Here are the facts about detransitioning: there are very few facts about detransitioning. We don’t have solid figures on the number of minors undergoing medical gender treatment in America, let alone how many regret it and try to live again as their natal sex.

Nor is there consensus about whether that’s what the term “detransition” actually means. Does it refer only to those who feel harmed by transition, who feel remorse — and a host of other unpleasant emotions — about the procedures that therapists and doctors affirmed and performed? Or does it include those who detransition due to extrinsic reasons, such as a lack of funds or stigma? Do those who only socially transitioned, or who may have tucked genitals or bound breasts but not taken hormones or undergone surgery, fall beneath the banner of detransition?

We don’t know the answers. But this much we do know: while most “gender-affirming” medical interventions have been covered by insurance for the past decade, there are no billing codes for detransition, no guidelines, and no standards of care. Many detransitioners have nowhere to go for help, either because their gender-affirming clinicians decline to aid them or because doctors who want to don’t know how.

That’s about to change, though. Texas Children’s Hospital is opening the nation’s first detransition clinic. The hospital isn’t doing so because most medical associations agree that this vulnerable, overlooked, and heavily politicized population desperately needs good care. Instead, it’s capitulating to the demands of Texas Attorney General Ken Paxton and the Trump Justice Department.

In 2023, the Texas legislature banned pediatric gender medicine, then launched an investigation into Texas Children’s Hospital for continuing to provide it, by way of submitting “false billings to public and private payors to secure insurance coverage for pediatric sex-rejecting procedures”, per the DOJ. The hospital “violated the Federal Food, Drug, and Cosmetic Act, the False Claims Act, and federal fraud and conspiracy laws”.

Paxton sued the hospital, and the settlement agreement decrees that five gender physicians will be fired. The hospital will pay the state $10 million, stop all gender procedures, and create a multidisciplinary detransition clinic to “help patients reverse the damage caused by ideologically-motivated physicians who harmed patients by performing dangerous medical interventions”.

There’s no doubt that such a clinic is needed. Detransitioners suffer from myriad iatrogenic effects, ranging from vaginal atrophy to joint pain. Even the effects they once sought — lowered voices and facial hair for females, breast growth for males — can later be considered unwanted, even devastating. Detransitioners have largely been treated with disdain by the mainstream media, which variably denies their existence or dismisses them as tools of the political Right.

There is, however, doubt about the ideological motivations of Paxton and Trump, who may well be using them as tools. When they frame providing healthcare for detransitioners as simply one stop in their long haul to end “the radical transgender movement”, they are clearly catering to their base rather than trying to create lasting change in the politicized fields of medical and mental health. Just as with the gender medicine industry, they are attending to the symptoms rather than the underlying cause.

Some kids really do suffer from debilitating distress about their sexed bodies. Some kids really do emerge as gender nonconforming, more like the opposite sex than their own. Some clinicians are motivated not purely by ideology but by a desire to help children and have been trained to believe that transitioning is the way to do that. They’re not all radical ideologues rubbing their hands and laughing maniacally at the prospect of transitioning another child. An entire generation has been trained to believe that each person has a gender identity and that it must be affirmed, otherwise they are in imminent danger of suicide.

The problem, of course, is that no solid evidence supports those beliefs, and gender-affirming clinicians are likely too emotionally and financially invested to accept that reality. This new detransition clinic won’t change that, because of who created it. It’s hard to put faith in the same federal Justice Department that Trump has used to persecute his enemies and protect his own emotional and financial interests. But, in the absence of other options for detransitioners, it matters that they can finally start to get help.

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Lisa Selin Davis is the author of Tomboy. She writes at Broadview on Substack.

LisaSelinDavis

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