Detransition

Gender transition, often shortened to just transition, is the process of a transgender person changing their gender expression and/or sex characteristics to accord with their internal sense of gender identity. Methods of transition vary from person to person, but the process commonly involves social changes (such as clothing, personal name, and pronouns), legal changes (such as changes in legal name and legal gender), and medical/physical changes (such as hormone replacement therapy and gender-affirming surgery). Detransition is the process of halting or reversing social, medical, or legal aspects of a gender transition, partially or completely. It can be temporary or permanent. Detransition and regret over transition are often erroneously conflated, though there are cases of detransition without regret and regret without detransition. The terms "primary detransition" and "detransition with identity desistance" have been used to describe those who cease to identify as transgender, while "secondary detransition" and "detransition without identity desistance" are used for those who continue to identify as transgender. The term has become associated with movements that aim to restrict the access of transgender people to transition-related healthcare by over-emphasizing the risk of regret and detransition. ==Occurrence==

Detransition has been heterogenously defined in the literature, but available estimates indicate detransition is rare. Advocates for Trans Equality's 2015 U.S. Transgender Survey (a cross-sectional nonprobability survey of transgender adults) reported a history of detransition in 13% of those who had pursued broadly-defined gender affirmation. A review in 2024 analyzed detransition among those who received puberty blockers or cross-sex hormones. It found the studies used heterogenous methodologies and definitions of the term, with small time frames, low participation, and lack of consideration for patient-level data and confounding factors. The majority of studies were small cohorts from specialized gender clinics or were limited to pediatric/adolescent ages. Most were from the Netherlands, the United States, the United Kingdom and Denmark. It gave point-prevalence proportions of 1.6–9.8% for discontinuation of cross-sex hormone and 1–7.6% for discontinuation of puberty blockers among the transgender population. The review noted that the "current literature shows that the decision to detransition appears to be rare" and stated that estimates of those who detransition due to a change in identity are likely overinflated due to conflation between a change in identity and other reasons for discontinuation reported such as "financial barriers, side effects, poor compliance, social issues or goals of treatment met". Transgender elders may also detransition out of concern for whether they can receive adequate or respectful care in later life. The National Center for Transgender Equality conducted a survey of individuals who currently identified as transgender. The results published in the 2015 U.S. Transgender Survey found that 8% of respondents reported having ever detransitioned; 62% of that group reported having subsequently retransitioned. A mixed-methods analysis of the survey's data published in 2021 found that the vast majority said detransition was in part due to external factors, such as pressure from family, sexual assault, and nonaffirming school environments; another highly cited factor was "it was just too hard for me." Forced medical detransition Some state legislatures in the United States have enacted or sought to enact laws which would force transgender people who were unable to flee to medically detransition by criminalizing or restricting their access to care. Arkansas was the first US state to ban transgender healthcare for minors, with the age limit being increased to 26 by August 2024. States have also sought to ban such care for those under 26, restrict access for all ages, or limit public and private insurance coverage of it. In 2024, over 112 bills in 40 states proposed bans on trans healthcare for minors. A study by the Williams Institute found that approximately 114,000 transgender minors lived in states which banned transgender healthcare, and approximately 240,000 transgender minors lived in states that banned it or proposed banning it in 2024. Transgender prisoners are often forcibly detransitioned in many state and federal prisons within the US. Transgender prisoners have been subject to the same in the UK. On March 12, 2023, a Saudi trans woman named Eden Knight died by suicide after being forcefully detransitioned. Knight wrote in a suicide note that her parents had hired an American private intelligence firm and a Saudi lawyer to relocate and forcibly socially and medically detransition her. After becoming dependent on the lawyer for food and shelter and fearing he would report her to U.S. immigration authorities, Knight wrote that she returned to her parents in Saudi Arabia. She secretly continued feminizing hormone replacement therapy, but after being found out twice she died by suicide. Clinical pathway As of 2023, there were no clinical guidelines for detransition. In August 2024, following recommendations in the Cass Review, NHS England announced plans for the first NHS service to support patients wishing to detransition. They said: "There is no defined clinical pathway in the NHS for individuals who are considering detransition. NHS England will establish a programme of work to explore the issues around a detransition pathway by October 2024." == Cultural and political impact ==

Controversy surrounding detransition within trans activism primarily arises from how the subject is framed as a subject of moral panic in mainstream media and right-wing politics. Detransition has attracted interest from both social conservatives and gender-critical feminists on the political right. Activists on the right have been accused of using detransitioners' stories to further their work against trans rights. Some gender-critical feminists see detransitioners' experiences as further proof of patriarchal enforcement of gender roles and medicalized erasure of gays and lesbians. Other feminists have expressed disagreement with this opinion, referring to those who hold these beliefs as trans-exclusionary radical feminists (TERFs). This attention has elicited in detransitioners mixed feelings of both exploitation and support. In 2017, the Mazzoni Center's Philadelphia Trans Health Conference, which is an annual meeting of transgender people, advocates, and healthcare providers, canceled two panel discussions on detransition and alternate methods of working with gender dysphoria. The conference organizers said, "When a topic becomes controversial, such as this one has turned on social media, there is a duty to make sure that the debate does not get out of control at the conference itself. After several days of considerations and reviewing feedback, the planning committee voted that the workshops, while valid, cannot be presented at the conference as planned." Many ex-gay and Christian Right affiliated organizations also promote programs aiming to discourage transition and promote reversal or desistence of transition. A key characteristic of these organizations are the construction of "transgenderism" as a sin against God or the natural order. In the 1970s, Exodus International platformed Perry Desmond, an "ex-transsexual" who evangelized throughout the US and supported Anita Bryant's Save Our Children campaign. Another prominent characteristic is ex-transgender testimonials, which depict "the transgender lifestyle" as destructive as opposed to contemplation of God and encourage other transgender people to join them. These organizations portray "gender ideology" and "transgender ideology" as a social contagion threatening to the natural order. Ky Schevers, an "ex-detransitioner" whose detransition was prominently profiled by Katie Herzog spoke about her experiences in a community of gender-critical feminist detransitioned women, drawing parallels to the ex-gay movement and conversion therapy. Litigation Some individuals who later detransitioned have filed lawsuits against healthcare providers, alleging medical malpractice due to improper mental health evaluations. Bell v Tavistock was a legal case brought by a detransitioner (Bell) and decided by the Court of Appeal (England and Wales) in 2021 on whether puberty blockers could be prescribed to children under 18 without prior court approval. The High Court (Administrative Court) ruling, which was overturned on appeal, said that doctors of teens under the age of 18 may need to get authorization from the courts prior to prescribing puberty blockers. The Court of Appeal overturned the decision stating "it was for clinicians rather than the court to decide on competence" to consent to receive puberty blockers. The first case of a detransitioner winning a medical malpractice lawsuit in the United States was Varian v Einhorn. Fox Varian, who transitioned at 16, was awarded $2 million in her case against her psychologist and the surgeon who performed top surgery on her due to them breaching the accepted standard of care. According to the New York Times, the lawyer who represented Varian sought to downplay the significance of the verdict stating "This was never a debate over the legitimacy of gender-affirming care... It was about whether medical professionals met the standards that covered their own profession.” Dr. Schechter, the president-elect of the World Professional Association for Transgender Health (WPATH) testified that the initial treatment was based on "assumption and inference" and that the health providers failed to follow the standard of care their organization has sought to promulgate. ==See also==