A Clinician’s Journey: Why I Support Detransitioners (And You Should, Too)
By Mckenna Coffey
Like most, if not all, therapists educated in the last ten or so years, I learned two things in graduate school: 1) gender is a spectrum that has nothing to do with biology and 2) trans people are marginalized; we support them by affirming their identity and advocating for them to receive any medical procedure they desire. Period.
For whatever reason, the lectures I took on this subject stick out to me. I remember a silent classroom, everyone dutifully taking notes and nodding their heads in agreement. No challenging questions were ever asked. The teacher suggested that if one had beliefs that were not in alignment with this approach, they should seek further education on the subject. At that time, it sounded reasonable enough. Who am I to question someone’s gender? If someone wants a procedure, why shouldn’t they have it? Everyone is on their own journey, right?
Theory vs Practice
Then, I got into clinical practice. It just so happened that I started working with transgender & gender-questioning people right away. Some had been post-transition for some time, while others were still grappling with their gender and how to medically pursue it. All of them had significant trauma histories and/or co-occurring diagnoses of a moderate-severe nature. Over time, the depth of how heartbreaking the trans experience truly is became increasingly clear. But the more I was exposed to gender ideology, the less I understood it. I heard stories of people hating themselves for being trans while also claiming it had saved their life. Others were profoundly proud of their identity, but feared retribution from the “community” should they openly discuss how medical transition had harmed them. Others did not understand their gender at all, but still pursued medical treatment, fervently believing that cosmetic procedures would help them align with a gender they could not describe. Over and over, I saw people who were deeply struggling and convinced that transitioning was the only way to feel better. There was another pattern, too— in every case I have worked on, clients were approved for medical intervention after one appointment in which risks were either not discussed or deeply minimized.
Because this is such a charged subject, I will be crystal clear: I deeply care about all my clients, and those that have been trans or gender dysphoric have truly been some of my favorite individuals to work with. It is precisely because I care that I found the helplessness of working on some of these cases to be so frustrating. The simple fact is this: what is taught in universities has no practical application to helping people who experience gender dysphoria.
Discovering Detransitioners
So, I set out to understand why. It was at this time that I first became exposed to not just detransitioners, but transition regret. Think about it: I am a social worker from California who went to graduate school in Los Angeles. LBGTQ+ topics were discussed extensively in my program. But I had never heard of a detransitioner or transition regret. It occurred to me then that I also had not been taught about where Gender Theory came from. How did academics conclude gender is a spectrum? What disciplines and individuals advanced that idea? How is it possible to make the authoritative claim that sex and gender are unrelated and culturally constructed when our physiology itself is sex-dependent, and particular cultural roles are given based on physiology? Let us also note something that is obvious yet never discussed. Gender theory is just that: a theory. Yet 100% of current therapeutic recommendations are based on it.
Therapy Beyond Trans
Exploring these questions is outside the scope of this post, though they should be addressed. But here I have written the arc of my journey in hopes of demonstrating just how important having an organization like Beyond Trans is. Our medical and mental health complexes have failed and will continue to fail individuals who experience gender dysphoria, so long as they remain committed to an over-medicalized response to a gender theory totally lacking in logic. Detransitioners face retribution from activists and cold-shoulders from doctors who once supported them carte blanche. As therapists, we have a duty to resist the harm perpetuated by our profession and develop strategies for supporting people in healing from gender dysphoria.
I am proud to have taken steps in that direction and grateful that Beyond Trans exists to empower the detrans community and the professionals that serve them.
For resources about detransistion and detransisitoners, Genspect recommends
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Photo by Mari Helin on Unsplash