Understanding gender detransition
By: Dana Pham
Tags: LGBTQ, Mental Health, Psychology, Transgender, Detransition

Gender detransition refers to reversing a gender transition, and reidentifying as the gender assigned at birth. I recently came across a detransitioner, Peter, to talk about something that I struggled to understand. Detransition has been used interchangeably with ‘sex change regret’, which is not the same thing. As a transwoman, I wished to better understand detransition, and have a respectful dialogue about it with Peter. It was not an easy thing to do. Peter detransitioned after questioning his political views, and started attending church once he started his detransition.

On the other hand, I transitioned nearly a decade ago, and during that time my political views went from progressive to conservative, and I recently became a regular church-goer. Only that I’m not detransitioning, nor interested in doing such. I caved in to detransition once due to social pressure, but it felt very wrong and distressing very quickly. Never taking such morally repugnant action again. So I asked Peter, who went from male to female then back to male, what do changes in political and religious views have to do with gender identity and dysphoria, or lack thereof:

“I discovered that I was indoctrinated into leftist thinking, and when I started questioning the trans issue I came to the opinion that it also is an agenda, and I no longer believe in the whole concept that people can change their ‘gender’, that biological sex is it, and doesn’t change.

I experienced gender confusion from age 5, which became a regular feature of my life. I found out that I was a DES baby. My mum had taken the potent estrogen when I was in the womb, so I put my confusion down to the effects of the drug. When I found that out I wanted to detransition even more.”

DES refers to diethylstilbestrol, a drug that was prescribed to prevent miscarriages during the 1940–70s, albeit ineffectively. Peter referred to this video to elaborate: https://www.youtube.com/watch?v=3fjmnyq0n2s. I contested that gender confusion is not the same as gender dysphoria, but he clarified that he now calls it confusion, after having called it dysphoria post-transition. The conversation continued:

Dana: “Why do you think you called it dysphoria at the time, instead of confusion? Was it because you were indoctrinated into leftist thinking? If so, please elaborate.”

Peter: “Because it seemed to be an apt description at the time, now I call it confusion because I believe it’s more accurate. I would have benefited more from some kind of biological sex affirming treatment instead. When I found out about the category ‘transgender’ I thought that was me because of the confusion I felt. Now I think giving transgender affirming treatment is wrong, people should be helped to come to terms with their biological sex.”

Dana: “Do you think that because you believe that your experience is applicable to the experiences of others, including mine? Because my experience was dysphoria, not confusion. I’m sorry that the healthcare profession failed by not vetting you enough for transition candidature.”

Peter: “To me that is just semantics, I saw my experience as dysphoria before, now I judge it as confusion. The health profession doesn’t really vet people, it just relies on people’s self-assessment. At least that was my experience. I don’t think people should be given affirming treatment, instead they should be helped by biological sex affirming treatment, because I think the entire concept is wrong, that you can’t really change gender/sex. When I talk about detransitioning I often get accused of not being a real trans, but that wasn’t the case. I was trans for 20 years before I stopped believing the validity of the concept.”

Dana: “It isn’t semantics. Confusion refers to uncertainty about what is happening, intended, or required. Dysphoria refers to a state of unease or generalised dissatisfaction with life. When you said, “now I judge it as confusion”, it implies that you misjudged your experience. In other words, your experience wasn’t dysphoria. It seems to me that said healthcare professionals didn’t do their jobs properly, and for that I am sorry that they failed you.”

Peter: “Yes, but the way I’m using the words to describe my experience is entirely subjective to me, so at the time dysphoria was an accurate description, now looking back I prefer the word confusion. It seems to me that I was treated no differently from any candidate for treatment, in fact now it is even easier than ever, and affirming treatment is being pushed as the only option.”

Dana: “If it’s subjective, then what’s the objective description? What evidence or research do you know of that supports alternative options?”

Peter: “It’s difficult to be objective when we’re talking about people’s feelings. There has been research by different people, for example Zucker’s clinic in Canada had a high success rate with biological sex affirming treatment. Unfortunately that kind of approach has been shut down and research suppressed.”

I referred Peter to my gender transition memoir: https://link.medium.com/FWlVa3MyYX. I wanted to understand from his perspective, how biological sex affirming treatment would’ve helped me as an alternative. I also pointed out to him that at present, the literature points in the direction that being trans is likely to be innate, that gender identity is usually known by ages 3–5. Even Kenneth Zucker, an American-Canadian psychologist and sexologist who’s (in)famously fallen out of favour with the trans community, has agreed that at age 3, children begin to self-label and form their gender identity.

Zucker further elaborated in a 2015 CAMH Gender Identity Clinic for Children Review, that “at age 15, the gender dysphoric child’s dysphoria will most likely to persist, 70%-80% to be specific”. As an authority in North America on this subject matter, he was known to prescribe puberty blockers and later HRT for trans adolescents. I put to Peter that I think he’s misunderstood Zucker’s research. Zucker’s sacking from the clinic is not proof alone that “that kind of approach has been shut down and research suppressed”. Peter disagreed with my assessment:

“Biological sex affirming treatment means helping people feel comfortable with their biological sex. I’ve heard differently about Zucker. His research found that 80–95% of children with gender issues naturally came to accept their biological sex without any treatment, so that implies gender identity isn’t innate and can change over time. It’s not just about Zucker’s sacking and his clinic being shut down. Any biological sex affirming approach or research into it is routinely squashed.

I read your memoir. Interesting. My mum was more supportive, but I wish she had retained a traditional Catholic belief like your parents. Looking back I would’ve preferred the approach of your parents, though I would’ve hated it at the time.”

I referred to Peter research, supporting his case, that hasn’t been quashed, which includes https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330 and https://www.tandfonline.com/doi/full/10.1080/00332925.2017.1350804. But I argued that trans children should be allowed to socially transition genders, and trans adolescents should be allowed to hormonally transition genders in a careful and medically appropriate manner. I then elaborated:

“Despite attempts to prove that trans children and adolescents can grow out of being transgender, the proof of that, which has been thrown around in public discourse, is flawed. As I’ve pointed out to you Peter, some studies seem to show that lots of young trans children change their mind. What these studies do is that they randomly take a group of children from gender clinics and follow them, only to seemingly find that most aren’t trans when they grow up. But what does that mean?

It means that a lot of these studies are just studying children, at random, that attend these gender clinics, without differentiating between those who have a gender dysphoria diagnosis, those who identify as trans, with or without diagnosis, and those who don’t identify as trans at all. All these children attended these gender clinics for a wide range of reasons, not just for gender dysphoria diagnosis. So the next time you hear the argument that “60–90% of children will naturally grow out of it”, it’s because that 60–90% weren’t trans to begin with. In fact, many of these 60–90% are LGB(-T)QIA in some way, shape or form, just not T.

The 10–40% don’t deserve to be forgotten — they deserve gender identity presentation alignment as appropriate, not denial of transition treatment. It’s worth noting that during the child’s formative years, the most rapid cognitive and emotional growth occurs. We now know that children’s physical and emotional environments dramatically impact the development of their nervous system. This is especially true of the brain and has profound implications for their psychological health as adults. Let’s get it right for the 10–40%.”

Despite that, Peter couldn’t agree, claiming that from his reading and reasoning, transgenderism is an agenda that’s being pushed, with the science behind it questionable. Specifically, most studies he’s looked at are allegedly biased towards affirming treatment, and that dissenting views are not given adequate consideration. Admittedly, I don’t believe detransitioners have been served well, given that WPATH’s (World Professional Association of Transgender Health) Standards of Care don’t offer detransition guidelines, even though a majority of WPATH surgeons want to see such guidelines included. I did find it interesting that Peter proceeded to accuse me of entrenching my views and showing no interest in learning about his views. I then clarified:

“To be fair, it appears that both of us have entrenched views to varying degrees, whether right or wrong. Hence this conversation. I’ve been hearing your views, but that doesn’t mean you’re free from any challenges from me. Otherwise why would I ask to begin with? A good learner doesn’t rest on their laurels, that’s for sure. If you haven’t already, be prepared to be challenged, because I’ve been prepared for your challenges.

Transgenderism could be an agenda that’s pushed, but not necessarily. Please elaborate on why the science is questionable. Is the bias towards affirming treatment because there’s an agenda, or is it because the evidence for non-affirming treatment consistently unconvincing? I’ve provided you with references to recent dissenting views which have been given adequate consideration, I think. Personally, I find them unconvincing, but I’m happy to hear you argue otherwise.”

And so he did. Peter argued that the entire medical field has bought the affirming paradigm, and that doctors who dissent are consistently silenced or fired:

“The dissenting science is often shut down before it can do any studies. Meanwhile, the affirming camp refuse to look into detransition or any dissenting views, saying they are too dangerous to be given air time, as they could cause trans people to be suicidal. But this is just one small aspect of the sexual revolution that has been raging for decades. This video is a doozy, looking at the subject from a social and political philosophical point of view: https://www.youtube.com/watch?v=QPVNxYkawao.”

I watched the YouTube video, which was a presentation by Rebecca Reilly-Cooper in critically examining the doctrine of gender identity. Rebecca appeared ignorant of the neuroscience behind gender identity, and growing genetic research on the matter. I put to Peter that preliminary neuroscientific research have come about over the years and more recently, which indicate that the brains of trans adults and children resemble their gender identity, not their apparent ‘biological sex’. If the brain acts as a sex organ, which it does, perhaps trans people are indeed intersex.

If this sounds incomprehensible, it’s because we’re currently in the middle of an explosion of brain research, which has greatly enhanced our understanding of the human mind. Stay tuned for more to come. There is also a piece of preliminary genetic research recently which indicate that “certain ‘versions’ of 12 different genes were significantly overrepresented in transgender women”. One study published a few years ago looked at identical twins and found that when one twin is transgender 40% of the time, the other twin is too, which is genetically significant. There are even case reports of twins raised apart and both coming out as trans.

Of note, the Royal Children’s Hospital in Melbourne, Australia, has seen more than 700 children diagnosed with gender dysphoria, and only 4% of those children ‘grow out of it’. 96% of those diagnosed as trans as children remained so at late adolescence. On that alone, it appears that the medical field hasn’t bought the affirming paradigm completely, as they do acknowledge the 4%. So the real question is, what do we do about the 4%? I put to Peter that I think he has the answer. I also put to him that:

“I do agree that dissenting doctors should not be silenced or fired. But the silencing or firing that has happened is not necessarily an indicator of a cover-up. The dissenting science is given consideration in ongoing longitudinal studies. If the longitudinal studies will support dissenting views, then it will show.”

Pete reiterated that it’s clear that dissenting studies are strongly discouraged, and that amongst gender affirmers, such as myself, there is a bias against dissenting views and a bias towards the affirming paradigm, ensuring their studies have questionable scientific value. I disagreed, and he continued:

“I have noticed the presence of bias in the scientific world frequently. In the field of transgender studies there’s a glut of light and fluffy affirming studies and no or very little scientific dissent apparent, which is necessary for good science. There are accusations of self-peer reviewing and bias in peer reviews. I wouldn’t trust their conclusions when they seem desperate to prove ‘born that way’. The subjectivity of gender as discussed in the Rebecca Reilly-Cooper video exposes the trans movement as ideologically based, and one that is currently elevating the subjective feeling of gender identity over the reality of biological sex, changing our society. This is typical of the leftist thinking that also produces ‘science’ that denies the existence of race, and shuts down studies in the area by calling it ‘racist’.

Dissenting science in the trans field is simply called ‘transphobic’. You may claim I must not have been a real trans (and that is the reason I detransitioned), but I can assure you I had the dysphoria we spoke of earlier, transitioned, and lived happily for 20 years before questioning the entire concept. My experience is evidence that it is possible to find a way to end the dysphoria and accept our biological sex, and I can assure you that I wasn’t ‘born that way’, and I bring the message that others can also affirm their biology over their gender identity, that it can be overcome.

Overcoming dysphoria is being able to feel comfortable with the biology you were born with, in my case taking testosterone has helped with this, which leads me to think that low levels of testosterone contributed to my hatred of being male. Which also suggests people who are given opposite sex hormones would contribute towards strengthening their trans identity. Overcoming the need to go against your innate biology would be different for each person, because there are many causes, including psychological/trauma that contribute towards gender dysphoria. Reparative therapy is a good model to use, as well as the hormonal side. Such therapy should be encouraged, in fact there is no reason why biological sex affirming treatment shouldn’t be tried first and studied for effectiveness, and studies of this sort are very few: there is a huge ideological bias against this treatment.”

I have no idea what my testosterone levels were by early adulthood. Regardless, wouldn’t you think then that my male puberty would’ve reduced my gender dysphoria, not increase it? It is my position that increasing testosterone levels only made my dysphoria worse. It is the psych’s role to address comorbidity issues, which they do. Of course, the not-so-good psychs won’t address comorbidity issues, but there are bad apples around wherever you go. I did not experience any psychological trauma growing up that contributed towards my dysphoria. Rather, it was the other way around: the neglectful decision to not treat my dysphoria in childhood by means of transition exacerbated my dysphoria further than needed. I wanted to know from Peter what effective reparative therapy looks like, especially for effectiveness:

“Everyone’s different. I’m not here to judge or dispute the experience that is real for you, but to use my experience and logical conclusions to say there is another way to look at it, if they so choose. I know of many cases of successful reparative therapy and heaps more ex-homosexuals who have reclaimed their lives through Jesus, and I know many detransitioners who have decided to leave transgenderism, and feel much better for it, including me.”

I tried detransition once due to social pressure, and I am never trying it ever again. I can’t see this matter any other way other than transition for myself. My final word: detransition stories can be far more complicated than tabloid headlines would have you believe, sometimes distorted and abused. Peter is a pseudonym, and we agreed to disagree.