Where Detransition Narratives Go Awry

The problem isn't admitting that detransitioners exist; the problem is how and why we talk about them.

The existence of detransitioners — people who undergo some degree of gender transition but decide to stop transitioning or revert back to their gender assigned at birth — has been weaponized to justify harm and discrimination against transgender people. Why do so many people find detransitioners’ stories so compelling that they are disproportionately highlighted over those of happy and healthy trans kids?

Before I meander through a lot of different points, I want to just state upfront the two takeaways I’m hoping to convey here:

  1. Detransition narratives are captivating because cis people can more easily relate to the experience of being not transgender than they can to the experience of being transgender.

  2. To the limited extent they are relevant to health care, detransition narratives should compel us to improve access to affirming transgender care for kids, not restrict it, but they are told with an anti-trans bias.

Let’s go.

The 60 Minutes segment

On May 23, 2021, CBS’ 60 Minutes aired a segment that trans rights activists had been dreading for months. That’s because many of them had been invited to participate, and declined upon learning the segment would focus on detransitioners. Indeed, the segment turned out to be as problematic as they feared.

It hit almost all the tropes that activists warned producers to avoid. It featured only one trans kid who had a good experience transitioning, compared to a whole panel of detransitioners (more than 30 were interviewed). It disproportionately emphasized the voices of professionals who express some degree of skepticism about affirming treatment — unsurprisingly two of Jesse Singal’s go-to interviewees. The segment also recycled some of the utterly false claims that YouTube and social media were somehow turning kids trans through some kind of “social contagion.”

It was only in a 60 Minutes Overtime segment, which did not air with the main story, that the producers truly wrestled with any of these concerns, and they still defended their story as being about “health care.” Unfortunately, they served up exactly the narrative that opponents of trans health care wanted to hear — and they heard it loud and clear.

With many states still considering bills to ban, criminalize, or otherwise limit affirming health care for transgender youth, 60 Minutes only fed into fears that transition was dangerous or harmful. Detransition narratives have been at the heart of attacks against the trans community over the past few years, from Ryan T. Anderson’s book, to Jesse Singal’s reporting, to the growth of the false “Rapid Onset Gender Dysphoria” narrative. These anti-trans campaigners are using the existence of detransitioners to convince themselves and others that kids cannot and should not be allowed to be trans, and it’s a massive distortion of the truth.

Detransitioners are real, but the exception.

Transphobes often complain that transgender people reinforce gender stereotypes, but most don’t realize that this was often forced upon trans people seeking care. Historically, trans people have been subjected to “gatekeeping” when pursuing medical support. This meant that doctors created hurdles that trans people had to overcome to prove they were trans and access the care they needed. At times, that even meant conforming to stereotype to prove they were willing and able to live as the gender they hoped to transition to — for a full year or longer — before they could take any medical steps to resolve their dysphoria.

Over the decades, trans activists and their care providers have learned that such gatekeeping is problematic. It can stigmatize and torture trans people, force them to ironically present as someone they aren’t (there are butch trans women and femme trans men!), and needlessly delay them receiving the care that they need. Over time, the Standards of Care have improved, transgender visibility and acceptance have increased, and so too has the demand for transgender medical care.

As a result, the pendulum has swung away from gatekeeping, but in some cases it has arguably swung too far. Dr. Marci Bowers, who was only featured in the unaired 60 Minutes Overtime segment, noted that there are an increasing number of gender clinics and surgeons who are “popping up to meet the demand” but not following the Standards of Care and who aren’t properly trained to produce good results. And this can begin to explain how people could be receiving care not consistent with the Standards of Care.

Some of the most prominently shared detransition narratives, including those featured in Ryan T. Anderson’s book and those highlighted on 60 Minutes, feature stories about receiving care very quickly and without a proper diagnosis. As interviewee Garrett told Lesley Stahl, “I went for two appointments and after the second one I had, like, my letter to go get on cross-sex hormones.” He added that he received surgery after just three months on hormones, which is inconsistent with the Standards of Care. But in many of these cases, there are other mental health concerns underlying what the individuals believe they are experiencing as gender dysphoria. Rushed misdiagnosis leads to the wrong treatment, and some only realize this too late. The problem isn’t that affirming care exists; it’s that they received the wrong treatment for their issues.

These particular detransition narratives, however, represent only a fraction of the already small minority of people who experience transition regret. Research from the 2015 U.S. Transgender Survey found that 82.5% of those who detransitioned did so because of external pressure, such as pressure from family, unwelcoming schools, and vulnerability to violence, including sexual assault. So even framing detransition only around misdiagnoses in health care erases most of the people who have experienced detransition, as well as the many anti-trans factors responsible.

Worse, many of the detransitioners most eager to tell their stories of misdiagnosis have been coopted into the service of transphobia. People like Ky Schevers, who writes at Reclaiming Trans, have been raising awareness about how anti-trans activists try to capitalize on the pain some detransitioners experienced to compel them to turn against transgender people. Their willingness to join the anti-trans movement is then weaponized against all trans people (including those who might not have detransitioned but for stigma and discrimination):

The existence of detransitioners does not change the reality that the overwhelming majority of trans people do not regret transitioning. The question posed by these specific narratives is to what extent affirming trans care can be, in some situations, too lax. Does the pendulum that swung away from gatekeeping need to swing back in that direction to minimize the likelihood of people having to detransition? Opponents of trans rights — the “gender critical” and “gender skeptical” — are adamant that the answer is yes and thus we must ban all affirming care for trans youth.

They are lying.

We need better, smarter care for trans youth.

The answer to the pendulum question isn’t about how strict or lax the care is for transgender youth. The answer is how smart the care is.

When I wrote my 2017 feature report on health care for trans kids (which I hope you’ll still go read if you haven’t), my main focus was debunking the “desistance” myth, the distortion of older research that attempts to claim most “trans” kids turn out to not be trans. Detransition narratives capitalize on the same bias against transgender people: If I can keep my kid from turning out trans, they’ll be better off.

Julia Serano is still, for my liking, the best at explaining the double standard inherent in this thinking:

For example, authors often raise fears that some children (i.e., ones who are “really cisgender” in their minds) may be pushed into the “wrong” puberty, and thus may have to undergo expensive medical procedures to correct those bodily changes. But this precisely describes what a trans child would face if they were not allowed to transition until adulthood. If the former example concerns you, but the latter one doesn’t, then that’s a clear sign that you value cis bodies and lives over trans ones.

While I think Serano is spot-on, I do think her framing might not resonate with trans skeptics who, despite the harm they are causing, genuinely don’t believe they’re taking a prejudiced position (or at least insist they aren’t). So I offer this alternative framing I hope people will consider when hearing about transgender issues and detransition narratives:

Cis people can more easily relate to the experience of being not transgender than they can to the experience of being transgender.

We all have a natural bias toward our own experiences, and most of us are cis, not trans. Even in would-be allies, this bias might be compounded by knowledge of the challenges trans people face going through transition and the discrimination they face for doing so. So of course, when it comes to protecting the children (a particularly effective framing for discriminatory political messaging), many people are more inclined to latch onto narratives about kids not turning out trans.

All of the messaging informing skepticism around affirming trans youth focuses on this instinct in intersecting ways:

  • Desistance: My kid might not turn out trans, so it’s better if I can prevent that.

  • Social contagion/”Rapid onset gender dysphoria”: My kid isn’t actually trans, so if I just cut off their access to pro-trans narratives, they’ll stop thinking they are.

  • Detransition: Other kids regretted transitioning, so that’s all the more reason to keep my kid from transitioning.

The only thing that has changed in the nearly four years since I first published my report on why trans kids deserve affirming care is that there is now even more research supporting this point. Not only do studies increasingly show how trans kids benefit from the opportunity to transition, but they are also doing more to rebut the kinds of myths informing skepticism.

For example, The Trevor Project’s recent National Survey on LGBTQ Youth Mental Health found that trans and nonbinary youth are less likely to attempt suicide when their gender identities are respected. The distinction wasn’t subtle. The kids who received no respect for their pronouns were nearly twice as likely to have attempted suicide than those who received universal support. This speaks to just how much mental health anguish is caused by rejection of these young people’s identities.

Another recent study directly undermines the “Rapid onset gender dysphoria” (ROGD) narrative. ROGD was concocted by anti-trans parents who didn’t want to believe their kids were actually trans, so they invented a fake diagnosis to suggest that the kids were being brainwashed to suddenly turn trans when they really weren’t. A recent study, however, surveyed both trans youth and their parents and found that the kids could trace back their own feelings of being trans several years before their parents believed they started experiencing them. The kids were feeling trans long before they came out as trans, but the parents were seeing the feelings and the coming out of the feelings simultaneously. Thus, what parents might perceive as a “rapid onset” had been underway in their kids for far longer.

We don’t need to be more skeptical of whether to let kids transition; we just need to be smarter about following the Standards of Care we already have. When administered properly, the current model is designed to give kids time through early social transition and perfectly safe puberty blockers to make sure that more permanent steps like cross-sex hormones are the right steps. It’s not about the gatekeeping of the past, which forced adult (post-pubescent) trans people to endure dysphoria for longer. It’s about making sure young people like Garrett aren’t handed cross-sex hormones and surgery inconsistent with the Standards of Care.

But cases like Garrett’s are so exceptional that they bear no connection whatsoever to the bills currently pushed in various states to ban affirming care for trans youth. Lesley Stahl’s attempt to justify the piece by claiming the detransition narrative was about health care only serves the narrative driving this legislation. And if Stahl and the 60 Minutes producers had listened to the trans community about that, they might have gotten it right. But they missed crucial details about the stories they were telling.

What’s wrong with telling detransitioners’ stories?

Grace Lidinsky-Smith, the detransitioner most prominently featured in the 60 Minutes segment, posed this question on Twitter a few months ago:

This isn’t how I’ve seen anyone attempt to portray detransitioners, but that’s besides the point. The Trans Journalists Association has a direct answer to her question: These stories are disproportionately told and they “misrepresent the social and financial complications of transition.”

But that answer assumes that Lidinsky-Smith’s motives are sincere. They are not. As Lee Leveille and Heron Greenesmith reported this week, Lidinsky-Smith helped co-found a disingenuously-named group called “Gender Care Consumer Advocacy Network” (GCCAN). Leveille was also a co-founder of GCCAN, but s/he “soon realized that Lidinsky-Smith and other members were actively reaching out to and partnering directly with staunchly anti-trans groups like Rethink Identity Medicine Ethics and 4thWaveNow.” In other words, Lidinsky-Smith is specifically motivated to tell her story by anti-trans advocacy.

By surely no coincidence, 4thWaveNow is also one of the anti-trans, pro-ROGD “parent groups” where Jesse Signal found families to talk to for his notorious Atlantic article fueling skepticism of affirming trans kids.

It’s bad enough that 60 Minutes ignored or downplayed cries from trans rights activists not to shine another spotlight on this narrow group of detransitioners. It’s worse that they were duped into doing so by people specifically trying to harm trans kids by making it more difficult to access the care they need and deserve.

We should be concerned that detransitioners exist and work to improve access to quality affirming care to make sure everyone who takes steps to transition is receiving care consistent with the Standards of Care. Doing so will help reduce the number of detransitioners by reducing both the stigma and discrimination against trans people and the anecdotal cases of misdiagnosis. But that’s not the motive for many of the detransitioned people trying to tell their stories, let alone the anti-trans activists trying to elevate them.

If our response to detransitioners is to limit care for trans youth, we are falling into that old same double standard of preferring kids be forced to turnout cis, even when they aren’t. When 95+% of kids receiving trans care are benefiting from it, we shouldn’t throw them under the bus on behalf of the tiny minority who have gone through detransition or otherwise expressed regret. We need to recognize that being trans is natural and healthy and figure out how to improve the access and quality of care so fewer people end up experiencing detransition.

We know detransitioners exist, and their stories are valid even when their motives are not. But in the face of rampant attacks on trans youth, we need to focus the spotlight back on the trans kids who are thriving to ensure that remains the case.

UPDATE: I made numerous changes to this piece after I first distributed it to better reflect the fact that the people who detransitioned because of misdiagnosis are themselves a small fraction of the people who detransitioned. Stigma and discrimination are the primary causes of detransition, and it was a mistake not to countenance that context.

At the end of the day, I’m still a cis guy talking about the experiences of trans, nonbinary, and detransitioned people. Please click through the many links I’ve included throughout this post to hear more from them directly and seek out more of what they’ve said about these issues. Try to keep in mind your own instinctive biases when you do.

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Until next time, stay platinum!