Search “detransition” on the New York Times website and you’ll find 276 results, compared to more than 10,000 for “transgender”. To those who believe in “gender ideology” — that each person has a gender identity, which, should it not match one’s sex, needs medicating — that might seem fair. After all, we often hear that the detransition rate is “less than 1%”.

But the reality of those who transition and then try to return to living in their natal sex is much more complicated — as a recent New York Times article on the subject highlights.

In a piece entitled “The Truth About Detransitioning”, Kinnon MacKinnon, a trans researcher focused on improving trans medicine through the study of detransition, explores this complex phenomenon. Unlike much of the gender-affirmation industry, MacKinnon acknowledges the reality of detransition and does not attribute it solely to external factors, as gender psychiatrist Jack Turban’s flawed research has suggested.

Rather, MacKinnon shifts us from “it’s not happening”, past “it’s happening, but not because treatment is bad”, to “it’s happening and sometimes treatment is bad, but not as bad as Trump says”. Movement? Yes. But the truth? Doubtful.

MacKinnon writes that: “My personal experience, that of most trans people I know and a large body of research, show medical transition can help many resolve their gender dysphoria and improve their quality of life.” But some of that research, especially relating to minors, has been declared “very low certainty” by multiple systematic evidence reviews, which examine not only outcomes of studies but their reliability. Low or very low certainty claims can’t be relied upon, and the true effect could be the opposite of what’s asserted.

So while it’s true that some people are very happily transitioned, it can be devastating for others. MacKinnon notes that recent studies — conducted during a period when the number of people transitioning sharply increased — suggest a higher-than-expected rate of such negative outcomes, ranging from 5 to 10%.

According to MacKinnon’s own study, only 29% of those who detransitioned did it for “external” reasons: “lack of familial support, feeling discriminated against or an inability to get the treatment they need”. They didn’t regret — they just couldn’t keep going. Meanwhile, 20% blamed external reasons as well as “changing gender identity” and “mental health challenges”. They fared worse after transition, and didn’t consider themselves trans in the same way.

That leaves two more cohorts. The next group, making up about 20%, “cited changing gender identity, but generally did not feel regret about their earlier transition”. These may be the people who shift from trans to non-binary as an off-ramp, but we don’t know. Some studies suggest regret can take up to a decade to set in. Maybe they’ll feel worse later, or maybe they won’t. Besides, is that how we measure the treatments’ success: whether or not someone feels bad about it later?

This brings us to the largest group — 33% who detransitioned due to “identity changes, mental health-related factors, and dissatisfaction with treatment”. Stories elsewhere have shown how these tend to be the most troubling cases: individuals left with permanent physical damage, often realising too late that their reasons for transitioning masked deeper issues needing attention, ranging from internalised homophobia to autism.

Given this significant percentage, one might expect greater caution regarding the scale and rapid pace of gender-affirming surgeries. Yet MacKinnon remains firm on one point: “Nothing in my team’s research, or any other studies on detransition, should lead to the conclusion that policymakers ought to issue blanket bans on gender-affirming care.”

That’s a hard assertion to make based on MacKinnon’s own data. If only 29% detransitioned for external reasons, and the majority reported worsening mental health and regret, why wouldn’t policymakers consider banning treatments that led to those results? After all, gender-affirming care proponents haven’t offered alternatives or modifications, suggested stricter guidelines or more rigorous follow-up.

While I have never publicly supported outright bans, I understand why many view them as a response to a regulatory vacuum left by the rapid expansion of the gender-affirmation industry without sufficient oversight. The lack of effective safeguards created the environment in which those 33% in the study were harmed by the treatments they understood would help.

Researchers like MacKinnon need to move beyond merely asking why people detransition. If their aim is to offer meaningful alternatives to broad bans, they must listen closely to those who regret their transitions. For example, it would be valuable if the New York Times commissioned a detransitioner to contribute to these discussions. The essential question should be: how can the medical community prevent these harmful outcomes in the future? Without confronting this issue, research risks becoming a purely academic exercise that ultimately fails the people it intends to help.

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Lisa Selin Davis is the author of Tomboy. She writes at Broadview on Substack.

LisaSelinDavis

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