The aim of this study was to analyze the pathways of detransitioning, which is a rare, but serious complication of gender-affirming treatments (GATs). The patient group consisted of all patients who were referred to the Helsinki University Hospital’s Gender Identity Clinic (GIC) wanting medical treatment for detransition from 2018 to 2019. A new assessment was made systematically and retrospective data were collected. The sample consisted of nine patients originally diagnosed with gender identity disorder (F64.0). Seven of them were assigned female at birth and two were assigned male at birth. All seven females at birth had “major” regret and both males at birth had “minor” regret. All patients except one male assigned at birth wanted their previous GAT to be reversed. The mean regret time (i.e., time from the first diagnosis of F64.0 to the beginning of the new evaluation period) was seven years. The detransitioners had a high number of psychiatric diagnoses. Childhood trauma, sexual abuse or rape, eating disorder symptoms, borderline personality, and psychotic symptoms were common among detransitioners. Retrospectively, the patients reported that the need for transitioning in the first place was not the transgender identity or gender dysphoria, but reasons related to the maturation process and unresolved psychological stressors. An assessment made by the psychologist at the GIC revealed childhood trauma and severe challenges in parenting and attachment. It is important to acknowledge, support, and evaluate those regretting treatments and/or detransition, and to learn from them.
The number of detransitioners appears to be growing. Compared to a Swedish study in 2015 (Dhejne et al., 2011) where 15 people wanted to detransition during a 50-year period, in this study there were nine detransitioners in two years (2018–2019). The following year the number of detransitioners was even higher: nine in one year (2020). In addition, it is probable that this study or any study about detransitioning is likely to miss a fair number of detransitioners. Returning to the clinic is mentally burdensome for many reasons. Only the patients who seek treatment or are applying for a new legal gender will return to the GIC. In addition, they need to be in a psychiatric condition that allows them to do it. In a recent online study (Littman, 2021), only 24% of detransitioners informed their doctor or clinic that they had detransitioned. In another online study (Vandenbussche, 2021), only 29% of detransitioners reported getting help from the same doctor as in their transition. The regret rates today are probably higher than previously assumed. This study was not able to determine the regret rate because the naturalistic sample consisted of only those detransitioners who contacted our clinic on their own initiative.