From the Guidelines
The percentage of people who regret their gender transition or detransition is approximately 1%, as reported in a systematic review and meta-analysis of prevalence [(@32@)]. This low rate of regret is consistent across several studies, including a review of 27 studies that found little evidence of significant regret following gender-affirming surgery (GAS) [(@32@)]. The exact figure may vary depending on the study methodology and population examined, but the overall trend suggests that the vast majority of transgender individuals who undergo gender-affirming interventions do not experience regret. Some studies report regret rates as low as 1% for trans men and 2% for trans women, with dissatisfaction with surgical results and loss of social support being common causes of regret [(@9@)]. It's essential to note that detransition doesn't always indicate regret, as individuals may detransition temporarily due to external factors such as social pressure, discrimination, or financial constraints [(@32@)]. Key factors that contribute to positive outcomes for transgender individuals include access to hormone treatment, social support, and competent healthcare providers 1. Overall, the current evidence suggests that gender-affirming interventions can significantly improve the quality of life and mental health outcomes for transgender individuals, with very low rates of regret or detransition [(@28@, @29@, @32@)]. Some of the key findings from recent studies include:
- A systematic review of 27 studies found that 1% of transgender individuals experienced regret after GAS [(@32@)]
- A review of hormone therapy found that it can be associated with improved mental health outcomes, including decreased depression and anxiety [(1, @28@)]
- A study on penile inversion vaginoplasty outcomes reported significant improvements in quality of life, body satisfaction, and positivity for trans women [(@29@)]
From the Research
Prevalence of Regret and Detransition
- The prevalence of regret and detransition among individuals who have undergone gender transition is not well-established, with varying estimates across studies 2, 3, 4, 5, 6.
- A study of 100 detransitioners found that 60% reported becoming more comfortable identifying as their natal sex, while 49% cited concerns about potential medical complications from transitioning 4.
- Another study of 78 previously trans-identified young adults found that 91% reported improved psychological health since detransitioning, with marked decreases in self-harm and gender dysphoria 6.
Reasons for Detransition
- Reasons for detransition are varied and include:
- Experiencing discrimination (23% in one study) 4
- Becoming more comfortable identifying as their natal sex (60% in one study) 4
- Concerns about potential medical complications from transitioning (49% in one study) 4
- Confusing mental health issues or reactions to trauma for gender dysphoria (most common reason in one study) 6
- Homophobia or difficulty accepting themselves as lesbian, gay, or bisexual (23% in one study) 4
Clinical and Research Issues
- The term "detransition" can hold a wide array of possible meanings, leading to inconsistencies in its usage 2.
- There is currently no guidance on best practices for clinicians involved in the care of detransitioners 2.
- Comprehensive care by a multidisciplinary and experienced team is essential for individuals who are detransitioning 3.
- More research is needed to understand the population of detransitioners, determine the prevalence of detransition as an outcome of transition, and meet the medical and psychological needs of this population 4, 5, 6.