A Typology of Gender Detransition and Its Implications for Healthcare Providers

Expósito-Campos, Pablo

doi:10.1080/0092623x.2020.1869126

Cited by 24 publications

(41 citation statements)

References 47 publications

(52 reference statements)

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“…This process of identity exploration should not necessarily be equated with regret, confusion, or poor decision-making because a TGD adult’s gender identity may change without devaluing previous transition decisions (MacKinnon et al., 2021 ; Turban, Loo et al., 2021 ). TGD adults should be assisted in this exploration and any other changes in their identity (Expósito-Campos, 2021 ). While exploration continues, gender-affirming treatments that are irreversible should be avoided until clarity about long-term goals and outcomes is achieved.…”

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

“…The decision to detransition appears to be rare (Defreyne, Motmans et al., 2017 ; Hadje-Moussa et al., 2019; Wiepjes et al., 2018 ). Estimates of the number of people who detransition due to a change in identity are likely to be overinflated due to research blending different cohorts (Expósito-Campos, 2021 ). For example, detransition research cohorts often include TGD adults who chose to detransition because of a change in their identity as well as TGD adults who chose to detransition without a change in identity.…”

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

“…While little research has been conducted to systematically examine variables that correlate with a TGD adult’s decision to halt a transition process or to detransition, a recent study found the vast majority of TGD people who opted to detransition did so due to external factors, such as stigma and lack of social support and not because of changes in gender identity (Turban, King et al., 2021 ). TGD adults who have not experienced a change in identity may choose to halt transition or to detransition because of oppression, violence, and social/relational conflict, surgical complications, health concerns, physical contraindications, a lack of resources, or dissatisfaction with the results (Expósito-Campos, 2021 ). In such cases, MHPs are well placed to assist the TGD person with these challenges.…”

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

“…Due to the limited research in this area, clinical guidance is based primarily on individual case studies and the expert opinion of HCPs working with TGD adults (Expósito-Campos, 2021 ; Richards & Barrett, 2020 ). Accordingly, if a TGD adult has undergone permanent physical changes and seeks to undo them, the assessing HCP should be a member of a comprehensive multidisciplinary assessment team.…”

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

See 3 more Smart Citations

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Coleman

Radix

Bouman

et al. 2022

International Journal of Transgender Health

806

492

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Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for t...

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Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

Section: Chapter 5 Assessment Of Adultsmentioning

confidence: 99%

See 2 more Smart Citations

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Coleman

Radix

Bouman

et al. 2022

International Journal of Transgender Health

806

492

View full text Add to dashboard Cite

show abstract

“…Though there is still little research on this population, discussions of individual cases are available (Withers 2015 , 2020 ; Levine 2017 ; D’Angelo 2020 ; Korpaisarn & Modzelewski 2019 ; Turban & Keuroghlian 2018 ; Marchiano 2017 ). Detransition has also begun receiving increased attention in the clinical literature (Butler & Hutchinson 2020 , Expósito‐Campos 2021 , Entwistle 2021 , Guerra et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Gender detransition: a case study

Marchiano

2021

J Analytical Psychology

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Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in the numbers of young people detransitioning or returning to identifying with their natal sex after pursuing medical transition. A case is presented of a young woman who pursued a gender transition and returned to identifying as female after almost two years on testosterone. The author considers and critiques the affirmative model of care for gender dysphoric youth in light of this case.

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Reidentification With Birth-Registered Sex in a Western Australian Pediatric Gender Clinic Cohort

Cavve,

Bickendorf,

Ball

et al. 2024

JAMA Pediatr

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ImportanceSome young people who identify as transgender and seek gender-affirming medical care subsequently reidentify with their sex registered at birth. Evidence regarding the frequency and characteristics of this experience is lacking.ObjectiveTo determine the frequency of reidentification and explore associated characteristics in a pediatric gender clinic setting.Design, Setting, and ParticipantsThis retrospective cohort study examined all referrals to the Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital between January 1, 2014, and December 31, 2020. The Gender Diversity Service is the sole statewide specialist service in Western Australia that provides children and adolescents up to age 18 years with multidisciplinary assessment, information, support, and gender-affirming medical care. All closed referrals for this study were audited between May 1, 2021, and August 8, 2022.ExposureReidentification with birth-registered sex.Main Outcomes and MeasuresThe number of referrals closed due to reported reidentification with birth-registered sex was determined, as well as descriptives and frequencies of patient demographics (age, birth-registered sex), informant source, International Statistical Classification of Diseases, Tenth Revision gender-related diagnoses, pubertal status, any gender-affirming medical treatment received, and whether subsequent re-referrals were received.ResultsOf 552 closed referrals during the study period, a reason for closure could be determined for 548 patients, including 211 birth-registered males (mean [SD] age, 13.88 [2.00] years) and 337 birth-registered females (mean [SD] age, 15.81 [2.22] years). Patients who reidentified with their birth-registered sex comprised 5.3% (29 of 548; 95% CI, 3.6%-7.5%) of all referral closures. Except for 2 patients, reidentification occurred before or during early stages of assessment (93.1%; 95% CI, 77.2%-99.2%). Two patients who reidentified with their birth-registered sex did so following initiation of puberty suppression or gender-affirming hormone treatment (1.0% of 196 patients who initiated any gender-affirming medical treatment; 95% CI, 0.1%-3.6%).Conclusions and RelevanceThese findings from a pediatric gender clinic audit indicate that a small proportion of patients, and a very small proportion of those who initiated medical gender-affirming treatment, reidentified with their birth-registered sex during the study period. Longitudinal follow-up studies, including qualitative self-report, are required to understand different pathways of gender identity experience.

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A Typology of Gender Detransition and Its Implications for Healthcare Providers

Cited by 24 publications

References 47 publications

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Gender detransition: a case study

Reidentification With Birth-Registered Sex in a Western Australian Pediatric Gender Clinic Cohort

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