'Ghosted by the one who did the mastectomy': Detransitioners face 'detransphobia,' study finds
“Ghosted”— ignored — by the surgeons who altered their bodies and ostracized by the communities that once embraced them, the largest study of detransitioners in Canada and the U.S. in decades is exposing a new form of stigma: detransphobia.
The survey of nearly 1,000 people suggests that many who halt or reverse a gender transition feel poorly supported by LGBTQ groups and gender-affirming care practitioners, and wish doctors “took a more neutral approach to care.”
“The mainstream gender-affirming care system largely presumes that gender identity/expression is immutable and that TGD (transgender) people will engage in only one gender transition,” the York University-led research team wrote in wrote in the International Journal of Transgender Health.
“While this may be the reality for many TGD people, this presumption can create environments in which multiple transitions, gender fluidity, and detransitions are misunderstood or even stigmatized.”
While there’s no universally agreed upon definition, detransition “has been conceptualized as stopping, shifting or reversing aspects of an initial gender transition, often motivated by a shift in how one understands their sex/gender,” the researchers wrote.
It can mean changing names and pronouns, halting hormone therapy or seeking reversal surgeries such as breast reconstruction following a double mastectomy for masculinizing, female-to-male chest surgery.
“Some people who detransition may self-label as ‘detrans’ for short,” the research team wrote.
Estimates for detransition range from as low as less than one per cent, to as high as 30 per cent. Many studies only followed people for a few short years, meaning people can get lost to follow up.
Some who detransition may later resume the process — retransition — especially if the felt forced to detransition because of family pressures, discrimination or what one survey participant described as “the climate of fear around trans people.”
For others, the pressures are internal, the researchers wrote, including a shift in identity or a realization that their gender dysphoria was tied up in something else, “such as trauma or internalized homophobia.”
“Irrespective of their current gender identity, those undergoing a detransition often retain ‘atypical’ sex characteristics from prior hormonal and surgical treatments, leading to vulnerability to gender minority stressors and, potentially, an experience of ‘reverse dysphoria,'” the researchers wrote, meaning distress with the physical changes to their bodies.
Yet no formal health-care guidelines exist to help meet the medical and psychological needs of detrans people, who can also face social rejection and stigma from LGBTQ communities, said the research team, which is composed of a majority of LGBTQ researchers.
“I feel so alienated now, and super isolated from the rest of the queer community,” one study participant said.
“I lost every adult and friend in my life when I chose to detransition,” added another.
“I lost everything I had socially.”
The study is based on an anonymous survey, conducted between December 2023 and April 2024, of 957 people aged 16 and older living in the United States (704) or Canada (253) who self-identified with experiences of detransition, as well as one-on-one follow-up interviews with 42 selected participants.
In an effort to capture as wide a range of experiences as possible, the researchers advertised on Instagram, TikTok and other major social media platforms. The survey was sent to more than 615 trans and LGBTQ groups and gender clinics. Researchers also developed a protocol to spot and weed out scam, bot and fraudulent responses.
Respondents were asked to rank their degree of agreement (always, sometimes, never, not applicable) to a series of statements, like, “I needed health care but didn’t receive it.”
Most participants (79 per cent) were born female, reflecting the startling surge in biological girls being referred to gender clinics. One Canadian study found that, of 174 youth aged 15 and younger referred for puberty blockers to one of 10 gender clinics in Canada, 82 per cent were born female.
When asked how they describe themselves, 40 per cent of survey respondents were comfortable with “detransitioned,” 43 percent with transgender, 33 percent non-binary and about 20 per cent “cisgender”
About 42 per cent reported a history of discontinuing, and then later resuming transition.
Many people mentioned challenges getting access to medical care, or financial support to cover detransition procedures like voice training to deal with voice deepening, or laser hair removal for body and facial hair — side effects from testosterone therapy used in female-to-male transitions.
“I was turned down by four surgeons and ghosted by the one who did the mastectomy,” one participant described in the search for a surgeon for breast reconstruction.
Others said they would not have detransitioned “if I’d had any support whatsoever.”
About 60 per cent said they “sometimes” or “always” avoid doctors, which other research has put down to fears of being judged for detransitioning; 42 per cent reported that their health-care provider “never” seemed knowledgeable when discussing detransition. Some reported receiving no information at all about what to expect going off hormones and how to avoid the side effects of stopping cold turkey.
“I had no confidence in my providers when I stopped transitioning,” one said.
Some described wanting “non-trans-affirming care providers,” saying past therapists were too eager to encourage their transition in the first place, or to retransition after detransitioning, “despite no expressed desire to do so.”
“Many shifted from (transgender) to gender non-confirming lesbian, gay or detrans identities, and, in hindsight, wished they had access to providers who took a more neutral approach to care,” the researchers wrote.
That backs previous research “and carries implications for gender-affirming care delivery,” they said.
Many described a need for professional mental health support, such as grief counselling “for losing a life I thought was gonna make me happy.”
Some felt detransitioning is being politically weaponized. “Conservatives want us to speak to them to ‘prove’ that transitioning is ‘evil.’ Liberals want to silence us for fear that we’ll somehow ‘influence’ trans people to detransition,” one said.
“We’re in a horrible space and it’s nearly more painful detransitioning for me than it was just suffering through an identity that didn’t fix my problems like everyone said it would.”
People expressed a need for detrans support groups and other community resources “to speak with other detrans people in person,” not online.
The study was funded by the Social Sciences and Humanities Research Council, a Canadian federal research funding agency.
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