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Psychological effects of detransition

Detransition has far-reaching psychological consequences for many people. Alongside grief, shame and identity confusion, a substantial proportion also experiences deep anger or bitterness about the care they received — the feeling that they were taken into a far-reaching medical pathway without their underlying problems being seriously investigated. That suffering is real, and current care is ill-equipped to meet it.

Grief over an irreversible past

A central psychological theme is grief. Detransitioners grieve over a body that has been permanently changed: the voice that does not return, breasts that have been amputated, fertility that has been lost, genital anatomy that is no longer what it was. For young people who started blockers and hormones as adolescents, a normal puberty never occurred — a development that can no longer be made up.

This grief is different from many other experiences of loss because the damage was inflicted within a medical pathway the patient themselves — often at a young age, often under pressure from psychological suffering — asked for. That makes processing complex: there is no external cause to be angry with, and at the same time a deep awareness that the care system should have prevented it.

Shame, isolation and distrust

Shame is a recurring theme. Shame about the altered body, about the conviction that once seemed so certain, about having to explain again to family and those around what has happened. Many detransitioners describe social isolation: friends made during transition fall away; the original environment is hard to regain; and the trans community often reacts dismissively to their story, because it is experienced as threatening to its own identity.

Almost all published testimonies — on platforms such as transspijt.nl, in interviews such as in HP/De Tijd, and in international work collected by Genspect — point to deep distrust of the original practitioners. Patients describe that they felt afterwards manipulated by "informed consent" procedures that in practice were not very informed, and by care providers who let their own affirmative conviction weigh more heavily than critical investigation of what was really going on.

The role of underlying problems

Research among detransitioners — including Vandenbussche (2021) and the detrans survey of Littman (2021) — shows a consistent pattern: a majority had untreated co-morbidity at the start of transition. Depression, anxiety disorders, eating disorders, PTSD, autism spectrum disorders and internalised homophobia or misogyny are common.

In retrospect these respondents often see their dysphoria as a symptom or as a coping strategy for something else — not as a self-contained, biologically grounded identity that could only be resolved by transition. The fact that this distinction was not, or barely, made in their care pathway feeds both the psychological burden and the criticism of the gender-affirmative model.

Identity after detransition

Finding a rebuilt identity takes time. Those who have presented as trans for years have to learn to know themselves again — often in a body that is no longer the original one. Some detransitioners describe how they now feel female or male as they did as a child, but the body no longer fits. Others struggle longer with the question of who they are.

What helps, according to many experiential experts: contact with other detransitioners, a therapist who does not immediately re-affirm but can tolerate the complexity, and time. What does not help is a care system that would rather not hear their story.

Inadequate care

In the Netherlands there is no specialised mental health care for detransitioners. Regular therapists rarely have experience with this specific combination of grief, medical trauma and identity reclamation. Specialised transgender care is institutionally linked to transition and is experienced by many detransitioners as not a safe place to share their story.

The Cass Review (2024) has explicitly addressed this problem internationally: structural, non-stigmatising after-care is needed for people who detransition or doubt, separate from the affirmative clinics themselves. That recommendation remains almost entirely open in the Netherlands.