Detransition

Detransition refers to the (complete or partial) reversal or discontinuation of a gender transition undertaken earlier. It is a subject that has long been underexposed in the care system and in public information — while it contains crucial information about the risks of the current medical pathway, particularly for young people.

What detransition involves

Detransition can have several dimensions. A social detransition means a return to the name, pronouns or presentation from before the transition. Legal detransition concerns reversing the registration of sex. Medical detransition includes stopping hormones or, in a number of cases, surgical procedures to (partially) correct physical changes made earlier — surgery which in turn carries new risks and lasting consequences.

Not all detransition is complete or permanent: some people stop temporarily, others return definitively to living in their biological sex.

Reasons for detransition

Research shows a mixed picture. A systematic review from 2024 (PubMed, 2024) and the work of Vandenbussche (2021) and later studies mention, among other things:

• realising that one's own problems were not solved by medical transition;
• underlying mental health problems (depression, trauma, autism, eating disorders, internalised homophobia) that had wrongly been interpreted as dysphoria;
• regret about irreversible physical changes (breasts, voice, fertility, sexual function);
• the feeling in retrospect of having been insufficiently informed or of having ended up in a care pathway that moved too fast;
• a return to a coherent self-image as a (often) gay man or lesbian woman.

In activist sources detransition is often reduced to 'social pressure from outside'. Research and testimonies of detransitioned people themselves show that the real motives are usually more complex and regularly relate to regret and realisation in hindsight.

Well-known detransitioners

Keira Bell is the best-known British detransitioner. As a girl she started puberty blockers through the Tavistock clinic GIDS, went through the full medical pathway and later detransitioned. She brought the case Bell v. Tavistock (2020), in which the British High Court ruled that it was highly unlikely that children aged 13 or under, and very doubtful that 14- and 15-year-olds, could give 'Gillick-competent' consent to puberty blockers. In 2021 the Court of Appeal overturned that ruling. Bell testified that clinics had made it easy to enter a pathway, but that the long-term consequences — irreversible loss of fertility and sexual function — had not been adequately communicated.

Walt Heyer is an American author and activist who wrote several books about his detransition. Through his website sexchangeregret.com he collects testimonies of others with transition regret. His work is important as an early documented counterweight to the view that medical transition is almost always successful.

Stories and research on transition regret and detransition: transspijt.nl.

Internationally there is a large online community of detransitioners, including on Reddit/r/detrans (tens of thousands of members). In the documentaries The Detransition Diaries (Jennifer Lahl) and Dysphoric (2023) several detransitioners speak.

Prevalence and debate

How often detransition occurs is difficult to measure. Many clinics have hardly followed detransitioners, if at all, and people who have regrets often do not return to the same care provider — which can systematically underestimate the figures. Estimates therefore vary widely. Earlier figures of around 1% (from pre-2010 cohorts) are regarded by critical researchers as not comparable with the current population of young people with late-onset dysphoria.

The British Cass Review (2024) concluded that the available data on detransition are downright inadequate and that reliable long-term follow-up is virtually absent. A critical literature review (PMC, 2024) confirms that structurally: the prevalence figures depend on the definition of detransition and the quality of the follow-up, and both are problematic in the existing literature.

Experiences of detransitioners

Detransitioners form a heterogeneous group. A growing number of testimonies at home and abroad describe serious suffering: lifelong medication or post-operative complications, loss of fertility and sexual function, and the feeling of having taken an irreversible decision as a young teenager, the consequences of which only became visible later. See for example the personal testimony in HP/De Tijd.

In the Netherlands there is hardly any specialised aftercare for detransitioners. Many people find support in (international) online communities. The Belgian organisation Cry for Recognition brings together testimonies of detransitioners, parents and clinicians and offers Dutch-language resources.

The legal side

Detransition also has an administrative dimension: registration of sex, name and documents can be changed again, once more with costs and processing time. See legal aspects of detransition.

What this means for care practice

Detransition experiences provide strong arguments for restraint in the gender-affirmative care model, certainly for minors and young adults. This applies all the more because many comorbid conditions — autism, depression, trauma, eating disorders — can play a role that is missed in a purely affirming approach. A careful pathway focused on exploration (instead of automatic affirmation) is now used as a guideline by Sweden, Finland, Norway, Denmark and the United Kingdom, among others.