The Mainstream Media Needs to Talk About Detransitioners

Or: The op-ed that no one would take

I’m very glad that the LA Times took my op-ed on the implications of turning tomboys of the past—real and fictional—into trans boys as we know them today. We have an understanding of gender that is very much located culturally in this moment, very different from understandings of the past and, hopefully, different from future understandings if we allow our knowledge to evolve. Big if, I know.

Some people called the piece a cop-out because I didn’t condemn these portrayals or call it lesbian erasure or say that gender identity ideology is causing grave harm to children. To them I say: You might have good points, but would any mainstream newspaper take an op-ed like that right now? To be honest, I sent this piece to The New York Times, The Washington Post, Time, The Atlantic, The New Yorker, Newsweek and CNN. Two of those places got back to me with nos; the others didn’t bother to reject it. I feel very lucky that I had such a caring, careful and respectful editor at the LA Times who allowed me to express these points, and I have had some incredible email responses from people who felt relieved that we could stop the fighting for a moment and sit with complexity.

The following piece was also rejected or ignored by most of those places, along with Persuasion, Common Sense with Bari Weiss, USA Today, The Wall Street Journal (too left for them, as discussed earlier), Columbia Journalism Review, and Slate. I wanted to do Laura justice by sharing her story, and the research about detransitioners, to a wide audience in the mainstream media. I’ll share it with you here and hope that you will help me disseminate it.

---

Image: Wikimedia/Creative Commons

The Mainstream Media Needs to Talk About Detransitioners

Their experiences are key to creating good health care for gender-diverse youth

Laura was never like any of the other girls—that is, she was never girly. At 11, she was diagnosed with autism, though she never received any help with navigating the world as a person with autistic traits. She’d suffered severe childhood abuse, and was later diagnosed with PTSD. She has polycystic ovarian syndrome, which can cause higher-than-normal levels of testosterone in females, and, she suspects, may have contributed to her gender nonconformity, since there are connections between testosterone and male-typed interests.

As puberty hit and her differences from traditional girls were exacerbated, she sank into depression. She seemed to be attracted to gay men, who never returned her affections. She was friendless. With each passing year, her despair and isolation increased.

At 15, she found trans people on Tumblr, and her school’s gay-straight alliance taught her about gender identity. Maybe, she thought, she was genderqueer. “I was like, well, that seems to make sense,” she said. “I’m very androgynous and I don’t really know what else you would call it.”

Changing her identity didn’t alleviate her suffering. She became suicidally depressed, hospitalized several times, and desperate for relief. At 18, she began to identify as trans. A psychiatrist later diagnosed her with gender dysphoria, and at the appointment where she got her testosterone, she scheduled her double mastectomy, otherwise known as top surgery. It all happened within months.

Those changes did not provide relief, either. “It had nothing to do with my body, so I felt no better,” she said. Eventually, she detransitioned: She went off testosterone and spent the next four years learning to be comfortable with her nonconformity and slowly making peace with a body she had permanently altered.

No one is keeping track of how many kids and young people regret medical transition—or how many are helped by it—so nobody knows how common Laura’s story is. More detransitioners are speaking out on social media and forming their own networks and groups, and a 60 Minutes episode featured a few of them in a story about trans health care.

But rarely have mainstream or left-wing media outlets dared to discuss them, other than to say why we shouldn’t. I was once told by an editor at a center-left news outlet that I shouldn’t use the word in a story to refer to those who regret changing their bodies, because one activist doctor had said it was a “fraught claim.” After a top gender-affirming surgeon and a gender-affirming psychologist, both trans women themselves, tried to blow the whistle on “sloppy” care,  the United States Professional Association for Transgender Health (USPATH) and the World Professional Association for Transgender Health (WPATH), which provide guidelines for treating gender dysphoric youth, officially opposed practitioners discussing these matters in the press. But it didn’t matter; the mainstream press ignored their explosive claims anyway, and many people I talked to decided that because this story wasn’t in the mainstream press, it wasn’t worth believing.

Some lobby groups and activists try to dissuade the media from referencing detransitioners at all, or try to control how the media writes about trans kids, rather than acknowledging that some kids suffering from gender dysphoria may not continue to identify as trans, and should be given therapy first and not leap to medical interventions. They fear that acknowledging them will contribute to the legislation aiming to ban gender-affirming care for minors. But some of the most experienced practitioners in the country, including adult trans people themselves, disagree. They think that not acknowledging detransitioners will backfire, and cause the whole industry, and the acceptance trans people have recently gained, to collapse.

Still, the left and center media continues to report a singular narrative. They paint those who critique the medicalization of gender nonconformity as hateful, rather than as concerned about children’s safety and wellbeing, and they push the contention that regret is rare and that people only detransition because of stigma, access to care or financial problems, when the research on that is paltry.

But a new study by therapist Lisa Marchiano in the Journal of Analytical Psychology, as well as a new study by Lisa Littman in the Archives of Sexual Behavior, interrupt that singular narrative, finding that more people are detransitioning because they never should have altered their bodies in the first place.

Marchiano’s study is a narrative of one individual detransitioner, whose complicated mental health and familial problems were ignored by her parents, the school psychologist and the clinic that facilitated her transition. Littman’s survey of 100 detransitioners finds that kind of experience all too common. Some 71% of respondents said that they, like Laura, believed that medical transition was the only path toward feeling better. The same number did not want to be associated with their natal sex or said their body felt wrong. They understood transition as the way to relieve gender dysphoria, and that it would allow them to “become their true selves.”

Participants said they experienced pressure to transition; that therapists presented transition as a panacea; doctors pushed hard for drugs and surgery; and friends told them they should transition—sometimes relationships depended on it. Some 60% of the detransitioners returned to identifying as their biological sex once they understood that the biological categories of male and female could accommodate them and their nonconformity. And almost three-quarters did not report their regret to their doctors or therapists; that means their stories are not being heard by the people who facilitated their transitions.

Unlike in past studies, external pressures counted less—23% experienced discrimination and 17% worried about the financial cost. More than half of respondents said they had not been properly evaluated by doctors of therapists, and 65.3% said their evaluations did not investigate whether trauma played a role in their desire to transition.

In other words, they did not get good health, or mental health, care, in part because they were fed a one-sided narrative, supported by both the media and the medical establishment.

This is just one small study, conducted by Littman, whose past research on rapid onset gender dysphoria—also a phrase the left and center media will only utter to debunk it—was incredibly polarizing. People who detransitioned because of external pressures may not have been willing to participate in her study. But that doesn’t mean that the media shouldn’t report on it, and that the medical and mental health fields shouldn’t be carefully scrutinizing their approach.

Littman’s study doesn’t conclude that no young people should receive medical interventions for gender dysphoria. It comes to the mild conclusion that “Future research about gender dysphoria and the outcomes of transition should consider the diversity of experiences and trajectories.” That is, more than one story needs to be told, more than one experience considered. It further concludes that “More research is needed.” Yet somehow that is a controversial, or even transphobic, claim.

It’s our job in the left and center media, of which I consider myself a part, to give the full story, and to move past the activist argument that doing so is hate speech or will make trans people vulnerable. I’ve tried to sell versions of that story, of this story, to every major newspaper and magazine I could think of, but no one will consider it. Until that changes, this issue will be hopelessly politicized, keeping us from seeing a complicated issue more coherently.

Cost-benefit analysis is the backbone of policy-making, but we cannot make good policy about gender dysphoric youth if we don’t acknowledge the costs. And even if it’s a small group that’s being harmed, that cost—removing healthy body parts, making permanent and unwanted changes—is a high one. While many people report being happy with transition, we can’t silence detransitioners and then say regret is rare.