Detransition is generally understood within medical, transgender, and detrans communities to mean the process of stopping or reversing medical transition and returning to living as one’s biological sex. Although the term “detransition” has also been used to refer to people who only socially transitioned then went back to identifying as their biological sex, desistance is the more common term for these individuals. There is no concrete meaning for detransition, but it is most often used to refer to the reversal of medical transition.
When a person detransitions, they are stopping the process of transition. I say “stopping” because medical transition has no final stopping point; a medically transitioned person must continue to take HRT throughout their lifetime to keep their opposite-sex appearance.
The most common way in which people detransition is to stop HRT. If the person’s reproductive organs have not been removed, the body will begin to produce the normal amount of sex hormones for that individual. Over time, the person, whether male or female, will return to an appearance more aligned with their biological sex. No other steps are needed to detransition. However, if reproductive organs such as ovaries or testes have been removed, then the person must take the synthetic hormones that match their birth sex to detransition medically. Lack of hormones in the body will have a negative effect on bone density and overall health.
For females who detransition, this means stopping the administration of testosterone. If the ovaries have not been removed, the production of female sex hormones will resume. Over time, changes such as fat and muscle redistribution, softening of skin, and female hair growth patterns will reappear. The female person will lose their masculine appearance and look more biologically female again. The process of detransitioning is slow. It can take a year or more for the female body to re-feminize and begin producing normal levels of female sex hormones.
It’s important to make clear that when I say “appear female”, I am not referring to manner of dress, hair style, or stereotypical feminine ways of being. I am referring to the biological state of the body, with an understanding that males and females have different secondary sex characteristics based on their biology and sex hormones.
It is important to note that not all detrans females will necessarily wish to look female or be able to appear female as readily as they did before transition. Things like male-pattern balding and larger amounts of facial and body hair are not reversible through the implementation of female sex hormones alone. Laser hair removal and electrolysis are the most common medical interventions used by detransitioned women to address excess facial and body hair. Some things are not reversible once testosterone has been taken. Clitoral growth and deepened voice will not reverse to pre-testosterone levels once testosterone is stopped and estrogen is taken.
For males who detransition, the first step is to stop administration of estrogen, testosterone blockers, and all other HRT. If the reproductive organs have not been removed, then the production of testosterone will resume. If reproductive organs were removed, then synthetic testosterone will need to be administered for the health and proper function of the male body. Like that of females, it will take time for the body to revert to a more masculine appearance, such as male muscle mass, body fat distribution, skin becoming rougher, body hair and overall male hair production and pattern. Male libido, sperm production, spontaneous erections, and ability to orgasm will return, and testicular atrophy will reverse. Some men report painful erections in the first couple of months off HRT due to the genital atrophy experienced on estrogen; this does subside with time and healing.
For males who did not undergo SRS, most of the effects of estrogen are reversible. However, any glandular breast tissue gained on estrogen is not reversible. Some men opt for a mastectomy to remove their breasts. Others may bind their breasts to hide them, and others have found that with exercise and muscle building, breast tissue can become less noticeable.
Full reversal of SRS is impossible. Most detrans individuals who underwent SRS choose to live with the genitals they have, instead of undergoing further SRS. Some males who detransition and underwent vaginoplasty opt to have phalloplasty to regain the appearance of male anatomy. This is a very expensive and complicated surgery, and often takes two years to fully complete. For females who had phalloplasty, the removal of the phallus and a vaginoplasty is the only option if one wishes to have the appearance of female genitalia.
Although detransition SRS surgeries are performed, and some detrans people do choose to undergo SRS to gain the appearance of their biological genitalia, most detransitioning/detransitioned people choose not to. Detrans individuals are often traumatized by their experiences with medical transitioning and the medical community, and for this reason, most detrans people who underwent SRS as part of transition choose not to undergo any further medical procedures during detransition.