In late September, the United Kingdom’s Bath Spa University turned down an application by James Caspian, a psychotherapist who specializes in working with transgender people, to conduct research on gender reassignment reversals. The university deemed the subject “potentially politically incorrect.”
Caspian is hardly someone to be considered against gender change. Since 2001, Caspian has worked extensively with gender variant people and has been a trustee of a UK charity “dedicated to education about and support of transgendered, transsexual and cross-dressing individuals.”
Caspian’s interest in reversals germinated in a conversation in 2014 with Dr. Miroslav Djordjevic, a leading genital reconstructive surgeon based in Belgrade with years of experience in gender reassignment surgery. Djordjevic told Caspian of the uptick in requests to his clinic for reversal surgery from men who had previously transitioned to female (known as “transwomen”). Djordjevic received his first request to undo the previous male-to-female surgery and recreate male genitalia in 2012. Within six months, six more transwomen had sought out his expertise for surgical reversal of gender reassignment.
Djordjevic, an award-winning researcher with several hundred papers published in peer-reviewed journals, books, and abstracts, and a professor of urology and surgery, lamented to Caspian about the lack of academic study on the subject of reversal. So Caspian decided to take up such a study. The university approved Caspian’s research project at first, and he began preliminary investigation.
“I found it very difficult to get people willing to talk openly about the experience of reversing surgery,” Caspian said. “They said they felt too traumatized to talk about it, which made me think we really need to do the research even more.”
Caspian’s preliminary findings suggested a growing number of young people—particularly young women transitioning to men—were having regrets. When he provided a detailed proposal to the university, he was told that it must be submitted to the ethics committee. The committee rejected his research proposal, citing concerns over potential criticism towards the university. The university is currently investigating the matter.
I Feel Vindicated in Highlighting Trans Regret
As a former transwoman whose life was devastated by gender transition, I have been interested in research about gender change regret for years. In fact, I wrote a book that investigated where the research was pointing and how research was stifled or results skewed. I’ve been told that either I don’t exist or was never “really” transgender.
Over the past 12 years of running the website sexchangeregret.com, I’ve heard many stories of the rush to surgery and the regret that sets in later. It’s been an uphill battle to debunk the myth that “gender change is the answer to all gender dysphoria” and to interest people in acknowledging that those who don’t want to continue living as the opposite gender deserve compassion, treatment and support.
Djordjevic is a refreshing exception in the world of gender change surgeons. First, he enforces strict guidelines for gender dysphoric patients who desire a gender change, in a process that can take two years and includes psychiatric evaluations. He then applies the same strict guidelines to those requesting reversal. I am particularly impressed by what The Sava Perovic Foundation, of which Djordjevic is chairman and surgical team leader, says on its website:
Gender reassignment reversal requires strong, convincing, explicit, psychiatric evaluations from two or more experts in gender dysphoria. They must both approve the reversal surgery.
Of course, the evaluations CANNOT be from the incompetent mental health professional who approved the totally wrong initial surgery.
Strong, convincing, explicit, psychiatric evaluations from two or more experts in gender dysphoria is required.
The new evaluations MUST address the issue of how such a terrible mistake was made in the first place.
The new evaluations should explain how World Professional Association for Transgender Health (WPATH) Standards of Care, carefully developed over decades by many highly qualified professionals, failed to protect the patient from mistaken and inappropriate gender change.
The second way in which Djordjevic is an exception in the world of gender-change surgeons is that he is genuinely concerned about the stories of crippling depression he hears from those who request reversal surgery. Third, Djordjevic advocates for rigorous academic research into the phenomenon of detransition.
James Caspian Deserves Praise, Too
Caspian also gets my applause because of his willingness, even in the face of being called politically incorrect, to follow the evidence about gender-change reversals and his desire to investigate further and shed much-needed light on why some people are so devastated. I sent a note to him, urging him to persevere. He wrote back that the research is so needed and thanks for the encouragement.
Like Caspian, I have heard the same stories from people who want to detransition: they are traumatized by the prospects. I’ve written about their struggles and shared their stories, and I’m gratified to see that I’m not the only one realizing that this population does, in fact, exist.
“Tranzformed” is the name of a recently released documentary featuring 15 detransitioners, both male and female, myself included. We speak candidly of how we arrived at the place where gender change seemed to be the answer to our confusion, and how and why we chose to reverse, or detransition.
In late September, six of us who have detransitioned or are in the process met around a table for a day and shared our lives and stories. The difficulty of detransition arose time and again. Several participants used nicknames, not their real names, even in this presumably safe environment, because of shame and concern for backlash from transgender activists. All expressed a similar story: they were convinced by the trans activists that transition was the answer and now they live with the negative consequences of that decision. The pain, fear, and frustration of those still in the process of detransition were evident.
It’s Hard to Get Your Body Back Again
Detransition is a difficult and lengthy process: physically, emotionally, psychologically, and legally. Friendships become strained. Family relationships are stressed. Restoring legal documents is tedious and draining.
It is vital to point out that very few of those who detransition will undergo genital surgery to attach a recreated penis. Any interest that transwomen initially have in the surgery usually fades after considering the surgical risks, costs, time invested, and outcomes. Most will decide that having reversal genital surgery is not worth the time and money.
Australia’s “60 Minutes” recently aired a story about a youngster who began transitioning from a boy to a girl at age 12, but now two years later, has changed his mind. From an early age, Patrick Mitchell felt uncomfortable in his own skin and didn’t feel like he fit in. He remembers first hearing about the concept of “trans” at age seven. From that point on, he wanted the doctors to make him a girl.
At age 12, he was diagnosed with gender dysphoria. He begged his mother to let him transition into a girl and, with her support, began taking estrogen and presenting socially as a girl. But now, two years later, he finds his feelings have changed. As he told Australian “60 Minutes,” “I began to realise I was actually comfortable in my body. Every day I just felt better.” With the support of his mother, Patrick is planning to stop his transition and to have surgery to remove the breasts that developed due to the estrogen.
Not all children can have the self-awareness to know that transitioning no longer feels right or to admit they changed their mind. Some feel locked in or trapped. I hear from young adults who transitioned as teens and want to go back but are facing lifelong consequences. The effects of taking cross-gender hormones can be irreversible, even though the person stops taking them. Doctors report infertility can result.
For example, I’ve heard from young women who must undergo painful electrolysis to remove facial hair that sprouted from taking testosterone, and I’ve heard from men who continue to look feminine. Some surgeries cannot be undone, such as altered genitalia or facial changes. Fortunately for Patrick, he can have surgery to change the appearance of his chest, but even then, scars are inevitable.
I have been vocal about regret and detransition with my books and website, sexchangregret.com, for over 10 years now. The well-respected surgeon Dr. Miroslav Djordjevic and the psychotherapist James Caspian are discovering what I have known all along: regret and detransitions are on the rise because too many “gender affirming” surgeries are performed on people who don’t need them.