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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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6 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

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