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Detransition

Detransition refers to (wholly or partly) reversing or stopping a previously undertaken gender transition. It is a topic that has long been underexposed in the care system and in public information — while it contains crucial information about the risks of the current medical pathway, particularly for young people.

What is detransition?

Detransition can have several dimensions. A social detransition means returning to the name, pronouns or presentation from before transition. Legal detransition concerns reversing the sex registration. Medical detransition includes stopping hormones or, in a number of cases, surgical procedures to (partly) correct earlier physical changes — surgery which in turn has its own risks and lasting consequences.

Not all detransition is full or permanent: some people stop temporarily, others return definitively to living in their biological sex.

Reasons for detransition

Research shows a mixed picture. A 2024 systematic review (PubMed, 2024) and the work of Vandenbussche (2021) and subsequent studies cite, among other things:

• realising that one's own problems were not solved by medical transition;
• underlying mental-health conditions (depression, trauma, autism, eating disorders, internalised homophobia) wrongly interpreted as dysphoria;
• regret over irreversible bodily changes (breasts, voice, fertility, sexual function);
• feeling insufficiently informed in retrospect, or having been swept into too fast a care pathway;
• a return to a coherent self-image as a (frequently) homosexual man or lesbian woman.

In activist sources, detransition is often reduced to 'external social pressure'. Research and the testimonies of detransitioners themselves show that the actual motives are usually more complex and regularly involve regret and later realisation.

Prevalence and debate

How often detransition occurs is hard to measure. Many clinics have barely tracked detransitioners, and people who regret often do not return to the same provider — which can systematically underestimate the figures. Estimates therefore vary widely. Older figures of around 1% (from pre-2010 cohorts) are regarded by critical researchers as incomparable with the current population of young people with late-onset dysphoria.

The British Cass Review (2024) concluded that the available data on detransition are frankly substandard and that reliable long-term follow-up is virtually absent. This is a serious problem: a care model that offers far-reaching, irreversible interventions without insight into outcomes cannot substantiate its own claims.

Experiences of detransitioners

Detransitioners form a heterogeneous group. A growing number of testimonies at home and abroad describes serious harm: lifelong medication or post-operative complications, loss of fertility and sexual function, and the feeling of having taken, as a young teenager, an irreversible decision whose consequences only became visible later. See for instance the personal testimony in HP/De Tijd.

In the Netherlands there is hardly any specialised aftercare for detransitioners. Many people find support in (international) online communities.

What this means for care practice

Detransition experiences provide solid arguments for restraint in the gender-affirmative care model, particularly for minors and young adults. This is all the more so because many comorbid conditions — autism, depression, trauma, eating disorders — may play a role that is missed in a purely affirming approach. A careful, exploration-focused pathway (rather than automatic affirmation) is now used as a guideline by, among others, Sweden, Finland, Norway, Denmark and the United Kingdom.