Detransition is Not a Death Sentence

Stop predicting the ending to our stories

Over the past few months, I’ve been concerned by a couple of narratives being presented around detransitioners and what our lives will look like.

The first condemns every person who might detransition to a life no longer worth living. In it, detransition means realizing that your body will never be what it used to be; that you may now have chronic pain or ongoing medical issues; that you may have permanently reduced your options for dating; that you may never have a healthy relationship with sex; that you may have lost the ability to have children; that you might be mistaken for the opposite sex for the rest of your life; and the expectation is that the burden of coming to this realization will surely overwhelm them so much that they will never recover and likely commit suicide.

Are those things possible? Yes.

Are they horrifying to realize? Yes.

Is it objectively a tragedy? Yes.

But let’s not pre-emptively kill detransitioners. Have we learned nothing from the very narratives we rail against?

Let’s sidebar.

There is a false belief that altering your body is a form of suicide prevention. We all know this is a false belief. The data does not support the claim that transition will stop someone from killing themselves. At best, it can be said that individuals who have access to medical transition self-report that their mental health improved during short-term follow-up. (I probably would’ve said transition made my life better until the year before I detransitioned. Subjective perception means nothing.)

Many people have talked about how damaging this transition-or-die belief is. The affirmation approach forecloses any other options — you’re trans, end of story — and the “lifesaving” narrative plants the belief that, unless you transition, there is a high likelihood that you will kill yourself over the distress. Any vulnerable and desperate person would be drawn to the idea that they could eventually achieve happiness and success in life simply by changing their body.

But again, the data doesn’t suggest this. It doesn’t even suggest that trans-identified people are killing themselves at unprecedented levels. Suicidal ideation in trans-identified people is about the same as suicidal ideation in people with comparable mental health conditions. Let’s not downplay the severity, of course. They are still highly distressed, and many of them are in desperate need of immediate help, but telling parents they’ll either have a live son or a dead daughter is not only grossly manipulative; it’s dangerous.

It’s dangerous because suicide is a social contagion. Hearing about suicide causes others to contemplate suicide, especially if the person overidentifies with the perceived “cause” of the suicide. Guidelines from suicide prevention agencies about how to report on suicide warn against the very way it is weaponized by activists. These are a few from the Samaritans website.

• There should always be references to suicide being preventable.

• Do not speculate about the “trigger” of a suicide; it oversimplifies the reasons someone may end up taking their own life.

• Extra caution should be taken around young people, who are especially susceptible to contagion.

In 2010, after the media featured several high-profile suicides of bullied gay teenagers in the United States, Dan Savage and Terry Miller launched the It Gets Better Project, inviting people (of all orientations) to make videos with the hope of encouraging resilience. The videos were pleas not to give up, because high school can be awful, and the best is yet to come.

Youth who are trans-identified generally don’t have people telling them that it’s going to get better. They have people telling them that they are entitled to whatever drugs or surgeries they personally feel will cure what ails them, and if they can’t access it, their lives are at risk. This is not creating a generation of survivors; it’s creating a generation of victims.

No one should have death suggested as a solution to mental distress.

This includes detransitioners.

We are at the beginning of what is likely to be a tidal wave of people realizing they have been lied to about what medicalization can and cannot offer. It’s an awful betrayal to come to terms with, especially when the consequences are concrete and lifelong. There also aren’t very many examples (yet) of people who had their bodies altered, lived for a period of time as the opposite sex, then publicly resumed living life as their own sex. It’s hard to picture what our lives are going to look like when we have no frame of reference, and it’s very easy to be pessimistic about the future.

It’s also very easy to believe that “reversing” everything will solve the issue. Throw money at the problem. Alter your body even more.

A little while ago, I was made extremely uncomfortable when I saw a crowdfunder that had been set up for a young detransitioned woman which included a laundry list of surgeries to try and “get her back to herself”—not just laser hair removal and breast reconstruction, but things like voice feminization surgery, chin reduction, rhinoplasty…

I understand the appeal of more surgery. Every detransitioner does. We’ve all been down the rabbit hole obsessing over an image of our ideal selves. Surgery offers a quick fix. Working through your issues and coming to a place of acceptance takes hard work and, often, a very long time.

So what happens when you’ve exhausted every cosmetic procedure and you’re disappointed with the results? Or you’re just as mentally unwell because nothing beyond the surface has been addressed? How is this any different than medical transition in the first place? We’re once again telling young people that if they just alter their body to look the right way, everything will get better for them.

No. Absolutely not.

More and more, I have been seeing detransitioners emphasize that the process we go through is not simply one of de-medicalizing (or re-medicalizing, as the case may be). In my first year of detrans advocacy, I had a simplistic definition of “detransition” that primarily involved ceasing cross-sex hormones and “living as one’s sex” to the extent that doing so is possible.

But as new detransitioners arrive on the scene and choose different pathways for themselves, everything feels much more complicated. Every one of us being a unique individual, we all have different values and priorities. Who am I to demand a detransitioned woman shave her facial hair? Who am I to tell a detransitioned man who can’t produce sex hormones that he must take exogenous testosterone in order to “be a man”?

There is nothing that anyone has to do to be their sex. There is no effect from medicalization that must be reversed, no surgery that must be corrected.

I am a woman with scars where her breasts once were; with coarse hair growing on my cheeks and chin; with a voice that has been deepened by synthetic hormones. I could live my life in any way that I choose, including slipping back into a “male” social role and going mostly undetected, like I was doing for a decade before I detransitioned. But I would remain a woman. I have been a woman the whole time.

The lesson learned from detransition is one of reconciling with reality: coming to terms with what our bodies look like now; learning how to adjust the expectations we had for our lives; and recognizing that no alteration of our bodies can change the fact that biology endures.

It is a process of grief, but the pain is not insurmountable. Nor can it be repaired with more surface modifications—such choices should be made after thorough and careful consideration, not when one is desperately trying to latch onto the hope that one can simply get one’s old body back.

Neither extreme pessimism nor extreme optimism is useful at the end of the day. Don’t try to predict our outcomes, and start talking about what we can realistically do to make things easier to bear. It’s no different from any other human experience: make connections with people who understand; develop the skills you are lacking (critical thinking, time management, conflict resolution, etc.); and once you’ve made it through the hardest part, focus on what is still available to you that gives you meaning in the long run.

What happened to us will never be okay, but we will be.