Others, however, contend that a diagnosis is essential for health-care access. Many insurance plans that cover gender reassignment surgery may not if gender dysphoria weren't considered a disorder by the APA. Jackie describes dysphoria as an unease in her body, one that she hoped would be alleviated if the world saw her as male. Jackie found tips online on how to pass as male—what sort of clothes to wear, how to bind her chest and change her walk. She cut her waist-length hair, changed her name, and asked people to start calling her "he" and "him. This covered her testosterone injections, and it likely would have covered her chest reconstruction, commonly called "top surgery," too.
But eight months ago, right when she was preparing for top surgery, Jackie changed her mind. After five years on testosterone, she was also concerned about her health. While the long-term effects of hormone therapy are largely unknown, high doses of testosterone can damage the liver. Some physicians also recommend hysterectomies for trans men over concerns that their risk of certain cancers and infections may increase. Hysterectomies, of course, are irreversible, as is genital reconstruction: A penis that has been constructed into a vagina cannot be undone, nor can the reverse.
Jackie didn't want to be on hormones anymore, but she didn't know what to expect. Would her voice get higher? Would her facial hair fall out?
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What did this mean for her identity going forth? Resources on detransitioning are scarce. Most health-care providers, even those specializing in gender identity, have little experience with detransition. Lara Hayden, program manager at the Seattle Children's Hospital Gender Clinic, told me that while a few patients have stopped transitioning, they've never had a patient fully transition and then transition back. Ami Kaplan, a therapist in New York who has worked with transgender, gender variant, and genderqueer clients for more than 20 years, said that after two decades in practice, she knows of only one client who fully transitioned and then later detransitioned.
Until recently, the "gatekeeper" model of trans care was standard, and it meant that who could or could not change their bodies was ultimately up to therapists. Ray Blanchard, a retired sex researcher and psychologist in Toronto who was among the early clinicians advocating for sex reassignment surgery now called gender confirmation surgery , said that when he started in the s, patients had to live as their target gender for two years before medical intervention. Buck Angel, a human-rights activist and filmmaker, transitioned 23 years ago, when gender reassignment was much more rare.
Angel was in therapy for 10 years before he transitioned, and, he says, that worked for him. And I've never looked back. Since day one, it's been nothing but the perfect choice for me. Today, the standard of care has changed. According to guidelines issued by the World Professional Association for Trans Health, health-care providers should ask for a letter from a therapist before medical intervention, but therapists themselves aren't required to see clients for any particular length of time. Some doctors don't require a letter at all. Instead of talking to therapists, Jackie found a community online.
She's now a moderator of Detransition Info , an online resource for people to ask questions and share their experiences. Jackie and other detrans people I spoke to said their online community is in the hundreds, but no one knows precisely what percentage of the population has detransitioned. It's not even clear how many people are transgender.
That's double previous estimates.
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By all accounts, detransitioners make up a tiny percentage of that already small population: A year study out of Sweden found that only 2. There have, however, been almost a dozen studies of looking at the rate of "desistance," among trans-identified kids—which, in this context, refers to cases in which trans kids eventually identify as their sex at birth. Canadian sex researcher James Cantor summarized those studies' findings in a blog post: Only very few trans-kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks.
Some trans activists and academics, however, argue that these studies are flawed, the patients surveyed weren't really transgender, and that mass desistance doesn't exist. Indeed, some of the studies cited by Cantor had sample sizes as low as 16 people and were more than 40 years old, and one was an unpublished doctoral dissertation. But the most recent study, published in in the Journal of the American Academy of Child and Adolescent Psychiatry , followed up with adolescent patients at a gender identity clinic in Amsterdam and found that two-thirds ultimately identified as the gender they were assigned at birth.
For the parents of transgender children, this idea of desistance can be problematic, if not outright offensive. It makes it sound like being trans is a choice. For my child, the idea that she could choose to not be a girl is like choosing for the sky to be green and the grass to be blue. That's how much of a fixed, unquestionable reality this is for her. Mack says her daughter's identity as female is firm, and it has been since a very young age. Today, her daughter is in a wide community of trans kids, her parents are supportive, and it seems unlikely she'll desist.
And most trans people—anecdotally, at least—are glad they transition. This includes John Otto, a Seattle man who started transitioning 17 years ago. I was 45 when I started transitioning—I certainly had given it a go being a woman. That may be true for some detrans people—especially trans women, who generally have a harder time passing and who lose the benefits inherent with appearing male in society—but it wasn't the case for Cass, a year-old detrans lesbian in California.
Cass was severely bullied as a gender nonconforming kid and says transitioning actually made life easier. She started taking testosterone at 20, and her community was largely supportive.
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She didn't have a hard time finding work or people to date. Three months before Cass started taking testosterone, her mom committed suicide. And that worked for a while, but over time, she started to sense that her dysphoria was rooted more in the trauma of her mother's death and her own internalized misogyny than in gender identity. As an adolescent, she had been masculine, butch. Living as a man provided a kind of refuge until I was ready to dive into all that.
When she was ready, Cass, like Jackie, looked online for advice, and she met a woman a few years older who had detransitioned. Her experiences were the same—from childhood bullying and internalized misogyny to the sense that transitioning hadn't really solved her dysphoria at all. Reddit prides itself on its independence.
These sites are all perfectly horny, but they also have specific rules in place to prevent harassment. There's a strong pro-community spirit that mirrors that of Reddit itself. Ultimately, there's nothing explicitly different about hooking up on Reddit as opposed to using Craigslist, AdultFriendFinder or any other no-strings-attached hookup engine; after all, we've been using anonymous Internet forums to find hookups for decades now.
But redditors say there is something unique about the community itself. Getty Images. Copy link.
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The Detransitioners: They Were Transgender, Until They Weren't
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