Hypocrisy, Hate and Harm #no2h8splc
August 6, 2013
Why I keep records of my transition
August 8, 2013

Transitioning Back To One’s Assigned Sex At Birth

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:

    1. 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:

  1. 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.

Further reading:
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’

  • James

    I’m in the process of a Retransition to male after ten years as female and I can tell you it is the hardest thing I have ever experienced and there is no support or even information out there! There are a few “born again” fanatics burning with regret and looking for someone to blame etc…

    I’m pre-op and loved being female, I have no regrets and there is no external pressure, in fact, my therapist and doctor think I should stay female but after ten years I don’t want it any more. I’ve lost connection with being female and started feeling a kind of masculinity I like.

    I grew up with gender dysphoria and after ten years living “full-time” I still have dysphoria so what has changed? I pass but I still have trans anxieties, I still see the man in the mirror even if no one else does. I’m burned out with trans anxiety so in the end I think life will be easier to live with the “version” of masculinity I like and just accept dysphoria is for life. Trans anxieties are worse than dysphoria.

    Anyway, I think we all need to be more open and talk about all our journeys because it’s not black and white.

    I’m not transitioning back to anything I’m transitioning on…

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  • These people discussed in this article are weak in mind and heart and conviction, and have absolutely no business being any sort of mouthpiece for transness anywhere. I am not commenting on the author’s motivations but am focusing on the reality that these “public transitioners” have been given far too much of a soapbox to stand on than they deserved. This is especially so in light of there being so many earnest, self-affirmed, driven, and amazing transpersons all over this country that journalistic resources completely ignore as if they don’t even exist. How dare.

  • MgS

    I have one huge problem with the notion of “detransition” as related to RLE. It implies somehow that there is a “pass/fail” system in place.

    It isn’t. Just as it is becoming more and more clear that psychological gender is a spectrum, so is the experience of gender transition. More and more, we are seeing people stepping into the place where they are comfortable, and a few step beyond that place and have to adjust course.

    The language of “failure” is political dynamite which plays into the hands of those who would deny transgender people access to appropriate care. I have seen a lot of people attempt transition, and a number of them have stepped away from full transition not because they “failed”, but because they found where they had arrived at did not work for them.

    Suicides are tragic for all who are touched by that person’s passing. Transition is difficult for us all. Those who choose to step away from that place still need our collective support. Isolation, fear, and the language of failure are ultimately at the root of what takes people into the darkest of places. Let us lose the language of failure and help those around us to find their place with our support. Those who choose to step away from the very public moment of gender transition and return to prior states are just as much a part of the trans story as those who arrive in their chosen gender role fulfilled by it.

    In short, someone’s reasons for choosing a particular path are their own. I for one am glad that today people feel that the option to step away from full gender transition is available to them. Being trans is difficult, and working and living through being trans is even more so in a society that still struggles with the notion. The more that we can do to normalize the elasticity of human experience in these situations, the better off the trans community will be as a whole.

  • Hi Autumn – I was honestly really hurt when I read your comments. I don’t think your speculation in my case is factual or called for. Isn’t the whole point that people (all of us) should be able to live in a way that’s authentic and not judged? I think I’ve been very transparent, and I’ll let that speak for itself.

    If there is one thing I’ve learned in the past seven years is that gender isn’t binary, and it isn’t a letter on a piece of paper (laminated or otherwise).

    I’m happy to still be here.

    • Bex H.

      I completely agree with you Michael!! This article is a hot mess. I have no idea what Autumn was even trying to say. I read your blog and cannot express my sympathy enough. You have been through a tremendous health scare over the past 9 months and I wish you the best in health and happiness. I trust that you have made the best decisions for you and your family. I honestly cannot say I would have made a different decision if I had been in your shoes.

      I urge everyone to read Michael’s blog from the last year and to completely ignore this article which has absolutely nothing to do with him. http://meganwallent.com/

  • Zoe Brain

    Don’s situation is apparently the result of a biological issue.
    Much as was mine.
    In his case, evaluation by himself and his medical team concluded that a) The natural change was reversible and b) Gender Identity was male.
    In my case a) Cause of natural change unknown (turned out to be the 3BHSD form of CAH) and b) Gender Identity was female.
    I can attest to how mind-bending hormonal chaos can be.

    I’m not saying the jury’s still out on Don’s case. It’s not, a verdict has been reached. It will take some time to see if there’s an appeal (to stretch the metaphor). I hope not. We may have lucked out.

    But then, I lucked out too with exactly the opposite circumstances.

    • As I said, I have no particular insight into what happened with Don Ennis. The medical explanation given by him may be truth, or it may be an elaborate cover story.

      That said, I’ve seen the comments in articles about Ennis’s return to the sex assigned to him at birth — such as here and here. Those comments go to what I wrote in this paragraph:

      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.