Following the Newsnight segment on “detransitioners”, we’ve listed some evidence-based research about transition ‘regret’ that representatives of the Tavistock and Portman gender identity clinic could have cited on the programme….
1. This research by Prof. Dr P. T. Cohen-Kettenis, VU University Medical Centre, Department of Medical Psychology, shows that of 162 trans adults, only 1 reported they would choose not to transition again. Another had some regrets but would choose to transition again (0.6% regret rate) Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals. You can read the research: “Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals” here.
2. Cecilia Dhejne, at the Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, found that of people undergoing SRS, regret was about 2.2% and there was a significant decline of regret over time. An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets. You can read their paper: “An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets.” here.
3. Research by Prof Christina Richards; “Detransition rates in a national UK Gender Identity Clinic” has shown that less than 1% of the 3,398 trans patients who accessed NHS support went on to detransition. This was presented at WPATH and was conducted at the Nottingham Centre for Transgender Health.
4. This study by the Institute of Clinical Neuroscience, Department of Psychiatry and Neurochemistry, Göteborg University, Sweden, found that the most common reason for detransition is the person couldn’t cope with the family and community support they lost and the experiences of transphobia. Read the paper: “Factors predictive of regret in sex reassignment.” here.
5. It needs to be remembered that there are also many incidents of trans people detransitioning who then retransition later on. This article “I detransitioned because of transphobia, but I always knew I am a woman. Now I’m living as my authentic self” provides a first-hand account by a transgender woman, Kate Hutchinson, from Diversity Role Models, who detransitioned then retransitioned again.
Kate Hutchinson – Diversity Role Models
6. Recognising and supporting trans people who choose a different pathway is crucial, but as Lui Asquith from Mermaids importantly stated; we need to make sure that their experiences aren’t cited as a reason to not provide internationally recognised treatment for those trans people who need it.
"You can't make someone be trans."
Lui from @Mermaids_Gender says the transitioning process is “rigorous” and that the experiences of detransitioners should not be used to suggest that people are “being pressured or made into being trans"#Newsnight pic.twitter.com/yqiQVOL2mr
— BBC Newsnight (@BBCNewsnight) November 25, 2019
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I have stopped hormones since 1994-5 and still have limited body changes leftover, Do I regret the issue simply yes, I would love to be still on the pills and go through but I got involved with someone and we live trans aware. She is a fully developed female and I am still in a state of flux. Although reading the research on regret is an issue in some of the pre-op trans. But I feel that the whole of my life has been living on the edge of a blade that splits you in half and because of society and issues with accepting trans people I decided to stay male. It is something I regret and I wish for fuller body changes then I have. I enjoyed that freedom as I came out back in the pre-internet days. (sorry if this is a bit confusing the spellchecker is having a field day) I wish that things for trans people would be more open and about time we had a soap with someone with trans issues on the television. Perhaps those that follow such programmes might learn more. I must admit being a soap-free house leads to many people not turning up to catch one of the soaps. I feel a lot better mentally not watching the soaps and the storylines they have.
But regret can lead to serious problems and many have used the hormones and sterilised themselves in the process, loss of sex drive and other things soon change a person. I found it to be a blessing as I could think more freely without the sexual pressure placed on me. So, what if I looked down there and it was gone? I would not miss it, it has given other women enjoyment over my 66 years and I had problems with the act as I felt different. But would I regret it not being there, easy to say no when you are on the other side of things? Once done it is gone, finished with and then you wonder about other things. I wonder if it will hurt having sex, well I guess it will. All women have to endure that and it turns to pleasure after the right effort is used. If anything I wonder more about my looks then the changes. We tend not to look after our faces etc. Well, Men just do not, unless you are a footballer it seems on the TV ads.
I learn of post-op trans simply leaving the community once they are complete. There lies another problem, you have used the friends for support and then you are turning away as it is no longer needed. I think you might feel that you need them more as you are now in a different world and at first you might be accepted by non-trans people, but they are just curious about your transition and it soon wears off. In the period of my absence from the treatment, I am still worried that things have not moved on at GIC’s. Stories of candidates not getting the right treatment and also the extra demand on the services of the clinics has given to longer periods between appointments, something that is a major issue to a trans person as the panic to change is becoming an urge. But when you read the papers and the 1-2% rate is very low compared to other treatments. Which leads to education and your decision on the op.
Education is reading issues that arise after you are no longer that gender. Personally, before I met my partner I was reading as much as I could. I did not take the decision lightly and was honest with others. My partner knew from the start. I feel that I would have to go off and find a quiet place for a week or so to read and study things. Of course, back then it involved tracking down papers etc in hard copy. Not like today. I had access to a university library at a medical school and managed to find papers while studying and part of a project. This electronic doorway is such a major help to the trans community. Whatever your doubts, issues etc. Research your path well. Let’s get that 1% to zero.
Thank-you for sharing the evidence – surprisingly I’ve read most of them already as most trans advocates do. What we’re facing currently is massive amounts of disinformation and propaganda in the UK, and a lot of our time is spent deconstructing myths and fighting for healthcare and dignity rather than supporting each other. It’s a sad state of affairs when we have to continually justify our existence.
Personally I’ve had conversion therapy, where HRT and GRS was derided as part of “therapy” and spent decades trying understand what was going on for me and it took radical self acceptance to understand that I was trans and to give myself permission to get treatment. I worried about my income and my job, but learned that I couldn’t be sacked and that was enough for me to be able to transition.
As far as HRT goes: it was a no-brainer, I was suffering from chronic and acute dysphoria and I was in a lot of distress: life was almost unbearbale. With surgery, I considered the worst case scenarios including complete loss of sensation, bowel perforation, even death. I work in health and was very aware of surgical complications and I think most ts women, who have had some awareness of who they are for their whole lives have a lifetime of considering such things.
It’s interesting that as time has gone on, and I’m now 6 years post op, my satisfaction with lower surgery has increased. I’m super happy with my surgery, and some initial loss of sensation has resolved over time. I can’t imagine having even had anything different downstairs, and it’s lovely not to live with the embarrassment and humiliation of having the wrong bits.
When the psychiatrists were talking with me, they did discuss, briefly, the complications and they were happy that I knew what I wanted and understood the risks. I think this would have been better facilitated by medical staff with experience of complications, raher than psychiatrists, but I’m fortunate having a medical background and understood the risks. The risks that I had to balance, were living in misery and high levels of dysphoria, and the risks of dying or having a poor surgical outcome. It was again an informed decision.
I’d like to thank you for all your ongoing work. I’m really lucky to have you fighting my, and other ts women’s corner (and all trans and non-binary folk).
I think you need to look more carefully at “Detransition rates in a national UK Gender Identity Clinic”. This is the method they describe using. “Patient assessment reports created between August 1st 2016 to August 1st 2017 were scanned electronically for words related to detransition or regret. The reports that were retrieved in the search were reviewed by study authors to identify evidence that patients had detransitioned or expressed regret related to their transition. Data extraction included patients’ age, gender identity, gender assigned at birth, and descriptions of their detransition or regret.” I do not think this method would give an accurate picture. Were patient assessment reports only written for people who had completed their transitions? And if so, when? I have read about an initial period of euphoria after making transition progress, and then dissatisfaction because the transition is not enough. What about people who regretted it years later? What about people who are “lost to follow-up”? One could argue they are so happy they have no time for the subject or they are too depressed to deal with it. The point is that we don’t know. I have read, several times, that the follow-up is very limited. That there are no good studies documenting the outcome of transitions. It seems like they did another survey of their files a few months earlier that year (in May). That one doesn’t seem very robust either.