Detransitioning

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Detransitioning, occasionally referred to as Retransitioning, is the process of reverting back to the gender assigned at birth after transition has taken place, or more rarely, after it has thought to have been completed. An alternate form of this is to change to something beyond binary gender. (an example would be a male to female, then to androgyne) People who have had cause to question their gender or detransition may utilize such acronyms as M2F2M (MtFtM), F2M2F (FtMtF), or F(or M)2A. Much less often will one say they are M2M (MtM) or F2F (FtF). In all of theses cases M = Male, F = Female, A = Androgyne.

The rate of people who have regretted transition varies from 0.5% to 5% depending on the study. It is generally accepted that the average rate is 1%, with regret in trans women greater in frequency then trans men. A theory to the cause stems from the increased social needs many trans women have, combined with societal factors that stigmatize biological males who are gender variant.

Contents

Effects of transition

Reversible changes

While it's easy to say in text, the best time to stop transition is before HRT, that is usually when questioning starts to occur.

For former trans women, breast tissue can be reduced back to a male profile and if breast augmentation surgery done, the implants removed. Testicular function will slowly return; depending on the length of time on antiandrogens, with spermatogenesis (sperm production) being the indicator.

For former trans men, the breasts can be restored using reconstruction techniques, (assuming the glandular tissue has not been removed) and hair removed with laser hair reduction and/or electrolysis. If top surgery has not been done, the effect to the breasts a binder has done are fairly easy to restore, although a breast lift may needed if the skin of the breasts has been stretched. Voice development on testosterone can, to an extent, be reversed using voice therapy.

Irreversible changes

The most obvious stage when physical changes can not be reversed is after gender reassignment surgery, or when reproductive organs have been removed as part of orchiectomy, hysterectomy and/or oophorectomy.

In the case of former trans men, male chest reconstruction can only be partially reversed due to the nature of the surgery. The lipid (fatty) breast tissue can be reconstructed, but any glandular tissue removed will not grow back through estrogen treatment.

Detransition options

While on paper it is best to try and prevent regret of transition, in the effort to try to be more true to self identity wise, it's easy to overshoot the mark using stereotypes of dress and/or behavior to gauge progress. Detransition has to be done considering the consequences just the same as when having chose to transition in the first place.

While the options explored below are some of the possibilities, it is up to the individual to assess where they are psychologically and support wise, and what needs to be done to make for better mental health stability. A therapist versed in treating gender variant clients is recommended to assist with issues, preexisting or otherwise, during detransitioning.

Identity introspection

Knowing where to go starts with knowing oneself. Whether going to a male role, a female one, somewhere in-between, or genderless, the choice of action has to be done with even more certainty then was done the first time around. Waiting to decide may look like not being able to, but in the end it will be out of a more informed decision when it comes to ones unique identity, and not based off emotion and/or misguided ideas. A stable identity and expression must come from within, and not be fueled by the opinions of others.

If the basis of transitioning was simply because the belief one isn't "X" and therefore must be "Y", (grass is greener theory) then attempting to understand the reasoning behind the thinking is an introspection option. The reasoning behind that theory could be anything from confusing gender expression with identity, to disbelief in non-binary gender as it relates to the facets of identity and role. Separating preferred gender expression, gender identity, gender role, and sexuality will allow for easier understanding of the influences that make up the core self, and if one or more is based off external validation of a false belief.

Retransition

Retransition, while technically a way to resume transition in progress, is where one changes path to fit a unique identity. Most of the time this means an androgynous identity and/or expression, where acceptance of the grey zone between male and female is preferred to attempting to act a role in the name of appeasing society.

Gender null (or a similar genderless identity) is also an option, but must be done with careful consideration to not overreacting to rebellion of the common gender roles. (in that reasoning behind it may be "if neither fit, then I'll be none of the above") Bigender identity entails dealing with the perceptions of an unstable identity, and may be confused with part time cross-dressing. (which is an option on itself)

Detransition

The choice to detransition back to the gender role assigned at birth can be a much more difficult task then starting transition was. Depending on the progress made, it can be impossible to revert without loss of privilege previously enjoyed. (because one can't "take back" coming out) (discuss why happens and how to manage)

Retransition to target gender

The choice to resume transition may or may not be in the best long term interest based on the reasons transition was first done with. As was stated earlier, separating gender into the parts that one presents to the world, and to self, are key to forming a stable identity. A stable identity and expression must come from within, and not be fueled by the opinions of others.

Losing ones job can present unique issues not related to identity and/or expression. Being "forced" to discontinue HRT may not alone contribute to other issues, (such as lack of social support) but often will compound preexisting issues, especially depression.

Stopping transition from lack of social support may be from any number of factors that may not be apparent at first glance. Not "passing" as ones gender nay be bad choice in clothing style and/or colors, need to change hair style, or facial hair removal. Subtle mannerisms such as walking style (hips vs shoulders) and how voice is used (statements vs question tones and emphasis of beginning of words vs a flowing effect) can shape how gender is perceived.

Detransition prevention

Reducing the chance of people regretting the choice to transition starts before transition happens in the first place. The three topics below are intended as a starting point of things to consider when talking to a therapist about transition.

Mental health

People considering transition generally need to, at some point, see a therapist prior to obtaining medical treatment. While many believe they are ready for HRT and/or surgery, the problem lies in the lack of ability to self assess without bias.

During evaluation, most therapists will want to attempt to assess if there are serious comorbid conditions that are affecting judgment, or otherwise are a threat to the well-being of the client. They will only know if it may affect psychological stability if the client has been forthcoming and honest during the interview process.

Social support

The transition process requires a "team effort" of social and financial support. Next to misdiagnosis, lack of social support was rated as the primary cause of regret of reassignment surgery.[1] From friends leaving, family disowning, to harassment at ones workplace or school, the contributing factors to lack of social support can be great.

Family support

Some will attempt to transition without social support of immediate friends and/or family, however, transitioning alone can be a difficult task, as perceived social isolation can contribute to depression.

Also of possibility is related to not finding a partner if single, or if married, separation which may or may not end in divorce. The stigma attached to trans people can deter partners while attracting ones who sexualize the bodies of pre-surgery people.

Support of friends

(support group?)

Financial support

(job stuff)

Transition attitude

  • Body Image: (Notes about polarization of attitude of transition (a to b, grass is greener syndrome, extreme opposites)
  • I feel I should be (am) the other sex and most people do not feel the way I do
  • Because most other people don't feel this way, there must be something different about me
  • The different thing about me is that I must have GID
  • If I have GID that means I am a transsexual
  • If I am transsexual, that means I must actually be the other sex
  • If I am the other sex, I must seek transition.

People who detransitioned

Note: pronouns used are intended to acknowledge current or last known identity. This is not an all inclusive list of people who have chosen to detransition or retransition, but notable cases of regret.

Mike Penner/Christine Daniels

Former writer for the Los Angeles Times Mike Penner, 52, who had the transition name Christine Daniels, is a famous case of a high profile person who (partially) transitioned to female, then reverted. His suicide is believed to be based on issues not addressed during transition that were compounded after the choice to detransition.

Renée Richards

Renée Richards is a fairly famous case of a person who had regret after surgery. She had SRS in 1975 at the age of 40 and initially was a source of awareness to people whom had thought transition was not possible. With fame came infamy, and with media attention, she became known as a "transsexual" rather then a "woman".

Another factor was presentation physically. She has a well toned body, but had neglected her face, most notably the bonny structure of brow and jaw. The biggest factors might have been internal, in the time leading up to SRS, she cross-dressed on and off, reverted hormonally more then once, and went as far as to have a mastectomy (removal of the breast tissues) done.

Currently, she goes as far to discourage other older people from transitioning, in spite of being in isolation from the trans community.

Sandra (Ian) MacDougall

Sandra (Ian) MacDougall is a more recent case of a person regretting transition. She had SRS in early 1998, but did not prepare for social transition, nor the responses by others who were reacting to her mixed presentation. Other issues were related to unrealistic expectations of surgical treatment, in that she believed surgery could change her persona and validate feelings of identity that were made under false pretense.

Since the interview in The Scotsman, she has vowed a life of celibacy and has made repeated desires to medically detransition. It is not known if she has researched into reversion into a male gender role and use of testosterone to regain a resemblance of her old life.

See also

Further reading

  1. Factors predictive of regret in sex reassignment by M. Landén, J. Wålinder, G. Hambert, B. Lundström (Acta Psychiatrica Scandinavica, Volume 97 Issue 4, Nov 2007)

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This page was originally authored by members of Susan's Place and Susan's Place WikiStaff.

With special thanks to interalia

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