Psychological consequences of detransition

Q: What are the most common psychological consequences?

Grief over permanent physical changes, shame, identity confusion, depression, and anxiety. Many also experience deep bitterness about a care pathway that did not protect them. Some additionally experience relief and a sense of recovery. Both can exist at the same time. Many detransitioners also describe social isolation.

Q: Is there specialised mental healthcare for detransitioners?

No, hardly any in the Netherlands. Regular mental healthcare can provide support but usually lacks specific experience. Many detransitioners do not experience specialised transgender care as a safe place to share their story. Peer support through transspijt.nl is the first place where many feel understood.

Q: Does untreated psychological distress invalidate the original transition?

Not automatically — but the self-reported experience of many detransitioners is that their dysphoria was indeed connected to those untreated problems, and that if those problems had been addressed first, the transition probably would not have taken place. This is precisely where the gender-affirmative model falls short.

Q: How do you deal with the reactions of those around you?

Many detransitioners describe this as one of the most difficult aspects. Losing the trans community, mixed reactions from family, and the emotional burden of explaining all over again what happened. Time, peer support, and a good therapist can help — there is no quick solution.

Psychological consequences of detransition — Foto: Hedaetul Islam via Pexels

Detransition has profound psychological consequences for many people. Alongside grief, shame, and identity confusion, a significant number also experience deep anger or bitterness about the care they received — the feeling that they entered an intensive medical pathway without their underlying problems being properly investigated. That suffering is real, and current healthcare systems are poorly equipped to address it.

Grieving an irreversible past

A central psychological theme is grief. Detransitioners grieve a body that has been permanently changed: a voice that will not return, breasts that have been removed, fertility that has been lost, and genital anatomy that is no longer what it was. For young people who started puberty blockers and hormones as adolescents, there is also the fact that a normal puberty never took place — a development that cannot simply be made up later.

This grief differs from many other experiences of loss because the damage itself occurred within a medical pathway that the patient requested — often at a young age and often while suffering psychologically. This makes the process of coming to terms with it complex: there is no external perpetrator to be angry with, while at the same time there is a deep awareness that healthcare should have prevented it.

Shame, isolation, and distrust

Shame is a recurring theme. Shame about one’s changed body, about a conviction that once seemed so certain, and about having to explain all over again to family and those around them what happened. Many detransitioners describe social isolation: friends they made during transition drift away; reconnecting with their original social circle is difficult; and the trans community often responds dismissively to their stories because they are perceived as threatening to its own identity.

Virtually all published testimonies — on platforms such as transspijt.nl, in interviews such as the one in HP/De Tijd, and in international work collected by Genspect — point to a deep distrust of the original healthcare providers. Patients describe feeling manipulated afterwards by ‘informed consent’ procedures that were not very informed in practice, and by healthcare professionals who gave their own affirmative convictions more weight than a critical examination of what was actually going on.

The role of underlying problems

Research among detransitioners — including Vandenbussche (2021) and the detransition survey by Littman (2021) — shows a consistent pattern: a majority had untreated comorbidities when they began their transition. Depression, anxiety disorders, eating disorders, PTSD, autism spectrum disorders, and internalised homophobia or misogyny are common. A Finnish study of nine detransitioners found a psychiatric history in all nine.

In retrospect, these respondents often view their dysphoria as a symptom or coping strategy for something else — not as a standalone, biologically grounded identity that could only be resolved through transition. The fact that this distinction was not, or barely, made during their care contributes both to their psychological burden and to criticism of the gender-affirmative model.

Identity after detransition

Finding an identity of one’s own and rebuilding it takes time. Those who presented as trans for years must learn to get to know themselves again — often in a body that is no longer the one they started with. Some detransitioners describe now feeling like a woman or a man, as they did in childhood, but finding that their body no longer matches. Others struggle for longer with the question of who they are.

According to many people with lived experience, what helps is contact with other detransitioners, a therapist who does not immediately re-affirm them but can tolerate complexity, and time. What does not help is a healthcare system that would rather not hear their story. The essay I was trans, and now I’m not anymore on genderplek.nl describes what it is like to learn to inhabit a changed body again.

Inadequate care

In the Netherlands, there is no specialised mental healthcare for detransitioners. Regular therapists rarely have experience with this specific combination of grief, medical trauma, and reclaiming one’s identity. Specialised transgender care is institutionally connected to transition and is experienced by many detransitioners as an unsafe place to share their story. Information about where people can currently turn for help can be found at support after detransition.

The Cass Review (2024) addressed this problem emphatically at an international level: structural, non-stigmatising aftercare is needed for people who detransition or have doubts, separate from the affirmative clinics themselves. In the Netherlands, this recommendation remains almost entirely unimplemented.

What are the most common psychological consequences?

Is there specialised mental healthcare for detransitioners?

Does untreated psychological distress invalidate the original transition?

How do you deal with the reactions of those around you?