Canadian researcher Kinnon McKinnon was only mildly surprised this spring when his talk, along with dozens of others, wasn’t listed on the upcoming conference’s website. He was scheduled to discuss one of the most troubling topics in medicine: patients who transition to a different gender but later change their minds (known as desexualization).
The Society of Pediatric Endocrinology, which organized the conference, said his presentation was kept confidential due to safety concerns. The previous year’s rally included protests against gender healthcare. When he spoke in a Chicago hotel ballroom, audience members were asked to submit questions anonymously on notecards. Recording was not allowed. Despite the room being full, it was eerily quiet.
Dr. McKinnon, 39, an assistant professor of social work at Toronto’s York University, is transgender and presented alongside another trans researcher. He joked as he grabbed the microphone. “They’re really bringing in transgender people and having them talk about simple topics, right?”
He has become used to trying to defuse tensions with scientific conferences, gender clinics and TikTok posts, as the once-murky subject of transition reaches into the U.S. presidential election and a future Supreme Court case. There is.
A small group of detransitioners, primarily young women who underwent treatment to live as trans men but later regretted it, have become the public face of the Republican-led ban on gender health care for minors. In frequent testimony at statehouses and appearances in right-wing media, they have described irreversible procedures they underwent as adolescents, claiming they were misunderstood or ignored by doctors.
Activists who advocate for gender health care for young people say such experiences are extremely rare and that patients are more likely to regret their transition than they are to regret a common medical procedure such as knee surgery. They claim it’s much lower.
And healthcare providers have been slow, and sometimes reluctant, to recognize the risk that patients’ emotions may change in the future. As a result, little research exists on how often detransition occurs and why, even though more people are sharing their personal stories online.
Dr. McKinnon announced the news in early October, shortly after presenting the latest data from a Canadian government-funded study of more than 900 transsexual people at the World Association of Transgender Health Professionals conference in Lisbon. told the Times. These are edited excerpts from the conversation.
Can you tell us a little about your own experience with change, how long it lasted, and what changed?
I began my sexual transition in 2009. I was around 24 when I started my social transition and 25 when I started testosterone.
Before starting my doctoral work in 2014, I was a transgender YouTuber and a surgical practice model who performed my top surgeries. I was pretty active on Instagram, mostly documenting my journey as a transgender powerlifter. It feels like it was a lifetime ago. I now wear more of an academic researcher hat.
Perhaps this reflects the rise in anti-trans sentiment in our culture, but we’re finding that online spaces can feel very negative right now. In the early days, I felt something more active in the online trans community, but perhaps more hidden.
Was there a lot of discussion about detransitioning in the trans community in 2010?
No, it certainly wasn’t. I began this process shortly after a period of severe restrictions on gender-affirming healthcare in Canada. There has been a very strained relationship between the healthcare system and the transgender community.
I think the result was a sense that acknowledging the possibility of regret and transition could actually put someone at risk of receiving treatment.
When did you first start thinking about detransition as a research topic?
My PhD project investigated how clinicians assess whether trans adults are ready for hormone therapy or surgery. Concerns about remorse are one of the main considerations doctors have in denying access, and I studied how trans people experience these assessments as gatekeeping .
But in 2017, I was at a conference where a speaker was talking about how science and activism can collide. She gave the example of detransition, saying that detransition is happening and that trans activists are trying to block research on this topic. I was in disbelief because I had never seen an example of detransference occurring either among my friends or in the scientific literature. It was unpleasant, but it also piqued my interest.
A few years later, I obtained funding for a pilot study and interviewed 28 people who had detransitioned. I thought what you would mainly find were people facing excessive discrimination. And that was true for some too. However, for the majority of people, their sense of identity changed over time.
I was initially very skeptical of my data. That was unexpected.
In September, you published data on your latest study, the largest study to date on detransition. What did we find?
That transition is a very complex and diverse experience.
The study included more than 900 people who detransitioned in the United States and Canada, two-thirds of whom had undergone medical transition.
One group detransitioned due to more endogenous factors, such as poor mental health due to transition, reconceptualization of identity, and dissatisfaction with treatment. This is also the group I regret the most. A person is 90% female at birth.
Another group that detransitioned was more aggressive. Although their identity has changed, they quit because they are satisfied with their treatment and happy with their current situation.
And another group de-transitioned due to lack of support and discrimination. And we found that approximately 6% of the sample reported detransitioning due to U.S. state laws.
Political activists often talk about detransition in extremes. It’s either a very rare outcome or a big wave coming. What do we actually know about rates?
These discussions about this number raise the question that I think is more important: how do we develop better health systems, systems that can support people not only during transition but also when detransition occurs? It actually deviates from the problem.
In terms of numbers, the best-quality research suggests that the proportion of people who are detransitioned due to identity change may be between 5 and 10 percent.
Now, in terms of people just coming off hormones, that rate in North America would be between 16 and 30 percent. However, there are many reasons why transgender people choose to stop using hormones. Either because of side effects or simply because they are happy with their current situation. It’s really frustrating when people bring up these higher numbers and say this is an avalanche of people detransitioning.
Some say the demigration rate is 1%. You just started Substack with another researcher named “The One Percent.” Where did that number come from?
I call this the “Relic of 1 Percent Regret.” Because I think this is a relic of research from an older era. Such studies usually do not address feelings of wishing one had made a different decision. No consistent definition of regret has ever been used throughout this literature.
Also, the people receiving gender-affirming care today are very different. Older literature mostly featured adult trans women who were assigned male at birth. What we see today is the vast majority of young trans men who were assigned female at birth. Gender fluidity and non-binary identities are also moving forward.
The way we think about transition today is very different from what we thought 30 or even 10 years ago. The question arises as to how applicable these older studies are.
The first study on transitional transition was published in 2022, the same year that the state banned gender care for youth for the first time in Arkansas. How has the escalation of politics affected your research?
I am not aware of any studies that have investigated this type of outcome and reached a conclusion that recommends a complete ban on treatment. Although I am opposed to the ban, I am certainly concerned about my research being taken out of context.
In recent years, it has become very difficult because everything has become political and it is mainly the right-wing media that talks about detransition. I feel like I’m driving a lifeboat for people left behind after a shipwreck, and I also feel like I’m at the mercy of very rough seas.
The majority of detransitioners I spoke to do not support an outright ban, and many feel marginalized and misrepresented by the public debate. But certainly some of them feel like they deserve to fail and be better.
Most people who experience this are LGBTQ. You don’t have to look back in the history books to know that our health care system can help us, but it can also harm us.
Recently, there have been a number of cases in which patients who have had their medical transition terminated have filed medical malpractice lawsuits against doctors. Do you think these doctors are justified in being sued?
A transgender person filed a medical malpractice suit against a surgeon. So this is not specific to just detransitions. When there is evidence of medical malpractice and someone is really seriously injured, I think they deserve their day in court.
That said, detransition cases need to be understood within a broader trend of socially conservative efforts to place restrictions on gender-affirming medical care. The story is true. But at the same time, they are positioned with a very clear political strategy.
You post a lot on TikTok, including sharing your own experiences with complex medical issues like infertility. why?
Trans medicine does not know everything. I feel a responsibility to share with young people what I know about infertility research, my own experiences, and the effects of testosterone and estrogen.
Before I transitioned, it was standard to have a hysterectomy and oophorectomy, or removal of the ovaries. If you go through such procedures, you won’t be able to have children. One paper, based on a Dutch sample of trans adults who transitioned as children, found that between 35 and 44 percent reported regretting their infertility.
That doesn’t mean everyone needs to have children. But the way you feel about parenting in the future may change.
Some say there is too much focus on detransition in the media. How do you respond to that?
Detransition is a human experience that is beginning to emerge in our society. We have a duty to try to understand it.
In some ways, it’s very similar to how ideas about transgender people were constructed decades ago. In the 1990s, transgender people appeared on talk shows such as “Jerry Springer” and were sensationalized. Transgender people were basically used as a form of entertainment. Over time, we have become a more balanced expression of who we are.
I think we are now going through a phase of detransition. It’s very sensational and polarizing. What is not often focused on is humanity?
