(I’m indebted to Susan’s wiki outline for this, weirdly enough: I don’t think I’ve ever seen it laid out at all, with subheadings and differentials and checklists and so on.)
There’s preventing regret, an implicit social responsibility and an official medical and patient responsility. This prevention inhabits all stages of the process: doctors are supposed to consider regret at each new step in transition, and most of all when they are evaluating patients for surgery. Trans people must scrutinize themselves for regret and potential regret. They must also constantly field concerns about regret as a community.
There’s proving the absence of potential regret, which still forms part of some standards of care, particularly those related to the RLE.
There’s defining likely indicators of regret, which is something clinicians and trans people are supposed to do in unequal collaboration.
There’s regret due to negative consequences of transition: lost family, lost job, lost marriage.
There’s regret due to the perceived inadequacy of treatment or subjective judgments about the potential of treatment.
There’s regret due to transitioning too quickly or without sufficient support.
There’s regret due to transitioning too slowly, transitioning in fits and starts, or transitioning late.
There’s regret due to being transsexual, i.e. having been “born in the wrong body.”
There’s regret due to transitioning into a male or female identity that doesn’t fit an ambiguous or complex internal landscape.
There’s regret due to mistaking a different trans status for transsexuality, e.g. transitioning when you are actually satisfied with cross-dressing.
There’s regret due to ideology, such as religious belief.
There’s regret due to internalized prejudice, such as homophobia, sexism, or transphobia.
There’s regret due to having made a terrible mistake about one’s gender identity.
There’s that population of regretters, people who made a terrible mistake about their gender identity or were victimized by doctors who made a terrible mistake about their gender identity. They seem to make up the smallest population of regretters, and are by far the population that has the least amount of contact with care providers (who claim not to encounter them), but they form the archetypal demographic for “regret.”
There’s the assumption that we must protect these people from themselves.
There’s the assumption that we must protect ourselves from these people.
There’s the assumption that this population will become a more real terrifying reality as transsexuality becomes more commonplace and accessible: that they are coming, increasing.
There’s retransition to mitigate negative consequences of transition.
There’s regret due to the failure of retransition.
There are trans people who have stopped transition or even reversed somewhat and then started again–Jan Morris and Renee Richards are two examples; Richards even had a mastectomy at one point.
There are trans people who have gone back into the closet and then re-emerged, sometimes years later.
There are trans people who agonize over their decision for years or decades, in part because of fears of regret.
There are clinicians with evolving attitudes towards control, support, and authority.
There are official standards with evolving attitudes towards regret.