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On Regret of Gender Transition

transgender regret

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”.  This post attempts to explore this phenomenon.

Some reasons why this might occur include:

  •  The person is not transsexual.  The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender.  Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t.  Sometimes the discovery just isn’t possible without trying it out.  The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.
  • Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness.  I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as:  the idea that one will have a social community, better social skills, be more popular, etc.  When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition.  It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through.  Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.
  • The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life).  These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender.  Additionally, transitioning is hard.  There are many hoops to jump through and one enters into a group of discriminated against people.  This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition.  The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”.  Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German  into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery.  These included 2000 individuals from 1961 to 1991.  This doesn’t take into account individuals who transition without surgery.  About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Krege S., Bex A., Lummen G., et al. (2001). Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU International. 88:396-402.

 This study shows little or no regrets possibly due to surgical advances.

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8 Comments Post a comment
  1. Henry Hall #

    The medical profession regards all cases of detransition as regrets. This is a false assumption and throws their statistics and conclusions way off for at least two reasons:

    1. Some detransitions are purely economic. Typically an MTF finds themselves unemployable in the new sex. Faced with a choice between destitution, bankruptcy and/or homelessness versus detransition they choose the latter and regain employability through male privilege. The regret is not having succeeded at transition, not at having attempted transition. Retransition will typically accompany retirement from working life.

    2. Some detransitions occur because the transitioner never really wanted to transition in the first place. They were forced into transition because that was the only way to access needed cross-sex hormones and surgery, since the HBIGDA-SOC requires social transition as a condition of somatic medical assistance. Typically this is an FTM who returns to the lesbian community after having obtained mastectomy and testosterone. Often they present male in the workplace but remain female legally and outside the workplace.

    June 19, 2011
  2. Yes, thanx for pointing out the financial issues.

    In the latest version of the WPATH SOC, section VII you’ll see that there is provision made for those who want hormones but not a social transition.

    June 19, 2011
  3. Suzan #

    No one ever mentions people getting involved with religious cult. The Dominionists and other Fundamentalist cults of the desert monotheistic religions put enormous pressure on any LGBT/T member to leave the sin of being LGBT/T.

    Several of the most prominent regreters including Jerry Lynch and Desmond Perry are cult members.

    Perhaps it is time to start treating religion or at least extreme forms of religion as pathologies. I think maybe people should be allowed to do interventions the way parents and friends sometimes do drug and alcohol dependency interventions when someone becomes involved with one of these cults.

    June 20, 2011
  4. Henry Hall #

    A.B. Kaplan :
    In the latest version of the WPATH SOC, section VII you’ll see that there is provision made for those who want hormones but not a social transition.

    The WPATH SOC is still secret and under wraps until September 2011. Maybe you have access to the draft versions.

    The HBIGDA-SOCv6 Section VII does indeed provide for hormones without Social Transition and with (usually unwanted) psychotherapy. However, in the typical case, genetic females simply cannot pass as men without top surgery. And being a bearded lady is no fun at all. That is why so many feign GID, do a token transition and detransition as soon as possible after top surgery.

    Forcing people into unwanted psychotherapy in which they have to lie simply wastes time and money brings the mental health profession into still further disrepute.

    June 21, 2011
  5. beneficii #

    Hi Ami,

    What do you think of this?

    I think that a case can be made that depraved indifference is being exhibited by these two solitudes: conservative religious spokespersons, and professionals active in treating transsexuals.

    I like this author, as I think he keeps a very good website, but I think he goes too far with that comment, because those professionals are really trying as hard as they can to assist transsexual people. It seems to me that the author of this piece is criticizing those professionals for not engaging in serious dialogue with religious conservatives, whatever that would entail.

    August 24, 2011
  6. I’m coming to this very late, I know, but I am a trans person who has recently completed what is typically defined by the medical and mental health professions as full transition – courses of psychotherapy, letters, HRT, RLE, and, finally, SRS. This procedure took nearly five years for me due to my providers taking an extremely conservative approach; it was more than a year from the start of therapy until I had any HRT prescribed, and over three more years before I had HRT that would feminize my body. I was not permitted access to SRS until two years of RLE, during which time I had very successfully integrated professionally and socially as my gender.

    And yet, I have deep regret. My experience with the various providers was that they were interested in restricting me to a certain way of being, that I was to be a woman who was straight, wore overtly feminine clothing and wore makeup, gave up any interests which they considered even questionable for women, and wanted SRS. That wasn’t me; I’m a lesbian woman whose dress varies greatly, never wears makeup, rides motorcycles, and is proud of her professional career. I had also wanted to be non-op but, in the course of questionable actions taken by my physicians, I came to experience dysphoria about my genitals that I could no longer handle, and was advised that SRS would address that. In a sense it did, but it has brought me new dysphoria about my body, specifically my genitals, and I have much regret about a significant portion of my transition as a result.

    Sometimes, the issue is physicians and mental health professionals enforcing their biases onto trans people.

    June 6, 2013
  7. Jesse Harris #

    I’m 58 years old at the time of this entry and I transitioned 27 years ago.

    I’m FtM……and I’m on this site because of my own frustrations regarding my regrets. Actually, the word “regret” really doesn’t apply. I do wish that I had had more options.

    I began my transition in 1986 when there was very little information, no easy resourcing, nor websites to investigate. Support groups were secretive and hard to find, and there were none, to very few, professional sources such as mental health and medical persons to access. The traditional “Harry Benjamin Standard of Care” was alive and well along with all the gate keepers, who were stringent in their requirements. Transitioning was nothing like it is these days. In 2014, we have the “gender spectrum”. Back then, the only option was the very strict gender binary- either male or female- nothing else.

    I came from the lesbian community, and came out as a separatist, in 1976. I was a radically political separatist, and a huge target for the homophobes wanting to prove a point. I was verbally and sexually assaulted, evicted from several residences after the discovery that I was gay, and blatantly denied employment because “we don’t hire dykes here”. All of these situations took place because there were no laws in place to protect the gay community. In the early ’70’s and prior to then, we could go to jail just for holding hands in public.
    I did the best I could to keep a job, and a roof over my head, along with raising my child. It began to wear on me but there was no other way of living as I knew it.

    I transitioned to survive my life. I had no idea that history would be rewritten for our community and that some day it would be just fine to be the dyke that I was…..and still am.

    In reality, there is no way for me to reverse this process. My journey was completed and my transition finished. I am a man in society’s eyes in every aspect. However, I am still and have always been lesbian identified. There are aspects of my life that must remain as they are. Reversal would be like another transition, and at my age not really an option.

    There are aspects of myself that are truly transgendered. I’m masculine identified. I see life as a lesbian because my orientation never changed through my transition. And I’ve never been heterosexual.

    There are people that do not allow me the luxury of a place within the gender spectrum. There are those who have disdain for my perspective on the world and have had negative things to say toward me for my views. Every person’s transition is unique to themselves and their experiences. And the only way to actually know how it all will play out is to live the journey. No one can really know what they will feel about it all until they experience it.

    May 23, 2014
  8. B2G #

    I think the use of the nebulous word “regret” should be a clue that we are to be treated to fact free opinion.

    Most successful people have “regrets” about their success. Most parents will express regrets about having children. Most war heroes express regret over their heroics. Many ER MD’s express regrets on both, those that they save…and those that they lose.

    All humans have regrets…and most of us given the choice would do it again. We all have regrets about things that we have…or are doing, still, we move on. In every other endevour, those weak individuals that can’t move on and insist on publicly wringing there hands are largely derided. The “big” star that “really” wanted anonymity comes to mind. And so too with transsexuals, if you lied to get surgery, show some dignity, shut up and move on. That you would publicly speak on the matter, knowing full well that it does harm to those who legitimately seek surgery is highly immoral behavior…and should be seen as such.

    Those who hold up such people as warnings, should be clear about what motivates them, further restrictions on a overwhelming successful therapy that has helped the overwhelming majority live fuller happier lives.

    I transitioned, had hrt and my testes removed, I could not make it economically and returned with PROFOUND REGRETS to the sex of my birth…WHERE’S MY HEADLINES? [Crickets chirping]. I don’t regret transitioning, I don’t regret taking estrogen [I still do], I don’t regret having my testes removed [I am happier without them]. I do regret failing economically, but I console myself with the thought that I gave it my personal best, but was denied a livelihood by the country I had served honorably.

    Had I had SRS, [I still wish for it…just as strongly as ever], I would not call a TV station and complain about having to “suffer” the SAME RESTRICTIONS as 50% of the population face every day. Only a truly worthless person would do something like that, I’d just go on about my life, living every day as fully as I could.

    I’d like to add one thing to this discussion, given the widespread difficulty of un/under employment this nation faces for ALL people, but particularly, those visibly gender variant, does it make makes sense to have RIGID restrictions that have led to uncounted suicides and destitution? Gender variants, who’s percentage of unemployment is measured in the 80’s to 90’s could be helped far more often by a medically compassionate community. A community who recognized that the motivation to be the opposite sex of one’s birth does not correspond perfectly to a body and mindset that is the patriarchal ideal of what is masculine and feminine. Why is medical help conditioned on how well the transsexual conforms to a standard no longer held for either sex? Why is medical help conditioned on how “tolerant” the surrounding society is? Aside from birth control, can you think of any medical condition in which the doctor would beseech the untrained masses for medical opinions and then unquestioningly follow them?

    Though it is as unavailable to me as planned pregnancy was once to women, I have no doubt I would be much happier with a vaginoplasty, than without. I don’t think my medical treatment should be conditioned on whether I can be successfully employed as a woman. To me, “the standard of care” should be; is this person of sound mind, is this desire persistent [in proportion to the person’s age]…and if this turns out to be..not what you would’ve hoped for, can you be an adult about it, realize it’s your fault and move on. Having lived happily [no REGRETS] without my testes I don’t see how, an economically ruinous popularity contest AKA “real life test”, a doctor, or therapist who barely know me should trump a desire that has been persistently part of my life since I was a very young child.

    Is this medically indicated, is the person of sound mind and can the person deal with the consequences as an adult. All this other psychobabble, has caused, by many factors, more financial ruin, more REGRETS and more suicides, than the EXCEEDINGLY RARE case of a “regretted” surgery…caused entirely, let us remember, by a patients insincerity. Bad things often happen to people who lie, we shouldn’t give them the time of day, much less the podium, nor should we punish innocent bystanders.

    June 18, 2014

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