De-re-detransitioning

Just when I thought the ‘transitioning’ mania couldn’t get any worse, it has.

As it is only to be expected, there are not a few people who, having undergone ‘transitioning’ to try to change their outward appearance to resemble that of the opposite sex, subsequently regret doing this. They are known as ‘detransitioners’. And some of these, we are informed, then regret detransitioning and wish to re-detransition. And if they change their minds again, will they be known as de-re-detransitioners?

Comprehensive, sensitive, robust
I hasten to say I am not writing this in any spirit of levity but only in response to the highly esteemed British Medical Journal (BMJ) which on 17 June 2023 sported a three-page scholarly article on the matter. The authors treat this situation with all due seriousness and stress the need ‘to better design future research studies and care’. And in case there should be any doubt about this, they repeat it in different words:

To bolster comprehensive gender care services, sensitive and robust research is needed.

Presumably, insensitive and non-robust research isn’t needed, and if gender care services are to be bolstered it wouldn’t be in a noncomprehensive way.

Stylistic solecisms aside, to get a flavour of this approach let me quote one sentence from the middle of the piece:

People assigned female at birth may have dysphoria about the results of mastectomy or chest masculinisation surgery or the permanent deepening of the voice; people who were assigned male at birth may have dysphoria regarding breast growth from oestrogen therapy.

Indeed, such people may well have dysphoria under these circumstances. But this dysphoria, that is, a state of feeling unhappy, uneasy, or dissatisfied should have been anticipated and thus could have been avoided, by questioning the assumption that the entity called gender dysphoria exists in the first place.

That is not to say that some people may not be happy about themselves due to perceived incongruence between their sex and their feeling that, contrary to appearances, they belong to the opposite sex, both sexes, neither sex, something in between, or something that changes from time to time. For economy of words, people in this situation are beginning to be known, or they wish to be known, as ‘transgender’ (‘trans’ for short).

Medically uncertain
Trans people may face a further problem, for, according to the BMJ:

People undergoing detransition may have unmet care needs while making medically uncertain decisions.

This is the point: it’s medically uncertain.

Not to worry. The ever enthusiastic BMJ opines thus:

Although there are detransitioned people who feel appreciative of their gender transition process in that it was an opportunity for self-discovery, care services must be able to recognise and hold therapeutic space for complex feeling such as regret and grief.

Is there really anything complex about regret and grief in this situation? Such feelings may be all too obvious and last for the rest of the trans person’s life.

The authors conclude by repeating, yet again, not just their perception that research is necessary, but that it is increasingly (!) necessary:

It is increasingly necessary to transform gender care research in order to understand the impact of changes in gender care delivery and to reflect greater awareness of detrans people in society.

And as if even that doesn’t say it strongly enough, the next sentence reads:

Rigorous and nuanced detransition research is indispensable.

Ordinary research, which we’re now told is indispensable, won’t cut the mustard: it must be rigorous and nuanced!

Now we come to central problem of the BMJ article. How can you do research on transgenderism, including detransitioning, and would it even be ethical? We need to remember that the research proposed in this context is on hormonal administration and surgical operations in physically healthy people.

Unethical
It would mean taking a group of people claiming to be suffering from gender dysphoria and, after obtaining their fully informed consent, facilitating them to proceed with altering their healthy bodies with hormones and surgery, and following them up for years or decades. A similar group of gender dysphoric people would need to be found who would agree not to undergo hormonal manipulation or surgery. And then the outcomes in the two groups in terms of general satisfaction with life, or otherwise, would need to be studied.

A little thought will tell you this kind of research would be unethical and almost impossible to carry out. How can anyone who has not gone through puberty and reached the age of at least 25 really understand the implications of irreversible bodily alterations including their effects on sexuality and fertility?

Something wrong with the medical profession
There is something wrong with the medical profession if this kind of research is seriously contemplated. And, even if it were somehow to be carried out, what sort of results would be expected? That we can distinguish people in whom hormones and surgery would be appropriate from those in whom it would not be?

We don’t need research, however rigorous and nuanced. We need common sense.

This is because so-called gender dysphoria is entirely subjective. It needs understanding and psychosocial support – not bodily alterations except, perhaps, as a last resort and only in people over the age of 25.

Picture credit: Wikimedia Commons

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