Roger-Luc Chayer (Image : AI / Gay Globe)
With the increasing number of gender reassignment surgeries performed in recent years, gender transition has been accompanied by an unexpected consequence: detransition.
Gender-affirming surgeries, also known as gender confirmation surgeries or, more traditionally, gender reassignment surgeries, refer to a range of medical procedures designed to align a person’s physical characteristics with their gender identity. These procedures are performed following a medical and psychosocial assessment and are part of a gender transition process that varies from one person to another.
Depending on each patient’s needs and personal goals, these surgeries may include mastectomy, breast augmentation, vaginoplasty, phalloplasty, metoidioplasty, hysterectomy, oophorectomy, orchiectomy, as well as various facial feminization or facial masculinization procedures. In some cases, voice modification surgery may also be considered.
It is important, however, to distinguish these surgical procedures from hormone therapy, which represents a separate medical approach, as well as from the social aspects of transition, such as changing one’s name, identity documents, appearance, or social role. Not all transgender people wish to undergo surgery or hormone treatment, and every transition journey remains unique.
In recent years, the expression “gender-affirming surgery” has become increasingly common in medical and scientific communities. It is now preferred by many healthcare organizations because it better reflects the goal of affirming a person’s gender identity rather than suggesting that gender is being “assigned” or “reassigned.” However, the term “gender reassignment surgery” remains widely used in everyday language and in certain legal, historical, and media contexts.
Unfortunately, some people discover after completing their gender transition, and once physical changes have become apparent, that they may have made a decision that does not correspond to their long-term needs or expectations. They may then wish to stop, reverse, or partially undo their transition: a process known as detransition.
People who choose to detransition do so for many different reasons, and specialists agree that there is no single profile or universal explanation. Detransition may be temporary or permanent, partial or complete, and each person’s experience is different.
For some individuals, the decision results from a change in their understanding of their gender identity. Over time, they may come to feel that the transition they began no longer reflects how they perceive themselves or what they want for their future. Others describe dissatisfaction with surgical outcomes, medical complications, side effects from hormone therapy or surgical procedures, or ongoing psychological difficulties that were not resolved through transition.
In other situations, detransition is influenced by external factors rather than a change in identity. Family rejection, discrimination, employment challenges, financial difficulties, or concerns about personal safety may lead some individuals to interrupt their transition while continuing to identify as transgender.
Researchers also note that some people, following medical or psychological follow-up, reassess the reasons that originally led them to pursue a gender transition. They may conclude that other factors, including trauma, anxiety disorders, depression, or other mental health concerns, may have influenced their initial decision.
Current scientific studies indicate that detransition remains a relatively uncommon phenomenon compared with the number of people who undertake a medical transition. The majority of patients report improved quality of life and do not experience regret regarding their transition. Experts nevertheless emphasize that available data remain limited and that reported rates of detransition vary depending on definitions used, populations studied, and the length of clinical follow-up.
For healthcare professionals, recognizing detransition does not challenge the benefits of gender-affirming care for the majority of transgender individuals. Instead, it highlights the importance of comprehensive assessment before any intervention, fully informed consent, and appropriate medical and psychological support throughout the entire process, whether it leads to transition, detransition, or another evolution of a person’s identity.
The challenge lies in the fact that the motivations behind a person’s decision to pursue a gender transition are deeply personal and unique. Although multidisciplinary teams—including physicians, endocrinologists, psychologists, and psychiatrists—conduct evaluations before beginning medical transition, there is no infallible method capable of predicting with certainty whether the process will permanently meet an individual’s needs.
Healthcare professionals must address a complex reality in which gender dysphoria may sometimes coexist with other psychological, psychiatric, or medical issues. The purpose of clinical evaluation is precisely to determine whether transition represents the most appropriate response to the distress experienced by the patient, while considering their overall health and life circumstances. Despite these precautions, it remains impossible to completely eliminate the possibility that some individuals may later find that transition did not provide the improvement they hoped for in their quality of life or self-perception.
For anyone considering detransition, specialists recommend not taking action alone or abruptly stopping hormone therapy without medical supervision. The first step is generally to consult the healthcare professional responsible for transition-related care or, if unavailable, a family physician or endocrinologist. A medical assessment can help determine the possible consequences of stopping or modifying treatments and establish an appropriate plan based on the individual’s situation.
At the same time, psychological or psychiatric support is often recommended to explore the reasons behind the decision to detransition, reflect on expectations, possible regrets, and challenges encountered. The purpose of this process is not to persuade someone to continue or abandon their transition, but rather to help them make an informed decision based on their reality, health, and personal well-being.
When gender-affirming surgeries have already been performed, detransition may also require consultations with specialized surgeons to evaluate options for reconstruction or additional treatments. Some physical changes caused by hormones or surgery may be reversible, while others are permanent or can only be partially modified.
Experts emphasize the importance of providing people experiencing detransition with the same level of respect, listening, and support offered to those beginning a transition. Detransition is a healthcare journey in its own right, requiring an individualized approach based on the best available scientific evidence and respect for patient autonomy.
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