Why do we study detransition?
In this post, we share our aspirations and commitments to studying detransition and gender diversity in today's climate
Detransition is a risky topic to talk about, let alone to study.
Some argue that it rarely happens, citing the 1% figure. They see detransition as a rare outcome, and almost exclusively driven by external factors such as lack of support, discrimination, and social pressure. Never an issue arising from cost-containing neoliberalist or for-profit medical systems, or hasty clinical decisions.
Others claim that detransition is increasing in large numbers, up to 30% or even higher. These actors position detransition as one of the greatest proofs of the failure of the gender-affirming model of healthcare, which ought to be shut down completely, or at the very least, banned to prevent young people from accessing it.
As a result, detransition has become one of the most contentious and polarized issues in the field of gender medicine, acquiring a central role in the often heated discussions about all things related to trans.
Interestingly, one of the most important theoretical works on detransition, written by sociologist Rowan Hildebrand-Chupp in 2020, was published as part of a series in The Sociological Review entitled “TERF Wars: Feminism and the fight for transgender futures.”
If we take for granted that detransition falls under the umbrella of the so-called “TERF wars,” or even a larger-scale fight for political power between Right and Left, then anyone who talks about it is suspect.
Moreover, if we add to this the political polarization and the context of anti-intellectualism and attacks against academic freedom (from both the Right and the Left), some may wonder who in their right mind would risk their career or reputation on this ostensibly “rare” issue.
The debates about gender-affirming healthcare and detransition are a microcosm of some of the biggest socio-political issues of our time.
One common question we have both received fairly regularly from well-intentioned trans and LGBTQ+ people (and gender-affirming providers) in response to this research is: “What are the risks?”
But we would like to turn the tables by asking instead:
“What are the risks of not doing it?”
Below, we’ll explain what commitments keep us grounded in this work.
Think of it as The One Percent’s manifesto.
Why do we study detransition?
1. Because it’s the ethical thing to do in the field of gender-affirming care
When people think about ethics in medicine, beneficence, non-maleficence, and autonomy are the principles that most readily come to mind. Justice is often the big forgotten one: the idea that access to health care should be fair and equitable, and that everyone deserves appropriate consideration and treatment.
Currently, two serious ethical issues come to mind:
We don’t know definitively how often detransition/regret occurs, or to what extent these experiences will occur over the next several years; and relatedly
There are no formal resources or services designed to meet the needs of people who are currently detransitioning.
For example, the latest version of the World Professional Association of Transgender Health standards of care (WPATH-SOC) does not include a detransition chapter.
A recent paper aimed to serve as a future WPATH-SOC Ethics chapter, titled “Principlism and contemporary ethical considerations for providers of transgender health care,” includes only superficial mention of detransition/regret in the context of transition-related decision-making and risk, rather than an exploration of detransition-related care needs. It also neglects to include and engage with the many new studies on experiences of detransition and gender fluidity that have been published in recent years.
Sadly, we know of situations where someone has detransitioned and attempts to refer for therapeutic supports were declined by multiple providers who cited they “don’t believe in detransitioning.” We have ourselves referred detrans young people to trans support groups, only to have these trans-led groups tell us that it is not an appropriate space for them.
Some detransitioning people feel abandoned by the care system that offered support and celebration during their initial gender transition. They feel ignored and cast aside through the detransition process.
This is an injustice.
We believe that everyone deserves access to recognition, support, and care resources.
To start to build formal recognition and services, we need to fully understand the wide range of detransition/retransition and gender fluidity experiences, which is what our respective research aims to do.
2. Because we embrace a vision of society that welcomes all forms of sexual and gender diversity
Embracing sexual and gender diversity means considering all kinds of experiences related to gender and sexuality, and that of course includes detransition. Many, if not most, people with detransition experiences are LGBTQ+.
When we fully engage with detransition, the connections to expansive understandings of sexual orientation, sexuality, and gender identity beyond binary and conventional frameworks is apparent. We also create an environment where people are able to make choices or express themselves without pressure to adhere to restrictive categories or mainstream frameworks of self-understanding.
A society that truly embraces gender diversity ought to see all gender-related experiences as equally legitimate, and detrans is a relatively new iteration of gender diversity.
This approach can also help to dispel misconceptions that trans and detrans experiences are antithetical to each other, which, frankly, seems to be a new cultural schism produced via dominant ideas about gender identity as an innate, immutable trait, transnormativity/transmedicalism, and the ongoing ideological “gender medicine wars.”
3. Because we need to empirically explore and deconstruct dominant narratives
We are both academics with backgrounds in critical social science. This means that we’ve been trained to look at the ways in which narratives or ideas structure our society, institutions, and even contribute to how people think about themselves and make sense of their lives.
In studying detransition experiences, we’ve drawn on some useful critical theories that have helped us analyze the narratives and ideas that structure gender medicine. One of these theories is what scholars Austin H. Johnson and Evan Vipond have called “transnormativity.”
Transnormativity is a concept used to unpack transmedicalism, or the ways that trans and nonbinary people have been made accountable to Western biomedical “born in the wrong body” narratives: to be considered “truly trans,” one must engage in a binary, linear female-to-male or male-to-female medical transition. This idea, though rooted in clinical healthcare practices, has alienated many gender diverse people, including trans, nonbinary, and detransitioned people.
Detransition challenges and disrupts many of the transnormative ideas and orthodoxies that still dominate gender medicine and the public imagination. It also shows the damage these ideas can do to the lives of people whose experiences simply “don’t fit” mainstream trans discourse, or who felt pressured by society or the medical system to pursue medical treatments that may have caused them harm.
A more fulsome understanding of detransition and gender fluidity has the potential to relax some of the rigid transnormative narratives that can impose unintended pressures for gender diverse and gender nonconforming people.
Relatedly, we also feel it’s important to think critically about the conflation of gender nonconformity with transness, because many lesbian, gay, bisexual, and queer people are gender nonconforming but do not consider themselves to be transgender.
4. Because all outcomes are important to build a high-quality gender-affirming healthcare system
Detransition, like any other outcome, reveals important facets of the experience of gender transition that can inform the care of future patients. By gaining a deeper understanding of why detransition occurs, what factors are likelier to play a role, and under what social or clinical conditions, we’ll be able to recommend better informed decision-making.
Ultimately, this comes back to our first commitment, ethics. Studying which aspects of current models of care or systemic-level factors might have cracks and weaknesses is the responsible thing to do when a group of patients have begun to come forward saying they felt harmed by the care they received.
Selectively ignoring detransition as an outcome (which has long been endemic of gender medicine) and failing to openly discuss this with current patients (or their parents) is practicing uninformed consent.
5. Because underplaying detransition has real consequences
Detransition is complex and sometimes involves challenging stories and emotions. It requires a tolerance for discomfort and, especially if you have been in the trans rights movement for a long time, it may even bring you to reflect on strongly held beliefs. We’ve been there, so we understand why some people have difficulty dealing with the topic. However, this doesn’t come without a cost.
When we underplay detransition or engage in any form of negative prejudicing or stereotyping, we’re adding stress to an already stressful and difficult experience. We’re diffusing responsibility and minimizing harm. We’re dismissing the legitimate concerns and challenges of detransitioners as “anomalies,” as mere collateral damage for which no one will ever be held accountable. We’re contributing to the invalidation, rejection, and erasure of the lived experiences of people who didn’t find what they were hoping for in transition. In essence, we’re rendering detransitioners unintelligible, alienated, and marginalized.
Detransition is a human experience, and to negate it is to negate our innermost human drive for meaning-making and wellbeing.
In The One Percent, we share a commitment to research on detransition as it relates to ethical considerations in care delivery, and also to expanding ideas about gender diversity that push beyond the binary and into a more liminal space.
We hope to start conversations that have long been missing from the academic and public spheres.
We invite our subscribers to see detransition as a critical issue in need of further understanding, not controversy, and as an essential element in the pursuit of a more just and caring society.
Thank you for reading The One Percent!
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