Carol had long suspected that her daily life in rural California would be easier if she were a man. Yet she was stunned by how true it was. Like butch woman (masculine), (and 'not very smiley') had regularly been treated with mild contempt, he says.
After a double mastectomy and a few months of testosterone - which gave her facial hair and a gravelly voice - 'people, cashiers, everyone, suddenly became so damn friendly'.
Yet Carol he soon felt unhappy as a trans man. At first, the testosterone he started injecting himself with at the age of 34 lifted his mood and energy levels. But after two years he began to suffer from terrible side effects. L'vaginal and uterine atrophy (which can cause tissue breakdown and bleeding) was 'extremely painful'. Her cholesterol levels had risen and she had palpitations. She also became so anxious that she started to have panic attacks.
So he took anti-depressants and they worked. "It was like a light bulb went on for me," he says. "It was like this, I needed antidepressants; I didn't need a sex change".She realised that her gender dysphoria, the painful feeling of being in the wrong body, did not make her a man.
Almost three years ago, after four years as a transsexual, Carol became a 'detransitioner': someone who took cross-sex hormones or had surgery, or both, before realising it was a mistake. His experience illustrates the dangers of a 'gender affirmative' model of care accepting thepatients' self-diagnosis of being trans, now standard practice in American transgender medicine.
No one knows how many detransitioners there are, but anecdotal evidence and increasing membership of online groups suggests that the number is growing rapidly. A recent survey conducted by Lisa Littman, doctor and researcher, out of 100 detransitioners (69 of whom were women), found that thea majority felt that they had not received an adequate assessment prior to treatment. Almost a quarter stated that homophobia or homophobia difficulty accepting being gay led them to transition; 38% considered that their gender dysphoria was caused by trauma, abuse or mental health problems.
Carol believes that the roots of her gender dysphoria lie in the in his childhood. Oneeducation that has been both fanatically religious and abusive brought home two damaging messages. One was the importance of the "rigid gender roles'. that women were there to serve; they were less than men". Her mother's endless fury that Carol would not bow to this notion of femininity, which included wearing only clothes ("I didn't even walk like a girl", whatever that meant") meant that she had grown up believing that her way of being a woman was somehow 'all wrong'. The other message was that homosexuality was 'an abomination'.
Carol's 'revelation' came, as she amusingly describes, when she developed a 'strong crush' on her mother's female real estate agent at the age of 16. Realising this caused a meltdown (although she didn't call it that at the time). First he "fasted and prayed to God to take all this away". Then she started drinking heavily and having one-night stands with men 'in the hope that something would click'. When she came out at the age of 20, many of her relatives excluded her from family gatherings.
It was in her early twenties, when many lesbians in her social circle ("almost always the butch ones") began to identify themselves as trans men that she began to think: "This must be it! This is what's wrong with me! " But she was told that she had to live as a man for six months before being approved for treatment and the thought of using the gents was intolerable. By this time, she had met the woman who would become her wife and had found some stability.
But he was still deeply unhappy. "I just felt wrong," she says. "I was disgusted with myself, and if a good answer comes along and says, this will solve the problem, guess what you're going to do?" Mid-30s, no longer needed to see a therapist to be prescribed testosterone. (Planned Parenthood uses an "informed consent" model in 35 states, which means that trans patients do not need a therapist's note). Yet Carol saw a therapist because she wanted to "do it right". The therapist did not explore her childhood trauma, but encouraged her to try testosterone. Months later, Carol had her breasts removed.
The detransition was the hardest thing I've ever done.she says. She was so terrified and ashamed that it took a year to remove the testosterone. To her relief, her cholesterol levels returned to normal in a few months. She still has hair on her face and a deep voice. Her mastectomy 'is like any other loss: it dissipates but never disappears completely'.
He now spends a lot of time doing campaigns to get the stories of other detransitioners heard. This is not an easy job. Outspoken detransitioners are often vilified. One gender medical doctor criticised the use of the term 'detransitioner', saying, with extraordinary cruelty, 'it doesn't really mean anything'. Dr Littman's study found that only 24% of detransitioners told their doctors that the transition did not work. This may help explain why some people dismiss the phenomenon.
Carol is concerned about girls who are taking puberty blockers to avoid becoming women, possibilities he would have gladly avoided. E is concerned about butch lesbians being encouraged to consider that they are actually heterosexual men. He now considers this homophobic. "My wife told me recently that during the transition she accepted it for two months before realising it was crazy. And she was right. She was told that his wife was really a man, so that she was bisexual or straight. It was bullshit "
This article appeared in the US section of the print edition under the title "Portrait of a detransitioner ".
Original text heretranslation by Laura De Barbieri