Interviews: Four Detransitioned Women Share Their Therapy Experiences

I have always been a believer in the healing power of therapy. When I was beginning my transition journey, I found many therapists willing to help me on my road to self-realization through medical transition. I was affirmed at every turn and encouraged. It is a common enough story around gender issues, transgender identification, and transition. Many of my detransitioned female friends have similar stories of affirmation and support for their transition from therapists. 

Imagine my surprise when upon beginning my detrans journey I found not one therapist that was willing to even approach the idea that transition had been harmful to me, both physically and mentally. Or that my reasons for transitioning were trauma based and not an innate identity. I was left to feel completely isolated and alone. Failed by the same community that just four years before was overwhelmingly present. I’m not alone of course, many detrans women have experienced the same situations as I have. 

To understand our own needs and shed light on what is lacking in the mental health community I sent out some basic interview questions to detrans women regarding their experiences with the mental health community.  I received four thorough and well-articulated responses I wish to show here in their entirety. Detrans Voices is about the voices and experiences of detrans people and its very important that we be allowed to tell our stories in full. For this reason and the fact that I found the answers so insightful and intelligent I have left the answers unedited. I hope this is the beginning of a much-needed conversation within the mental health field.  

Interview With F.

Did you seek the help of a therapist when beginning your detransition? Why? 

At first, I didn’t. However, after some years I realized I was mentally struggling with feelings of regret and unsure about the possible negative effects that testosterone had on my uterus, ovaries and libido, for example. Also, I was considering getting my facial hair lasered, which could be partly covered by my health insurance if I’d have a recommendation of a therapist.

Tell us about your experiences with therapists around your detransition. 

Initially, I went back to the therapist that diagnosed me when I was 19. I tried to explain to her that I felt like I had made a mistake and that I did not consider myself to be a man, nor had the wish to be physically male anymore. She did not believe me and tried to explain me that all men are different and that I don’t have to fit the stereotypes. Luckily, she referred me to a gynaecologist for the questions I had regarding the physical aspects. This gynaecologist was great and referred me to another therapist, and a sexuologist. This second therapist worked in a ‘gender team’ and had experience with ‘regret’ and ‘non-binary’ patients. He did not question me being a woman; he was mostly listening and I felt heard and taken seriously. What I particularly liked about this therapist, was that he did not judge anything I said, but just responded with questions that made me think about my own views, motivations and wishes. He helped me to figure things out and suggested approaches for combatting the things I was struggling with.

Were there any ideas, questions or advice given by the therapist that was unhelpful? 

It did not help me that my first therapist could not believe I am a woman after all, since she diagnosed me with gender dysphoria. Yes, I was the ‘perfect’ FtM, and no, I did not see any differences between me and other FtMs before, but that did not rule out the possibility of me feeling like a wasn’t a trans man after all. It felt very unhelpful that this therapist held onto stereotypes (because I’m ‘masculine’ in the way I move and present) on one hand, but on the other hand told me to reject stereotypes for men. It weren’t the stereotypes for men I felt restricted by; I just felt alienated between men and invisible between women. I felt like I had betrayed myself in a certain way, by having changed my appearance and now blending in with the rest of society, even though the combination of my appearance (female) and the way I moved and dressed made me who I am.

What are some key ideas or words that would be helpful when counseling detrans women? 

To get to the root of the feelings. What’s behind the dysphoria? Might shame, insecurity or trauma play a role? How did you feel about yourself in the past? What are you still dysphoric about? Are your aware of the judgements of society you’ve internalized? Might there be internalized homophobia? We’re looking for sustainable solutions.

What would you like to see the mental health community do better when treating detrans women?

To listen, respect and not judge. Use the techniques and methods you’ve learned to apply. Don’t treat us like we’re something completely different from your other patients. Also, focus on our personal story and life, don’t make it about the bigger picture as we need to figure/sort out our own life first.

Interview With Rachel

I sought out a therapist when I began detransition. I was more focused on addressing my PTSD than focusing on my detransition as a whole, because I’ve come to realize that a lot of my anxiety about my body stems from my PTSD and the trauma I incurred. The therapist was very confused about why I would not want to continue transitioning. She also did not understand why I would have discomfort around being a lesbian. I think that that therapist only had experience with anxiety and trauma within certain circumstances, and could not understand why or how one would apply this anxiety to their body, except because of gender dysphoria. And, this therapist believed that the only treatment for gender dysphoria was transition. So, she often implied that I would continue to suffer distress unless I continued to transition. 

It would have been helpful to have had my anxiety addressed as something separate from the vague notion of gender dysphoria. My anxiety comes from specific things and, to treat is as. One mass of unknowable stress, is a disservice to the anxiety I feel. I have a trauma response to being touched, to seeing my body, and to being socially seen as a woman. These things should have a light shone on them because a growing number of women are internalizing the misogyny and sexual trauma they experience. Instead of pointing it out and treating it, it felt like my therapist was trying to treat the symptom of my trauma because she wasn’t equipped to treat the trauma itself. 

I would like to see the mental health community stop shying away from the seriousness of mental health issues. We are treating mental illnesses with plastic surgery and steroids, instead of actually psychoanalyzing and doing progressive therapies like Cognitive Behavioral Therapy, which is proven to help with anxiety and trauma. Mental illness also is expressed in different ways, depending on culture, age, sex, and environment. Pretending that mental illness can only be expressed in a certain way means that therapists are refusing to acknowledge and treat the very real problems that some are experiencing. Detrans women have a very specific relationship with their bodies. Mental health practitioners need to be made aware of how we live in our bodies each day and how our anxiety is expressed. The question should not be “How do we get this person in for surgery,” but “How do we treat the source of this person’s problem in the most natural, holistic way that will improve their long-term health?”   

Interview With W.

Did you seek the help of a therapist when beginning your detransition? Why?

I did. I informed my GP that I intended to detransition and he then referred me to a therapist. I was already rather distrustful of therapists by that point due to some negative experiences with them in the past, but I was so desperately depressed I knew I needed to seek some form of help. Self-soothing with alcohol and other self-destructive behaviors to cope with my situation was just making me feel even worse, so I figured trying therapy again was the healthier option.

Tell us about your experiences with therapists around your detransition.

The therapists I saw when I began detransition seemed uncomfortable with the topic, which in turn made me uncomfortable and less willing to open up. It was like they had no idea how to deal with me; that they didn’t understand how I could have gender dysphoria but still regret having transitioned. During one appointment, my therapist had someone work-shadowing him. When trying to explain how I came to regret my transition – how I’d realized I could never be a real man and was essentially living a lie in order to run from my problems – my therapist turned to the person shadowing him and assured them that these were my views and certainly not his. It was as if I had just said something so awful that my therapist felt the need to butt in just to make sure everyone knew he didn’t agree with my views. I was dumbfounded. I sat there feeling angry and embarrassed for what remained of the appointment. I decided after that that I would have to deal with my detransition alone and that I would never subject myself to therapy again.

Were there any ideas, questions or advice given by the therapist that was unhelpful?

I was given two suggestions by my therapist. The first was that I was non-binary, had I considered that? When I said no, I don’t personally believe people can be non-binary, the therapist became visibly annoyed. He stopped smiling, sat back in his chair and folded his arms. He became quite curt, and it made me want to just walk out. I’ll never forget how hopeless that appointment made me feel. The second suggestion, offered by another therapist and by my GP, was that I return to the gender clinic. I was told that detransition was simply not something my therapist/GP knew enough about, and that the best course of action was for me to return to the gender clinic that I had transitioned through. This was after I had already made it clear that I didn’t want to return to the clinic that had enabled my transition. Overall, nearly every therapist, GP and social worker I discussed my transition regret and detransition with gave off the impression that they just didn’t want to hear it.

What are some key ideas or words that would be helpful when counseling detrans women?

That depends on each woman and why she chose to transition and detransition. Personally, I found facing the hard truths of my situation the most helpful. Yes, I made a mistake. No, it cannot be completely undone. Yes, I’m going to be misgendered now and again. No, I will never be as I was pre-transition. Yes, I still wish I was born male. No, it will never be possible for me to be male. From there I was able to explore things more thoroughly, to really dig deep into my issues and where they came from. Rather than saying “it’s all because I have gender dysphoria,” I began to ask “well, where did the dysphoria come from? Why did it develop in my teens and not my childhood? What was going on at that time?”. It is my opinion that detrans women will never be able to accept themselves and move on if we don’t confront these hard truths.

What would you like to see the mental health community do better when treating detrans women?

The mental health community would do well to not treat detransitioners as some brand new category that is yet to be seen or understood. Known issues like eating disorders, body dysmorphia, questioning identity, depression, anxiety, trauma, internalized homophobia, internalized misogyny, grief etc. may all be factors that can result in women and girls developing gender dysphoria and seeking transition. Rather than aiming to treat gender dysphoria, it may be better to identify and treat what other issues a patient may have – viewing gender dysphoria as a symptom of another condition, rather than as a stand alone one.

Interview With Grace 

Did you seek the help of a therapist when beginning your detransition? Why? 

I did, because I was so freaked out from my mastectomy that I just didn’t know what to do with myself. I sought out a woman who could do EMDR, which promised to take my extreme panic and grief and make it smaller, more manageable. It did work well for me.

Tell us about your experiences with therapists around your detransition. 

My gender therapist was about as helpful as banging my head against a wall, vis-a-vis gender dysphoria. She just select-replaced my name into the top surgery form letter and sent me on my way. My therapist I sought for mastectomy grief was much better. There was one uncomfortable moments where she seemed to want to make me admit that most people were improved by transition, which I found strange. But her techniques helped me a lot.

Were there any ideas, questions or advice given by the therapist that was unhelpful? 

She showed me how therapeutic techniques could be used on gender dysphoria and surgery regret. Before, I had bought into the idea that trans issues were special and unable to be treated with therapy. But she helped me realize that my problems were not special. I am a normal person with normal problems, and can be helped with the kind of techniques that help other people.

What are some key ideas or words that would be helpful when counseling detrans women? 

“I did then what I knew how to do. Now that I know better, I do better.” – Maya Angelou

What would you like to see the mental health community do better when treating detrans women?

I’d like to see a little bit of etiquette training for therapists: if someone is detransitioined, it’s not appropriate to spend a lot of time suggesting they should reframe themselves as nonbinary. It’s not appropriate to use their therapy time to talk about how good transition is for other people. Detransitioners, to use a tired old phrase, are valid. We need help dealing with the problems caused by transition, dysphoria, and everything else. I think regular therapeutic techniques can be used to help detransitioners with their issues, so I’d like to see more of that.