Changing ones mind on Gender Transition .... on de-transitioning

Prepared by A. B Kaplan fellow blogger and Psychotherapist

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”.

This post attempts to explore this phenomenon.

Some reasons why this might occur include:

The person is not transsexual.

The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender. Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t. Sometimes the discovery just isn’t possible without trying it out.

The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.

Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness. I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as: the idea that one will have a social community, better social skills, be more popular, etc.

When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition. It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through. Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.

The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life).

These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender. Additionally, transitioning is hard. There are many hoops to jump through and one enters into a group of discriminated against people. This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition. The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”. Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery. These included 2000 individuals from 1961 to 1991. This doesn’t take into account individuals who transition without surgery. About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Krege S., Bex A., Lummen G., et al. (2001). Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU International. 88:396-402.

This study shows little or no regrets possibly due to surgical advances.

also see the PDF download to the left column of this blog along with the Transgender Journal and other related resources.

Additional reading:

Transitioning – For those transgendered individuals who decide to transition (to present and live in the other sex outwardly), these emotional/psychological issues may come up:

Fears about finding a partner

1. Impact on family relationships with parents, children, partners and other relatives
2. Impact of relationships at work and with friends.
3. Fears about violence and prejudice when one is read as transgendered.
4. Feelings about having to experience surgeries, hormones, (and for MTF transsexuals) facial hair removal and voice changes.
5. Frustration of having to change or explain legal documents (drivers license, passport, titles to property, diplomas, etc)

Post transition issues – Some issues that may arise include:

1. Disappointment that transitioning didn’t solve all problems.
2. Level of satisfaction with appearance
3. Level of satisfaction with any surgeries

Emotional issues that were not addressed before.

When one decides not to transition. Not everyone is able or wants to transition. This is a perfectly valid choice for people to make. However these individuals must learn to cope with the tension that the gender dysphoria produces. Sometimes this can be helped by having times when one can cross-dress, interact with others who are aware of one’s status, talk about the issue, and take low-levels of hormones (that don’t effect the body outwardly).

Other mental health issues not related to being transgendered. Just because some one is transgendered doesn’t mean they don’t have other issues in their lives. It can be hard for some people to let themselves seek treatment for other issues when the gender dysphoria is so prominent a concern.

The good news: It’s important not to lose sight of the satisfaction one can have by acknowledging and (if possible) changing what can be changed and moving towards of one’s authentic self.

Peace and tolerance

H