Understanding detransition

Dr MacKinnon speaks about Re/Detrans Canada study findings

Image by Nick Youngson CC BY-SA 3.0 Pix4free

Today I attended the Center for Gender and Sexual Health Equity (CGSHE) Speaker Series talk, Beyond the Binaries: Detransition in Sexual & Gender Minority Communities with Dr. Kinnon R. MacKinnon.

Below are some of my notes from this 1-hr webinar:

Dr MacKinnon reviewed his findings from Canada's first Re/Detrans study. He shared that going into the project he held the popular belief that most people detransition because of social discrimination; however, through this qualitative research he learned this was not an accurate statement.

Dr MacKinnon highlighted some of the difficulties in the use of terminology in different research studies as detransition can refer to different things (detransition doesn't always mean regret, for example). In his own study he uses the term to refer to a shift in identity as well as stopping and reversing a gender transition.

He underlined the importance of studying detransition experiences as a key component of better understanding identity development more generally, as well as improving healthcare for all.

He pointed out the limitations of many of the current studies out there looking at trans healthcare. These studies often consist of cross-sectional surveys that do not ask questions about shifts in identity over time. He also pointed out the dearth of research on longterm outcomes. This is an especially critical gap in our knowledge when we look at the time range for detransition to occur -- on average detransition seems to happen 5-12 years after medical interventions took place.

While Dr MacKinnon reported that we lack high quality studies looking at the prevalence of detransition, he noted that the studies that exist clearly show a higher rate of detransition than previously thought, with ranges from 7%-40% depending on the study design.

His literature review also found that most studies saw higher rates of natal females detransitioning, with female detransitioners ranging from 64%-95% of participants. The reason for this is as of yet unknown.

His own study followed a constructivist grounded theory methodology and involved interviews with 28 detransitioners from across Canada. The majority were female assigned at birth, and 57% identified as having a disability. Most identified as nonbinary and 100% identified as LGBTQ+. About a third reported feelings of regret. Participants expressed wanting to talk about their detransition experiences in order to improve healthcare for others.

The detransitioners described avoiding healthcare providers who had helped them transition, which is consistent with other detransition studies (e.g. Littman's study of 100 detransitioners), and many reported going through their detransition in isolation, losing social supports in the process.

Dr MacKinnon emphasized the need for more community supports for detransitioners as well as a need for collecting more research data on past and current identities when doing studies on trans and detrans populations.

During the Q&A portion of the presentation, Dr MacKinnon shared that the vast majority of detransitioners in his sample had gone through an assessment process prior to medical transition, with some going through an informed consent process.

Regarding the assessment process, many reported that they were under-informed about the risks and benefits of medical treatment and were not informed of alternatives for managing their gender dysphoria.

Many also described being on long waitlists to access gender affirming treatment, but that once their turn came up they felt rushed through.

Many participants reported other co-occurring mental health diagnoses such as autism spectrum disorder, borderline personality disorder, PTSD, and obsessive compulsive disorder -- which were often not assessed for at the time of transition, but were identified after they had undergone medical interventions.

3 key takeaways:

• A need for more longitudinal outcome data for gender affirming care (>5 years)

• A need to collect data on past and present identities when running cross-sectional community surveys to better understand identity shifts over time

• More peer and community supports needed for detransitioners

The full seminar is available on Youtube: