Dear Mr. Dad: As the parent of a child who identifies as trans, I appreciate your evenhanded approach to talking about sexual identity, gender identity and sexual orientation. My child, who’s 10 and hasn’t started puberty yet, socially transitioned a year or so ago and everyone in the family has gotten used to the idea. But now they want to do a gender-affirming medical transition, starting with hormones. I’m trying to be supportive, but I’ve heard a lot of stories about people who’ve detransitioned and I’m frightened my child won’t be happy with the results of their transition and won’t be able to recover from the effects of the hormones and possible surgery. What do I need to understand?
A: Thanks so much for your question. You’re diving into a complicated topic, so let’s start with some definitions, beginning with the different types of transition. “Social transition” happens when a person takes on the name, pronouns and outward appearance (haircuts, clothing and sometimes behavior) that match their gender identity. “Medical transition” generally happens after social transition and may involve hormone therapy (to create masculine or feminine characteristics) and/or surgery (to reconstruct their body so their sex characteristics align with their gender identity). “Legal transition” involves legal name changes and, depending on what state you’re in, changing sex on official documents like birth certificates, driver’s licenses and passports.
As to your worry about detransitioning — undoing social, medical and/or legal transitions and returning to the sex people were assigned at birth — it does happen. But despite the media hype, it’s pretty rare. How rare? Given that very little research has been done on detransitioning, it’s hard to come up with firm numbers. And the various types of transitioning I outlined above make accurate statistics nearly impossible.
That said, let’s look at some of the data. A 2015 study by the National Center for Transgender Equality (transequality.org) found that 8% of 28,000 respondents reported detransitioning. Of those, 62% detransitioned only temporarily. Another study put the percentage of detransitioners at 13%. However, both studies found that of those who detransitioned, the No. 1 cause was external pressure — usually from a parent.
To be fair, several opposing studies estimate that the percentage of trans people who’ve experienced “transition regret” is far higher (one, published in the Archives of Sexual Behavior, put it at 50%). However, these studies often don’t differentiate between people who were exploring different gender identities, those who had transitioned socially but not medically, and those who had transitioned medically. Common sense tells us it’s a lot easier (though it could be embarrassing) to change one’s mind after an experimental phase or a social transition, but a lot harder — and, consequently, a lot rarer — to change one’s mind after having gone through a chemical and/or surgical transition. (Some hormonally induced changes, such as voice drop and hair growth are not reversible, but others, such as fat distribution and muscle growth, may be.)
The most important thing you and your family can do right now it to (a) make sure your child is seeing a good therapist who specializes in gender issues and who can help your child figure out who they are without imposing a particular philosophy; (b) find a different therapist who specializes in helping parents with trans children; and (c) talk with your child’s pediatrician to see whether puberty blockers would be appropriate, perhaps as a way to give yourselves more time to explore all the options.
Your goal as a parent should be to have your child be healthy, happy and safe. Nothing more, nothing less. Educate yourself on these issues and expose your child — and yourself — to opinions that support what your child wants as well as those that oppose it. That’s the only intellectually honest way to make decisions that will very likely have significant long-term consequences.
