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Detransition research (Vandenbussche, Littman, Boyd)

Detransition — a return to the birth sex after a previously begun medical or social transition — is a phenomenon that the affirmative model denied for decades. No one knows the actual figures: clinics do not conduct follow-up measurements, and detransitioners no longer dare to face their former doctors. Researchers mapping this are cancelled; that is precisely why the group remains invisible.

Vandenbussche (2021/2022) — the study that turned the numbers around

Elie Vandenbussche, a detransitioner herself, published a large international survey study in 2021/2022 among 237 detransitioners from 22 countries, distributed via detrans forums rather than clinics. In doing so, she captured precisely the group that drops out of official clinic cohorts. Key findings:

• Average age at start of transition: 19 years.
• 71% biological women — fits the ROGD curve .
• 70% of respondents never reported detransition back to the practitioner — making them invisible in any clinic statistics.
• 60% indicated that they had received insufficient information before treatment.
• Main reasons: realization that dysphoria was associated with trauma, internalized homophobia, autism, or dissociation.
• 47% rediscovered a lesbian identity after detransition that was suppressed before transition.
• Median time between the start of transition and detransition: four to five years — beyond the reach of virtually all clinical follow-up.
• Only a minority received appropriate detransition care; peer support proved to be the most important recovery factor (76%).

The study was published in the Journal of Homosexuality and was included in the literature of the Cass Review and the Finnish COHERE report. Vandenbussche continues her work via post-trans.com . An extensive discussion can be found at transitieschade.nl/detrans/onderzoek-vandenbussche .

Littman (2021)

Lisa Littman's follow-up study (100 detransitioners) confirms the picture:

• 55% felt in retrospect that insufficient information was provided before transition — informed consent existed on paper, not in practice.
• 60% received no psychotherapeutic evaluation — the "gatekeeping" that WPATH claims to abolish had in practice not been done for a long time.
• 38% were not informed about fertility loss; 22% did not receive a psychiatric comorbidity assessment.
• Many respondents describe socially driven and/or trauma-related dysphoria.
• The group is predominantly young, female, and highly educated — exactly the ROGD profile.

Boyd, Pullen Sansfaçon, MacKinnon (2022) and DARE (2025)

Boyd et al. (2022, International Journal of Transgender Health ) found in a British NHS practice that 12.2% of patients detransitioned or medically stopped in the last decade. Roberts et al. (2022, US Military Health System) counted 29.8% stoppers within four years of starting hormones. The DARE study (MacKinnon et al., 2025) shows that detransition is not a linear trajectory: people switch identities for years, stop hormones, resume, and have doubts. The rigid WPATH criterion of "formal clinic feedback" misses this entire spectrum.

How many detransitioners are there really?

Estimates vary — from 1% (old affirmative figures, distorted by massive dropouts) to 30% in newer cohort studies with more thorough follow-up. WPATH (Coleman 2022) cites 0.3-3.8%, based on the Amsterdam Wiepjes cohort and the British Davies cohort. The University of York, which conducted the evidence reviews for the Cass Review , found 5-15% within ten years among medicalized minors, with a strong underestimation due to loss of follow-up. The Voorzij study estimated up to one-third trans regret among adult female detrans respondents. Clinics lose contact with 25-50% of their patients within five years — this "lost-to-follow-up" group is recorded as "success" in the regret statistics, while detransitioners actually report active avoidance of contact. See also the regret study for the methodological analysis by Bustos 2021.

Voices of detransitioners

Behind the numbers lies a strikingly consistent pattern: a rapid diagnosis, a trajectory that unfolds naturally, and an environment that reinforces affirmation and disqualifies doubt.

Clinics do not continue measuring

In 2022, Amsterdam UMC published (Boogers et al.) that 1.9% of treated minors "stopped." The definition was narrow: only formal discharge counted, and follow-up was limited to those who were still in care. Internationally, this figure is consistently regarded as a lower limit. The Dutch DBC system does not have a separate detrans category; a patient who tapers off treatment remains listed in the system under the same diagnosis. The Center for Expertise in Gender Dysphoria (CEGD) examines its own patients, without external oversight. The IGJ does not maintain separate figures. Anyone wishing to know how many people stop treatment in the Netherlands will find no government source. See Dutch detransitioners — the voices that are not heard .

Irreversible damage that remains

The irreversible damage caused by hormones and surgery turns detransition into a grieving process involving permanent loss. Vandenbussche and Boyd register mastectomy and fertility loss as the two most regretted procedures.

• Breast tissue: in top surgery, all glandular tissue is removed. No reconstruction restores mammary glands or natural breasts. Loss or permanent reduction of nipple sensation in 30-50%; chronic pain and nerve damage in 10-25%. In the US, the number of mastectomies in young women rose from a few hundred per year in 2010 to more than 8,000 in 2021. See irreversible loss of breast tissue .
• Fertility: anyone under the age of 16 who starts puberty blockers and subsequently receives cross-sex hormones is, in almost all cases, permanently infertile — no mature eggs or sperm maturation. Gonadectomy permanently rules out reproduction. Regret usually only manifests around the age of 25-35 when the desire for children becomes relevant — outside the measurement window of virtually all clinical studies. See infertility after hormones and surgery .
• Voice, hair growth, genital surgery: testosterone permanently lowers the voice and causes irreversible beard growth and male pattern baldness. Genital surgery causes permanent loss of function. The overview at transitieschade.nl/schade documents thirteen specific categories of damage.

$2 million for detransitioner — US ruling (February 2026)

On February 2, 2026, an American jury held a psychologist and a surgeon medically and legally liable for the counseling of a then 16-year-old girl, leading to a double mastectomy. The now 22-year-old woman was awarded two million dollars in damages. The jury ruled that practitioners had performed no or insufficient differential diagnosis for underlying psychological issues; the affirmative approach was initiated without realistically considering alternatives, comorbidity, or developmental stage. This is one of the first civil rulings in the US to classify the standard gender-affirmative approach for a minor as professional negligence. See the full report .

Vasterman and Kuitenbrouwer: the Dutch Protocol is untenable

Peter Vasterman and Jan Kuitenbrouwer characterized the Dutch Protocol in NRC (April 29, 2024) as "a medical Titanic" — an experimental treatment for an insufficiently understood condition. No RCTs, no untreated control groups, no long-term outcomes. The current patient population (adolescent-onset girls with autism, eating disorders, trauma) is fundamentally different from the group for which the protocol was developed. Their demands: a Health Council study independent of the AUMC, an audit of consultation room practice, and a patient record-based study into the long-term outcomes of everyone who received hormones and surgery since 1995. See the full reconstruction at dutchprotocol.nl and the VUmc protocol criticism .

The canceled researchers

Vandenbussche was dismissed as "anti-trans" by affirmative activists. Littman survived the ROGD attacks . MacKinnon (Boyd co-author) was publicly attacked when she raised the issue of detransition care. Biggs (2022, 2023) — who debunked the methodology of the Dutch Protocol — faced systematic opposition from WPATH circles. The pattern: anyone collecting data on harm caused by transition is silenced, not refuted. See publication bias and fraud for the full picture.

An invisible group

Detransitioners are dismissed as "exceptional" and stigmatized. WPATH and Dutch mental healthcare providers have hardly any care pathways for them. Many detransitioners only speak anonymously, for fear of attacks by trans activists. Detrans communities on Reddit and in closed support groups number tens of thousands of members. Irreversible physical damage — breasts gone, voice low, fertility lost — remains. The diagnosis was often wrong; the surgeries are permanent. Transition does not cure — it confirms a diagnosis and closes the exit.