On Detransition

Note: This post owes a great deal to the contributions and input of a friend who had lived through relevant experiences. While they wish to remain anonymous, I want to express gratitude for their help and lend credit where credit is due.

Last week a story broke in the British press concerning a young trans woman, Ria Cooper, who at 17 had been the youngest patient to ever receive hormone treatment for gender transition under the NHS. Ria was now considering “detransition”, that is, the choice to eschew her scheduled lower surgery, discontinue the use of exogenous hormones and anti-androgens,  and return to living and presenting as male, within general cultural concepts of male-ness.

Obviously the often notoriously vicious and transphobic mainstream British press seized on the story, providing as it did an apparent “confirmation” of the initial fears and doubts that the cis public had expressed when Cooper first sought treatment: their outrage at the idea of “kids being given sex changes!”, the idea that at 17 she was “too young” to make such a decision, the distrust of the NHS funding gender transition at all, let alone for “unconventional” patients like trans youth, the idea that it was a frivolous and risky expense of the NHS’ public funding, and the general “gatekeeping” mentality: cissexist or cis-centric biases that lead to the idea that medical gender transition is something that demands an especially extraordinary amount of caution, evidence that the patient is “sure” and capable of being “sure”, and evidence that the patient is “really” trans. Cooper’s (immediately publicized) choice to detransition offered an almost irresistible narrative for everybody in Britain who had expressed outrage, disgust, unease or even mild suspicion that it was a “bad idea” to “allow” her to be treated. It offered them all a chance to feel smug, collectively shrug their shoulders and sigh “I told you so”.

Naturally, this was how the story was spun. It was also intertwined with additional tut-tutting to allow the general cis-centric consensus to feel very proud of its initial suspicions, such as hitting on a note of “wasted tax dollars” (a sentiment that would be considered in extremely poor taste if the medical issue in question was chemotherapy failing to prevent a cancer from coming out of remission, or medications failing to slow the progression of HIV into AIDs, or a heart transplant being rejected by its recipient despite an expensive immuno-suppressant regimen), and the misogynistic explanation that female hormones had in and of themselves “caused” Cooper’s mood swings, depression and eventual suicide attempts. This latter explanation did far worse damage than simply being a trite and sexist simplification designed to confirm the pre-existing biases of the general public, however, in that it also buried the lead, buried the real story, and buried the complex and tragic truth of Ria Cooper’s experiences since their transition. I’ll return to this momentarily.

Worryingly, but perhaps not surprisingly, the reactions of The Trans Community, and the discussions that ensued, weren’t any less callous, simplistic or centered on the affirmation of pre-existing biases than those of the cis public. While it’s entirely understandable to be very frightened about what affect this story might have on how gatekeeping procedures and medical access to transition-related treatment are done in the UK and under the NHS, particularly for British trans youth, it’s appalling how many trans women have laid the blame for this risk on Ria Cooper and her supposed “recklessness” or “bad decision-making” or “selfishness” rather than on the press (for how the story has been presented), the cis public (for their biased reactions), and the NHS (for being all too quick to prioritize the cissexist biases of the public over the needs of transgender patients).

Trans women globally have taken this as an opportunity to reengage the concept of there being “true transsexuals” and those who just “think” they’re trans. They’ve taken it as an opportunity to again decry the “cheerleaders” and talk up the importance of being “absolutely sure” (while downplaying the fact that doubts are a near-universal experience of trans people). It’s been used to invest the bizarre essentialism-without-essentialism of “gender identity” with renewed power, to play up binarism, to validate the internal gatekeeping and heirarchies within the Trans Community, to sanctify the conventional narrative, etc. To do all the things trans women often do to consider their identities and gender valid and legitimate at the expense of others. To say “I’m a real woman” by pointing to someone else and saying “they obviously weren’t”.

And perhaps most disappointing is that what has been entirely absent from the conversation is any genuine compassion or support for Ria Cooper herself, or any effort to take into consideration the actual complexity and tragedy of her situation. Absent has been any effort to respect her agency, her right to make this choice despite her earlier choice (which she also had the right to make)… and her right to regret. Unless we’re supporting someone’s right to make choices that turn out to be wrong for them, we’re not genuinely supporting their right to make choices. We can’t claim to support people’s agency and autonomy if we don’t support their right to regret.

This echoed horribly what I had said recently about how after we’re done patronizingly coo-ing over the “Child Who Simply Knew”, we’re happy to toss them to the wolves once they grow into young trans women with adult sexualities, facing complex adult problems, making complex adult decisions, and in need of resources to survive in the adult world (with its very adult risks of very adult consequences).

Even woven through much of the nominal “support” and “compassion” that HAS been offered to Ria there’s been a coded, selfish attempt at validation of our own identities. “Clearly Ria didn’t have a female gender identity, and we all ultimately need to go with what our gender identity really is, on the inside”. That’s silly. Gender can’t be wholly internal. It’s semiotic. It’s between us and others. Its always relational, social, interpersonal, cultural. Its an attempt to negotiate, understand and express the internal in relation to the socio-cultural and interpersonal, and negotiate, understand and express that relationship. Talking about Ria’s “gender identity” without talking about her experiences of gender is an empty gesture that’s ultimately far more about telling ourselves that our genders are solid, consistent and solely our own than it is about trying to understand and sympathize with Ria.

Likewise our general and very noticeable silence on the subject of detransition. Which is, to be dead honest, a kind of erasure that has been overwhelmingly consistent, and gone almost entirely unchallenged. This is a subject most trans people refuse to touch, and when it is spoken of we’re rarely willing to go much beyond the simplistic and naive “oh I guess their gender identities were [assigned sex] after all” explanation. The reason for this silence and erasure certainly isn’t respect or sensitivity for those who’ve made such choices, or lived such experiences.

So, about that buried lead…

Even some of the articles that most directly presented the story as one of how Ria’s “sex change hormones” had “caused” her depression, and that she was clearly “too young” to have made such a choice, nonetheless included quotes from Ria about how she had been treated by her family and friends in the wake of her transition. I can’t help but wonder if this is because the cis bias of the reporters was so thick they didn’t even realize they were including evidence of how they’d distorted the story and glossed over highly significant details. Ria described how her mother no longer permitted her to live at home or come by, unless she did so “as a boy”, how her father openly described her as an “embarrassment” and disappointment, how she ended up alienated from almost all of her friends, and how she considered detransition the only option for having interpersonal connections again, how she considered detransition her only chance to be happy. And that she herself tied this not to the mood swings “caused” by her HRT, but because detransition would allow her to regain her family and connections and support systems.

This wasn’t simply an issue of medical transition, and the physical changes, being something that Ria didn’t want (perhaps tellingly, perhaps not, I wasn’t able to find any statements by Ria on how she felt about her body, its changes, and what changes detransition will sacrifice). I don’t feel comfortable speculating on Ria’s feelings and whether or not she experiences dysphoria about male or female physical characteristics, or how intensely, but what’s clear is that this is very largely an issue of her being unable to cope with the intense pressures and alienation of being trans in a transphobic world. Which is to say nothing of the pressure, stress, transphobia, and lack of privacy or ability to adapt to a relatively “normal” life as female, she must have faced transitioning under such public scrutiny as “Britain’s youngest sex change patient!”.

Age is pretty relevant here, however. Though I’m not of the opinion that adolescence is “too young” to make choices about one’s sex, gender and body, and in fact have very strong feelings about the rights of trans youth to make such decisions independent of often heavily-biased parents and children’s social resources, I’ve long considered age to have a pretty big impact on one’s experience of transition, or being trans. It’s a complex thing, and it’s not as simple as one age group having it “harder” or “easier” than another, but one thing that’s generally consistent is that AMAB (assigned-male-at-birth) people who transition, or otherwise fall outside gender norms, later in life have had more opportunity to achieve stability first; stability in terms of identity, friendships, career, relationships (perhaps marriage), education, financial independence, savings, children, etc. While arguably such individuals have more to lose from transition, those who do so early end up shunted into a marginalized and under-privileged identity before having the opportunity to achieve those kinds of stabilities, or really take advantage of nominal male/cis privilege in acquiring them. Consequently, the experiences of trans youth, particularly those who live in poverty or belong to other marginalized identities, are noticeably different from people who were first normatively sexed/gendered as men prior to transition, and the risks of being cut off or alienated from family, friends, support networks, and social structures are far far greater. There’s a reason homelessness, addiction and survival-sex-work are serious and commonplace problems amongst trans youth but not amongst transitioners who are well into adulthood.

Given the importance of interpersonal connection for a young person, the importance of establishing an identity at that age in relation to the people around you, how terrifying (for very good reason) it is to try to find your way in young adulthood without any stability or supports, and how sensible it must have seemed to accept conditional love and acceptance, support and resources, where its unconditional equivalents were unavailable, it’s impossible and foolish to simply write off Ria’s decision as having been a question of her being “not really trans”, or “not trans enough”, or having had a “male gender identity”. But it would also be presumptuous and foolish to make the claim that she’s therefore not “really” in need of detransition, doesn’t “really” regret her initial decision, that she won’t “really” be a man afterwards, or that detransitioning would necessarily be a “mistake”. It’s just not as simple as that. Neither camp of explanations really deals with gender, or detransition, in a realistic way.

It would be wonderfully comforting to be able to simply, or even effectively, take apart the question of transition and detransition and break it down into basic distinctions of sex (and feelings about the body, dysphoria), gender (the way a sexual identity ends up being understood and expressed) and the way that gender relates to other people and is treated by them. But it’s just not that easy. It would be a comforting illusion, at best. And as always, at worst, it erases the experiences of many who don’t fit our model, and tosses them under the bus so that we don’t have to look directly at our own anxieties about how messy and tangled these things are.

Gatekeeping processes, and highly narrow definitions of what being “really” trans entails and requires, are still heavily enforced both by the cis-controlled establishments and culture that affect our lives and access to treatment and resources, as well as the trans community itself and the resources and supports we (conditionally) offer people who are seeking treatment or transition. And these are the things that people will initially encounter when they begin looking into the idea of “a sex change” (especially given the near total absence of accurate education and information about transition generally available to those who aren’t specifically seeking it out) . They don’t find trans-feminist blogs and books and various affirming outlooks that prioritize self-determination. What they find are the old, archaic narratives and concepts, and ideas of what being a trans woman is “supposed” to mean. They find tsroadmap.com, with its “menus” of various purchasing plans by which you can buy your all-important “passability” (within narrow, commodified, sexist, cissexist, binary-centric, white-centric, ableist concepts of female beauty and “feminine appearance”). They find the COGIATI with its ridiculous ideas of what constitutes a “female brain” (language! social skills!) and what constitutes a “male brain” (maths! spatial reasoning!). They find Anne Lawrence, and Jennifer Finney Boylan, and Susan’s.org, and My Husband Betty, and a whole fuck ton of middle-class, white, binary-identified, wholly linear (more on this soon), narratives geared around adult transitioners who’d already established the economic independence necessary to take the purchasing plans seriously. They certainly don’t find anything much about what this means if you’re young, if you’re poor, if your family are going to kick you out, if you’re on the streets, if you’re a person of colour, if you didn’t already have a normatively sexed body, if you don’t necessarily “identify as” (whatever that means) exactly the presented options,  if you have serious disabilities, either physical or mental, if you don’t have medical access, if you’re an addict, if you’re a sex worker, etc.

But people don’t often just shrug their shoulders and say “I guess transition isn’t for people like me!” and go on their way. If it weren’t such a pressing need, they wouldn’t really be in that position of seeking information and resources in the first place. What instead ends up happening is people get forced to try to work with what’s available anyway. And while that often ends up as eschewing the conventional models, and doing things like seeking “black market” hormones or pumping,  it also often leads to people forcing themselves into tiny narrow boxes that don’t really fit with what they want and, most importantly, don’t really fit with what they need. Things like believing that in order to resolve a dysphoria about your physical sex, you need to dive into acceptance of a gender presentation that makes you just as uncomfortable as your body used to, such as the high-femme “passable” expectations of the mainstream trans resources and narratives.

And as I mentioned earlier, a gender presentation doesn’t occur in a vacuum, nor is it wholly an extension of the internal to the external. Gender is always negotiated between oneself and the world to which one is expressing it, between what you want to “say” with your gender and what everyone else “hears”, between how you wish to present and how you end up being read, between your idea of who you are and what your culture designates as signifying that kind of self, between you and the people around you. And what your experience of gender is ends up largely determined by how you end up being treated. A trans woman accepted and embraced by her family ends up experiencing her gender differently than a trans woman who is rejected and regarded as an “embarassment” and told she’s only permitted to wear “men’s clothes” at her family home. Those genders will mean different things to those two women, too.

It’s no fucking wonder that many trans people end up feeling worse off than when they began. Nor is it any wonder that people often have to go through a complicated process of negotiating and renegotiating themselves and their relationship to both their bodies and their presentations, that may manifest as changing or adapting their idea of themselves, their gender, their sexual identity, and what they want and need, rather than simply moving “forward” along a nice, easy, uninterrupted process of Gender A to Gender B, “pre” to “post”.

It’s not always entirely up to us what our gender means and how we live through it.

Partly it seems that a lot of our reluctance to deal with detransition, and what it suggests, is related to anxiety about implications like that. Likewise all trans people have to live, for awhile at least, with detransition sort of hanging around in the back of our heads. A perpetual, unavoidable “option”, a “way out”, and that can be a really frightening and demoralizing thing to notice lurking around in your own head. Talking about it grants it more power, more weight… especially if we talk about it in non-demonizing, non-patronizing, non-demeaning ways. So, generally, we don’t. We’re also rather obliged by the medical establishment and by our own peers to uphold the veneer of absolute, unwavering certainty in our decision. That’s how we maintain our presence as “real” transsexual people, after all, and how we maintain our right to sit at the cool trans girls’ table at the coffee shop after the support group is over.

And we’re understandably frightened by how gatekeepers and cis people pounce on the idea of detransition to limit our access and justify the humiliating and exhausting processes they oblige us to work through in order to access treatment, how our families use the idea to point out how we might “just be confused”, how its used as a way to instill us with doubt and anxiety and dread that we might wake up one day horribly regretting our decision and suddenly repulsed by our bodies, miserable, alienated and unable to ever go back. It’s used by various people with anti-trans agendas, like TERFs (trans-exclusionist radical-feminists), to undermine the legitmacy of trans care entirely, and speak about it is as a system that “pushes” people into “mutiliating” their bodies. There’s dozens of ways the reality of detransition is exploited and distorted into the “regretioner” myth and used against trans women as a cudgel. So we’re scared of acknowledging or speaking of that reality at all, lest we feed the myths and attacks by lending them legitimacy. What we don’t think about, though, is all the real people and real experiences, many of which are actually common kinds of stories and narratives for trans people, that we’re erasing, hurting and neglecting in the process.

And through all that, yes, we’re also probably a little bit scared that “gender identity”, “dysphoria” and “transition” are all a lot less clear cut and stable and unwavering than we thought they were. Just like cis people can feel a lot of anxiety about how the existence of trans people destabilizes the certainty of sex and gender as absolutes, trans people can feel a lot of anxiety about how the existence of detransition can destabilize the certainty of gender identity and dysphoria and transgenderism as absolutes.

Maybe we aren’t the simple “female brains” housed in “male bodies” we wanted to believe we are. Maybe transition wasn’t the only possible path. Maybe we never really were certain. Maybe it’s all a bit of a gamble, and all a little bit fluid. Maybe there’s no way of “knowing” who we are. Maybe “who we are” isn’t fixed and unassailable. Maybe our “gender identity” isn’t some internal, essential, unwavering fact that can never be compromised. Maybe we’re partly dependent on the people around us, and on our circumstances. Maybe we could have been wrong. Maybe we have no way of saying for sure what we “really” are.

Maybe it’s not the linear story we always told, either. I’ve written often about the various consequences of privileging specific kinds of trans narratives over others, and how we’ve allowed a singular sort of archetypal trans narrative to gain a position as the experiences we’re all assumed to have, or “supposed” to have had. But on a deeper and more subtle level there’s a dangerous way that the structure of that narrative is hemmed into a very narrow range, and that this occurs in a much more extensive and much more insidious way. It has so much ubiquity it often remains almost invisible. This is something I’d probably refer to as “linear-normativity” or something like that, which is how transition is assumed to always occur in a linear progression. The aforementioned process of going from Gender A to Gender B in a straight, narrow, uninterrupted line, clean of zigs or zags or backsteps or swerves.

This form of normativity is coded into our (highly limited) language of self-reference itself: “Transition”. “Male to female”. “Pre/Post-op”. “Trans”. And we lack any terminology to articulate our existence outside of it.

Implicitly, an identity like “trans woman” itself becomes hinged on an assumed backstory. A male gender assignment. A “male socialization”. Physical masculinization by endogenous hormones. “Coming out”. Physical feminization by exogenous medical intervention.

That simply isn’t a universal story, or what trans-womanhood inherently means. We’ve been gradually challenging certain limitations in what we assume a trans identity must be in a paradigmatic sense, challenging binaries and who does and doesn’t get represented and seen, who does and doesn’t control the image of what a trans person is… but we haven’t yet challenged the assumptions of trans identity in a temporal sense. We’ve gradually expanded our lexicon of ways to say “this is who I am”, but to every one of those Ams, assumptions are still attached about the Hows, the how you got there. “Male to female”.

Trans narratives don’t always move in steady, tidy arcs. Some of us never had a “pre-transition” life, or never really were normatively sexed by the gender binary. Some of us experienced our medical intervention where our adolescence would have been, being no more a “transition” than what is experienced by every other teenager. Some of us weren’t given binary sex assignments, and binary sex assignments aren’t, laterally, universal in terms of what they mean and how they’re lived or how they play out (although they certainly have meaning relative to one another; being AMAB certainly creates different experiences than being AFAB, or intersex). Some of us weren’t socialized in conventional ways (if there even is a conventional kind of male or female socialization). Some of us experienced our adolescence and physical sexual development in ways outside the binary assumptions. Some of us sought different kinds of medical interventions, such as trying to become more physically aligned with our assigned sex, before seeking “transition” in a conventional sense.

And some of us had doubts. And some of us moved backwards, or sideways, or renegotiated things, in the process of arriving at our identities. Some of us detransition. Some of us “retransition”. For some of us, none of those terms would even make sense to articulate our experiences.

Those things aren’t rare. They just happen to be things more often experienced by marginalized portions of our Community more often than by the privileged. Trans youth, and trans people who’ve dealt with street life, addiction, sex work, violence, intense alienation and various other more severe consequences of transphobia and cissexism are particularly likely have had times of intense doubt in their lives, and periods in which they explored their options. And those more vicious consequences fall disproportionately on PoC, PwD and the impoverished.

To act like detransition is something that can ONLY indicate a lack of not “really wanting it” or not “really being trans” is to demonstrate an enormously privileged mindset. One of the most basic kinds of privileged-bias: assuming things are as easy or difficult for everyone as they were for you.

Anyway… that idea of transition, and transness, as inherently linear is just as protected for its superficially “validating” qualities as the essentialism of “gender identity”, “male/female brains” and “men’s and women’s clothes”. It, again, allows us to feel our identified gender is every bit as valid and secure as our cis peers, while remaining on more or less the same kind of conceptual ground as the cis-centric view of gender. We can feel ourselves valid and secure without having to dive into the scary, uncharted waters of granting ourselves that validity, unconditionally, and on our own terms. We can continue feeling there’s some kind of external, quasi-objective standard by which we know ourselves to be “really” women… “deep down”.

But there is no deep down with gender, of course. And that’s fucking terrifying for people who have to daily face a hostile world insisting that they’re just a fake.

We have every psychological reason in the world to refuse speaking of detransition, to mock and belittle and hate and blame detransitioners, or to offer our “support” to them only in terms that reaffirm our own sense of relative superiority and security. But we have every ethical reason in the world to not let ourselves be that petty, and as I’ve said a thousand times, we can’t grow as a trans movement until we’re a movement that includes and genuinely supports all of us: even those of us who regret it. Even those of us who didn’t always know, who had second thoughts, who took missteps, whose stories weren’t linear, who had to fight and negotiate and renegotiate what it is to be trans. Those of us for whom some kind of detransition wasn’t giving in, but attempting to survive.

It’s nothing but straight-up arrogance and heartlessness to, speaking from a position of relative comfort and security, denounce someone for “giving up” after facing harsh realities of a struggle you were spared.

I don’t have any clear or easy answers about detransition and what it means, or any special insight into the actual nature of gender, sex, dysphoria and why we do or don’t feel the things we feel and need the things we need. And I’m not any less anxious, insecure or scared than any other trans woman. But hopefully this can help nudge us in the direction of at least being willing to talk about detransition, talk about what it means for us and our assumptions, and stop erasing people just for the sake of insulating ourselves from questions we’re afraid to answer.

I can’t speak to what Ria Cooper’s “real” reasons for this choice are. It would defeat every point I’ve tried to make if I presumed to. But the least we can offer this young person, discarded and hated from every corner of her life, is to not exploit her situation ourselves. To not make it all about us and the effect it might have for us or how it makes us feel. We can at least afford her the right to regret, the right to make her own choices about what she needs and wants, the right to want her family and friends back, the right to sacrifice transition for the sake of human connection… the right to do what she believes will make her happy. The right to do that without any of us presuming we knew her and her interests better than she knew herself.

Best of luck, Ria. I hope you find your happiness, whatever form it takes.