Detransition

TL;DR: QueerAF has confirmed that leaked guidance seen by the Good Law Project is in use by NHS England. It reveals the 6000+ children currently on the waiting list for the new Children And Young People’s Gender Service are being invited to have their mental health assessed. At these assessments children and their families will be advised to stop gender-affirming treatments, and that if they continue without “appropriate care” they could face safeguarding referrals. It could result in young people being forced to medically detransition.

Two recent papers from York University, from a team led by assistant professor Kinnon MacKinnon, offer a wider sampling. MacKinnon and his team interviewed 28 detransitioners who told them complicated stories of identity evolution, medical complications, and experiences with anti-trans and anti-nonbinary discrimination. Taken together, they suggest ways providers and society as a whole could better support trans, nonbinary, and gender-nonconforming people. Spoiler: It’s not by banning care.

Published in PLOS One on Nov. 29, the first paper sought to “qualitatively explore the care experiences and perspectives of individuals who discontinued or reversed their gender transitions.” The second, published in Psychology of Sexual Orientation and Gender Diversity on Nov. 30, took those qualitative findings and attempted to demarcate four discrete subtypes or pathways for detransition.

Of 28 interviewees who answered a call for people in Canada who had shifted or discontinued a transition, 10 were at birth assigned male, and 18 female. They all had negative experiences during their initial transition. But most did not follow the typical sequence that widely shared detransitioner stories follow, of switching genders, then switching back to identifying as cis. A clear majority, 60 percent, had shifted from a binary trans identity when they began transitioning into a nonbinary identity at the time of the interview. By contrast, only six identified as female or a woman, and none identified as male or a man.

Like “detransition,” “regret” can also have different meanings. Narayan et al. (2021) surveyed surgeons who perform gender-affirming surgeries about their experiences with patient regret (which they reported to be in the 0.2–0.3% range). They documented three different “types” of regret: “true gender-related regret” (typically a change in gender identity), “social regret” (typically due to external pressure from family members or societal transphobia), and “medical regret” (e.g., complications due to surgery). Notably, they reported that only 6.5% of patients who experienced regret believed that they had been “misdiagnosed.”

In other words, just as we shouldn’t conflate “detransition” with “regret,” we also shouldn’t conflate “regret” with inadequate assessment or having been misdiagnosed as transgender. Once again, this confirms my previous point that the “mistaken and regretted transition” narrative only applies to a small fraction of those who detransition, and thus represents a miniscule number of people who choose to transition in the first place.

To put these numbers in perspective, let’s try a thought experiment: Imagine 10,000 people transitioning. If 2% of them experienced detransition or regret, but only 6.5% of those individuals felt that they had been misdiagnosed as transgender in the first place, that would represent 13 people. Out of 10,000. That’s an incredibly small number of people — no wonder journalists and politicians who want to promote the “mistaken and regretted transition” narrative have to rely on the same handful of detrans interviewees over and over again.