Your Preferred Narrative on Detransition Needs Complicating

What is Detransition and How Common Is it? The two questions everyone has about detransition, definitively answered for all time.

by Evan Urquhart

The topic of detransition has received an enormous amount of media attention lately, most of it misleading, and much of it inflammatory. A week ago, Assigned Media asked followers on BlueSky, Mastodon, and Twitter for their questions about detransition. By far the most common question was about how frequent detransition is, with a second strain of questions longing for more clarity on what should and shouldn’t be counted as a detransition.

What people actually mean by detransition and how frequently detransition occurs are hotly contested, interconnected topics. What follows is our best attempt at providing answers about who is described as or describes themselves as a detransitioner, and what the research says about the people who stop or reverse a medical transition.

Q: What’s the definition of detransition?

Detransition refers to stopping or reversing the medical steps involved in a gender transition such as hormone therapy, particularly when this is accompanied by social changes, such as returning to live as a member of one’s birth-assigned gender or shifting to inhabit a nonbinary identity.

When a person who did not undertake permanent medical steps returns to living as their birth-assigned gender, this is called desistance. Some research into detransition conflates detransition with desistance. A trans person who stops taking hormone therapy without any shift in gender identity or presentation would not normally be considered to have detransitioned.

Q: Who counts as a detransitioner?

In the mainstream, detransitioners have often been presented one-dimensionally, based on a few high-profile individuals who once identified as a transgender men and women. After a period of time these detransition activists came to re-identify with their birth-assigned sex and desired a mainstream, cisgender body and appearance. This was complicated by the permanent effects of their prior medical transition, causing them great regret and unhappiness.

Let’s call the above narrative binary medical detransition with regret. It describes a person currently living as their birth-assigned gender who previously lived as the other binary gender, and deeply regrets every medical step they took during that period.

While research into detransition is still very new, we can be certain that binary medical detransition with regret is not the only pathway associated with detransition. In fact, it doesn’t even seem particularly common among people who detransition. Three common complications to the narrative are a nonbinary detransition, where a person reverses some of the social and medical steps they took to transition because they discover that a nonbinary identity fits better than a binary trans identity did, a detransition under duress where discrimination, poverty, and/or legal restrictions results in a person feeling they can’t continue their transition, and a detransition without regret, where a person views their past transition positively, despite no longer identifying in the same way they once did.

Devin Cantu identifies as detransfeminine and nonbinary. They tweet as @dwoozle, and are a member of a growing group of detrans people who feel let down by the dominant narratives. They write, "Everything that you know about detransitioners from mainstream media portrayals is a lie. Right wing platforms and even mainstream media itself only picks certain detransition stories to sensationalize them so they can pit it against trans people and transition healthcare. You can't get people’s attention by being nuanced and non bigoted. People pay more attention to train wrecks with polarizing extremist views because that's what grabs attention and engagement. We are not who and what the media portrays us as."

Qualitative research into detransition experiences can help illuminate these diverse perspectives. Some recent papers based on in-depth interviews include a 2022 exploration of healthcare experiences of people who medically detransitioned, a 2023 look at narratives of young people who discontinued transition, and an exploration of experiences and perspectives of people who discontinued a gender transition, also from 2023.

Q: How common is detransition?

Two statistics are frequently referenced in discussions of how frequent detransition is, and both of them are misleading. 

Advocates for the trans community frequently reference a systematic review by Bustos et al. that looked at studies of transgender surgical regret. It found a surgical regret rate in the 1 percent range. Unfortunately, since many (perhaps most) people who detransition don’t undergo surgery, and many (perhaps most) people who detransition don’t regret transitioning, 1 percent is a very good estimate of surgical regret, but not of detransition. 

On the other side, anti-trans activists frequently reference a study by Roberts et al. that found 30 percent of patients who received a prescription for cross sex hormones under the U. S. Military Healthcare System ceased refilling prescriptions by the time four years had passed. Stopping refills was more common among those assigned female at birth, and less common among those who started treatment as a minor.

The Roberts et al. study is well designed, but its relevance to the discussion of detransition is limited by the fact that it contains zero information about detransition as we’ve defined it. Patients may have discontinued hormone treatments for any reason, and with or without returning to live as their birth-assigned sex. Some patients may have continued treatments with another provider, or by paying out of pocket (though we should note the study excluded those who stopped using TRICARE insurance entirely). 30 percent is a higher discontinuation rate than other studies have found, meaning it may be best looked at as an upper limit on detransition.

Q: In other words, the rate of detransition most likely lies between 1 percent and 30 percent. So, what other studies can cast light on this?

An Australian study looked at 79 young people who underwent a rigorous assessment process in a gender clinic in New South Wales, Australia. Of 68 who met the criteria for gender dysphoria, 51 started cross-sex hormones and 2 (4 percent) had later stopped hormones and ceased to identify as transgender. One additional participant stopped hormone therapy while continuing to identify as transgender. (There were diverse paths taken by those who didn’t access cross-sex hormones including some who did and did not continue to identify as trans or as nonbinary, but none of them would be considered detransitioners as they did not take permanent medical steps to transition.)

Another study examined the charts of 175 adult patients in Exeter, U. K. They found 12 patients (6.9 percent) returned to living in their birth-assigned gender, with 2 of them mentioning regretting their transition. There was also a study of 41 adult patients in Southwest England that found 8 patients discontinued hormone therapy after starting, and 4 of these had notes in their history consistent with either regret or detransition. 

Finally, the U. S. Transgender Survey of 2015 collected information about 27,715 transgender adults in the U. S. who agreed to complete an online survey. Of these, 17,151 reported having pursued some form of medical or social transition, and 2242 (about 13 percent) reported some history of detransition, meaning a period in which they returned to living as their birth-assigned gender. A study of their responses by Turban et al. found 82.5 percent reported an external factor driving their detransition, such as a lack of family support or employment discrimination, while 15.9 percent reported an internal factor such as uncertainty or fluctuations in their gender identity.

Q: So… what’s the detransition rate??

Taking all of these studies together, we clearly can’t say exactly how common detransition is, and the detransition rate will always be complicated because researchers define detransition differently. A 30 percent detransition rate is not supported, and neither is a rate of 1 percent. 

A rough guesstimate would be that between 4 and 13 percent of people discontinue hormone therapy and resume living as their birth-assigned gender for some reason, with an additional group of people discontinuing hormone therapy without returning to live as their birth gender. Regret seems to be rare for patients accessing hormone therapy, but may be more common than the 1 percent regret for surgery.

Detransition seems to have attracted the interest of multiple teams of researchers, so a clearer picture is likely to emerge in time. While we wait for better data, the advice to listen to people who detransition continues to feel imperative, with the catch being that mainstream narratives of detransition are insufficient because they don’t seem to represent most people who have stop, reverse, or shift their gender transition.