What is the actual rate of people who regret transitioning
Executive summary
Medical and surgical studies consistently find that explicit, sustained regret after gender-affirming surgery is uncommon—typically reported at well under 1% in recent systematic reviews of surgical cohorts [1] [2]—but the true rate of regret across all people who transition (including those who take hormones or socially transition) is uncertain because of variable definitions, short follow‑ups, and differing study populations [3] [4].
1. What the best surgical data show
Large systematic reviews focused on gender-affirming surgery (GAS) report regret rates that are very low—often cited around or below 1%—and conclude that regret after GAS is rarer than regret after many other elective surgeries, based on pooled studies of thousands of operated patients [1] [5] [2].
2. Why surgery-focused rates don’t settle the broader question
Surgical cohorts are a subset of all people who transition; many who transition receive hormones or only social changes, and regret or detransition in those groups isn’t captured by GAS registries, so a low surgical regret rate does not by itself mean regret is universally rare among everyone who transitions [3] [4].
3. Definitions and measurement problems that widen the uncertainty
Different studies define “regret” differently—some count only those who revert legal sex or pursue reversal surgery, others count self‑reported ambivalence—and detransition (stopping or reversing transition) is often conflated with regret despite many detransitioners citing external pressures or non-regret reasons; these definitional inconsistencies make direct comparisons and an “actual” single rate impossible from existing literature [6] [7] [4].
4. Evidence that suggests higher numbers in certain samples
Mixed clinical and community samples yield very different signals: in at least one qualitative/clinical study a minority reported regret (22%) and another 11% reported ambivalence, though that study’s participants were self‑selected and not a representative population-level sample, illustrating how sampling methods can inflate apparent regret rates [7].
5. Time matters—a delay in many cases of regret
Regret, when it occurs, may not appear quickly: some literature reports median times to post‑surgical regret measured in years—figures such as a median of up to eight years for surgical regret, and shorter median timelines (3–6 years) reported for mixed‑intervention groups—so short follow‑up studies risk undercounting later regret [3].
6. Non-medical drivers of detransition and why they matter
Many who stop or reverse transition cite external pressures—family rejection, employment discrimination, insurance and legal barriers—or changes in life goals rather than intrinsic remorse, which means detransition rates cannot be read as direct measures of “regret” without careful context [6] [8].
7. The balanced bottom line
For people who undergo gender‑affirming surgery, the best pooled surgical evidence places explicit, sustained regret at very low levels—around or under 1% in many reviews [1] [2]—and mainstream reporting, including AP, summarizes that regret appears uncommon [9]; however, across all transition pathways the true regret rate is unknown because of variable definitions, heterogeneous study samples, loss to follow‑up, and the likelihood that regret can emerge many years later, so any single “actual” percentage for everyone who transitions cannot be stated confidently from current published evidence [3] [4].