Overview: “Detransitioning” is a difficult and controversial issue in the LGBT+ community. Although rare, medical providers, including rehab centers, should be fully informed on what detransitioning is, what it isn’t, and how they can offer a supportive environment to this population.
What Is “Detransitioning?”
On a strictly factual level, detransitioning is the ending or reversal of gender transition, either temporarily or permanently. It can happen due to a number of factors, including social pressure, health concerns, lack of financial means to continue treatment, or a realization that their gender identity is not what they believed it to be.
Unfortunately, the narrative around this topic is oversimplified, where the focus is often on the “regret” of people who have detransitioned. This overlooks the fact that detransitioning is a small percentage, predicted to be approximately one percent, of what’s estimated to be less than one percent of a given population.
It also fails to consider that many detransitioning situations are potentially involuntary. This can be a source of severe personal distress, as detransitioners can feel isolated or struggle with self-esteem.
Gender confirmation surgery is not performed lightly. The World Professional Association for Transgender Health (WPATH) issues standards of care for gender confirmation, a 120-page document that includes recommendations for mental health, speech and voice therapy, hormone therapy, and other topics. In addition, these treatments are not always covered by insurance, and doctors trained in transgender health are not yet widely available, both of which create obstacles to transition.
Those who do receive treatment very rarely note any regret at all, usually related to specific results as opposed to the surgery itself. There is often a strong correlation between better mental health and a safe, supportive transition.
Thus, people who halt or reverse their gender transition often have special mental health needs that are not well met by their own communities.
Detransitioning and Mental Health
A study of 237 people living with detransition conducted by a German researcher found that people in detransition often need complex medical care related to the end of hormone therapy, complications from surgery, and other needs.
It also found a lack of support from all sides of the issue. Medical professionals, mental health professionals, and the wider LGBT+ community were all found to be sources of negative experiences. Poor understanding of the topic and a belief that detransitioning individuals were “giving in” to social pressure, were the most commonly reported issues.
Above all, people in detransition found it most helpful to speak with others in the same situation. As it’s such a rare situation, often those with similar experiences offer the most helpful support.
While detransition is rare, the higher incidence of substance use disorders in the trans and LGBT communities indicates that rehab centers and other recovery specialists will need to prepare for detransitioning residents. Following are some ideas on ways to do that.
- Keep reference documents, such as WPATH standards of care, on file and accessible.
- Ensure access to digital support groups, where possible.
- Provide access to mental health professionals who specialize in gender identity issues.
- Train staff on gender identity concerns and their impact on mental health in general.
- Residents should have materials available to learn more about gender identity.
- Be attentive to the needs of detransitioning people. Care, respect, and attention are often what’s most helpful in creating a supportive environment.
How Harris House Can Help
At Harris House, we take a holistic approach that includes gender identity issues to treating all individuals with substance use disorders. We believe that everyone deserves a supportive place to get started on the road to recovery. If you or a loved one need help with substance abuse treatment, call us to learn about admissions.