In the past few months there have been two public transitioners who transitioned first fom men to women and then back to men. One was Michael Wallent (F.K.A. Megan Wallent; second transition announced in her March blog entry News), and the Don Ennis (F.K.A. Dawn Stacey Ennis; reported in the New York Post article I’m a guy again! ABC newsman who switched genders wants to switch back).
I wrote an essay back in 2008 for Pam’s House Blend, and I’m not sure if the reasons I spelled out in that essay that that essay I wrote for Pam’s House Blend applies in these two cases — or even surgical regret without transitioning back applies here. But, regret is a rare thing that only happens in about less than 1% in Female-to-Males and 1-1.5% in Male-to-Females (per , as cited by International Journal of Transgenderism paper Transgender Individuals’ Experiences of Psychotherapy).
I frankly find Don Ennis’s claiming of “transient global amnesia” as the impetus to transition back to male to be a rather incredible claim, but it is ultimately up to him to decide whether or not he should live as Dawn or Don.
And as for Michael, He states his detransition has to do with no longer being able to take estrogen due to health reasons. I believe Michael had facial feminization surgery, breast implants, and very likely had genital reconstruction surgery. Choosing to detransition over no longer being able to take estrogen seems an unconvincing reason. Millions of post-menopausal women do without estrogen, so it doesn’t seem that having estrogen coursing through one’s body isn’t intrinsic to being female. It’s a reasonable sounding explanation, but that reason wouldn’t seem to explain a total detransition. Frankly, there are multiple methods for estrogen delivery, and some minimize the risk of blood clots.
To me, it seems very likely something else is going on in both of these cases, but I have no specific insight as to what the something else might be for each of them.
Again, I wrote a piece for Pam’s House Blend on transitioning back to one’s assigned sex at birth back on October 24, 2008. The piece original entitled About The “Real Life Experience” and Detransitioning is still up on the PHB website, as well as when I reposted the piece on February 26, 2009. I wrote the original version of that essay at the time that Christine Daniels transitioned back to living as Mike Penner, explaining to the target audience of cis lesbian, gay, and bisexual community why some transition back to their assigned sex at birth.
In November of 2009, Christine Daniels died as a result of suicide. Christine’s passing still weighs heavy on me.
Below is the essay I wrote back in October of 2008. Even though the thoughts on transitioning back to the sex one was assigned at birth may not apply directly to Don Ennis’s and Michael Wallent’s transitions back to male, it seems appropriate to again repost this essay. The essay explains some of the reasons why some transition back to one’s assigned sex at birth, although I wouldn’t say that the reasons put forward in this essay apply to transition back to one’s assigned sex at birth.
Some days I hate my job at Pam’s House Blend, and this is definitely one of those days. I really need to explain what the Real Life Experience [(RLE) — also referred to as the Real Life Test (RLT)] is and why some transsexuals detransition…And, this is because the person I met as Christine Daniels is apparently detransitioning (also called retransitioning) to Mike Penner.
Basically, I need to separate the personal from the professional when discussing how detransitioning fits into transsexual experience — a sometime component of transitioning sexes — and yet on the very personal level I wish it weren’t at the impetus of someone I’ve known and care deeply about that’s leading me to discuss the subject.
But life is what it is.
So, the first thing that needs to be explained is exactly what a real life experience is, and where detransitioning fits into the real life experience.
Page 17 of the Harry Benjamin Standards Of Care For Gender Identity Disorders says this about the RLE (emphasis added):
The act of fully adopting a new or evolving gender role or gender presentation in everyday life is known as the real-life experience. The real-life experience is essential to the transition to the gender role that is congruent with the patient’s gender identity. Since changing one’s gender presentation has immediate profound personal and social consequences, the decision to do so should be preceded by an awareness of what the familial, vocational, interpersonal, educational, economic, and legal consequences are likely to be. Professionals have a responsibility to discuss these predictable consequences with their patients. Change of gender role and presentation can be an important factor in employment discrimination, divorce, marital problems, and the restriction or loss of visitation rights with children. These represent external reality issues that must be confronted for success in the new gender presentation. These consequences may be quite different from what the patient imagined prior to undertaking the real-life experiences. However, not all changes are negative.
Parameters of the Real-Life Experience. When clinicians assess the quality of a person’s real life experience in the desired gender, the following abilities are reviewed.
1. To maintain full or part-time employment;
2. To function as a student;
3. To function in community-based volunteer activity;
4. To undertake some combination of items 1-3;
5. To acquire a (legal) gender-identity-appropriate first name;
6. To provide documentation that persons other than the therapist know that the patient functions in the desired gender role.
Real-Life Experience versus Real-Life Test. Although professionals may recommend living in the desired gender, the decision as to when and how to begin the real-life experience remains the person’s responsibility. Some begin the real-life experience and decide that this often imagined life direction is not in their best interest. Professionals sometimes construe the real-life experience as the real-life test of the ultimate diagnosis. If patients prosper in the preferred gender, they are confirmed as “transsexual,” but if they decided against continuing, they “must not have been.” This reasoning is a confusion of the forces that enable successful adaptation with the presence of a gender identity disorder. The real-life experience tests the person’s resolve, the capacity to function in the preferred gender, and the adequacy of social, economic, and psychological supports. It assists both the patient and the mental health professional in their judgments about how to proceed. Diagnosis, although always open for reconsideration, precedes a recommendation for patients to embark on the real-life experience. When the patient is successful in the real-life experience, both the mental health professional and the patient gain confidence about undertaking further steps
So, what’s supposed to happen when a transitioner has a unsuccessful RLE is that the transitioner detransitions.
I had an appointment with my own therapist, Patricia Wojdowski, L.C.S.W., on Wednesday. While at the appointment, I asked her some questions regarding detransitioning, and asked if I could post her responses at Pam’s House Blend.
I actually was kind of surprised at Patricia’s answers. Basically, in her long practice with trans clients (she’s been involved with studying and treating transsexuals and other gender variant people since the mid-seventies), the single commonality for all of her detransitioning clients has been that external pressures were the impetus. All of her clients who have detransitioned still considered themselves as having a gender identity that didn’t match their natal sex, but external pressures — issues such as inability to find employment, biases and discrimination in the workplace, an inability to find appropriate housing, conflict with friends and/or family, etc. — are why the RLE is evaluated by the client as unsuccessful, and the client decides to detransition.
I know there are other reasons than the ones my therapist cites. Sometimes the reason is relating to faith, where one becomes an “ex-transsexual” or “ex-transgender” (the trans equivalents to “ex-gay”). Sometimes it’s because the person really isn’t a transsexual, and an unsuccessful RLE catches them before they experience transsexual regret. Since my therapist doesn’t practice conversion (or reparative) therapy, she wouldn’t see those who are detransitioning for reasons of faith. But, it is interesting that in all the years of her practice, she’s never seen a transsexual who has detransitioned due to because the detransitioner has figured out that he or she really wasn’t transsexual — all of her detransitioners have detransitioned due to external pressures.
So, back to our impetus — is Mike Penner detransitioning from Christine Daniels because he’s under external pressures, or is it because he figured out during his RLE that his gender identity really wasn’t female? Honestly, I have a guess, but I have no real idea.
The bottom line is that when a person begins a transsexual transition — especially a very public transition — one trades one set of problems related to having a hidden, real or perceived gender identity that’s in conflict with one’s natal sex for a completely new and different set of problems. That new set of problems often include difficulties related to housing, employment, and public accommodation –basically just dealing with others’ biases and discrimination — family issues related to one’s spouse/ex-spouse and children, as well as having one’s peers, friends and family still seeing you as either still a member of your natal sex instead of your target sex, or as a member of some “third gender” rather than as your target sex.
Detransitioning may relieve most of the transitioning stress, but at least in the case of male-to-female transitioners who detransition, one can’t go fully back to one’s previous life. Prior to transitioning, most are fairly closeted about having cross-gender identity and expression issues. When detransitioning, one’s peers, friends, and family — and in Mike’s case, the sports community audience he writes at the Los Angeles Times for — know there are at a minimum gender expression issues. In other words, since in broad society most can’t tell the difference between a male-to-female transsexual, a drag queen, a crossdresser, and an effeminate gay man, a detransitioner going back to a male expression of public gender is going to be perceived as if he were gay because of the time spent living as female; basically the detransitioner won’t fully regain his heterosexual privilege.
Transitioning is hard; detransitioning is hard. My warmest thoughts are with Mike — I wish him the absolute best.
The real life experience standards have changed in WPATH’s Standards Of Care, Version 7. The requirement listed in the section entitled Criteria for hysterectomy and ovariectomy in FtM patients and for orchiectomy in MtF patients lists the following requirements:
- Persistent, well documented gender dysphoria;
- Capacity to make a fully informed decision and to consent for treatment;
- Age of majority in a given country;
- If significant medical or mental health concerns are present, they must be well controlled;
- 12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones).
The section Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients adds a sixth requirement:
- 12 continuous months of living in a gender role that is congruent with their gender identity;
The section Rationale for a preoperative, 12-month experience of living in an identity-congruent gender role explains why this way now:
The criterion noted above for some types of genital surgeries – i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity – is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role, before undergoing irreversible surgery. As noted in section VII, the social aspects of changing one’s gender role are usually challenging – often more so than the physical aspects. Changing gender role can have profound personal and social consequences, and the decision to do so should include an awareness of what the familial, interpersonal, educational, vocational, economic, and legal challenges are likely to be, so that people can function successfully in their gender role. Support from a qualified mental health professional and from peers can be invaluable in ensuring a successful gender role adaptation (Bockting, 2008).
The duration of 12 months allows for a range of different life experiences and events that may occur throughout the year (e.g., family events, holidays, vacations, season-specific work or school experiences). During this time, patients should present consistently, on a day-to-day basis and across all settings of life, in their desired gender role. This includes coming out to partners, family, friends, and community members (e.g., at school, work, other settings).
Health professionals should clearly document a patient’s experience in the gender role in the medical chart, including the start date of living full time for those who are preparing for genital surgery. In some situations, if needed, health professionals may request verification that this criterion has been fulfilled: They may communicate with individuals who have related to the patient in an identity-congruent gender role, or request documentation of a legal name and/or gender marker change, if applicable.
• Joanne Herman‘s Transsexual regret
• Lynn Conway‘s A Warning For Those Considering MtF SRS
• Ex-Gay Watch: Can One Be A Transgender Christian?
• From Michael to Megan and Back Again: News
• New York Magazine: Transgender Newsman Don Ennis Has Second Thoughts After ‘Amnesia’