Editor’s note: The following essay appears in the Fall 2022 issue of Eikon.
What will you do when a detransitioner comes to your church?
With more young Americans identifying as transgender, easy access to cross-sex hormones, and insurance coverage for gender reassignment surgery, the number who have transitioned has exploded. In 2013, the American Psychiatric Association estimated the prevalence of gender dysphoria as 0.014% in boys and 0.003% in girls. A 2021 study found that 9.2% of public high school students in Pittsburgh, Pennsylvania did not identify with their biological sex, a roughly thousandfold increase in less than a decade. As the UK high court’s since-overturned 2020 decision regarding Keira Bell highlighted, few to no safeguards protect youth funneled into gender transition. Prior to the explosion in gender reassignment interventions, the previous standard of care — “watchful waiting” through puberty — resolved gender dysphoria for approximately 85% of children who once yearned to become the other sex. Roughly 17 out of 20 children with gender dysphoria desisted when never encouraged to transition. With today’s push for transition-affirming interventions, how many of those 17 will be rushed into gender transition and later regret that decision and detransition?
Detransition has multiple meanings, but denotes a cessation and possible reversal of the social, hormonal, and surgical changes that supported the individual presenting as other than their biological sex. We have an ever–increasing number of transitioned youth who may seek detransition. Sex researcher Debra Soh sounds the alarm:
Within sexology, we saw this tragic period coming for years, the only logical outcome following a generation of children being rushed to transition without critical thought. We tried to stop the epidemic that is coming. No one would listen. […] The more I learn about detransitioners, the more heartbroken I become. There is no question in my mind that the 2 percent statistic of those who regret transitioning is going to multiply vastly in the years to come. When society looks back on this in horror — we tried to warn you.
The 2% estimate Soh references originates from studies conducted when transition was less socially acceptable, no medical insurance would pay for it, and the prevalence of gender dysphoria was lower. Transition regret was almost certainly always higher than reported. Contributing to that underreporting is that regret often lags transition by a decade or more, but recent studies indicate that gap may be narrowing.
Society has cause to a tsunami of detransitioning. While transition-affirming interventions may initially feel like an accomplishment, especially for girls receiving testosterone (a known mood enhancer), the novelty eventually wears off. The reaction of the gender activist community to detransitioners has been to suggest they were never transgender in the first place, rather than offering sympathy. One recent study posits detransition as primarily a reaction to “pressure from family and social stigma,” while admitting detransition rates as high as 13%. Multiple studies from the United Kingdom support detransition rates of 10–20%. More inclusive surveys have described detransitioning for varied medical, social, and psychological reasons.
In the United States, we can expect thousands to tens of thousands of surgically or hormonally altered youth, disillusioned by a transition that brought them no healing, to be casting about for a new community. Any number of these young adults will seek out Christian churches holding a traditional binary view of sex and gender, but are these churches and their leadership ready to meet this need?
The works of Walker, Branch, Yarhouse and Sadusky, and others have provided insight into the challenges faced by people with gender dysphoria, but none to date has provided a biblical story in which those permanently changed by surgeries and hormones can see themselves as loved despite regretting that choice. While the parable of the prodigal son provides a general narrative of regret and return, the wayward son was whole in a way that detransitioners are not. In many ways, the biblical story of eunuchs provides specific hope for the sexually damaged.
Those railing against biblical views of marriage and sexuality were the first advocates for eunuchs as prototypes of transgender persons. Activists who do not see humanity divinely formed in only two sexes do not have a monopoly on this interpretation, however. Viewing the scriptural witness through a biblical theology lens reveals a trajectory towards hope for those whose sex organs are not whole.
Prohibition of Eunuchs
The story of eunuchs in the Bible has four movements: prohibition, promise, acknowledgement, and inclusion. In the Torah, eunuchs are prohibited from serving in the priesthood (Lev. 21:20) or worshiping in the assembly (Deut. 23:1). For quite some time after the law was given, we see few mentions of סריס (eunuchs) in Israel, but they gradually enter the picture, especially in the divided kingdom during and after the reign of Jezebel. Within Samuel’s admonition to the people about the drawbacks of kings, 1 Samuel 8:15 notes that סריס would be the eventual beneficiaries of tithes on grain and wine levied by the king. We see Jezebel defenestrated by her own eunuchs at Jehu’s command in 2 Kings 9:32. At the time of Josiah’s reforms, 2 Kings 23:11 uses the dwelling of Nathan-Melech the סריס as a landmark identifying where the horses “dedicated to the sun” were located prior to Josiah removing them, presumably as idolatrous. By the time Jeremiah is rescued after the intervention of Ebed-Melek (the first Ethiopian eunuch) in Jeremiah 38:7–13, eunuchs are openly present in Zedekiah’s court.
A Promise to Eunuchs
We see a promise to eunuchs in Isaiah 56:1–4. This is timely because the named male protagonists of the exile and return were possibly eunuchs, and they were understood as such by rabbinical sources.
Upon arrival in Babylon, Daniel — along with Hananiah, Mishael, and Azariah — is taught and acculturated into the ways of court by Ashpenaz the chief eunuch (Dan. 1:3–4). While the text never documents their castration, extra-biblical literature notes that such captives were often castrated for use as court servants. Bereft of their families, names (Dan. 1:7), and procreative abilities, captive eunuchs had no identity other than as servants of their new master. Indeed, this lack of external loyalties probably explains why Daniel can serve both the Babylonians and their successors, the Medes and Persians. Without family or the possibility of one, Daniel was just useful property to the new regime. After killing Belshazzar and taking over Babylon, Darius the Mede promptly appointed Daniel to high office (Dan. 6:1–2) as the first recorded act of his reign. Daniel is apparently quite long lived, as eunuchs tended to be, serving four kings. The accomplishments and conflicts of Daniel and his companions are all within the context of court intrigue: they have no duties in their captivity other than civic service. No wives or descendants are indicated for any of the four. On two occasions, Daniel is rewarded by the monarchs he serves (Dan. 2:48–49; 5:29), but neither involves any rewards of a marital or sexual nature, nor makes any promises to offspring or family. Josephus describes Daniel as a eunuch, but since he writes as an apologist, portraying a well-respected Jew as a eunuch to his Roman audience may be an attempt to draw points of similarity between the cultures rather than recitation of an established fact. Jerome notes such traditions in his commentary on Daniel, but suggests that Daniel 1:4’s clause “without physical defect” precluded the castration of Daniel and the other Hebrews. Origen and early rabbinic traditions both accept the castration of Daniel.
Mordecai, like Daniel and his companions, is another likely Hebrew eunuch. He arrived with the second wave of captives (Est. 2:5–6), has no offspring mentioned, moves freely throughout the court including observing the harem (Est. 2:11), and receives his reward without reference to any descendants (Est. 8:1–2). Like Daniel, understanding Mordecai as a eunuch does not detract from his righteous acts or undermine his role as a faithful servant of God in a foreign court. If Mordecai was a eunuch, his success may have prompted jealousy from Haman, who with a wife (Est. 5:10,14; 6:13) and ten sons (Est. 9:10) has a family who can benefit from the king’s favor.
Nehemiah was a high official in the court of Artaxerxes I, and likely would have been castrated to serve in that position. Nehemiah has no wife or offspring noted in the text, even though his brother Hanani is mentioned twice (Neh. 1:2; 7:2). Indeed, the Septuagint of Nehemiah 1:11 in both Codex Vaticanus and Codex Sinaiticus has a textual variant reading εὐνοῦχος (eunuch) instead of οἰνοχοός (cupbearer). Nehemiah waits on King Artaxerxes while the queen is present as a eunuch would have (Neh. 2:6) and is given governorship over outlying territories of the empire (Neh. 5:14). Had Nehemiah any hint of dynastic potential, Artaxerxes would hesitate to give him a position of remote authority. Like Daniel and Mordecai, Nehemiah’s status as a probable eunuch adds to the number of righteous potential eunuchs depicted in the Old Testament.
In addition to these named, faithful Hebrews, many others went into exile and were castrated to serve the Babylonian empire. Per the Torah’s prohibitions, no such eunuch could have been fully included in worship in the rebuilt temple. Unlike today’s detransitioners, no eunuch sought out his own castration, but that distinction is moot: Isaiah 56 promises all faithful eunuchs a place in the New Covenant.
Isaiah 56:1–8 is a prophetic word of hope to those excluded from the assembly under the Mosaic Law. In providing such hope, this passage departs from promises found elsewhere in Isaiah, which signal that benefits of worshiping God would be made available to outsiders; here, it explicitly includes the excluded. The passage calls out eunuchs and foreigners as being included in God’s blessings despite their nominal disqualifications. In doing so, the text highlights their faithful obedience, and specifically Sabbath observance. This passage is found in the third section of Isaiah, which focuses on the return from exile, necessarily including those made eunuchs during the exile.
The promise in Isaiah 56:5 is a triple entendre. The verb rendered “cut off” at the end of the verse (יכרת) is a very common verb with a variety of Old Testament uses. For example, it refers to the destruction of idolatrous monuments including Asherah poles (e.g., Ex. 34:13; Lev. 26:30; Judg. 6:25–6, 28, 30; 2 Kings 18:4), to the exile of transgressors from the nation of Israel due to sexual or other covenantal sins (e.g., Lev. 18:29; 20:17,18), as well as to castrated males prohibited from the assembly of the Lord (Deut. 23:1) and castrated animals forbidden as sacrifice (Lev. 22:24). Some translations render the permanence of these monuments without conveying this connection (e.g., “endure forever” [NIV], “not be eliminated” [NASB]) while others (RSV, NRSV, NKJV, ESV) maintain “cut off” with its range of meanings.
The Acknowledgement of Eunuchs
Jesus acknowledges eunuchs in Matthew 19:12, delivering a threefold taxonomy of the sexually imperfect: those born so (what we might term today as intersex), those made so by men, and those who made themselves eunuchs for the kingdom of heaven. While the last category has been the subject of historical debate due to its ambiguity, the middle category clearly included castrated slaves of Jesus’ time. Today, that category includes people surgically or chemically changed so they no longer have intact physique, appearance, or reproductive abilities. Jesus mentions all three kinds of eunuchs without condemnation. Even though disorders of sexual development are noted in the rabbinic literature, this is their only biblical mention. Thus, in what looks like an offhanded response to the disciples’s complaint, Jesus includes every person with imperfect sexual organs; he sees all of them. This mention does not seem to affect Jesus’ ministry between its utterance and his ascension, but the impact is evident in Acts.
The Inclusion of Eunuchs
The inclusion of eunuchs in the kingdom begins in Acts 8 with the conversion and baptism of the Ethiopian eunuch. Unlike Ebed-Melek from Jeremiah, who would be known to first century Jews, this Ethiopian eunuch is unnamed. Even though we regard Cornelius as the first Gentile convert, this eunuch was baptized first. Because the early church called no council to review Philip’s actions, we miss the significance of this inclusion. Philip does not need a vision from God telling him that this sexually imperfect foreigner should be included in the kingdom; the dual promise of Isaiah 56 is just a roll of the scroll away from where the foreign eunuch is reading in Isaiah 53 when Philip arrives at his chariot.
The ambiguous identification of the eunuch has prompted some commentators to question whether he was indeed castrated. He had come to Jerusalem “to worship” (Acts 8:27), which would have been problematic if he were castrated, even were he a Jew (which is not stated in the text), based on the restrictions of Deuteronomy 23:1. He may have been the African equivalent of a God-fearer, a Gentile who found Judaism attractive yet insufficiently so to prompt circumcision. Most strikingly, he has his own personal Isaiah scroll, not held as an heirloom, but read in a chariot! The Ethiopian eunuch is shown by the text to be literate, wealthy, and powerful. At the same time he is generally understood to be ethnically non-Jewish and almost certainly castrated by virtue of his trusted service to a female monarch.
Thus, the message of hope for eunuchs unfurls throughout the biblical narrative. Every imperfect person has a home within the kingdom, even the sexually imperfect. As an angel of the Lord leads Philip to the lost but receptive eunuch-foreigner, so we should also be ready to bring the good news to those kept from the assembly of the Old Covenant by their mutilated sexual organs but joyfully invited into the New.
But who can deliver this message of hope? Is there room in gender-as-spectrum ideology to embrace those who now believe their transition was misguided and possibly harmful? The silence on or perfunctory dismissal of detransition by Christian theologians advocating affirmation of transgender identities raises serious questions. Yarhouse and Sadusky suggest that this reluctance derives from the “lens” through which one views issues of gender identity:
If love for others means indiscriminately reinforcing every way a young person expresses themselves or their gender, it could become self-contradictory as the young person’s experiences shift […] As Christians who take seriously the fall, we know that people are not always reliable judges of their own well-being. The diversity lens’s tendency toward unrestricted affirmation may limit those who adopt it from asking helpful questions or providing resources beyond transitioning.
Psychologist Robert Withers suggests that intolerance for detransitioners is rooted in the critics’ own insecurities:
It seems likely too, that those members of the trans community who are most active in silencing and denying the existence of detransitioners are attempting to police in others the doubts they cannot tolerate in themselves. If someone can bear to think about a thing, they can usually bear to let others talk about it. But if a person’s sense of identity and social network are built around being trans, talking about doubts and regrets can be experienced as an existential and social threat.
Soh hypothesizes a political motivation behind such rejection, as detransitioners do not fit a neat narrative:
A question that is commonly asked is whether detransitioners were ever really transgender. Just because someone detransitioned doesn’t mean they never experienced gender dysphoria or that their feelings weren’t real. Similar to desisters, because detransitioners do not fit the story that trans activists would prefer to promote, they are dismissed by the community and told their dysphoria wasn’t that severe.
Shrier congruently observes: “This is the circular logic that pervades trans ideology: if you desist, you were never trans to begin with. Thus, no real transgender people ever desist. It’s an unfalsifiable proposition.”
Detransitioners seeking spiritual care are not likely to find it in churches that embrace transition, both because their presence might complicate that church’s outreach to transgender-identifying individuals and because the condolences offered by such a theological approach are, at best, weak. “Sorry it didn’t work out for you,” doesn’t begin to reasonably engage with the depths of pain and disappointment, let alone the physical consequences, of a regretted transition.
Thus, it will fall to churches holding to a binary view of gender to embrace and minister to detransitioners: if we do not do it, who will? And yet, the complexity of integrating persons with the physical hallmarks of a regretted transition into a congregation is not yet widely tested. Providing a biblical theology of redemption and hope as outlined here is a small step that can serve both detransitioners and the congregation that will need to welcome them in Christ’s name.
The complexities of welcoming and integrating detransitioners should not be underestimated. They will arrive with not only the physical and emotional scars from their journey, but also the underlying hurt that originally prompted it along with a worldview that made it seem sensible. And yet, the call to do something hard should not prompt Christ’s church to shirk this responsibility. Willingness to demonstrate love to people who appear unnatural will not come automatically, so church leaders must prepare their congregations’ hearts and minds now to effectively love detransitioners who seek them out.
When a detransitioner appears at your church, will you be ready with a story of hope and inclusion? Will you have prepared your church greeters and briefed your elders or leadership team on a strategy to extend love, hope, and inclusion to a person who has been poorly served by an ideology and community which now rejects them?
Jonathan Clemens is a Physician Assistant in outpatient practice in Olympia, WA, and serves as president of the Fellowship of Christian PAs. This article is developed from his Th.M. thesis at Western Seminary in Portland, OR. He is currently pursuing a Doctor of Medical Sciences.
 That is, undergone hormonal or surgical modification of their secondary sex characteristics.
 American Psychiatric Association and American Psychiatric Association, eds., Diagnostic and Statistical Manual of Mental Disorders: DSM–5, 5th ed (Washington, D.C: American Psychiatric Association, 2013), 454. For those not used to working with such small numbers, consider: of a million prepubescent children, split 50/50 between girls and boys, the DSM–5 numbers predict 70 boys and 15 girls will have diagnosable gender dysphoria.
 Kacie M. Kidd et al., “Prevalence of Gender–Diverse Youth in an Urban School District,” Pediatrics 147, no. 6 (June 2021), doi:10.1542/peds.2020-049823.
 “Other Countries Should Learn from a Transgender Verdict in England,” The Economist, December 12, 2020, https://www.economist.com/leaders/2020/12/12/other-countries-should-learn-from-a-transgender-verdict-in-england.
 Paul W. Hruz, “Deficiencies in Scientific Evidence for Medical Management of Gender Dysphoria,” The Linacre Quarterly 87, no. 1 (2020): 34–42.
 The term “desistance” is often used to refer to social detransitioning, generally in the absence of past surgical or hormonal interventions. For the purposes of this article’s call to pastoral care, these individuals are included, even without the specific physical modifications that prompt comparisons to eunuchs. Also note that the transgender population includes those who choose to present as nonbinary, so detransition may reflect a return to congruence with biological sex even if the individual in question never identified as the sex not conforming to their biologic sex.
 Debra Soh, The End of Gender: Debunking the Myths about Sex and Identity in Our Society, (New York: Threshold Editions, 2020), 188. Emphasis added.
 Studies which have suggested detransition is rare appear methodologically inadequate to draw such a conclusion. For example, Sasha Karan Narayan et al., “Guiding the Conversation–Types of Regret after Gender-Affirming Surgery and Their Associated Etiologies,” Annals of Translational Medicine 9, no. 7 (April 2021): 605, doi:10.21037/atm-20-6204, posits a 0.2–0.3% regret rate, yet surveyed surgeons rather than patients, only had a 30% response rate, and only considered a patient to regret gender reassignment surgery if that patient approached their original surgeon seeking reversal.
 Robert Withers, “Transgender Medicalization and the Attempt to Evade Psychological Distress,” Journal of Analytical Psychology 65, no. 5 (November 2020): 865–89, doi:10.1111/1468-5922.12641.
 Stephen B. Levine, E. Abbruzzese, and Julia W. Mason, “Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults,” Journal of Sex & Marital Therapy, February 24, 2022, 1–22, doi:10.1080/0092623x.2022.2046221. It is reasonable to posit that recent easing of barriers to transition and newer studies finding a decrease in time to regret are connected: lower effort to transition required less commitment.
 Soh, 185; Abigail Shrier, Irreversible Damage: The Transgender Craze Seducing Our Daughters (Washington: Regnery, 2020), 192.
 Jack L. Turban et al., “Factors Leading to ‘Detransition’ Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis,” LGBT Health 8, no. 4 (June 1, 2021): 273–80, doi:10.1089/lgbt.2020.0437. This study relies upon the online “US Transgender Survey” that only sought input from currently transgender-identified individuals. Its methodological limitations did not prevent it from being quoted in The New York Times, however: Azeen Ghorayshi, “Doctors Debate Whether Trans Teens Need Therapy Before Hormones,” The New York Times, January 13, 2022, sec. Health, https://www.nytimes.com/2022/01/13/health/transgender-teens-hormones.html.
 Levine, Abbruzzese, and Mason, 6–7.
 Lisa Littman, “Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners,” Archives of Sexual Behavior 50, no. 8 (2021): 3353–69, doi:10.1007/s10508-021-02163-w.
 Andrew T. Walker, God and the Transgender Debate: What Does the Bible Actually Say about Gender Identity (Centralia, WA: The Good Book Company, 2017).
 J. Alan Branch, Affirming God’s Image: Addressing the Transgender Question with Science and Scripture, 2019.
 Mark A. Yarhouse and Julia Sadusky, Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth (Grand Rapids, MI: Brazos, 2020).
 As Nancy Wilson opined in 1995: “eunuchs and barren women, I believe, are our gay, lesbian and bisexual antecedents” in Our Tribe: Queer Folks, God, Jesus, and the Bible, (San Francisco: HarperSanFrancisco, 1995), 124).
 While סריס is traditionally understood to have a dual meaning encompassing both castrated men and palace officials, recent scholarship has called that into question, suggesting that all סריס in the Old Testament are eunuchs. See Jonathan P. Clemens, “An Everlasting Name Which Will Not Be Cut Off: Eunuchs as Biblical Models of Hope For Detransitioners” (Th.M. Thesis, Western Seminary, 2021), https://www.tren.com/e-docs/search.cfm?p002-0989 for a more thorough discussion.
 Janet S. Everhart, “The Hidden Eunuchs of the Hebrew Bible: Uncovering an Alternate Gender” (Ph.D. Dissertation, Denver, CO, The Iliff School of Theology and University of Denver, 2003), 97.
 Everhart, 153 n123.
 Vern L Bullough, “Eunuchs in History and Society,” in Eunuchs in Antiquity and Beyond, ed. Shaun Tougher (London; Oakville, CT: The Classical Press of Wales and Duckworth, 2002), 1–18.
 Gary Taylor, Castration: An Abbreviated History of Western Manhood (New York: Routledge, 2000), 170–173.
 Piotr O. Scholz, Eunuchs and Castrati: A Cultural History (Princeton, NJ: Markus Wiener, 2001), 115. No explanation is offered for the cause of such longevity, but the use of eunuchs in antiquity for white collar, rather than laborer roles, likely plays a larger role than any medical differentiation. However, Kathryn M. Ringrose (The Perfect Servant: Eunuchs and the Social Construction of Gender in Byzantium [Chicago: Univ. of Chicago, 2003], 63) disagrees, noting that eunuchs tended to become osteoporotic and age prematurely due to testosterone deprivation. In the Byzantine context that Ringrose covers, eunuchs were generally castrated before puberty, not as men with fully developed skeletal calcium as Daniel and his companions likely were.
 “But now Nebuchadnezzar, king of Babylon, took some of the most noble of the Jews that were children, and the kinsmen of Zedekiah their king […] He also made some of them to be eunuchs […] Now among these there were four of the family of Zedekiah, of most excellent dispositions, the one of whom was called Daniel.” Flavio Josefo, The Works of Josephus: Complete and Unabridged, trans. William Whiston (Peabody, MA: Hendrickson, 1995), 278. (Ant.10.186–9, accessed via Logos Student Gold)
 St Jerome, Jerome’s Commentary on Daniel, trans. Gleason L. Archer (Eugene, OR: Wipf and Stock, 2009), 20–21: “From this passage the Hebrews think that Daniel, Hananiah, Mishael, and Azariah were eunuchs, thus fulfilling that prophecy which is spoken by Isaiah regarding Hezekiah: ‘And they shall take of thy seed and make eunuchs of them in the house of the king of Babylon’ (Isa. 37: 7). If however they were of the seed royal, there is no doubt but what they were of the line of David. But perhaps the following words are opposed to this interpretation: ‘… lads, or youths, who were free from all blemish, in order that he might teach them the literature and language of the Chaldeans.’” Jerome obviously either discounts or fails to consider that their unblemished status may have been a selection criterion for those to be made into eunuchs, as well as not a status that would have been necessarily documented by the text as modified by such mutilation.
 Everhart, 152–3. Note that Origen is hardly a disinterested party when discussing castration, if we can rely on Eusebius’ tale of Origen’s self–castration.
 Ibid., 155–6.
 Ibid., 153–55.
 Ibid., 154.
 Clinton E. Hammock, “Isaiah 56:1-8 and the Redefining of the Restoration Judean Community,” BTB 30, no. 2 (May 1, 2000): 46–57, doi:10.1177/014610790003000202.
 Andreas Schuele, “Between Text & Sermon: Isaiah 56:1–8,” Int 65, no. 3 (July 2011), 287: “The inner sanctum of the temple, God’s exquisite dwelling place on earth, is off limits to people without proper pedigree and, preferably, priestly lineage. Isaiah 56:1–8 departs from this tradition.”
 Hammock, 47.
 The direction to emasculate (eunuchize) oneself does not occur in literary isolation within the Gospel of Matthew. This verse recalls Matthew 5:29–30, where Jesus urged his hearers to pluck out an eye or cut off a hand if necessary to prevent succumbing to temptation. So R. Jarrett Van Tine, “Castration for the Kingdom and Avoiding the Αίτὶα of Adultery (Matthew 19:10–12),” Journal of Biblical Literature 137, no. 2 (2018), 415, doi:10.15699/jbl.1372.2018.340579.
 Emma Percy, “Can a Eunuch Be Baptized?: Insights for Gender Inclusion from Acts 8,” Theology 119, no. 5 (September 2016): 327–34, doi:10.1177/0040571X16647852.
 Scott Shauf, “Locating the Eunuch: Characterization and Narrative Context in Acts 8:26–40,” CBQ 71, no. 4 (October 2009), 765.
 Yarhouse and Sadusky, 92.
 Withers, 873.
 Soh, 185.
 Shrier, 192. The entire chapter on regret, 185–204, is sobering reading.
 As Shrier (201) reports: “Nearly all the detransitioners I spoke with are plagued with regret. If they were on testosterone for even a few months, they possess a startlingly masculine voice that will not lift. If they were on T for longer, they suffer the embarrassment of having unusual intimate geography—an enlarged clitoris that resembles a small penis. They hate their five–o’clock shadows and body hair. They live with slashes across their chests and masculine nipples (transverse oblong and smaller) or flaps of skin that do not quite resemble nipples. If they retained their ovaries, once off of testosterone, whatever breast tissue they have will swell with fluid when their periods return, often failing to drain properly.”
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