Spotting Anti-Trans Media Bias on Detransition

Image by Michaił Nowa from Pixabay

While most people who transition are happy with the outcome, a small percentage (likely in the 1 to 3 percent range; detailed below) may later choose to stop their transitions or take steps to retransition back to their birth-assigned gender. These individuals are often referred to as “detransitioners” or “detrans” people, although not everyone identifies with those labels. Their experiences are quite diverse: some detransition for more visceral or personal reasons, while others do so as a result of pressure from family members or societal transphobia; some regret their decisions to transition while others do not; some stop identifying as trans altogether, while others adopt different identities (e.g., nonbinary) and/or continue to participate in trans communities; some detransition permanently, while others may retransition at a later date (Turban et al., 2021; MacKinnon et al., 2022).

Despite this diversity, mainstream media outlets only seem to tell one particular detransition story: The individual in question is framed as someone who is actually cisgender, but who briefly thought they were transgender, and after transitioning they realized they had made a horrible mistake. Often, an emphasis is placed on the “irreversible changes” that accompanied their transitions, which audiences are likely to interpret as “disfiguring” or “life ending” (MacKinnon et al., 2021). While the vast majority of actual detransition stories do not fit this “mistaken and regretted transition” narrative, it seems to be the story that journalists most want to tell and that audiences most want to hear.

So why is the “mistaken and regretted transition” narrative so popular with journalists and audiences alike? Well, there are several interrelated reasons. First, as I discuss in my book Whipping Girl (pp.77–89), cisgender people tend to have a difficult time relating to transgender people’s experiences with gender identity and gender dysphoria, so they instead presume that we must be merely “confused” or “deluded” cisgender people. Second, most people tend to imagine cis bodies as “natural” and “pure” relative to trans bodies, which are “artificial,” “defective,” and/or “corrupted” in their eyes.

As a result, when an individual detransitions, onlookers often presume that they’ve had a realization that they were “mistaken” (read: they were “really cisgender” all along) and interpret their situation as a “tragedy” (read: they “ruined” their otherwise “pure” and “natural” cisgender body).

To put it differently (and borrowing from the “woman trapped inside a man’s body” cliché), the cisgender majority tends to view people who detransition as “cisgender people trapped inside ‘transgendered’ bodies” — which, for them, seems like a fate worse than death. This is why they imagine it as “life ending.”

On top of all that, many people are morally opposed to transitioning and still others are disturbed by it, especially when it comes to trans youth. For such people, relatively rare cases of detransition can be conveniently cited as “evidence” that transitioning should be reined in or banned altogether.

Since very few people who detransition fit the “mistaken and regretted transition” narrative, and most do not oppose trans-related healthcare for others, mainstream media outlets have relied almost entirely on the same handful of detrans activists for their articles and news stories. Notably, many of these activists ideologically detransitioned upon immersion in religious fundamentalism or “gender critical”/trans-exclusionary radical feminism (GC/TERF), and now work closely with anti-trans activist groups. Media outlets that platform these detrans activists rarely if ever disclose their ties to anti-trans activism.

With the rest of this essay, I hope to accomplish two things. First, I will share articles that discuss ideologically motivated detransition, prominent detrans activists’ ties to anti-trans organizations, and mainstream media stories that interviewed these individuals without disclosing their connections to anti-trans activism. Second, I will contextualize detransition — unpacking the concept, poring over statistics and studies, and suggesting potential future directions — for journalists and audiences who wish to learn more about the phenomenon without pitting such experiences against those of happily transitioned people.

Detransition, Anti-Trans Activism, and the Media

A good place to start is with people who used to identify as detransitioners and worked closely with anti-activists during that time, but have since renounced that activism and shared their experiences about it.

Elisa Rae Shupe’s story is told in Jude Doyle’s Xtra article The Making of a Detransitioner: Elisa Rae Shupe was a weapon in the hands of TERFs and Christian conservatives. Now, over 2,600 pages of leaked emails help tell her story, and also in Maggie Astor’s New York Times article How a Few Stories of Regret Fuel the Push to Restrict Gender Transition Care.

Shupe’s emails have shed light onto numerous anti-trans activist campaigns, as reported in the following articles:

• Mother Jones: Inside the Secret Working Group That Helped Push Anti-Trans Laws Across the Country
• VICE News: ‘Under His Wings’: Leaked Emails Reveal an Anti-Trans ‘Holy War’
• VICE News: Leaked Emails Reveal Just How Powerful the Anti-Trans Movement Has Become
• Jude Doyle: Inside the TERF Harassment Machine

Most of what I’ve learned about ideologically motivated detransition has come from former detrans activist Ky Schevers. She is profiled in Evan Urquhart’s Slate article, An “Ex-Detransitioner” Disavows the Anti-Trans Movement She Helped Spark, and in the Anti-Trans Hate Machine podcast episode Detransition Pseudo-Science and Misleading Examples. Schevers has written extensively about ideologically motivated detransition and its many parallels with conversion therapy and the ex-gay movement.

Along with another ex-detrans activist, Lee Leveille, Schevers co-founded Health Liberation Now!, which is described in the linked-to article as “an organization that both puts forward a positive vision of liberation for trans, de/retrans and gender-diverse people through equitable access to healthcare, while also developing resistance strategies against transphobic attacks.”

Leveille has published two reports on the Health Liberation Now! website that are especially pertinent to this topic. The Mechanisms of TAnon: Where it Came From is a comprehensive timeline chronicling how today’s anti-trans movement arose — it includes many instances of ideologically-motivated detransition activists working together with GC/TERF activists over the years. When Ex-Trans Worlds Collide chronicles collaborations between ideologically motivated detransition activists, the Religious Right, and pro-conversion therapy groups to undermine access to trans-related healthcare across the globe.

Once one becomes aware of the existence of ideologically motivated detrans activists, it becomes clear that mainstream media reporting on detransition (especially stories that promote the “mistaken and regretted transition” narrative) relies almost exclusively on such activists. For instance, back when Schevers was still a detrans activist, she appeared in high profile articles about detransition in The Outline and The Stranger.

As Schevers and Leveille have pointed out, detrans activist Grace Lidinsky-Smith has appeared in two high-profile news stories about detransition (one in The New York Times, the other on 60 Minutes), neither of which disclosed the fact that Lidinsky-Smith is the president of Gender Care Consumer Advocacy Network (GCCAN), an anti-trans organization that actively works to reduce access to gender-affirming care.

Schevers has also written about how the three detransitioners profiled in Jesse Singal’s 2018 Atlantic cover story, “When Children Say They’re Trans,” had connections with anti-trans activist groups. A more recent Atlantic article on detransition featured Chris Beck, who turns out to be a conservative Christian influencer who regularly gives interviews to far-right outlets like The Epoch Times and Christian nationalist YouTube channels.

In her previously mentioned New York Times article, Maggie Astor discusses how a handful of the same detrans activists (most prominently Chloe Cole) are being flown around the country to testify at Republican-controlled state legislature hearings as part of their efforts to ban trans-related healthcare.

The lesson here is not that we should distrust or discount the self-accounts of people who detransition. Rather, we should be suspicious of articles and news stories that depict detransition solely in terms of the “mistaken and regretted transition” narrative, both because they ignore the vast majority of people who detransition (whose experiences do not fit that narrative) and disproportionately platform ideologically motivated detrans activists (as they are among the few willing to recount this narrative).

It is not hard to find people whose detransition stories fall outside of the “mistaken and regretted transition” narrative. For instance, Astor’s New York Times article includes perspectives from people who detransitioned because of side effects from hormones, community rejection, economic insecurity, and/or because being nonbinary was a better fit for them — these are all common reasons for detransitioning (see below). In other words, journalists and media producers who ignore this diversity, and instead depict detransition exclusively in terms of the “mistaken and regretted transition” narrative, are likely driven by the unconscious biases I described in the opening section, if not outright pushing an anti-trans agenda.

Gender Bias in “Mistaken and Regretted Transition” Narratives

In Jude Doyle’s aforementioned article, ex-detrans activist Elisa Rae Shupe mentions that the anti-trans activists and journalists she worked with seemed less interested in her story because they were “invested in selling detrans women, not males.” Shupe goes on to say:

“People like me are inferior sales tools . . . Although some people will sympathize with narratives like the one that Laura Ingraham peddled, that I’m mentally ill, and instead of giving me therapy, the VA gave me hormones, etc., it’s not as good of a seller as a damaged young woman.”

Proponents of the pseudoscientific theory “transgender social contagion/ROGD” also focus on how it supposedly impacts “young girls” (read: trans youth who were assigned female at birth). In my recent essay, Explaining Assigned Sex Ratio Shifts in Trans Children, I show that there is no substantive evidence to support claims of a recent “explosion” in the numbers of trans male/masculine people relative to trans female/feminine ones. I go on to make the case that this focus on “young girls” seems designed to appeal to sexist sentiments that such individuals are not fully competent to truly understand themselves and to make decisions about their own bodies and lives.

Furthermore, we live in a culture that is obsessed with protecting straight white girls’ and women’s “purity,” “fertility,” and “beauty.” Given that many people unconsciously view transgender as a form of “corruption” and transition as a form of “mutilation,” it’s no surprise that journalists and audiences may find detrans women’s stories to be especially “tragic” and “life ending.” This too likely contributes to the disproportionate coverage they receive.

Detransition, Regret, and Dynamic Transition Trajectories

If we are going to have a nuanced discussion about this subject, we must first recognize that both “detransition” and “regret” are complex phenomena that are not always associated with one another. For instance, in MacKinnon et al. (2022), 67 percent of the detransitioned people they interviewed “expressed no regrets and/or positive feelings associated with past gender-affirming interventions.”

Let’s start by unpacking “detransition”: Some people only socially transition, for whom “detransition” might simply refer to changing their name, pronouns, and gender presentation. Some people hormonally transition, for whom “detransition” might refer to discontinuing said hormones — the effects of this would be largely reversible for someone who was taking hormones for only a couple months, but less so if they had been taking them for several years. Some people surgically transition, for whom “detransition” might involve either living with those changes or else seeking out potential reversal procedures.

Those who promote the “mistaken and regretted transition” narrative routinely do two things: They 1) emphasize the aforementioned “life-ending” scenarios of detrans people whose bodies have been permanently altered by trans-related procedures, and 2) claim that detransition is likely the result of lax clinical assessment, for which far stricter medical gatekeeping is their proposed remedy. However, these two points are in direct contradiction to one another: The individuals who have experienced the most irreversible changes from gender-affirming care are, almost without exception, the ones who’ve had the most clinical assessment (which is a requirement for trans youth and for most adult gender-affirming surgeries) and the longest “real-life test” (i.e., living full-time as a member of one’s self-understood gender, which has historically been a prerequisite for gender-affirming procedures; see Whipping Girl, pp. 119–122).

In their study, Preventing Transition “Regret”: An Institutional Ethnography of Gender-Affirming Medical Care Assessment Practices in Canada, MacKinnon et al. (2021) found that: “Regret and/or detransition are unpredictable outcomes which strict clinical assessments may not be able to reliably prevent . . . some people will detransition despite rigorous assessments and gender exploration.” They also point out that, “When clinicians delay or deny patients gender-affirming care [as would happen under stricter medical gatekeeping], rather than preventing regret or detransitioning, this may present clinicians with a different set of ethical and legal considerations.” They go onto say that, in addition to the known negative outcomes associated with denying trans people gender-affirming care, it would likely lead some individuals to seek out hormones and other procedures from non-medical sources.

Rather than reflexively viewing detransition as a matter of presumed “lax clinical assessment,” a more productive framework involves recognizing the existence of what MacKinnon et al. (2021) call “dynamic transition trajectories,” or what Turban and colleagues have described as “dynamic gender presentations” and “dynamic gender-affirming needs” (Turban & Keuroghlian, 2018; Turban et al., 2022; see also Turban et al., 2018). That is to say, some people who transition may later experience shifts in their gender identity, often toward understanding themselves as nonbinary. As a result, these individuals’ needs regarding gender-affirming care may also shift accordingly.

Some of the examples of dynamic trajectories presented in Turban & Keuroghlian (2018) and Turban et al. (2018) involve adolescents who found that beginning hormone therapy provided a clarifying moment that helped them to realize that they’d prefer to experience an endogenous assigned-sex-aligned puberty instead. Similar clarifying moments can also be found in trans adolescents who don’t fully realize they are trans until their endogenous puberty kicks in (and it “feels wrong” to them) and in trans adults who were unsure about whether transitioning would be the right decision until they actually began hormone therapy and realized it simply “felt right” to them. In my 2016 Detransition, Desistance, and Disinformation essay (specifically, section #5, “Who should transition?”), I discuss this visceral and experiential aspect of gender-affirming hormones further. The same holds true for exploring gender presentation: Sometimes the only way to know for sure whether we’d be happier moving through the world as another gender is by taking baby steps in that direction.

This is precisely why some trans people start out on low-dose hormone regimes and/or experiment with clothing or going by a new name before more formally transitioning. I am not sure whether instances where people take these sorts of initial steps but then reverse course should fall under the rubric of “detransition” or not — that is a semantic issue, I suppose. But what I do know is that framing such gender explorations in terms of “failed clinical assessment” or “transition regret” makes little sense.

Finally, just as some people who transition may later detransition, some people who detransition may later resume the transitions they previously abandoned. Drawing from a large survey of trans people in the United States, Turban et al. (2021) found that:

A total of 17,151 (61.9%) participants reported that they had ever pursued gender affirmation, broadly defined. Of these, 2242 (13.1%) reported a history of detransition. Of those who had detransitioned, 82.5% reported at least one external driving factor. Frequently endorsed external factors included pressure from family and societal stigma. History of detransition was associated with male sex assigned at birth, nonbinary gender identity, bisexual sexual orientation, and having a family unsupportive of one’s gender identity. A total of 15.9% of respondents reported at least one internal driving factor, including fluctuations in or uncertainty regarding gender identity.

Like “detransition,” “regret” can also have different meanings. Narayan et al. (2021) surveyed surgeons who perform gender-affirming surgeries about their experiences with patient regret (which they reported to be in the 0.2–0.3% range). They documented three different “types” of regret: “true gender-related regret” (typically a change in gender identity), “social regret” (typically due to external pressure from family members or societal transphobia), and “medical regret” (e.g., complications due to surgery). Notably, they reported that only 6.5% of patients who experienced regret believed that they had been “misdiagnosed.”

In other words, just as we shouldn’t conflate “detransition” with “regret,” we also shouldn’t conflate “regret” with inadequate assessment or having been misdiagnosed as transgender. Once again, this confirms my previous point that the “mistaken and regretted transition” narrative only applies to a small fraction of those who detransition, and thus represents a miniscule number of people who choose to transition in the first place.

To put these numbers in perspective, let’s try a thought experiment: Imagine 10,000 people transitioning. If 2% of them experienced detransition or regret, but only 6.5% of those individuals felt that they had been misdiagnosed as transgender in the first place, that would represent 13 people. Out of 10,000. That’s an incredibly small number of people — no wonder journalists and politicians who want to promote the “mistaken and regretted transition” narrative have to rely on the same handful of detrans interviewees over and over again.

Of course, these numbers are all estimates. Very few studies directly measure detransition itself. Most measure the rate of regret or the discontinuation of gender-affirming care, and infer detransition from that. And of course, each study will inevitably differ in sample size, methodology, and what they are testing for (e.g., the efficacy of social transition, gender-affirming hormones, specific trans-related surgeries, and/or continuing through a gender clinic program or longitudinal study). Despite those caveats, meta-analyses and systematic reviews of such studies have found the following:

• Cornell University’s What We Know Project (2018) performed a systematic literature review of 72 peer-reviewed studies and found “a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.”
• Bustos et al. (2021) performed a meta-analysis of 27 studies pooling 7,928 individuals who underwent gender-affirmation surgeries and found a rate of regret less than 1 percent for both transfeminine and transmasculine surgeries.
• Lexi Henny (2023) reviewed over 34 studies related to detransition, desistance, and surgical regret rates and found that the overall detransition rate was about 3.3%, the detransition rate for minors was 4.0%, and the surgical regret rate was 1.7–2.1%. Henny also calculated the combined regret/detransition rate to be 2.5–2.7%.
• Individual studies of gender-affirming care for trans youth have found similarly low levels of detransition, discontinuation, or regret, typically in the 1–3 percent range (see e.g., Olson et al., 2022; De Castro et al., 2022; Tang et al., 2022; van der Loos et al., 2022; Chen et al., 2023; Jedrzejewski et al., 2023).

This is why, when I opened this essay, I stated that the detransition rate is likely somewhere in the 1 to 3 percent range (although you could say “0.3 to 4 percent” if you wanted to include the entire breadth of statistics shown above).

Now, some people would prefer for this number to be higher, albeit for different reasons. Invisibilized minority groups are often ignored, in part, because they are believed to be very rare. So it makes sense that detrans activists and advocates might argue that the rate of detransition is likely higher, as this would suggest that they comprise a significantly sized population that should be taken seriously. In stark contrast, anti-trans activists (and others who are skeptical of, or opposed to, transitioning) will argue that the detransition rate is likely higher because it bolsters their assertions that gender-affirming care is misguided and should be reined in or abolished altogether.

In either case, those who claim that the detransition rate must be significantly higher than 1–3 percent will often forward one (or more) of the following three arguments:

Argument #1: Cite outlier studies. While outlier studies shouldn’t necessarily be dismissed offhand, it’s generally considered to be bad scientific practice to present them as though they are representative, especially in cases like this where the lion’s share of studies all fall within a similar range. Journalist Evan Urquhart has examined studies that have been cited to suggest that the detransition rate may be as high as 7, or 10, or 13, or 29, or 30 percent. He found that these studies either do not actually make such claims and/or that the aforementioned percentages are flawed interpretations of the data presented in those studies.

Argument #2: Claim that “things are different now.” According to this argument, the 1–3 percent findings may have been true in the past, but they do not reflect our current environment in which significantly more people are transitioning. Such arguments are most often made with regards to trans youth (for whom gender-affirming care is often imagined to be “new” and “experimental,” even though it isn’t) and the supposed emergence of “transgender social contagion/ROGD” (which postulates that there is a brand-new contagious form of gender dysphoria spreading among children, even though a slew of recent studies have shown otherwise). Crucially, anti-trans activists have been making these exact same claims since at least 2015–16 (eight years ago!), yet there has been no corresponding increase in detransition or regret (the most recent studies on trans youth cited in the final bullet point above fall in the 1–3 percent range). In other words, there is no evidence that “things are different now” with regards to the detransition rate.

Argument #3: Claim that detrans people are not being properly accounted for in the existing studies. This claim can take numerous forms. For instance, if a study follows trans people for two years after a particular gender-affirming protocol or procedure, one could posit that people who detransition typically do so after year three or later. Or, if a longitudinal study mentions that some subjects were lost to follow up, one could posit that those individuals have likely detransitioned and thus were reluctant to reconnect with their original doctors. Of course, these things could certainly be true for certain individuals or in certain instances, but it’s reckless to speculate that they must be happening on a grand scale without any hard evidence. By the same token, I could extrapolate from Turban et al., 2021 (which found that 13.1% of trans people previously detransitioned at some point in the past) that the 1–3 percent of people who detransition in the previously cited studies will all likely retransition again at some point in the future.

Speculation isn’t science. So we should refrain from inventing rationales for why the detransition rate must be significantly higher or lower than the existing statistics suggest.

While the 1 to 3 percent figure is imperfect (for all the reasons previously discussed), it is nevertheless the best estimate we currently have for the rate of detransition and/or regret. And even if it were a fewer percentage points higher, it would still be far lower than the regret rate for most non-trans-related medical procedures. For instance, a systematic review of 76 studies examining regret in a variety of non-trans-related surgeries found “self-reported patient regret was relatively uncommon with an average prevalence across studies of 14.4%” (Wilson et al., 2017). Another study examining primary care consultations and procedures found that 45% of patients experienced mild regret and 12% reported moderate to strong regret (in their Discussion, the researchers characterized these numbers as “low”; Becerra-Perez et al., 2016).

It’s notable that, in these studies of non-trans-related medical procedures, levels of regret far higher than those observed for gender-affirming care are considered “low” or “relatively uncommon.” This illustrates that 1) people generally understand that all medical interventions come with some level of risk, 2) the existence of “bad outcomes” or “regret” in some patients doesn’t undermine or nullify the positive results experienced by the majority of patients, and 3) many cisgender people throw points #1 and #2 completely out the window when it comes to gender-affirming care. This is most likely due to the biases that I described at the onset of this essay: These people view transitioning as some combination of frivolous, reckless, harmful, artificial, disturbing, mutilating, and/or morally repugnant, and thus cannot fathom that it provides any real benefits to anyone.

Moving Beyond Anti-Trans and Trans-Skeptical Framings of Detransition

Most trans people, people who detransition, and doctors who provide gender-affirming care, would likely agree with the following statement: We should do everything possible to reduce the number of unwanted irreversible changes, whether it be in trans people who may experience endogenous puberties that are incongruent with their gender identities, or in people who seek out physical transition but may later regret it.

Unfortunately, this potential consensus has been undermined by the far greater number of anti-trans and trans-skeptical people — whether they be activists, politicians, pundits, journalists, etc. — who seem heavily invested in pitting detrans and trans people against one another, leveraging the existence of the former as “evidence” that the latter should be denied life-saving care. These anti-trans and trans-skeptical people are interlopers who have no skin in the game, as they will not be personally impacted if gender-affirming healthcare is restricted or abolished.* Their interloper status gives them the freedom to ignore all the aforementioned nuances and the diversity of detransition trajectories, and instead push the “mistaken and regretted transition” narrative at all costs. While they have dominated this debate thus far, from here on out we should dismiss their overly simplistic framings and proposed solutions.

For those of us who do recognize the many complexities of this issue, there are two obvious interventions that would improve the lives of trans and detrans people alike. The first is more competent and accessible healthcare. A recurring complaint is that some doctors who administer gender-affirming care are not very knowledgeable about detransition, and thus are unable to adequately support their clients who do so. Future studies and efforts centered on supporting detrans people (rather than focusing solely on preventing detransition) may help in this regard, as discussed in Hildebrand-Chupp (2020).

Another longstanding problem is that some trans health providers have very binary expectations for their clients, presuming that they must want to (or should) strive for the most cisnormative outcomes possible. (I discuss this at length in Whipping Girl, Chapter 7.) This creates obstacles for gender-nonconforming trans people, and likely coerces some individuals who would be happier being nonbinary and/or experiencing a nonstandard transition (e.g., social but not physical; some procedures but not others) into “fully” transitioning — many detransition stories seem to fall into these categories. This is yet another reason why I find stricter gatekeeping to be a dubious solution: In addition to not preventing unpredictable (e.g., post-transition identity shifts) or ideologically motivated instances of detransition, strict gatekeeping has historically been associated with extremely rigid binarist and cisnormative criteria for patients to meet in order to transition. Reinstating these criteria would only exacerbate this problem rather than resolving it.

This is why I have argued that the gender affirmative model, with its individualized approach that appreciates and supports all gender-diverse outcomes (including nonbinary and nontransition possibilities) remains the best option if we wish to reduce the number of unwanted irreversible changes across trans and detrans communities.

The second intervention that would improve all of our lives is a societal-wide reduction in transphobia and cisnormativity. These forms of prejudice are directly responsible for the pervasive stigma that’s associated with being transgender and gender nonconforming. This stigma forces many trans people to detransition and simultaneously creates obstacles for individuals who are unable to “pass” as cisgender after they detransition.

In a world without anti-trans stigma, we could all explore our genders without constantly facing transphobic social pressure, or pressure to adhere to intracommunity ideals (which arise almost entirely in response to systemic transphobia). If we abolished cisnormativity, it wouldn’t matter so much if we appear somewhat gender nonconforming because we took our sweet time before deciding to transition, or if we ultimately decided to detransition because it wasn’t quite working out for us.

This is yet another reason why we should ignore what anti-trans and trans-skeptical interlopers have to say about this issue: Their arguments are steeped in anti-trans stigma, as seen in both their promotion of the “mutilation” and “life ending” stereotypes of detransition, and in their refusal to acknowledge that transitioning can ever be lifesaving and that a happily transitioned person can represent a good outcome.

*Footnote: The one potential exception to this “interlopers” characterization is anti-trans/trans-skeptical parents of trans kids, who may feel personally invested (via their child) in whether gender-affirming care is allowed, restricted, or banned.

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