Copyright The 19th*
For Ara Kareis, the Trump administration’s rhetoric about detransitioners and transgender people is not just wrong — it’s scary. “The whole administration is scaring me right now,” said Kareis, a 22-year-old North Carolina resident who detransitioned a few years ago. To her, the rhetoric shared by the president and the vice president that portrays gender transition as a form of mutilation is deeply harmful. And as providers of gender-affirming care have become federal targets, her own medical care has been disrupted. Her insurance, Blue Cross Blue Shield, has repeatedly refused to cover a pap smear or a routine breast cancer exam since her legal name, changed during her transition, is still male. The last time Kareis spoke to her endocrinologist, her doctor was concerned about losing her job under the Trump administration. “My regular care has been impeded because of the current administration’s politics,” Kareis said. “Things have been getting worse and worse as time passes.” Growing up, Kareis always felt more comfortable around boys. She was a social butterfly. Then, she hit puberty, and with new physical and hormonal changes came an intense depression. She grew apathetic and stopped seeing her friends as often. But when Ara started living as a boy, she felt like she got her life back — more like herself again. She began using male pronouns in sixth grade. Then, before starting high school, she came out to her mom as transgender. Her mom found her a gender therapist. The next summer, before her sophomore year, she was prescribed testosterone through her new therapist. And when she was 17, she had top surgery, or male chest reconstruction, through a double mastectomy procedure. But the physical changes happened too fast. She started growing a beard within a month, which is abnormal for someone undergoing hormone replacement therapy. It turns out that her endocrinologist at the time had prescribed her a dose of testosterone that was too high — a mistake corrected by the new doctor she started seeing nine months into her transition. Her first endocrinologist also hadn’t told her about bottom growth, one of the permanent side effects of taking testosterone that alters the appearance of one’s genitalia. Kareis hadn’t considered top surgery until a therapist recommended it to her, she said. She came to believe that, to be a man, she had to do it. After surgery, she told her therapist that she hadn’t felt ready to go through with it. The therapist dismissed her feelings and put the onus of the decision squarely on her. “He said, ‘Well, you just should’ve known,’” she recalled. Admittedly, that was the first time she had brought up any sort of hesitation about the procedure. “Because he said it like that,” she said, “I pushed that as far down as possible.” Ignoring her feelings of regret just led to more pain and heartbreak in the future, Kareis said. Now, Kareis wishes that she had been given more options and more time to think about what she wanted. If that had been the case, she may have felt more comfortable in the body she had at the time and not needed to detransition later in life, she said. “In medical fields, I wish that there was more respect for variations of gender identity and variations on masculinity, variations on femininity and variations on the levels of masculinity and femininity that people want,” she said. Kareis grew up queer and questioning her identity. She first came out to her mom as a lesbian, then, years later, as trans. Although she has detransitioned, she can’t relate to the cisgender experience of aligning one’s gender identity with sex assigned at birth without further exploration. That’s why she uses both she/her and they/them pronouns and identifies as a nonbinary woman. To her, that means being a woman who doesn’t identify with a cisgender experience. Kareis started their detransition at 20; it’s the hardest thing they have ever done, they said. She experienced so much grief as she detransitioned; she missed who she was before her initial transition and how her body used to look. She had also built so much of her life around being a man, so losing that sense of self was destabilizing. When she started to detransition, she didn’t leave the house for weeks and developed intense social anxiety. She didn’t know of anyone else going through what she was experiencing. Feeling alone and unable to be seen as the gender she knew she was, she questioned whether it was worth it to keep living. She attempted to take her own life multiple times. When Kareis reflects on that place and time in her life when she felt so low, she thinks about how many transgender people living with gender dysphoria go through the same thing — and how the current political situation is likely making it worse. “That’s something that is going to become an even bigger problem as hormone care is taken away, as trans care is taken away from youth and from people in the United States,” she said. Kareis and an ex-partner, a transgender woman, transitioned at the same time, finding camaraderie and mutual support as their bodies changed. Once Kareis was able to start gender-affirming treatment to look and feel more feminine, her gender dysphoria faded and her confidence grew. Through an outpatient mental health program and the support of her former partner, she was able to come out the other side. She started documenting her journey on Instagram a year ago. What started as a beauty and skincare page has grown into a platform to share advice about navigating detransition to over 16,000 followers. She takes questions from trans and nonbinary people looking for guidance on balancing their femininity and masculinity while on testosterone, or on how to decide if medical transition is the right path. She also gets questions from other detransitioners about physical changes like hair and breast regrowth. Right-wing figures are trying to push a narrative that gender transition ruins people’s lives and bodies forever, she said — but she’s proof that that’s not true. Part of why Kareis sought to build a platform on Instagram was, in their words, to be visible as a detransitioner who does not hate trans people. “The detransition space online is so oversaturated with right-wingers saying that transition is wrong for everybody, saying that they were saved from transition, saying all these harmful things about transition, and saying things to try to take away trans healthcare in America,” they said. “These stories are being co-opted by the right to take away health care.” Kareis wants to spread a message: Even if someone pursues gender-affirming care and completely regrets it, there is still life afterwards. They still have a choice to be who they feel they are. “Looking at me, I don’t think I’m ruined forever. I don’t think that somebody who detransitions is ruined. I think that we are worth more than our biological parts,” she said. As gender-affirming care clinics and hospital programs for trans youth shutter across the country, Kareis is growing increasingly worried. The administration’s rhetoric is violent, she said. “Taking away trans health care is taking away people’s lives,” she said. “They are closing their doors to minors, and that is going to just completely wreck lives. I have complicated feelings about my transition when I was young, but that doesn’t mean that I believe that nobody should transition young.” To her, detransitioners who have taken a right-wing stance against gender-affirming care are a loud minority. The vast majority of the online harassment she gets comes from cisgender right-wing accounts or other conservative voices, she said. They call her an abomination or demonic, or tell her to kill herself. She has a laundry list of blocked words on Instagram to protect her peace and her mental health. Without robust support from the medical community or LGBTQ+ organizations, detransitioners go online for resources — where they are often exposed to radical or extreme content about their identity. Many detransitioners look for support in Reddit, Facebook and Discord groups. Some are seeking advice on the best way to safely stop hormone replacement therapy. Others, feeling they have no one else to turn to, share stories of losing friends. There are people who are questioning what caused them to identify as trans in the first place. Then there are people who are struggling with gender dysphoria, both as a result of the gender-affirming treatments or surgeries that they pursued before and because they don’t completely align with their sex assigned at birth. The r/detrans thread on Reddit, created in 2017, currently has 58,000 members; in November 2023, one study on detransition noted that the thread had over 47,000 members. Detrans online networks are expanding, the paper notes, and it is plausible that more people who are unsatisfied with gender transition will encounter detrans narratives online and arrive at a new self-conceptualization. As a child, Kareis was a boy — that’s how she identified and how she truly felt. Maybe society had something to do with it, but society has something to do with all of our genders, she told The 19th. She’s not sure that so many people would align with a cisgender identity if we didn’t live in a world where gender, based on sex, is assigned at birth. “I really believe that identity can change over time. I believe that’s what happened to me, and I don’t think there’s anything wrong with that. I think that’s just a natural progression of being a human.”
