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In their campaign for gender-affirming care bans, Republican lawmakers have enlisted a small group of detransition activists — and they have become the public face of these efforts. State laws and proposed congressional bills to restrict gender-affirming care are named after them and they have also traveled the country to share their stories of regret. These detransitioners are speaking out against gender-affirming care in states where they have never lived or accessed the care, said Logan Casey, director of policy research at the Movement Advancement Project, which tracks LGBTQ+ policy. At legislative hearings, their arguments often overpower those of local residents testifying about the benefits of gender-affirming care for themselves or their patients. It’s largely because what they say reinforces preconceived ideas about a slice of medical care that is not only poorly understood, but has also been so maligned. “People who detransition are part of the community and that is part of the experience. Some people do that. And that is more than okay,” said Casey, who is transgender. “But the broader issue here on the policy level is the idea of banning health care entirely out of the experiences of an extraordinarily small group of folks.” The Williams Institute at the UCLA School of Law estimates that there are 2.1 million transgender adults in the United States — or about 0.8 percent of the country’s population — and a total of 724,000 trans youth. It is harder to calculate the number of detransitioners, and estimates vary widely, but experts agree the percentage is low. The World Professional Association for Transgender Health (WPATH) describes detransition as “proportionally rare” and notes that as more adults identify as trans, it’s expected that more people will also look to halt or reverse their transition. Now, as the federal government pressures gender clinics in blue states and liberal cities to shut down, the Trump administration and influential conservative groups like the Heritage Foundation have elevated detransitioners’ stories and selectively brought these onto bigger stages. Some have pointed out how effective those stories are. “This was a very tough issue, initially. It felt like there was absolutely no way to win,” said Jay Richards, senior research fellow at the Heritage Foundation, at an event on gender-affirming care hosted by the Federal Trade Commission in July. At first, it was hard to get Republican members of Congress engaged, he said. Then, something changed. “When detransitioners started deciding, ‘We’re going to talk about this,’ that changed the game entirely. You can have 12 people making interesting scientific and philosophical arguments and one detransitioner just sort of lays them to waste,” Richards said. One detransitioner who spoke at the FTC event, a 27-year-old mother, described herself as a “victim of medical fraud and abuse” because of the way she felt misled by doctors in the process of deciding to transition as a teenager. Taking testosterone worsened her mental health, she said, and not being able to breastfeed her child caused her significant emotional and physical pain. Another said that he gradually detransitioned after losing access to support services for homelessness, moving back in with his parents and undergoing extensive therapy. Research shows that experiences like this are part of a larger, complex picture — one that is being ignored by politicians. Detransition is not always based on regret. Some detransitioners experience negative side effects from transition, including surgery complications and hormonal issues. Some do not. And frequently, people who detransition still identify as trans or gender non-conforming. Gender identity shifts are one of the predominant reasons for detransition, whether someone shifts from a binary to a nonbinary identity or once again identifies with their sex at birth. People usually detransition due to a handful of reasons; it’s rarely just one deciding factor. Kinnon R. MacKinnon, a social scientist, has been studying these patterns for years. Gender-affirming care needs to be more holistic to meet patients’ needs, he said. Some patients in his research say that clinicians don’t see the bigger picture, either by not considering mental health needs unrelated to gender dysphoria or by thinking of transition as a means to reach a binary or traditional gender expression. In what he believes to be the largest-ever study on detransition, MacKinnon and his team surveyed nearly 1,000 people about the experience. He granted The 19th early access to the data, which has been peer reviewed and will be published in the coming months. In his study, 33 percent of participants detransitioned due to an identity change, mental health or treatment dissatisfaction. Within this group, some experienced strong regret and said they weren’t well-informed about the risks of gender-affirming care. The Trump administration has shown that it’s only interested in people in this group, MacKinnon said — but theirs is only one experience out of many. Twenty-nine percent of study respondents detransitioned primarily due to external pressure and discrimination, while 20 percent cited a changing identity without any regret about their initial transition. There is no evidence in his research to support blanket bans on gender-affirming care, he wrote in a recent New York Times opinion piece. The administration’s actions don’t indicate just concern about pediatric care, he wrote, but a wholesale rejection of trans and nonbinary people. “The decisions made by the Trump administration contradict what we see when we study detransition,” MacKinnon told The 19th. In July, at an event titled “the dangers of ‘gender-affirming care’ for minors,” the chairman of the Federal Trade Commission described detransitioners as “survivors” of gender-affirming care. Several detransitioners who spoke at the event also described themselves that way. They shared stories of being harmed or misled by the medical system, experiencing ongoing negative side effects from hormone replacement therapy and not feeling listened to. Their experiences mirror how transgender people are treated at the doctors’ office. Trans and gender-nonconfirming people routinely have to educate their own doctors to get appropriate care, are asked invasive questions, refused treatment or are subject to abuse. The health care needs for detransitioners and transgender people are similar, MacKinnon said, including the need for better research to understand long-term health outcomes of gender-affirming care. The Trump administration’s federal funding cuts for any research involving gender-affirming care or trans people will ultimately harm detransitioners, he said — “A large majority of people who detransition are LGBTQ+, so cutting funds to LGBTQ health research doesn’t make any sense. It’s definitely not going to help people who detransition.” MacKinnon, an assistant professor in the School of Social Work at York University in Canada, has been studying detransition for years. This group faces a lot of stigma and has little to no institutional help, he said. Some who detransition feel rejected from the LGBTQ+ community if they change their minds about their initial gender transition. Others feel that their physicians are afraid of treating them or don’t actually know how to help them. “There’s no availability of support or formal recognition of people who detransition and what their needs may be,” he said. Amid that scarcity, “gender-critical” organizations — which reject the validity of trans identities — have stepped in. The founders of Genspect, an advocacy group that opposes medical gender-affirming care and has been identified as an LGBTQ+ hate group by the Southern Poverty Law Center, is among them. In 2022, the Genspect founders created Beyond Trans, which bills itself as an “online support service offering space to reflect on the impact of medical transition.” External forces — like pressure from parents, employers and spouses to stop identifying as trans — are another reason why some people detransition. Experts warn that the Trump administration’s anti-trans policies will make both transgender people and those who detransition feel unsafe and ultimately cause trans people to hide their identities, exacerbating this phenomenon. On his first day in office, President Donald Trump declared that “there are only two genders, male and female.” He signed an executive order that day stating that one’s sex is unchangeable and that gender identity is false. This year, the administration has restricted trans Americans’ access to passports and military jobs, and made it challenging for them to obtain health care and insurance coverage. More trans adults will struggle to access care under new federal policies raising costs. “There will be more people detransitioning when we live in a hostile society that hates trans people,” said Ankit Rastogi, director of research at Advocates for Trans Equality, which administers the U.S. Trans Survey. “That’s rooted in our data.” The U.S. Trans Survey has found that the hardships of living as a transgender person are a primary motivator for detransition. And in MacKinnon’s recent study, about 6 percent of respondents said that they detransitioned due to bans on gender-affirming health care. Data for that study was collected from December 2023 through April 2024. Increasingly, politicians want to prevent trans youth from transitioning or identifying as trans at all. In statehouses across the country, Republican lawmakers have resurfaced the same claim over and over: that trans children will “desist” or eventually grow out of being trans, given enough time and outside pressure to conform with their sex assigned at birth. But the research from the 1990s that first gave rise to this claim has been widely disputed. As one analysis of four frequently-cited studies found in 2018, the oft-repeated claim that “over 80% of transgender children will come to identify as cisgender (i.e., desist) as they mature” is based on research that potentially misclassified subjects as trans and generally lacked context. Studies supporting this claim also underestimate the harm of attempting to delay or defer transition, the analysis found. “From a developmental perspective, a child who is repeatedly discouraged when she earnestly insists on being called ‘she,’ is learning, on a fundamental level, that she cannot trust her own knowledge of herself and the adults she depends on may not value her for who she knows herself to be,” the authors write. For years, conservative politicians and pundits have accused teachers, Democrats and LGBTQ+ adults of indoctrinating or “grooming” children into being trans. That is not true. What is true is that Gen Z is more likely to identify as LGBTQ+ compared to any other generation — and new studies find that young people are defying long-held beliefs about gender and sexual orientation. They feel more flexible about their identities and don’t view them as fixed. Until recently, at least, they felt society was more accepting. Politics has harmed their well-being and their mental health. One study published this summer, based on findings from researchers who followed the lives of 900 young people from 2013 to 2024, shows that gender identity was stable for 80 percent of this group, including trans kids who socially transitioned in childhood. They were no more or less likely to change their gender than their siblings or cisgender peers were. And when they did change their gender, that overwhelmingly involved change to — or from — a nonbinary identity. As young Americans are transforming conventional ideas about gender, they are also shaping the future. Gender non-conformity is becoming more common. More young people are thinking about gender as a concept that is flexible across time, or as something that isn’t anchored in what it means to be male or female.
