Detransition and gender fluidity: Deeper understanding can improve care and acceptance

• If you have been following recent coverage about gender-affirming health care, detransition will not be an unfamiliar topic.
• From mainstream journalists to transgender authors, many have taken an interest in people who underwent a medical gender transition and chose to return to their former identity.

Detransition is not new, but we are seeing new gender-diverse experiences

• Providers of gender-affirming medicine have long been aware of adults who medically transitioned and later returned to live in their former “gender role” or showed signs of regret.
• Dr. Harry Benjamin, the endocrinologist who was among the first to offer gender-affirming medical interventions in the United States, wrote about one such case in his 1966 book, The Transsexual Phenomenon.
• Using strict measurement criteria, they estimated that detransition was rare: around one to two per cent.

Understanding detransition can help us to enrich gender care

We have long known that sexuality can be fluid for some LGBTQ+ people. New research shows that it is not uncommon for trans and gender-diverse young people to report shifts in gender identity over time — dynamically moving between binary trans girls or trans boys, to non-binary, or to cisgender. In some cases, these identity-shift patterns can influence changes in desires for gender-affirming interventions.

• However, when a person’s gender identity or their desire for how they want to express their gender changes after already completing medical or surgical interventions, this may contribute to feelings of decisional regret.
• But because detransition and regret are being instrumentalized in debates about trans people and gender-affirming health care, organizations and care providers serving sexual minorities and gender-diverse communities may feel that offering outward support for detransitioners is politically risky.
• But if organizations and care systems fail to offer formal recognition and support, where can detransitioners turn to for help?

Detransitioners’ voices

• As social scientists who study gender-affirming health care, we understand what motivates these pursuits: a desire to be understood, and to seek validation and justice.
• Detransitioners’ voices, though, may be strategically positioned toward gender-affirming care restrictions, rather than to improve research or to develop comprehensive detransition-related care services.

Identity evolution and detransition are LGBTQ+ experiences

• Some might only detransition temporarily due to lack of support, external pressures and transphobia, and re-affirm a trans identity in the future.
• Regardless, detransition can bring about loss of community supports, stigma, shame and health care avoidance.
• Gender fluidity and detransition deserve further understanding and formal care services, not controversy.

• Kinnon R. MacKinnon receives funding from the Social Sciences and Humanities Research Council of Canada.
• Annie Pullen Sansfaçon receives funding from the Social Sciences and Humanities Research Council of Canada and the Canada Research Chair Program.