A qualitative metasummary of detransition experiences with recommendations for psychological support

  1. Pablo Expósito-Campos 1
  2. José Ignacio Pérez-Fernández 1
  3. Karmele Salaberria 1
  1. 1 Universidad del País Vasco/Euskal Herriko Unibertsitatea
    info

    Universidad del País Vasco/Euskal Herriko Unibertsitatea

    Lejona, España

    ROR https://ror.org/000xsnr85

Revista:
International journal of clinical and health psychology

ISSN: 1697-2600

Año de publicación: 2024

Volumen: 24

Número: 2

Páginas: 231-240

Tipo: Artículo

DOI: 10.1016/J.IJCHP.2024.100467 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: International journal of clinical and health psychology

Resumen

Objective The main goal of this article is to identify areas of psychotherapeutic work with detransitioners, that is, individuals who stop or reverse a gender transition, given the scarcity of information and resources. Methods We conducted a systematic review and metasummary of qualitative data published until April 2023. Data were extracted, grouped, and refined to conform meta-findings. Results The database search yielded 845 records, of which 15 comprising 2689 people who detransitioned were included in the review. A total of 582 findings were extracted, resulting in 34 meta-findings with frequencies ≥ 15 %. Two main thematic areas with several subthemes were identified. The theme “Gender transition” included “Perspectives” and “Emotions.” The theme “Gender detransition” included “Driving factors,” “Challenges” (a. Social and emotional difficulties, b. Lack of support and understanding, c. Negative healthcare experiences, d. Detransphobia, and e. Identity concerns), “Needs,” “Growth and evolution,” and “Identity and future.” Based on these meta-findings, we advance broad recommendations for supporting detransitioners in their various emotional, social, and identity needs. Conclusions Detransitioners are diverse in their experiences and perspectives and face significant challenges. Emotional validation with a focus on personal strengths and meanings, treatment of concurrent psychological issues, development of social networks, and support of identity exploration are key aspects of psychotherapeutic work with this population.

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Referencias bibliográficas

  • Butler, C., & Hutchinson, A. (2020). Debate: The pressing need for research and services for gender desisters/detransitioners. Child & Adolescent Mental Health, 25(1), 45–47. https://doi.org/10.1111/camh.12361
  • Butler, G., Adu-Gyamfi, K., Clarkson, K., El Khairi, R., Kleczewski, S., Roberts, A., et al. (2022). Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008-2021. Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2022-324302. Advance online publication.
  • *Cain, L. K., & Velasco, J. C. (2021). Stranded at the intersection of gender, sexuality, and autism: Gray’s story. Disability & Society, 36(3), 358–375. https://doi.org/10.1080/ 09687599.2020.1755233
  • Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., et al. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644
  • Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435–1443. https://doi.org/ 10.1177/1049732312452938
  • *Durwood, L., Kuvalanka, K. A., Kahn-Samuelson, S., Jordan, A. E., Rubin, J. D., Schnelzer, P., et al. (2022). Retransitioning: The experiences of youth who socially transition genders more than once. International Journal of Transgender Health, 23(4), 409–427. https://doi.org/10.1080/26895269.2022.2085224
  • Entwistle, K. (2021). Debate: Reality check—Detransitioner’s testimonies require us to rethink gender dysphoria. Child & Adolescent Mental Health, 26(1), 15–16. https:// doi.org/10.1111/camh.12380
  • Exposito-Campos, P., Salaberria, K., Perez-Fernandez, J. I., & Gomez-Gil, E. (2023). Gender detransition: A critical review of the literature. Actas Espan˜olas de Psiquiatría, 51(3), 98–118.
  • Gribble, K. D., Bewley, S., & Dahlen, H. G. (2023). Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm. Frontiers in Global Women’s Health, 4, Article 1073053. https:// doi.org/10.3389/fgwh.2023.1073053
  • Hall, R., Mitchell, L., & Sachdeva, J. (2021). Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: Retrospective case-note review. BJPsych open, 7(6), e184. https://doi.org/10.1192/ bjo.2021.1022
  • *Haarer, M. L. (2022). A phenomenological study of the experience of gender detransitioning [Dissertation, Regent University (United States)]. ProQuest Dissertations and Theses Global.
  • Hong, Q. N., Pluye, P., Fa`bregues, S., Bartlett, G., Boardman, F., Cargo, M., et al. (2019). Improving the content validity of the mixed methods appraisal tool: A modified e- Delphi study. Journal of Clinical Epidemiology, 111, 49–59. https://doi.org/10.1016/ j.jclinepi.2019.03.008
  • Irwig, M. S. (2022). Detransition among transgender and gender-diverse people—An increasing and increasingly complex phenomenon. Journal of Clinical Endocrinology & Metabolism, 107(10), e4261–e4262. https://doi.org/10.1210/clinem/dgac356
  • Jorgensen, S. C. J. (2023). Transition regret and detransition: Meanings and uncertainties. Archives of Sexual Behavior, 52(5), 2173–2184. https://doi.org/ 10.1007/s10508-023-02626-2
  • Koehler, A., Strauss, B., Briken, P., Szuecs, D., & Nieder, T. O. (2021). Centralized and decentralized delivery of transgender health care services: A systematic review and a global expert survey in 39 countries. Frontiers in Endocrinology, 12, Article 717914. https://doi.org/10.3389/fendo.2021.717914
  • *Kuiper, A. J., & Cohen-Kettenis, P. (1998). Gender role reversal among postoperative transsexuals. International Journal of Transgenderism, 2(3).
  • *Littman, L. (2021). Individuals treated for gender dysphoria with medical and/or surgical transition who subsequently detransitioned: A survey of 100 detransitioners Archives of Sexual Behavior, 50(8), 3353–3369. https://doi.org/10.1007/s10508- 021-02163-w
  • MacKinnon, K. R., Exposito-Campos, P., & Gould, W. A. (2023). Detransition needs further understanding, not controversy. BMJ, 381, Article e073584. https://doi.org/ 10.1136/bmj-2022-073584
  • *MacKinnon, K. R., Gould, W. A., Ashley, F., Enxuga, G., Kia, H., & Ross, L. E. (2022). (De)transphobia: Examining the socio-politically driven gender minority stressors experienced by people who detransitioned. Bulletin of Applied Transgender Studies, 1 (3–4), 235–259. https://doi.org/10.57814/8nd4-6a89
  • *MacKinnon, K. R., Kia, H., Salway, T., Ashley, F., Lacombe-Duncan, A., Abramovich, A., et al. (2022). Health care experiences of patients discontinuing or reversing prior gender-affirming treatments. JAMA Network Open, 5(7), Article e2224717. https:// doi.org/10.1001/jamanetworkopen.2022.24717
  • Narayan, S. K., Hontscharuk, R., Danker, S., Guerriero, J., Carter, A., Blasdel, G., et al. (2021). Guiding the conversation—Types of regret after gender-affirming surgery and their associated etiologies. Annals of Translational Medicine, 9(7), 605. https:// doi.org/10.21037/atm-20-6204
  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). Declaracion PRISMA 2020: Una guía actualizada para la publicacion de revisiones sistematicas. Revista Española de Cardiología, 74(9), 790–799. https://doi. org/10.1016/j.recesp.2021.06.016
  • Pazos Guerra, M., Gomez Balaguer, M., Gomes Porras, M., Hurtado Murillo, F., Sola Izquierdo, E., & Morillas Arin˜o, C. (2020). Transsexuality: Transitions, detransitions and regrets in Spain. Endocrinología, Diabetes y Nutricion, 67(9), 562–567. https:// doi.org/10.1016/j.endinu.2020.03.008
  • *Pullen Sansfaçon, A., Gelly, M. A., Gravel, R., Medico, D., Baril, A., Susset, F., et al. (2023). A nuanced look into youth journeys of gender transition and detransition. Infant & Child Development, 32(2), e2402. https://doi.org/10.1002/icd.2402
  • Pullen Sansfaçon, A., Planchat, T., Gelly, M. A., Baril, A., Susset, F., & Millette, M. (2023). Understanding the experiences of youth who have discontinued a gender transition: Provider perspectives. Psychology of Sexual Orientation and Gender Diversity. https:// doi.org/10.1037/sgd0000644. Advance online publication.
  • Sandelowski, M., & Barroso, J. (2007). Handbook for synthesizing qualitative research. Springer.
  • *Sanders, T., du Plessis, C., Mullens, A. B., & Bro¨mdal, A. (2023). Navigating detransition borders: An exploration of social media narratives. Archives of Sexual Behavior, 52(3), 1061–1072. https://doi.org/10.1007/s10508-023-02556-z
  • *Shepherd, A., & Hanckel, B. (2021). Ontologies of transition(s) in healthcare practice: Examining the lived experiences and representations of transgender adults transitioning in healthcare. Health Sociology Review, 30(1), 41–57. https://doi.org/ 10.1080/14461242.2020.1854618
  • *Slothouber, V. (2021). Narratives of de/retransition: Disrupting the boundaries of gender and time [Dissertation, University of Western Ontario (Canada)]. ProQuest Dissertations and Theses Global.
  • *Strang, J. F., Powers, M. D., Knauss, M., Sibarium, E., Leibowitz, S. F., Kenworthy, L., et al. (2018). “They thought it was an obsession”: Trajectories and perspectives of autistic transgender and gender-diverse adolescents. Journal of Autism and Developmental Disorders, 48(12), 4039–4055. https://doi.org/10.1007/s10803-018-3723-6
  • Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12, 181. https://doi.org/10.1186/1471-2288-12-181
  • *Turban, J. L., Loo, S. S., Almazan, A. N., & Keuroghlian, A. S. (2021). Factors leading to “detransition” among transgender and gender diverse people in the United States: A mixed-methods analysis. LGBT health, 8(4), 273–280. https://doi.org/10.1089/ lgbt.2020.0437
  • *Vandenbussche, E. (2022). Detransition-related needs and support: A cross-sectional online survey. Journal of Homosexuality, 69(9), 1602–1620. https://doi.org/ 10.1080/00918369.2021.1919479
  • *Yoo, A. (2018). Transition regret and detransition. In C. Stewart (Ed.), Lesbian, gay, bisexual, and transgender americans at risk: Problems and solutions. Volume 2: Adults, generation X, and generation Y (pp. 181–192). Praeger.
  • Zhang, Q., Goodman, M., Adams, N., Corneil, T., Hashemi, L., Kreukels, B., et al. (2020). Epidemiological considerations in transgender health: A systematic review with focus on higher quality data. International Journal of Transgender Health, 21(2), 125–137. https://doi.org/10.1080/26895269.2020.1753136
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