Making Light of Detransition
Their diagnostic tools are near-perfect, even when they don't use them.
In May, a new study into detransition was published, titled “Gender Identity 5 Years After Social Transition”. This followed a group of around 300 socially transitioned children over a five year period and by the end found that only 2.5% detransitioned and were living once again as their birth sex.
This was widely reported as demonstrating that detransition is rare and past high rates of desistence are “debunked”, that the few who did detransition “did not typically find the process traumatic”, that for such children “affirming them for who they are can be life-saving”, and that social transition allows them “to explore their gender identity in an environment that ‘honors their authenticity and wisdom’”.
However, these do not tell the whole story, and it is worth digging into the paper to see what it actually showed.
Throughout, the paper refers to both detransition and desistence as “retransition”. There seems to be no good reason for this, but given that this is not how detransitioners have referred to themselves, it serves to give the researchers a chance to assert their own authority over the language. Detransition implies a cessation, a returning to point of origin, while retransition creates the impression that an equivalent swapping of identity is taking place a second time.
Historically retransition has meant someone who transitions, detransitions, and then transitions a second time - but this new language changes the perception of this process, by making the dropping of pretence of being the opposite sex in actuality a second transition. It is a subtle but important shift in language - and so much of this whole mess is down to such linguistic shifts. If it sticks, it will become impossible to distinguish between a choice to halt transition from the choice to transition in the first place, as well as reframing stopping/desisting as an active choice to become something else.
In this way, understanding of detransition as the undoing a past mistake becomes instead just part of a “gender journey” - because if there are no wrong choices, clinicians can’t be liable for getting anything wrong.
It is important to note that the subjects of the study are very young children. The average age of social transition here is 6.5 years, and the average age at last followup is 11.9 years old. Almost 40% were socially transitioned under 6, at an average age of 4.3 years old.
Past research on desistence tended to show most dysphoria (80% or thereabouts) resolved by the end of adolescence, with the majority growing up to be lesbian, gay or bisexual. Meanwhile, according to one followup study on adult detransitioners, the average age of detransition was around 26.
It is simply far too early to tell which of these children will persist, yet many of these children have gone beyond social transition to medical interventions, with 60% on either puberty blockers or cross-sex hormones by the end of the study, all of which are major interventions with lifelong consequences. Indeed, 11.6% of the children were already on blockers at the start of the study. We do not know the exact ages of these children, but from the data in the table we can work out their average age was around 11.9 years old.
So this study is looking at very young children who are on average well below a typical age for desistence or detransition - far too young to draw a conclusion about likelihood of persistence - yet most are on irreversible medical interventions and all have been socially transitioned and affirmed in their cross-sex beliefs from a young age.
There is no cross-referenced data for ages of medical interventions, but there are some inferences we can draw from the data that is tabulated. According to the paper, of the 317 children at the start of the study, 70 were 14 years old or over at last followup, but 98 were on cross-sex hormones by that point.
This means at least 28 children under 14 were on cross-sex hormones - and looking at the table, one of those was “non-binary”.
Of those who have not begun medical transition either at the start of the study or by the end, we can calculate that they were 4 years old at the beginning on average, and 7.4 years by the end - so while approximately a third of the children studied have persisted but not yet started medical interventions, they are all still very young. That is, the only children who haven’t progressed down a medical pathway are simply too young for that to be an option yet. This makes it absolutely clear that social transition is the first step on a virtually certain pathway to irreversible medical interventions.
Detransition Rate vs Dropout Rate
Five years after an initial binary social transition […] [A] small number of youth were living as cisgender youth (2.5%) or nonbinary youth (3.5%).
The 2.5% figure here can be considered the detransition or desistence rate - but the research team lost contact with 28 participants over the course of the study, or 8.2%. This is more than three times the 2.5% estimate for detransition, and since this study found three quarters of detransitioners don’t return to their clinicians it isn’t unreasonable to speculate that some detransitioners may be present in this lost-to-followup number. As this paper notes, past studies into transition regret have all been plagued by “substantial drop-out rates”. There is a lot of uncertainty here which means the lost-to-followup number could be hiding a detransition rate of up to 10.7%, but there’s simply no way of knowing.
In keeping with the historic sex bias of gender dysphoria, two thirds of the children in the study are boys. The girls are also, on average, a year older. While a huge rise in the number of girls presenting at gender clinics has been observed, these are typically older than the children recruited at the start of this study.
The study admits this, but does not anticipate a change in detransition rates in later-onset gender dysphoric girls (quote edited for clarity):
One additional limitation in the present work is that the initial sample was disproportionately made up of [boys]. This is counter to recent reports that more peri and post-pubertal transgender youth seeking clinical services recently are [girls]. Historically, and consistent with our data, samples of prepubertal gender nonconforming youth identified by their parents as such, have included more [boys]. Importantly, we did not observe a significant gender effect in terms of rates of [detransition], so we do not predict any change in pattern of results if we had a different ratio of participants by sex at birth.
It seems reasonable to suggest that any findings of this study may not apply to a different cohort, with different age of onset, since multiple, distinct, superficially similar phenomena may be at play. They assume that observations about children affirmed as the opposite sex from from the ages of six to eleven are going to hold true for a cohort of mostly lesbian and bisexual girls experiencing huge distress in their sexed bodies during adolescence being affirmed as boys as a solution. There are so many clear differences, but contributing factors such as societal pressures on adolescent girls and social contagion cannot be examined if cross-sex beliefs are always affirmed, so the ideological belief in gender identity forces a universality of both root cause and solution. They don’t predict a change in the pattern because they cannot admit a potential difference in causation.
Basis Of Transition
It is striking just how young many of these children must have been when they were socially transitioned, and it is worth considering on what basis this action must have been decided and what form the transition took:
Increasing numbers of children are socially transitioning to live in line with their gender identity, rather than the gender assumed by their sex at birth—a process that typically involves changing a child’s pronouns, first name, hairstyle, and clothing.
As always it boils down to gender stereotypes. Boys and girls who must in some cases have been under four, who like the “wrong” clothes and hair for their sex, being told it must be because they are really the opposite sex. A bizarre form of gender conservatism is being lauded as progressive, where 4-year-old boys who like dresses are wrapped up in the pretence that this means they are “really” girls, and every adult in their lives affirms this.
When we look at past rates of desistence, detransition and regret, we are considering adults and children who have met the clinical diagnosis for gender dysphoria, and who were subsequently transitioned to alleviate the mental distress arising from this condition. Here is the standard DSM-5 criteria for diagnosing gender dysphoria in children:
Virtually all of this is based on sexist stereotypes of how a child of either sex is supposed to dress, behave and feel, and it is hard to unpick the distress someone feels in their own body from the distress they feel at being gender-nonconforming in a sexist society. The mandatory first criteria (insistence that one is the opposite sex) is confounded by the process of affirmation. That is, if adults believe a gender nonconforming child should be affirmed as the opposite sex from the outset, how do you unpick the child’s insistence from transient beliefs reinforced by adult behaviour? Affirmation is not a neutral intervention, and the DSM-5 checklist is a laundry list of stereotypes that can easily pathologise entirely normal behaviour.
So given this, can we really trust that the application of DSM-5 criteria in children is so accurate that it is right in almost 98% of cases, as this study would seem to indicate? The whole point of this diagnostic tool is to identify children who will not desist and who will be best served by transition - so if only 2.5% detransition (as this study claims) it would seem to be an accurate measure.
Either the diagnostic tool being used to determine whether a child should be socially transitioned is near perfect at identifying children that will never desist, or the social transition is creating the conditions for it.
But it is worse than that, because an unknown number of these children were socially transitioned without ever being clinically diagnosed.
This study did not assess whether participants met criteria for the DSM-5 diagnosis of Gender Dysphoria in Children. Many parents in this study did not believe that such diagnoses were either ethical or useful and some children did not experience the required distress criterion.
There’s the kicker - the diagnostic tool is not only not being used, it is actively believed to be unethical. Parents are deciding on their own whether to treat their 4-year-old boys as girls, ignoring diagnostic criteria that they consider useless and wrong, and yet we are supposed to believe that they are doing so with such precision that in almost 98% of cases they are correctly identifying a child who will never detransition and should be set on the path to near-inevitable medical transition as young as possible.
This is exactly the ideological belief that was apparent in the Helen Webberley tribunal judgement: transition is to be depathologised. It isn’t to be considered a condition in need of treatment, but an expression of a child’s true self. By that measure, diagnostic criteria are irrelevant. Transition is part of a “gender journey”, and there are no wrong turns - only later “retransitions”.
What can we really take away from this study?
Children who are socially transitioned at a young age are virtually certain to persist into adolescence
Children who persist into adolescence are virtually certain to progress onto puberty blockers and cross-sex hormones
Some children are on cross-sex hormones before the age of 14
These decisions are being made without any diagnostic process or safeguards
The only children who did not progress to medical transition were those too young to have done so by the end of the study. Given that the pathway from puberty blockers to cross-sex hormones is guaranteed to produce infertility and likely to impair sexual function, it means that a decision to socially transition a 4-year-old is invariably a decision to sterilise them and render them unable to orgasm in adulthood.
This study tells us absolutely nothing about likelihood of detransition or regret in adulthood, once a child can appreciate what it is they have lost.
Many of the children in this study are still prepubescent by the end, and some were socially transitioned at an age where they likely don’t really remember the time before, so that they have not detransitioned in that timespan is hardly a surprise.
For comparison, children typically stop believing in Santa between the ages of 8 and 10, depending on where in the world they are. In addition, according to this survey, two thirds carried on pretending after they stopped believing, to keep up appearances.
Replace Santa with a belief in being literally the opposite sex, and have every single adult in a child’s life reaffirm this belief every moment of every day, and it is hardly a surprise that a child that quite possibly can’t remember a time before continues to believe into early adolescence.
And if they doubted, would they say otherwise? In the face of so much affirmation?
This paper, and the commentary surrounding it, casts previous desistence rates of 80% as a product of unenlightened times, and social transition as the route to honouring a child’s “authenticity and wisdom”. Never mind that the majority of that 80% simply grew up to be lesbian, gay or bisexual adults, now they must be told they are the opposite sex as young as possible.
Young children can often quite easily pass as the opposite sex, so it can seem harmless, but framed as it is, it is just setting the child up to fear the onset of puberty and the manifest physical changes that will inevitably destroy the illusion.
Anyone with even an cursory knowledge of child development can see that socially transitioning a child is a major psychological intervention.
This paper should be ringing alarms about the permanence of cross-sex beliefs in children if the surrounding adults validate and affirm them. It tells us absolutely nothing about whether these children will ultimately detransition, or whether social transition is even beneficial - it only tells us that when it is done, very few children revert before progressing to medical transition.
And these decisions are being taken by parents and clinicians who believe that children should be affirmed in their cross-sex beliefs, without applying any diagnostic criteria.
Once more for the people at the back: parents are sterilising their gay kids.