Debunked: No, 80% Of Trans Youth Do Not Detransition

This is one of the most common arguments brought up in anti-trans hearings. The idea that 80% of trans people "will desist" is a complete lie that is easy to debunk.

Photo by Nikolas Gannon on Unsplash

One of the most common myths heard in anti-trans hearings is that most trans kids will desist if they are allowed to go through puberty. Sometimes specific numbers are given, such as 80% of trans kids desist. This statistic has been cited as low as 60% and as high as 99% in various legislatures. In Montana, a representative used this statistic to justify passing a medical ban. The Heritage Foundation has also pushed this myth. Nearly every hearing on this topic includes this myth. The desistance myth is one of the most persistent falsehoods and has been used against the trans community for decades. It is misleading and inaccurate as it comes from outdated DSM-4 criteria and decades-old data. Newer studies show that 97.5% of transgender youth are persistent in their gender identities. Let's examine how this falsehood originated, how it is misused, and what current research reveals about the rarity of desistence and detransition.

See an example of this claim being used on Fox News:

helena hind @cynicalzoomer

Conservative lawyer Harmeet Dhillon just said trans teens who transition "desist from transition at an 80-90% rate." This is false.

The DSM-IV, released in 1994, spelled out how to diagnose mental health conditions including “Gender Identity Disorder” (no longer a disorder). In this manual, clinicians made their first attempt to diagnose transgender youth. These first diagnostic criteria were an admiral early attempt, but contained a fatal flaw in how transgender youth were diagnosed: the diagnosis bafflingly did not require a youth to identify as another gender. Instead, it focused on factors such as “preference for cross-sex games and activities” and “preference for friends of the other sex.”

Problems with this diagnostic criteria should be immediately recognizable today: a cisgender tomboy with absolutely no identification as a boy would be diagnosed with gender identity disorder under these definitions. A cisgender boy who likes to put on an Elsa costume and play with girls could be diagnosed with gender identity disorder under these definitions. They were woefully inadequate for judging if youth were transgender. They also came during a time when youth transition did not exist as a medical practice, and so there were no real clinical guidelines on their treatment - thus, little effort was made to change the criteria which were primarily used for discussion in therapist offices and not to support or deny medical transition care.

In 2013, the DSM-V was published and in it, many corrections were made on how gender dysphoric youth are diagnosed. The most important correction was the requirement that a transgender youth demonstrate an insistent, persistent, and consistent desire or identification as the gender that the patient believes they are. The individual factors were also changed and adjusted. These diagnostic criteria were much more stringent, and are the diagnostic criteria used today.

See the changes:

Credit: ThinkProgress/Diana Ofosu

There is one problem though: until recently, all of the studies that came out used the old criteria. They included several people with no identification with another gender as meeting the criteria for “gender identity disorder,” which is itself no longer a disorder. These studies have a ton of other other problems as well, such as tiny sample sizes, very high dropout rates, old data from a time when youth transition was impossible, and even issues around conversion therapy practiced on trans patients. There are two pieces that are commonly cited. The first is numerous pieces of research by Ken Zucker, including a famous book published in 1995 that serves as the genesis of most “80% detransition” myths. The second is a series of studies from Thomas Steensma, usually centering around his 2011 or 2013 studies. Both of these studies contain the same core methodological flaw above, and both contain their own unique flaws that make them even more inaccurate.

Ken Zucker’s research on transgender youth was performed in 1995, a time when youth could not legally or medically transition. In fact, trans youth in that time likely all “desisted” for some time because of bullying, lack of access to care, and severe repression. I myself grew up as a transgender youth in that time period and I “desisted,” one of the many reasons I am writing this article.

Zucker is the genesis of the number that is most often cited, “80% desist from being trans.” Upon review of Ken Zucker’s research, half of Zucker’s patients did not even meet the definition of diagnostic criteria for transgender youth. His main research consisted of only 45 youth utilizing the old diagnostic criteria. A review of his clinic yielded much darker results, however: Zucker was engaging in conversion therapy practices that sought to push trans youth to identify as cisgender. His clinic was promptly shut down in 2015 as a result of a Canadian anti-conversion therapy law. Although Zucker denies the allegations that he engaged in conversion therapy, his practices and history paint a different picture. In the 1990s, he stated support for gay conversion therapy with the rationale, “a homosexual lifestyle in a basically unaccepting culture simply creates unnecessary social difficulties.”

In shutting down his clinic, a Canadian GIC review was conduced and a report was produced. From the report:

• Parents state they were encouraged “not to give into” allowing their youth to wear clothes not of their assigned sex at birth.

• Parents state they were told to avoid wrongly-gendered toys.

• Parents state they were told to ensure their children would play with children of their assigned sex at birth.

• Patients state they were asked intrusive questions about their sexual orientations as early as 9 years old.

• Transgender youth were pathologized and correlational mental health issues were interpreted as causative.

• Some patients reported pictures of them taken without their consent using cell-phones.

• Parental lack of acceptance and desire for the child to identify as cisgender guided treatment.

Because of a tiny sample size, outdated data, the impossibility of youth transition, and Zucker’s clear ideological motivations, his 80% detransition rate clearly should be viewed as false and useless in current research on gender affirming care, especially considering modern data, criteria, and research exists.

Steensma’s 2011 and 2013 studies had similar issues in his research, which in some ways had even worse methodological flaws. Steensma used the old criteria, which is not the way that gender dysphoria is diagnosed today. Worse, the two studies classified every youth who did not return to the clinic as having “desisted” or “detransitioned” with no long term follow-up. Half of the participants in the studies did not return and all were classified as having “desisted.” The sample sizes were tiny at the getgo - only 53 people were in the first study and 127 in the second study. Given the fact that a large portion if not the majority of Steensma’s patients were classified under decades old criteria and assumed permanently detransitioned simply for refusing to follow up, these studies cannot be used to make any reasonable claim of desistance rates.

Furthermore, transgender youth could not meaningfully transition until recently. Medical care for trans youth was highly gatekept if not barred entirely. Transgender youth were rarely, if ever, afforded any form of treatment. Many such youth lost hope in ever being able to transition as puberty took its toll and they were forced to repress over bullying and a dangerous public environment.

Modern studies show a much higher persistence rate as well as important factors behind detransition. In 2015, a study was done on thousands of transgender people, including detransitioners. Only 8% of people reported ever detransitioning - ten times lower than the 80% often cited. Of these 2,000 detransitioners, the largest sample size of any study, 62% of them reported that they only detransitioned temporarily. Among the remaining detransitioners, the most common reason for detransitioning given was parental pressure and discrimination. Only 0.4% of people reported detransitioning because they were no longer trans.

Among trans youth, desistance and detransition rates are incredibly low. The most recent study in the prestigious journal Pediatrics, one of the only studies that use modern requirement of youth identification as another gender, showed that 97.5% of trans youth continue to identify as trans on a 5 year follow-up. The sample size was also larger than all previous sample sizes of this population: 317 youth.

Anti-trans gender affirming care bans often start off with a list of “legislative findings” that seek to “state the science” around gender affirming care. In this list of findings, you might be surprised to see that the later studies are nowhere to be found, but the claims from the former studies pop up and are presented as factual when they are over a decade old, are dramatically outdated, and use standards that are not even in use anymore.

See Georgia’s “legislative findings” section of HB653, which would ban gender affirming care for trans youth

“Legislative Findings” of HB653 in Georgia

This statistic will continue to be misused to justify anti-trans bans all over the United States. Legislators will state that “80% of people detransition,” even when detransitioning is a statistical rarity. The same dozen detransitioners, like the “ex gays” of the 1990s, will be flown from state to state to justify bans, raising the question as to why they seem to only be able to find a small handful to testify. Meanwhile, actual trans kids who will grow up to still identify as trans, if they can make it to adulthood following these legislative onslaughts, are left to bear the damage of this misinformation.