On Regret

There’s a big urban myth about transition regret. The myth is that ‘most people regret transitioning’, and it’s often used by medical professionals, particularly those who are inexperienced or ignorant regarding trans healthcare, to refuse trans people treatment. Loz Webb writes.

This myth is also exploited by the cis media in order to run shock stories about ‘sex changes’ and ‘reverse sex changes’, and to push a particular anti-trans agenda that asserts that trans people, whether or not they are happy with their medical interventions, are ‘spending the taxpayers money’, as though trans people aren’t worthy to use the NHS and should be exempt from the free healthcare that everyone is entitled to purely as a result of them being trans. This anti-trans rhetoric, so prevalent in our media, undoubtedly feeds into a culture in which trans people are treated ignorantly, or as #transdocfail showed, sometimes appallingly by medical professionals, as well as contributing to the frequency of hate crimes carried out against trans people.

Last week, academic Ruth Pearce, was contacted by Sundog Pictures via the following unsolicited email:

“I’m currently working on an idea alongside Channel 4 following transgender individuals who have come to regret their sex changes and are keen to undergo further treatment / operations to reverse the change. The doc will be insightful and sensitive and will look at the way in which transgender individuals are treated in society and whether the process before someone is permitted an operation is robust enough.

I’m currently looking for real life cases to include in my pitch document and was wondering whether you might be able to recommend people I could speak to, or places I could contact to find individuals who are currently thinking about a reverse sex change. Any help would be really appreciated.”

At Recovering A Future, we are incredibly concerned about the motives of such a documentary, and the effect it could have on the lives and health of trans people. Despite the disproportionate representation that people who regret transitioning receive in the press, the recent Trans Mental Health Study, the largest study of its kind ever undertaken in Europe, with almost 900 respondents, 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).

In other words, the findings indicated that transition regret tends to be related to social stigma, poor surgical quality and results, and loss of family and peer support, rather than regret around ever having transitioned in the first place. It demonstrates that while someone’s dysphoria may be relieved by transitioning, the pressures of living in a transphobic society are not. This is important, as it indicates that regret is related to the same stigmatisation, othering, and ignorance that is perpetuated by the disproportionate and negative media focus on those who detransition - it indicates that documentaries such as this have an ill effect on the health and wellbeing of trans people.

Juliet Jaques writing on transition regret for The Guardian, writes:

‘Personally, I’ve not known anyone to detransition: this is not to deny that there are people who genuinely regret transition and particularly surgery purely because they’ve ended up with a body that wasn’t right for them, but instances do seem rare – partly because the pathway allows people to opt out at any point, and some remain on hormones before surgery for much longer than strictly necessary whilst they consider their options.’

Juliet makes a good point. Gender Identity Clinics require you to undergo at least one year of RLE, or Real Life Experience, during which you live full time as the gender you identify as before they will even consider HRT or medical treatment of any kind. Many trans people find themselves forced to undergo two years of RLE, just in case, and this can stretch out a lot longer if the person in question is non-binary, or is not suitably gender-conforming, or has a disability, or mental illness, or does not conform to the white western imperialist model of the gender binary. RLE itself is the topic of a future blog post, but it ensures that the process before any treatment of dysphoria can take place is long and drawn out, often to the detriment of the health and physical safety of trans people trying to access healthcare.

The idea of detransition and regret also ignores the reality that for many people detransitioning is instead retransitioning - a person may discover that their gender identity changes over time, or a person who assumed that they were a trans man or a trans woman may discover that they are non-binary and wish to have a body that reflects this, or someone’s gender identity may not change at all, but they may wish to undergo further HRT or surgery to alleviate subsequent dysphoria, and all of these things are fine. The reduction of the infinite ways to be trans down to ‘sex changes’ and ‘reverse sex changes’ obscures the fact that actually, all trans people are entitled to all the treatment they need, all the time. Just like everybody else.

In her excellent open letter responding to Sundog, Ruth draws attention to the fact that Sundog use the terms ‘sex change’ and ‘reverse sex change’, which, as well as being loaded terms rarely seen in use outside the right wing press, are inaccurate, meaningless and othering. Furthermore, she points out that projects such as Trans Media Watch and All About Trans, which exist to improve the media representation of trans people, both offer clear guidance on how to respectfully talk about trans people, which Sundog could have discovered with a five minute google search.

There are a lot of important stories to tell about trans healthcare. The majority of them revolve around outdated, pathologising medical practices, unnecessary gatekeeping, ableism, racism, sexism, and transphobia. Some of them are about detransitioning or retransitioning, and yes, those stories are important, and the people who live them have experiences that are important and valid. But seeking to weaponise those stories, to ‘look at the way in which transgender individuals are treated in society and whether the process before someone is permitted an operation is robust enough’, is an act that is harmful to trans people and could be, nay, will be used to make healthcare even more difficult for us to access. And regardless of how ‘respectful and sensitive’ Sundog claim they want their documentary to be, courting a cheap bit of controversy for Channel 4 at the expense of trans people’s right to healthcare is neither respectful, nor sensitive. It’s dangerous.