Something We Don’t Talk About

It happens more often than we think, trans people detransitioning but questions persist.

Detransition, Desistance, and Disinformation: A Guide for Understanding Transgender Children Debates
By Julia Serano
August 3, 2016

Over the course of those two-plus decades, I have witnessed the slow evolution from the old gatekeeper system — which engaged in pathological science and often harbored antagonistic attitudes towards its trans clients/research subjects — toward what is gradually becoming our contemporary trans healthcare system — one that works in partnership with trans communities, and which increasingly has trans people’s best interests at heart.

This evolution was not merely the result of trans activists “fucking shit up” (although admittedly things were contentious at times, and there were plenty of protests along the way). Rather, this change was facilitated by a more general trend within research and medicine — away from the paternalistic “Doctor Knows Best” attitudes of the mid-twentieth century, towards today’s recognition that practitioners and researchers need to actually be concerned about, and seek feedback from, the communities that they serve. This transition has not been perfect, nor is it complete (as many old-guard gatekeepers still adhere to the old ways). But the changes that have occurred in my lifetime have been immensely promising.
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You’ve probably seen some of these articles. They raise concerns about “80% desistance,” and offer examples of trans people who have since “detransitioned,” and they will leave you with the impression that trans health practitioners are engaging in some kind of reckless sociological experiment. Whenever transgender people object to these misrepresentations or the old gatekeeper ideologies, these pundits and journalists will decry “transgender activists are attacking science!” without ever acknowledging the countless trans advocates, researchers, and health providers who actually agree with us on many of these matters.

So what is behind these detransitions?

Many of the aforementioned problems begin with an over-simplification of either trans terminology and/or the breadth of transgender experiences, so that is where this guide will begin. I will also provide necessary background regarding gender transition in adults before addressing the more controversial topic of transgender children.

My thoughts are that one of the requirements for transitioning is living in your true gender which is designed to weed out those who transitioning is not for them and that is what it is doing. Ms. Serano lists her thoughts on why.

1. The distinction (and lack thereof) between transgender and transsexual
The word transgender historically (as well as within the context of this essay) refers to people who defy societal expectations regarding gender.
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Unfortunately, in mainstream discussions (as well as within certain segments of the trans community), the word “transgender” is increasingly (mis)used to specifically refer to people who identify and live as members of the gender other than the one they were assigned at birth — that is, people who have historically been described as transsexual. Some people who fall under this category don’t like the label “transsexual” (just as some don’t like “transgender”), but I will be using it here because the distinction between people who socially and/or physically transition (i.e., transsexuals), and those transgender-spectrum individuals who don’t transition, is germane to this conversation.

She also lists, “There are many transsexual trajectories.” Just because a person doesn’t transition doesn’t mean they are not trans. It takes a lot to transition, you have to be ready to give up your whole life and start anew and for many that is too much for them to handle.

She goes on…

3. What Is Transphobia?
So when I just mentioned trans people being harassed on the streets, or denied jobs or housing, most reasonable people would agree that those are examples of transphobia. But transphobia isn’t merely the “fear” or “hatred” of transgender people. No, it is best thought of as a double standard that is pervasive in our society, and which presumes that cisgender (that is, non-transgender) bodies, identities, and experiences are valid and the unspoken norm, whereas their transgender counterparts are deemed illegitimate, inauthentic, defective, and suspect in comparison.

I think that this is a big one. I takes a lot to stand up to the discrimination and all the negativity, it takes its psychological toll on us.

She continues,

5. Who should transition?
A subset of transgender people experience discomfort or distress with their birth-assigned gender and/or a strong desire to be the other gender — in the medical literature, this experience is referred to as gender dysphoria. It is not some “invented condition” or mere “gender confusion” — it is very real, intensely felt, and can become all-consuming and even debilitating over time.

While low-level gender dysphoria may be mitigated in various ways (perhaps through crossdressing, gender experimentation and exploration, etc.), the only remedy known to effectively reduce or eliminate intense gender dysphoria is gender transition. There is a large body of clinical evidence demonstrating this — this is why transitioning is medically sanctioned.

Once again, there are no tests to determine for sure whether any given transgender person should (or should not) transition. What happens in practice is that, if a person’s gender dysphoria and/or desire to live in their identified gender is intense enough, they will seek out the means to transition — either through the healthcare system, or if that’s not available, through other means. As I chronicle in chapter 7 of Whipping Girl, gatekeepers used to have extremely stringent criteria for approving gender transition (largely based upon childhood history, sexual orientation, and “passability”), and this ultimately forced many trans people who strongly felt the need to transition to either lie to gatekeepers about their history and/or transition DIY outside of the healthcare system. 

You must be true to yourself, all the therapist does is to guide you to find your true self. If you are lying to yourself the therapist might not find that out if you are good at hiding your thoughts and that is one of the reason we live in our true gender before we have surgery, to find your inner self.

She goes on to list other reasons and another one is…

7. Using people who detransition as pawns
I discussed people who detransition briefly in step #2. There are numerous reasons why a person might detransition: some of them visceral and personal (e.g., perhaps transitioning didn’t feel right for them), and others directly related to societal transphobia (e.g., the loss of jobs, housing, family, support system, safety). It could also be some combination thereof.
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The dynamic here is quite similar to the “ex-gay” phenomenon. Conservative forces who insist that homosexuality is a “treatable disease” or merely an “alternative lifestyle” love to tout the existence of “ex-gays” (some of whom may identify that way and regret their earlier homosexual ways). This stance understandably makes gay communities even more entrenched in their positions, and increases the likelihood that they will distance themselves from anyone who professes a shift in sexual orientation from gay to either bisexual or heterosexual. As a bisexual person myself, I am disappointed by gay and lesbian community tendencies to demonize those who experience shifts in orientation, just like I am opposed to trans people who want to throw people who detransition under the proverbial bus.

I know a person who did detransition and she did it because she could never find a job, she was couch surfing and faced harassment because she couldn’t integrate in to society. She was tall, large boned and masculine looking. I believe that she is trans and suffers from Gender Dysphoria even through she is living her life in her birth gender.

Then she asks,

9. Why does “80% desistance” even matter?
I’ve considered writing this essay for a while now. But the article that finally drove me to it is Singal’s most recent piece: “What’s Missing From the Conversation About Transgender Kids.” In it, he tries to defend the “80% desistance” statistic, which purports that 80 percent of children who experience gender dysphoria (or “gender identity disorder,” as it was called in previous versions of the DSM) eventually grow up to be comfortable in their birth assigned gender (often identifying as lesbian, gay, or bisexual). There are numerous reasons to be suspicious of how that number is derived, as explained by Brynn Tannehill, Kelley Winters, and Kristina Olson and Lily Durwood (plus my thoughts here).

As far as I know there has been no scientific study of people who transitioned and detransitioned. What are their sources to arrive at that number? How do they define desistance? Did they all follow the Standard of Care?