Why detransitioners frighten trans activists

There is a growing number of people who deeply regret having gender-reassignment surgery.

James Caspian

A few weeks ago, I drove to a town on the south coast of the UK to interview someone I will call ‘Alex’. Twenty years ago, when in middle age, Alex underwent a medical gender transition from female to male (complete with hormone treatment, hysterectomy, removal of vagina and ovaries, and phalloplasty – that is, the creation of a prosthetic penis). Alex now bitterly regrets transitioning and wants to live as a woman again, but is now, in every way, indistinguishable from other sixtysomething, balding males, and despairs of ever being able to do so.

Alex told me a harrowing story of childhood sexual abuse and lifelong post-traumatic distress disorder (PTSD). He had seen a television programme about people who had transitioned and identified with the people on it. He went to a support group for trans people, and decided to transition. He told me that he thought that he would become a different person, and that the trauma that had dogged him all his life would go away. It did not.

Later that same week I had a conversation with Felicity, also in her sixties, who transitioned even longer ago than Alex did, when she was in her thirties. She has no regrets about transitioning, but cautions anyone who thinks that it will make them a different person, and solve all their problems. She worries about young people in particular undergoing difficult and challenging medical treatment and surgeries.

When, several years ago, I began to research people who regretted transitioning, I knew that evidence was emerging of people doing so in greater numbers than anyone who worked in the field of transgender medicine had seen before. In November 2014, I met up with Dr Miro Djordjevic, a surgeon from Belgrade who does a lot of sex-reassignment surgery. He told me that he was worried because he had recently been asked to do several ‘reverse’ operations for people who regretted their gender transitions and were ‘detransitioning’. All were adults who had been born male, and had had their testes and penises removed. They now wanted a phalloplasty operation to create a semblance of a penis, as it is not possible to replace gonads and genitalia which have been removed. (In the case of Alex, there is no way that a vagina can be replaced.) Djordjevic told me the growing phenomenon of ‘reverse’ reassignment surgery had never been researched and it needed to be.

I began my preliminary research into the phenomenon as part of an MA at Bath Spa University, which it later prevented me from continuing, citing fear of criticism for allowing research on a subject seen in some quarters as ‘politically incorrect’. Still, while undertaking the initial research, I was shocked to discover that growing numbers of detransitioning young women were telling similar stories to each other. They discovered trans either through the internet and/or their peer group, and felt they were drawn into it as it seemed to answer their concerns about being a female in society. The ever-growing range of gender identities appealed to them, and many had histories of mental-health problems, sexual abuse and self-harm. In trans, they found a group in which they were accepted and even celebrated, especially so in the wider context of identity politics They felt powerful, often for the first time in their lives.

At the same time, the rise of the ‘affirmation’ model of transgender healthcare (which was later entrenched in the UK in the Memorandum of Understanding against Conversion Therapy being made policy in 2018) meant that patients, even under-18s, could obtain medical gender-reassignment pretty much on demand, and, in some cases, without parental consent. Small wonder, then, that by 2019 there are now groups of detransitioners, mainly young women, forming coalitions and support groups, and, in the UK, even a charity, in order to support themselves.

The thing that has most disturbed me in all of this – apart from the way that Bath Spa University prevented crucial and important research from being done – has been the sheer scale of the denial, vilification, ignorance and, at best, silence that has come from trans-activist groups and their supporters on the subject of detransition. In any other field of medical practice, if evidence began to emerge of a practice that so many patients were saying had caused them harm there would be an inquiry into it. There is so little research into the long-term outcomes of gender reassignment – and most of it predates mass use of the internet, and the subsequent huge rise in young people presenting at sex-reassignment clinics. It is acknowledged by experienced clinicians that over 90 per cent of patients are lost to follow-up. We know that detransitioners very rarely go back to the clinics that treated them.

One trans support-group spokesperson has said ‘we are not comfortable with detransitioners’. Once dismissed as such a small percentage of those who had transitioned they didn’t matter, the feeling now seemed to be that they were ‘difficult patients’. When ‘informed consent’ was the model for treatment – we inform you of the consequences and potential side effects of treatment, and as long as you are not mentally ill, you consent – there were bound to be those who regretted transition. Now that ‘affirmation’ is the order of the day, and trans has become a political movement, it comes as no surprise that there are many, many more who regret making such a life-changing decision.

James Caspian is a psychotherapist. To support his legal challenge against Bath Spa University, visit his fundraising page here

Picture by: Getty

To enquire about republishing spiked’s content, a right to reply or to request a correction, please contact the managing editor, Viv Regan.


Jonathan Swift

25th October 2019 at 8:53 pm

If the right to change you gender is celebrated, then why shouldn’t the right to change you gender back be equally celebrated?

Of course, the answer is that the second celebration points out that there was something amiss in the first celebration.

Old Man

23rd October 2019 at 8:36 pm

I understand that trans people (as all people) need some delusions and lies to protect themselves from the truth that could be bitter for them. But it shouldn’t go so far to claim that there are no researches about detransitioning except the bad one from 10970 – this is simply not true, and could be easily checked. In spite of the efforts of trans community to stop these kind of researchers, there is increased number of them, and more and more examples.
Here is the latest one from Sweden (country which is very, very, trans-friendly!):
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885 (the study: https://www.ncbi.nlm.nih.gov/pubmed/21364939)
A few others:

There are even more studies showing harming effect of puberty blockers and cross-sex hormons on children and teenagers. The results are alarming!

It is useful to check web pages like: https://www.piqueresproject.com/
Or see the documentary: https://www.youtube.com/watch?v=0R7DXnqkfJw

Everyone (adult!) has the right to make the choice, but getting all possible information should be a must for such a serious step, if one wants to make an informed decision. If you go for a holiday, you check pages and pages with the reviews of the hotels, and here one should ignore information that warn about the risks that are life-changing?!

Jerry Owen

23rd October 2019 at 8:24 pm

Lord Anubis
Your argument could be used re paracetamol or aspirin. That’s a nonsensical argument using thalidomide as a kind of equal to deliberate body mutilation.

Dominic Straiton

23rd October 2019 at 8:03 pm


PP Garb

23rd October 2019 at 7:51 pm

Recently, I often find myself pondering Self-actualisation on Maslow’s Hierarchy of Needs as I observe the UK right now. On reaching this pinnacle, it seems that’s folks become truly lost.


23rd October 2019 at 7:17 pm

Caspian should be allowed to conduct his research in peace. However, I would like to seem some hard evidence of large numbers of ‘detransitioners’ before coming to any conclusion about this issue. I have met many post-operative tg people who seem entirely happy with their ‘choice’, including many who transitioned years ago. Many who have transitioned are far happier and more socially/economically functional than they were at the beginning. So-called ‘gender change’ or ‘sex reassignment surgery’ should always be viewed as a last resort, and treated with great caution in the case of young people, but for some it is the right path and it has undoubtedly saved lives. A ‘sex change’ is better than a suicide.


23rd October 2019 at 10:35 pm

He explained that many people who seek medical transition are lost to follow up. That’s why it’s hard to know how many detransitioners there are. But they are beginning to become more visible on the internet, social media, reddit, Medium, youtube, despite getting deplatformed and having to create private sites.

“So-called ‘gender change’ or ‘sex reassignment surgery’ should always be viewed as a last resort, and treated with great caution in the case of young people, but for some it is the right path and it has undoubtedly saved lives. A ‘sex change’ is better than a suicide”

I believe the point of his post is that the currently political climate is rushing people too quickly into transition, that it is not currently the last resort. And the current political climate is trying to silence voices like his, for what only seems to be political reasons. Trans activists are refusing to acknowledge what is going on with some people.

Your response is really in agreement with what he said. He fully acknowledges some people are better off transitioning.

James Knight

23rd October 2019 at 5:32 pm

Slightly ironic for trans activists to claim it is only a very small % who detransition and therefore should not be considered important. They are themselves a very small % of the general population!

jessica christon

23rd October 2019 at 2:44 pm

When the writer says “… unless you are mentally ill…”, when gender dysphoria IS a mental illness, and calls biological women “men” instead of trans men, etc., there’s a real disconnect between his own acceptance of trans ideology and his alarm at the way that the “treatment” model has been changed to reflect this thinking.

jessica christon

23rd October 2019 at 2:48 pm

Correcting myself, the author didn’t refer to “men”, but “other sixtysomething balding males”.


23rd October 2019 at 7:22 pm

So what’s your wonderful magic solution for the pain and confusion often felt by people with gender dysphoria?

jessica christon

23rd October 2019 at 9:56 pm

How about treating it as a mental illness and stop pandering to it as a start? We don’t pander to anorexics who think they’re fat, or to schizophrenics who hear voices do we?

jessica christon

23rd October 2019 at 10:03 pm

What is happening now is cruel to the dysmorphics in the same way that it would be cruel to encourage and exacerbate the symptoms of any other sufferer of a mental illness.

Dyfrig Llew

23rd October 2019 at 11:05 pm

Jessica: what would you do differently to the psychiatrists who previously tried – in vain – to treat trans people as mentally ill? Bearing in mind that psychotherapy, antipsychotics and ECT have all failed as treatments for gender dysphoria. Which psychiatric treatment would you try using?

jessica christon

24th October 2019 at 1:08 am

@Dyfrig Llew
Why are you asking me about psychiatric treatments? My point is that the affirmative model is a direct result of the tenet that it’s unacceptable to question someone’s claim that they are the opposite sex, so anyone who doesn’t like the model needs to revisit the tenet on which it is based. Yet the author doesn’t revisit the tenet because – I suspect – he accepts it. That is my issue with this article, nothing else.

Dyfrig Llew

24th October 2019 at 9:44 am

Jessica: because you’re the one who said “How about treating it as a mental illness and stop pandering to it as a start?” The psychiatric treatment plan needs to be specific, realistic and effective otherwise we run the risk of psychiatrists giving up, having realised that no psychiatric treatment works for transsexuals. You know, like they did decades ago (Serano, 2007). It’s not enough to vaguely say “we should be treating this as a mental illness” without coming up with specific ways of doing so.

jessica christon

24th October 2019 at 11:35 am

Yes, I said that. Sorry, tired, should have just gone to bed! 😀

GD should be treated with anti psychotics and psychotherapy because they have been successful and despite trans lobbyists claims of the contrary I haven’t seen any evidence showing that they have a higher rate of failure with GD than they do with other mental illnesses.

However, my reply to Zenobia which you quoted was meant more along the lines of my original statement even though I wasn’t very clear. A starting position that GD is a mental illness would spell the end of the affirmative model in treatment and result in hormones and surgery being used as a last resort instead of routinely.
At the moment, treatment is being influenced by the “my truth” culture and this was always going to run into trouble because treatment should be based on scientific evidence, not “my truth”.

jessica christon

24th October 2019 at 1:22 pm

That is in reply to: DYFRIG LLEW
24th October 2019 at 9:44 am

Jim Lawrie

23rd October 2019 at 2:18 pm

They “felt they were drawn into it as it seemed to answer their concerns about being a female in society” – could you be any more vague? Who edits this stuff?

Ven Oods

23rd October 2019 at 2:09 pm

“part of an MA at Bath Spa University, which it later prevented me from continuing, citing fear of criticism for allowing research on a subject seen in some quarters as ‘politically incorrect’. ”

Jeez; it’s good to know that our unis are still such fearless defenders of science, research and learning.
Bath is obviously more Spa than University.
Perhaps establishments that can’t uphold such principles should be de-established?

Neil John

28th October 2019 at 12:01 pm

Universities, as bodies corporate, are only interested in income and maintaining said income, the business model may pay lip-service to academic freedom, but that’s all it is, a cheap blow job to keep the UCU (and others) quiet about it. Anything that attracts the wrong sort of attention, especially from ‘activist’ groups, will be minimised or shutdown completely.

One University I know only too well has neutered it’s Academic Senate to the point that it’s absolutely useless, the ‘Executive’ and ‘Council’ rule unchecked, the V.C./President is now just a stale/pale/male figurehead appointed for their hopefully advantageous political affiliations. The ‘real’ management is done by a Chief Operational Officer and his ‘professional services’ directors following the line given by the business executives on ‘Council’. I wish I could wax lyrical about the chancellor, but as she’s proven recently with some of her activism, she’s just another for political gain appointee, much like the sneering BBC reporter who’s the Pro-Chancellor.

Universities are indoctrination centres for some and simply a business for making money for others, whilst keeping large numbers of young people, and not so young perpetual s-too-dense, off the dole queue in the main. The few involved in real useful research have to struggle against the bureaucrazy (sp!) of their University, funding councils, the EU, attempts by well funded activists to shut them down and all too often against jealous fellow academics as well. Oh to be retired and free of the ‘Academic’ bullshit.

Willie Penwright

23rd October 2019 at 2:02 pm

This is a terrible tragedy for the individual concerned and, no doubt, for many others who chose the same path. However we must never cease telling our chidren and young adults that stupidity can kill.

Ian Davies

23rd October 2019 at 12:58 pm

“…..who does a lot of sex-reassignment surgery”
Can we have some adult terminology please. Your sex is not reassigned, the chromosomes remain the same.
Perhaps one day this craze will be looked back on as a form of dark ages when we lost our minds. And the preying on of pre teens by schools to encourage this to burnish their right-on credentials will be viewed as child abuse akin in seriousness to rape.

Jane 70

23rd October 2019 at 1:50 pm

This is what is so worrying: an individual’s karyotype is expressed in every cell in the body throughout the life span, so 46XY for a biological male will be maintained,, despite surgical and hormonal interventions aimed at producing a female appearance and persona.

Such a drastic alteration to basic biological function must surely have some adverse consequences, for both mental and physical well being.

Jim Lawrie

23rd October 2019 at 2:13 pm

The article tries quite few times to slip in hocus-pocus as science.

Gareth Evans

23rd October 2019 at 8:07 pm

Oh it’s this generation’s thalidomide scandal for sure.

Dyfrig Llew

23rd October 2019 at 11:54 am

“There is so little research into the long-term outcomes of gender reassignment”

Really? You can’t have looked very hard, because I know of at least 70 studies. The only one I know of showing negative results from transitioning is one flawed, academically dishonest and debunked study from the 1970s. The others all show benefits from transitioning, and that this detransitioning phenomenon is actually very rare (in less than 3% of all transsexuals). As you note, the detransitioners aren’t primary transsexuals (i.e. people who’ve spontaneously felt “in the wrong body” since childhood), but people who’ve arrived at the idea of transitioning though another route.

Here’s a helpful link to the extensive research on (de)transitioning: https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/#top

Weyland Smith

23rd October 2019 at 6:21 pm

“The only one I know of showing negative results … is one flawed, academically dishonest and debunked study from the 1970s”

Do you have a reference for this?
(Genuine question)

PP Garb

23rd October 2019 at 7:35 pm

If Bath Spa Uni are stopping ‘politically incorrect’ research, then should we assume no others are? And if they are doing so, it might explain why there’s only one output disagreeing with the current ideology.

Simon Giora

23rd October 2019 at 9:38 am

Gender dysphoria should be treated as a mental health issue not a life style choice. As the article points out many suffering from gender dysphoria have multiple other mental health problems.


23rd October 2019 at 7:13 pm

‘multiple other mental health problems’ —

Really? Every single one of them without exception? Which ‘mental health problems’? There isn’t a member of the human race that doesn’t have a ‘mental health problem’ at some point in their lives.

Weyland Smith

23rd October 2019 at 7:40 pm

“Many” not = “Every single one of them without exception”

Jim Lawrie

23rd October 2019 at 9:23 am

“In any other field of medical practice, if evidence began to emerge of a practice that so many patients were saying had caused them harm there would be an inquiry into it. ” Is that abortion you are talking about?

Jim Lawrie

23rd October 2019 at 9:21 am

“Alex now bitterly regrets transitioning and wants to live as a woman again, but is now, in every way, indistinguishable from other sixtysomething, balding males,”. Wrong . Alex is not male, not a man. Alex is a woman, mutilated by consent. Approved by doctors, as with an abortion. Did they advise Alex that she would go bald? She can stop taking male hormones and her hair might grow back, unlike real men. She can start taking female hormones to substitute for the ones her body can no longer produce because she consented to the removal of the parts that make them.

What does “live as a woman” mean? She is a woman. She can put on nappies and pretend to be a baby, but she will still be a woman.
We have here a woman who doesn’t know what she wants, but is certain of what she doesn’t want. How unusual.

No who is she going to blame all this on?

PP Garb

23rd October 2019 at 7:40 pm

My-my JIm… leaked out there methinks. A deep well of pain and resentment between the lines. We all give it away to those paying attention and while there’s not many of paying attention, we’re here.

I agree she is a woman btw. Whether doing as you say would result in a revert at that age, I know not. I suspect there’s a point of no return. The human body can only take so much. I have no idea why folks seem to think otherwise.

Dominic Straiton

23rd October 2019 at 9:14 am

“trans” has nothing to do with LGB. Its a duel morbidity mental disorder that has far more similarities to anorexia than anything else. I hope those who have had their lives ruined by chemical castration and complicated surgery often when children sue those responsible including social worker,s teachers, doctors,The NHS, politicians, activists and dispicable parents for every penny they have

PP Garb

23rd October 2019 at 7:42 pm

That’s when it will all right itself. It’s coming down the line, as sure as eggs are eggs. A car crash in slow motion is a terrible thing to witness. If only folks were listening.

Jim Lawrie

23rd October 2019 at 9:01 am

A far bigger problem is the millions of women who deeply regret and are haunted by having abortions, but businesses like BPAS who promote it for financial gain, and campaign to expand their operations overseas.

Baked Beans

23rd October 2019 at 8:33 am

There are, in this item, a number of references to ‘gender’ and also ‘sex’. Wlould the author be so kind as to explain what he is writing about?
Gender is a concept in grammar, masculine, feminine and neuter.
Sex is a defining characteristic in mammalian reproduction.
To mix the two is a clear indication of confusion.
Why is Spiked, by publishing this item, apparently endorsing confusion?
The only possible use of any publication is to reduce confusion on any matter.
Please, Spiked, do try to do better.

Weyland Smith

23rd October 2019 at 6:39 pm

The roots of gender in relation to sex go way back to Proto Indo European (PIE) languages.

“gender (n.)

c. 1300, “kind, sort, class, a class or kind of persons or things sharing certain traits,” from Old French gendre, genre “kind, species; character; gender” (12c., Modern French genre), from stem of Latin genus (genitive generis) “race, stock, family; kind, rank, order; species,” also “(male or female) sex,” from PIE root *gene- “give birth, beget,” with derivatives referring to procreation and familial and tribal groups.”


Ian Wilson

23rd October 2019 at 6:08 am

What is the motivation first trans activists.? I just don’t understand it.

Jane 70

23rd October 2019 at 5:25 am

To repeat what I wrote on another thread: the distress discussed in this article exemplifies what I’m sure will manifest in future years: an emotional and mental dissonance-a fracturing of the foundations of personal integrity to match the widespread cognitive dissonance which is the consequence of pc double speak.

This drastic surgical procedure must have significant psychological and physical consequences, since the assumed and chosen public persona is in conflict with the inherited genotype .Surgical intervention does not cancel out cellular expression of biological sex.

“In any other field of medical practice, if evidence began to emerge of a practice that so many patients were saying had caused them harm there would be an inquiry into it.”

The vaginal mesh scandal comes to mind: thousands of women have suffered agonising side effects following mesh implant surgery; the medical establishment is now taking this seriously :


Mr Caspian’s research deserves public and academic support.

David Webb

23rd October 2019 at 5:03 am

I think the millions of “liberals” who support the trans ideology are all personally to blame for the plight of the detransitioners, and any for any suicides that result from this. We have to pin the blame on them.

Jim Lawrie

23rd October 2019 at 10:17 am

They will sidestep that by spearheading the campaign for compensation and saying that some professionals failed their “patients” in the vetting stage. Therefore more robust procedures etc …..

Like this article, they will tinker around the edges, but avoid questioning the modern acqiescence to those who bawl “I want.”

Andrew Leonard

23rd October 2019 at 2:43 am

Transition regret is the 21st century’s version of Thalidomide

Jim Lawrie

23rd October 2019 at 10:55 am

How so?

Andrew Leonard

23rd October 2019 at 11:28 am

Human bodies are being partially ruined, due to our own failings

Jerry Owen

23rd October 2019 at 12:18 pm

Andrew Leonard
I think you will find that Thalidomide wasn’t any kind of lifestyle choice.

Andrew Leonard

23rd October 2019 at 1:24 pm

Nor is transition regret

Jim Lawrie

23rd October 2019 at 2:14 pm

Who is “our”?

Thalidomide was case of pharmaceutical fraud.

Lord Anubis

23rd October 2019 at 2:23 pm

@ Jerry Own. Well, indirectly at least, It kind of was. I was born right in the middle of the Thalidomide disaster and always felt that I had dodged a bullet (Mind, the awful side effects were relatively rare thankfully) Fortunately my Mother had an old fashioned GP who disproved of ANY medication being taken during pregnancy so she never took it. Thalidomide was not medically necessary. It was a “Lifestyle” drug in the sense that its purpose was to reduce the severity of morning sickness and make it easier for expectant mothers to get on with their normal lives rather than to treat anything in any way life threatening. It belonged to an era where the belief was that there would be a pill for every ill with no concern for the possible consequences. Thalidomide shattered that illusion.

Jerry Owen

23rd October 2019 at 8:20 pm

Andrew Leonard
Thalidomide was a cover up as Jim Lawrie rightly points out… I thought you might have grasped that. Further parents didn’t take thalidomide to change their children purposely.

Andrew Leonard

24th October 2019 at 3:15 am

Jerry, have you grasped that government promoted gender ideology, which denies the truth of there only being two genders – also amounts to a scientific cover-up?

The transitioning epidemic and mounting incidences of post-transitioning regret, has strong parallels with the Thalidomide episode. Granted, the equivalence is not perfect, but the parallels are obvious.

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