, complete reversal tabula rasa to the childhood gender assignment?
No wonder why the 1% figure has been peddled ad infinitum and survived until today.
Interestingly enough, we have been questioned on our expansive understanding of detransition and our decision to recruit nonbinary participants who understand themselves as detrans, resonate with the term “detransition,” or simply believe it captures their experience without falling into these more restrictive notions of detransition-as-reversal.
“I don’t think X or Y counts as detransition,” we have been told.
What would the reaction be if this same assertion was said about trans participants? The double standard is, of course, difficult to ignore.
So, are we being gatekept as researchers? Aren’t we doing exactly what others do in transgender research without any pushback?
Now, going back to the question that introduced our post: are more people detransitioning?
If we draw a parallel with the expansion of “trans” as a category of self-understanding, which has resulted in great increases in the number of people who identify as trans, then yes, it’s very likely that more people are increasingly understanding themselves under the detrans umbrella.
It’s also probably true that, with the increased access to medical transition and the broadening and individualization of transition pathways, more and more people are setting themselves away from the normative imaginary course of a gender transition. This means that, eventually, some of these experiences will converge with what we currently understand as detransition.
What is the main takeaway here?
First, we want to highlight that discussions and estimations of prevalence are lacking without a broader look at the social and cultural shifts in identity categories.
Second, that there are currently disparate ontologies informing researchers’ study design decisions in the mainstream fields of transgender medicine/transgender social sciences.
What makes this even more difficult for us as researchers is that peer reviewers are likelier to reject our studies because this discrepancy is largely obscured in our fields of study and to the wider conversations happening.
But we’ll leave the topic of peer review and censorship from academic journals for another post.
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