Sam Dylan Finch 🍓 @samdylanfinch Mental health & chronic conditions @Healthline. 🌱 Very earnest, very gay nerd. 🌈♿ Feb. 13, 2019 9 min read

I want to talk about detransitioning, as transgender, as someone who detransitioned at one time, and as someone who has supported others through that process.

Because the panicked narrative surrounding this isn't serving anyone.

So, some thoughts. In the form of a thread. 🧵

First off, this is not a thread that's going to talk about statistics. Not because I don't value research, but because the world that we live in is changing rapidly — which means the experiences of transgender people, as they move through the world, are changing rapidly too.

Stats can't account for the cultural & medical context, esp with older research. People who are transitioning right now are having a very different experience from those even a decade ago. Different surgery results, different levels of discrimination, both of which impact regret.

Additionally, some of this research hasn't even been conducted in the United States. Which, when we're talking about a marginalized group whose treatment (medically and socially) varies widely across the world, isn't a helpful point of reference in the slightest.

For starters, what is "detransition"? Broadly speaking, if you identified as transgender and took steps — socially OR medically — to make that identity known, and then took steps after to realign with your identity pre-transition, this is what we're talking about.

Speaking from lived experience, there are a lot of reasons someone might detransition or experience some form of regret around transition. And frankly, responding to the existence of regret by saying "no one should transition" is immediately revealing a bias.

Yes, a bias. Because without knowing WHY someone is experiencing regret or a desire to detransition, you've made the assumption that their transition is the problem, and not the myriad other factors that go into whether or not someone is happy with their transition generally.

Some of those factors have to do with environment — are they in an abusive situation and being coerced? Are they experiencing discrimination that makes them feel unsafe? Were the physical results not what they wanted or did they have a traumatic experience with their clinicians?

I came out as transgender first when I was 18 years old. But I was in an abusive relationship at that time, and in an incredibly controlling home environment. I started to socially transition, but the backlash made things unsafe for me to continue.

The trauma during that time put me in a state of denial. I did everything I could to convince myself I didn't actually need to transition, that I was just gender nonconforming, that I needed to embrace womanhood, thank GOODNESS I didn't transition, etc etc etc.

The reality is, if you are transgender or gender nonconforming in any way, chances are, you've experienced trauma. Because the world, as it exists, is not warm, affirming, and safe for people like us. That makes detransitioning awfully tempting.

And to protect ourselves, we often rewrite our own narratives many times before we finally feel safe enough to be ourselves. Ask someone who has worked with the trans population as a therapist — many of us swing back and forth, sometimes many times, before we "land."

NOT because we didn't know who we were, but because we were afraid. Human brains are wired to avoid pain. It's painful to come out. It's painful to live in this world as a transgender person. Our brains work overtime to try to adapt through the path of least resistance.

You could've spoken to me about ten years ago, and I would've told you there was no way in hell I was going to pursue hormones and surgery. In large part because I believed that would be the equivalent of losing my entire family — I did not believe they would support me.

Transitioning requires sacrifice in every case. In some cases, much more than others. And that's the crux of the issue: Detransition isn't necessarily regret around transition itself, but rather, grief over the sacrifices that we made and a lack of support around coping with it.

That grief is real. Every trans person, in some respect, has to grieve certain losses. Some of us lose families, jobs, a sense of safety when we walk down the street. Some of us lose certain aspects of our bodies that we did like, but were willing to let go of in order to "pass."

Some of us grieve the simple fact that we're no longer "invisible." We have to be hyperaware of how we move through the world at all times. It's exhausting to live in fear of people who might do you harm at any moment. No amount of gender euphoria makes that easy.

And then there's the simple fact that medical transition is, itself, very hard. Some people have side effects from HRT that they weren't prepared for, and without knowledgable clinicians, they're led to believe that they have to stop HRT altogether.

As an example, I have OCD, and when my symptoms were out of whack, multiple providers told me to stop testosterone — despite there being no evidence of the two being linked.

Many clinicians will attribute any and all of your problems to HRT because of their own bias.

Some people have surgery results that they aren't happy with, because these procedures are still evolving and not everyone has access to an experienced surgeon (of which there are already very few).

Many of the people that I've supported through their own detransition didn't detransition because they aren't transgender — it's that they aren't BINARY, but rather, some shade of genderqueer which meant they had to "course correct" and scale back on HRT.

Are there folks who will have transitioned and then realize that they are 100% cisgender? Sure. Do I think it's a staggering number that we should be alarmed by? No. AND? That shouldn't affect trans people one way or the other. They have nothing to do with each other.

A cisgender person who detransitioned is not the same as a transgender person who did, and the former should not impact the latter's access to affirming care.

This is like saying everyone should stop eating because someone got food poisoning at one restaurant.

Because listen: Detransition describes a broad spectrum of experiences that are impacted by MANY factors that are difficult to isolate. Because gender identity, itself, is shaped by so many different facets of our existence.

And those factors are all very important. The context under which someone detransitions, the age at which they did so, the steps they took to pursue transition, their reasons for detransition, their trauma history — ALL of these things matter.

So for starters, who are we talking about when we study detransition? Because you can have radically different circumstances under which this happens. And depending on where that person is in their journey, they could have radically different answers to the same question.

How do you properly study something on this scale when identity itself is fluid, and there are many factors that impact someone's overall satisfaction with transition, and those factors are constantly changing, AND you're talking about a small fraction of a small population?

And most importantly, how do you draw a solid conclusion that has longevity and is still applicable in the future? To be frank — I say this as someone with a degree in social sciences — you can't. It's like taking someone's temperature now to suggest what it'll be in ten years.

"Okay, Sam," you might be thinking. "I get it. This is super duper complicated. So what am I supposed to do with all this?"

That's the thing: Why do you feel like you NEED to "do something" about this?

I think it's telling that these folks are cherry-picking studies to suggest that transition regret is an epidemic, but they aren't listening to professionals & communities that have extensive knowledge of what factors influence a trans person's happiness/positive outcome.

Why is there a deliberate focus on preventing transition, instead of studying what makes a transition "successful" or leads to positive outcomes, and focusing on replicating that? I'll tell you why: They don't want transgender people to be happy. They want us not to exist.

I don't deny that people can regret certain or all aspects of a gender transition. What I'm suggesting is that the deliberate focus on regret & the assumptions made about why it happens is telling, and not backed by anything observable other than sensationalized outliers.

I don't mind in the slightest if people ask for this to be studied more closely. My objection is that if that research's starting place is one rooted in those assumptions and seeks out outliers to define a much BROADER and more complex phenomenon, it's not good science.

And the reason why a lot of this older research isn't done well is because it's conducted by people who don't have a grasp on this nuance or process, and therefore, the parameters of the studies themselves don't account for any of the necessary context.

Esp when we're talking about qualitative research, the questions you ask can make the difference, but you have to be thoughtful about what you're asking. But if you assume that people regretting transition is the same as regretting cosmetic surgery, you'll ask the wrong questions

There is a recurring and frustrating problem in a lot of research that oversimplifies what transgender people experience, and oversimplifies how gender is embodied and experienced. And when it's tinged with bias, conscious or unconscious, it exacerbates the problem.

And that's why trans people often ask for gender therapists who work with trans people, and folks who live in that space, to be involved in this process — because it's a type of expertise that is grossly underestimated. This shit is complicated.

If I surveyed a large group of people to ask if they regretted transition but didn't dig into the necessary context, I'd be lumping people together with the same emotion but drastically different experiences and reasons for feeling that way. That's the crux of the issue.

Which is all just to say, I need cisgender people to slow their roll on this "detransition" hype. This is a very specialized, complex type of research to be doing in the first place, at a time of rapid cultural, social, legal, and medical change.

And frankly, it's unlikely that, if you've drawn your conclusions based on a study (and have no background in untangling what legitimate research in this field even looks like) and a couple arguments you've had on Twitter, you've figured it all out.

I won't claim to know what transition regret, when accurately measured, would look like. But I don't think trying to restrict trans people's bodily autonomy — instead of making the world safer for them and making gender therapists more accessible to folks — is a smart move.

If you're not going to be helpful, maybe sit this one out. Because you can't deny the fact that transgender people exist, many of them joyfully thanks to affirming care. And the urge to ignore the abundance of info we have there seems convenient and deliberate.

Not to mention, condescending? Because if you've already underestimated how complex this topic is, chances are, you're def underestimating the time, thought, and effort that trans people put into surviving, accessing care, and better understanding themselves.

If you're looking to help people coping with regret, I wouldn't recommend taking up gender transition as your cause if you haven't thought this through. So maybe start up a non-profit that helps people cover up their bad tattoos? Idk. Channel that energy where it's needed.

Oh, also. Relevant link, around grieving transition, for those who want to dive into some of the nuance in my own story: 

You can follow @samdylanfinch.


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