Category: Detransition
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Around one in six young people treated with cross sex hormones ceased treatment.
An exploratory study1 of adolescents and young adults in Canada and the US found that 16.8% of those receiving “gender affirming medical treatment” (puberty blockers and cross sex hormones) stopped “treatment” within around five years of declaring a “trans” or “non binary” identity.
Of those who discontinued treatment, 37.3% did so for health reasons. 32% ended treatment due to a change in gender identity. 12% were persuaded by health professionals or a partner to explore different ways of approaching their gender dysphoria.
Stopping treatment was associated with having a “non binary” identity. Both continuing and non-continuing cohorts had a mean age of 16.1 when “coming out”, but those discontinuing treatment were slightly older (22.1 vs. 20.9.)
- MacKinnon KR, Jeyabalan T, Strang JF, Delgado-Ron JA, Lam JSH, Gould WA, Cooper A, Salway T. Discontinuation of Gender-Affirming Medical Treatments: Prevalence and Associated Features in a Nonprobabilistic Sample of Transgender and Gender-Diverse Adolescents and Young Adults in Canada and the United States. Journal of Adolescent Health. 2024 Oct;75(4):569-577. doi: 10.1016/j.jadohealth.2024.05.015. Epub 2024 Jun 28. PMID: 38944803. ↩︎
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A systematic review demonstrated flaws in measurement of regret rates across all studies.
A systematic review of regret rates across 27 studies1 showed that every study had insufficient follow-up time and/or high drop-out rates, which seriously compromise the reliability of the data on regret rates. The review’s authors describe this as a “moderate to high” risk of bias. They also note that definitions of regret and methods of measuring it are variable, and that participants may feel shame or fear of judgement and so conceal their regret. These factors combine to make the regret rate reported in the study unreliable.
- Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, Kim EA, Langstein HN, Manrique OJ. Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. Plastic and Reconstruction Surgery Global Open. 2021 Mar 19;9(3):e3477. doi: 10.1097/GOX.0000000000003477. Erratum in: Plast Reconstr Surg Glob Open. 2022 Apr 28;10(4):e4340. doi: 10.1097/GOX.0000000000004340. PMID: 33968550; PMCID: PMC8099405. ↩︎
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High drop-out rates mean reported detransition rates are misleading.
An ethics-focused meta-study of psychosocial outcomes of “gender reassigment”1 found that 20-60% of participants were lost to follow up. Remaining research participants were more likely to report satisfaction with interventions, so reported rates of regret/desistance/detransition in such studies may be highly misleading.
- D’Angelo R. Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry. 2018 Oct;26(5):460-463. doi: 10.1177/1039856218775216. Epub 2018 May 21. PMID: 29783857.
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- D’Angelo R. Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry. 2018 Oct;26(5):460-463. doi: 10.1177/1039856218775216. Epub 2018 May 21. PMID: 29783857.
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Time until treatment regret emerges may be eight years or more.
An analysis1 showed that the median time to surgical regret may be as high as eight years. For cross-sex hormone treatment, the time to regret may be almost eleven years (130 months). However, the analysis points out that the lack of thorough follow up in much of the research in this field, and the lack of detailed research into the detransitioner/desister population, mean that accurate figures are very hard to discern.
- Cohn, J. The Detransition Rate Is Unknown. Archives of Sexual Behaviour 52, 1937–1952 (2023). https://doi.org/10.1007/s10508-023-02623-5 ↩︎
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Cross-sex hormone treatment is stopped within four years by up to a third of patients.
In a study1 of the medical and pharmaceutical records of spouses and children of American military personnel, only 70.2% of those who started cross-sex hormone treatment continued the treatment after four years. Rates were lower for females taking male hormones (64.4%) than for males taking female hormones (81.0%).
- Christina M Roberts, David A Klein, Terry A Adirim, Natasha A Schvey, Elizabeth Hisle-Gorman, Continuation of Gender-affirming Hormones Among Transgender Adolescents and Adults, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 9, September 2022, Pages e3937–e3943, https://doi.org/10.1210/clinem/dgac251 ↩︎
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36% of patients at Amsterdam gender clinic were lost to follow up.
In a study of all patients at a clinic treating 95% of all trans-identified people in the Netherlands1, 36% of all patients were lost to follow up. This may make reported rates of regret or detransition highly unreliable2. Rates of “regret” in the study itself may be compromised by a definition of “true regret” marked by beginning hormone therapy reflecting the patient’s sex (e.g. testosterone therapy for detransitioning “trans women” or estrogen therapy for detransitioning “trans men.”) The study also notes that some of those experiencing “true regret” had thought that transition would be a “solution” for their homosexuality. Regret was expressed between 46 and 271 months after beginning cross-sex hormone treatment. This may suggest there is a long tail of such regret still to come, even from those who began treatment more than twenty years ago.
- Wiepjes CM, Nota NM, de Blok CJM, Klaver M, de Vries ALC, Wensing-Kruger SA, de Jongh RT, Bouman MB, Steensma TD, Cohen-Kettenis P, Gooren LJG, Kreukels BPC, den Heijer M. The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets. J Sex Med. 2018 Apr;15(4):582-590. doi: 10.1016/j.jsxm.2018.01.016. Epub 2018 Feb 17. PMID: 29463477 ↩︎
- https://catalogofbias.org/biases/attrition-bias/ ↩︎
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A Finnish study found detransitioners commonly had psychiatric comorbidities and childhood trauma, with most concluding their gender dysphoria arose from psychological distress rather than transgender identity.
A 2025 case series1 from Helsinki University Hospital reviewed nine adults who sought medical detransition after previously receiving “gender-affirming” treatments.
Seven were natal females and all expressed “major regret”; both natal males expressed “minor regret.” The average time from diagnosis to regret was 7 years. Patients had used hormones for an average of 7 years (median 4 years), with eight undergoing chest reconstruction/augmentation surgery and four females having reproductive organs surgically removed.
All nine had psychiatric comorbidities—mood disorders were most common (8 patients: 2 with bipolar II, 6 with depression), anxiety disorders (6 patients initially, 7 by detransition), personality disorders (3 patients, with borderline personality disorder increasing from 2 to 5 patients by detransition), and dissociative disorders (1 initially, 3 total). Childhood trauma was universal, with all having insecure attachment styles. Six reported sexual abuse/rape and six experienced school bullying. Eating disorders were diagnosed in 4 patients, with 78% having eating disorder symptoms.
Patients retrospectively believed their gender dysphoria stemmed from unresolved psychological stressors and developmental challenges rather than a stable transgender identity. The clinic has since revised its protocols to improve psychiatric screening, facilitate easier re-access for detransitioners without referrals, and emphasize clinical neutrality.
- Kettula, K., Puustinen, N., Tynkkynen, L., Lempinen, L., & Tuisku, K. (2025). Gender Dysphoria and Detransitioning in Adults: An Analysis of Nine Patients from a Gender Identity Clinic from Finland. Archives of Sexual Behavior, 54(5), 1981-1990. [Link] ↩︎
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Challenges reported by detransitioners include social and emotional difficulties, lack of support, negative healthcare experiences, “detransphobia”, and identity concerns
In a systematic review and metasummary of qualitative data up to April 2023, Expósito-Campos et al.1 analyzed the experiences of 2,689 individuals who detransitioned. From 845 records, 15 studies were included, yielding 34 significant meta-findings derived from data present in at least 15% of the cases. The study identified two primary themes: “Gender Transition,” encompassing perspectives and emotions, and “Gender Detransition,” covering driving factors and challenges such as social and emotional difficulties, lack of support and understanding, negative healthcare interactions, “detransphobia” (defined as stigma, loss of previous supports, and prejudices around detransition), and identity concerns. The study also explored the needs, growth, evolution, and identity exploration of detransitioners. These findings highlight the necessity for psychotherapeutic approaches that address the complex social, emotional, and identity-related needs of detransitioners, advocating for comprehensive support mechanisms within healthcare frameworks.
- Expósito-Campos, P., Pérez-Fernández, J. I., & Salaberria, K. (2024). A qualitative metasummary of detransition experiences with recommendations for psychological support. International Journal of Clinical and Health Psychology, 24(2), 100467. [Link] ↩︎
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In one peer-reviewed study of 100 detransitioners, 76% did not inform their clinicians that they had detransitioned
The majority (55%) felt they did not receive an adequate evaluation from a doctor or mental health professional before starting their transition1.
38% believed that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition.
- Littman L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of sexual behavior, 50(8), 3353–3369. [Link] ↩︎
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In one study of detransitioners, males were three times more likely than females to have transitioned for erotic reasons
In a study1 of 100 detransitioners, 38.7% of males identified with the comment “I had erotic reasons for wanting to transition”.
The figure for females was a third of this, at 13%.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
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In one study, female detransitioners were three times more likely to be lesbians than to be straight
A study1 of 100 detransitioners, the majority of whom were female, showed that 26.1% of the females were homosexual before they transitioned.
Only 8.7% considered themselves heterosexual.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
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One study of detransitioners found that a large proportion of them believed, in hindsight, that they were suffering from internalized homophobia
A study of 100 detransitioners1 found that homophobia or difficulty accepting themselves as lesbian, gay, or bisexual was expressed by 23.0% as a reason for transition and subsequent detransition.
In another study of detransitioners and desisters2 – most of whom were detransitioners who had undergone medical transition – 52% expressed a psychological need for learning to cope with internalized homophobia.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
- Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. [Link] ↩︎
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In one study of detransitioners, around half believed that they received inadequate care
The majority (55.0%) of detransitioners in a 100-participant study1 felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition.
A second study2 of detransitioners and desisters – most of whom were detransitioners who had undergone medical transition – arrived at a similar, although slightly lower, figure, with 45% of detransitioners not feeling properly informed about the health implications of the accessed treatments and interventions before undergoing them.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
- Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. [Link] ↩︎
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In one study of detransitioners, around half were worried about the medical complications of transitioning
A study1 of 100 detransitioners showed that 49% had concerns about potential medical complications from transitioning.
A second study2 of detransitioners and desisters – most of whom were detransitioners who had undergone medical transition – arrived at a higher figure, with 62% citing health concerns as a motivating factor for detransition.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
- Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. [Link] ↩︎
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In one study of detransitioners, around half originally believed that transition would lead them to be “treated better” if they were “perceived as the target gender”
In a study1 of 100 detransitioners, 50.7% of females and 45.2% of males identified with the comment “I felt I would be treated better if I was perceived as the target gender”.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
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There is very little evidence on the number of people who have detransitioned
In a study1 of 100 detransitioners, only 24% of respondents informed their clinicians that they had detransitioned. The vast majority made no attempt to contact their clinics.
Not only does this mean that we have no way of ascertaining how many people detransition, it also potentially impact clinics’ assessments of patient satisfaction.
One paper2 claimed that the detransition rate was 13.1%. However, this research relies on data from the U.S. Transgender Survey, which was conducted via community outreach organizations, and may therefore have excluded detransitioners who were no longer in touch with any such organizations. Only people who still identified as members of the trans community were included:
The 2015 U.S. Transgender Survey (USTS) was conducted by the National Center for Transgender Equality (NCTE) to examine the experiences of transgender adults in the United States.
By contrast, the study by Lisa Littman sought respondents from a political and ideological variety of sources.
In a recent retrospective case-note review3, performed as a service evaluation over twelve months, 6.9% of participants met the case definition of detransitioning, yet 21.7% disengaged from the study.
In general, detransitioners remain an underserved population in healthcare, with far more research required to understand their needs4.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
- Turban, J.L., Loo, S.S., Almazan, A.N., & Keuroghlian, A.S. (2021). Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT health 8(4): 273-280. [Link] ↩︎
- Hall, R., Mitchell, L., & Sachdeva, J. (2021). Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: Retrospective case-note review. BJPsych Open 7(6): E184. [Link] ↩︎
- Expósito-Campos, P. (2021). A Typology of Gender Detransition and Its Implications for Healthcare Providers. Journal of Sex & Marital Therapy 47 (3): 270-280. [Link] ↩︎