Evan Urquhart

Before discussing detransition/desistance, it's important to note that there's no clear definition of what these terms mean. Is someone who experiments with they/them pronouns and a nickname for 3 months detransitioning or desisting when they stop? I would say no!

I'd only call someone a detransitioner if they took concrete, permanent steps to transition lasting a yr or more, then reversed the steps. Detransition shouldn't include anyone who tried something out for a bit that had no permanent impact on their life.

Numbers about detransition are legitimately hard to find. The best numbers we have suggest that rates of detransition are extremely low. However, there are few enough studies and low enough sample sizes that a rational person could wonder if they tell the whole story.

A critique of this study could fairly say: 1. It only looks at post-surgery patients, not those who went on hormones, made a legal name change, or other big steps. 2. It's based on provider reports, so detransitioners who didn't tell a doctor their regrets were missed.

Those arguments are valid enough that I would agree that studies have under counted detransitioners, more likely than not. But then, I would encourage you to ask: By how much have they undercounted, do we think?

Forget study methods for a minute, and come with me to a place I like to call The Real World. In The Real World, patients get prescribed a medication or undergo medical procedures, and doctors follow up to a greater or lesser extent.

In The Real World, doctors don't see most patients throughout their whole lives, and are more likely to see them when there is a problem. Studies are helpful in quantifying if there are more complications than docs realize, or results are less favorable than they hoped.

What studies DON'T generally show is a massive numbers of patients who were extremely dissatisfied with a procedure, to the point of blaming the doctor who performed it, while the doctor remained totally unaware that there were any problems at all.

It is perfectly sensible to say, okay, the data shows less than 1% of patients detransition... but maybe it's something more like 2-3%.

It is NOT sensible to say okay, the data shows less than 1% of patients detransition, but eff that, it's probably 30% because I personally detransitioned, or because I personally have a hunch trans people will have regrets.

Common sense tells us that it's easy to meet trans people who have stayed transitioned for decades, who have lived most of their lives post-transition, and it's hard to find detransitioners. Sooo... maybe detransition is rare? And, look, the studies back that up.

So, the bottom line is that anyone who posits a huge number of hiding, quiet detransitioners that no study has ever been able to find is not using Occam's razor, or science. They're basing it on prejudice.

In summary: It's perfectly rational to believe that detransitioners are undercounted in studies that find extremely low numbers. It is irrational to believe they are massively undercounted to the point where it would change our understanding of transition or trans lives.