Trans “regret”

This has now been posted at

I’m putting this here because the LGBT news site that expressed an interest in publishing it has stopped responding, which I’m not massively surprised about really, given the furore of the past few days (BurchMoorGate is my preferred title so far). Many others have written inspirational pieces on the subject (CN Lester, Roz Kaveney, Christine Burns all pop instantly to mind; and CN even mentions the Trans Mental Health study which I speak about below), so I’m not going to attempt to add anything, but just bear in mind I wrote this in the context of #TransDocFail and other, smaller discussions that touched on regret that were happening last week.

A lot has been written in the media about regret amongst people undergoing transition. Most recently, David Batty at the Guardian wrote a piece about London GP Dr Richard Curtis, which opens with the example of “a woman who alleges that she was inappropriately prescribed sex-changing hormones and then wrongly underwent a double mastectomy”. The article is described by Zoe O’Connell as a ‘character assassination’ against Dr Curtis. There was also widespread coverage in late 2012 of Ria Cooper (who had been the subject of a Channel 4 documentary, Ria: Diary of a Teen Transsexual), with headlines such as “Britain’s youngest sex change patient wants to go back to being a boy”. Jane Fae describes the problems with these reports, none of which make the distinction between needing to de-transition due to a lack of support, or ‘changing your mind’ (something implied by the sensationalist headlines).

The general public would be forgiven for thinking that many, if not most, trans people end up wishing they had never started the process of transition.

There often is a certain amount of regret shown by trans people following a period of social (and to a lesser extent, medical) transition, but not for the reasons that the media would have you believe. Not because they ‘changed their mind’ or they ‘weren’t trans enough’, but because transition continues to be made unnecessarily more difficult than it needs to be, by public prejudice and a gatekeeping medical establishment.

The recent Trans Mental Health Study  [1] was the largest study of its kind ever undertaken in Europe, with almost 900 respondents. The study asked specifically about individuals’ feelings of regret following social and/or medical transition. These are the results:

In terms of social changes made during transition (coming out to friends and family, changing name, living full or part time in a gender not assigned at birth), 34% of respondents had minimal regrets and 9% had significant regrets. A small majority, 53% had no regrets.

Specific regrets given included: not having the body they had wanted from birth, not transitioning earlier, losing friends and family, and the impact of transition on others.

In terms of physical changes made during transition (resulting from hormone therapy and surgical interventions), the vast majority, 86%, had no regrets. Of the remainder, 10% had minor regrets and 2% had major regrets.

The specific regrets given include complications relating to surgery (especially loss of sensitivity), and the choice of surgeon (if surgery resulted in complications or required revisions and repairs).

The following impacts on wellbeing were reported by the researchers:

  • Transition was related to improved life satisfaction and body satisfaction.
  • Transition was related to a decrease in mental health service use, reduced depression, and better reported mental health.
  • For those with a history of self-harm, suicidal ideation and suicide attempts, all showed a reduction post-transition.
  • Very few participants regretted the physical changes that they had undergone as part of transition.
  • Most participants experienced improvements in the quality of their sex lives following transition.

It is clear from the actual reported regrets, along with the conclusions that transition is associated with a broad range of positive indicators, that most cases of regret around transition are not related to being a different gender to the one assigned at birth, or undergoing transition, but rather due to poor surgical outcomes, social stigma and huge barriers to medical care. For a startling insight into the difficulties faced by trans people accessing healthcare, see the hashtag #TransDocFail, started by @auntysarah and summarised on Thursday 10th Jan in the Guardian.

With these results, it seems apparent that the media regularly skews coverage and chooses stories based on a sensationalist agenda which tries to suggest that many people regret transition.

I’ll end on a selection of quotes from the study participants when asked about regret:

‘Regrets over loss of relationships and friends are minimal because, in general, I think there is little alternative [to] being trans – there is little room for regretting what has been done, because transition was essential’

‘Sometimes I regret ever being out, sometimes I regret the extent that I’m “stealth”. I walk a bit of a tightrope with it and it’s hard to know which way is best. I regret both at intermittent times.’

‘I have no regrets for transition, it is the best thing I can do under the circumstances. I have regrets that I’m trans and wasn’t just born male but that isn’t something I’m able to change.’

‘I do not regret transitioning, but I do wish that society was more understanding and accepting of trans people. I wish that the physical outcomes were better and that I had not lost so much (relationship, job, physical and mental health, home).’

‘I regret the loss of the privilege I had as someone perceived as cisgendered.’

[1] Disclaimer: I was peripherally involved in the TMH Study as part of the Advisory Board from the start, and contributed to writing up the final report. I am cisgendered (not trans).