What Data Shows About Transgender Detransition and Regret

A recent push in GOP-led states has focused on banning or restricting access to gender-affirming care for transgender minors amid concerns they might regret transitioning later on, with lawmakers saying the surgery has "life-altering" risks and is "irreversible." While transgender people choosing to detransition is not unheard of—it rarely happens, according to recent data.

The World Professional Association for Transgender Health (WPATH), which provides guidelines for gender-affirming care, recently updated its guidelines for treatment and cited a 2022 study by the International Journal of Transgender Health that partially detailed the extent to which transgender people might regret transitioning later on in their lives.

Gender-affirming care offers various types of support for transgender and nonbinary people, such as medical, surgical, and mental health services. The treatment also includes puberty-blocking medication to temporarily stop sexual development, according to the American Psychological Association (APA).

The International Journal of Transgender Health's study mentioned that individuals going through a process of identity exploration "should not necessarily be equated with regret, confusion, or poor decision-making because a TGD [transgender and gender diverse] adult's gender identity may change without devaluing previous transition decisions." However in last year's study, it was recommended that irreversible gender-affirming treatments should be avoided until clarity is reached in the exploration process.

The study also cited a Dutch research from a few years ago that was based on clinical follow-up studies of adolescents with childhood gender dysphoria who received puberty suppression, gender-affirming hormones, or both. The Dutch research found that "none of the youth in adulthood regretted the decisions they had taken in adolescence."

In 2021, a study published by Mary Ann Liebert, Inc., which publishes peer-reviewed research, looked into the reasons for past detransition among TGD people in the United States. Researchers surveyed 27,715 TGD adults, including 17,151 people (61.9 percent) who said they had gender-affirming treatment, with 2,242 (13.1 percent) of them reporting a history of detransitioning. However, the majority of those who detransitioned (82.5 percent) said their decision was influenced by external factors such as family pressure and societal stigma.

"A total of 15.9% of respondents reported at least one internal driving factor, including fluctuations in or uncertainty regarding gender identity," the study from 2021 read.

Researchers added that "clinicians should be aware of these external pressures, how they may be modified, and the possibility that patients may once again seek gender affirmation in the future."

Additionally, the Associated Press reported in March that only about 1 percent of individuals who had transgender surgeries expressed regret. That was based on a review of 27 studies, which involved some 8,000 people who were mostly in the U.S., Europe and Canada.

Health care professionals who provide gender-affirming care follow WPATH guidelines and typically have a pre-surgery process in place in which patients undergo necessary mental, psychological, and physical assessments, according to Mount Sinai, a New York City-based hospital group.

"Typical standards require letters of recommendations from a health care provider. Generally, you need one letter for facial surgery, one for chest surgery, and two for genital surgery," read the gender-affirming surgeries page on Mount Sinai's website. "Letters should come from a psychologist or psychiatrist working in the field of transgender health care."

Newsweek reached out by email to a number of experts on trans and LGBTQ+ issues.

Update, 6/18/2023 at 10:52 a.m. ET: Additional data from an Associated Press report was added.