No, Transition Regret is Not Like Regretting a Tattoo

The duty of a doctor providing health care is not equivalent to the duty of an artist providing a one-time service.

When talking about regret, detransitioners are frequently faced with the argument that they knew what they were getting into, it’s their own fault that made a “mistake,” and that regretting hormones or surgeries is exactly like regretting a tattoo or a piercing.

The only thing that transition and tattoos/piercings have in common is that they are forms of body modification, and both generally require the person receiving the modification to sign a consent form stating they understand the risks.

The comparison fails when one considers that hormones and surgeries are offered as forms of health care to treat a condition (gender dysphoria). Meanwhile, tattoos and piercings are purely aesthetic and are relatively reversible.

Piercings close up, and tattoos can be removed, even though the procedures for reversing the modifications aren’t perfect. For example, I had two lip piercings (“snake bites”) that I ended up taking the jewelery out of. (I did want the piercings, but my body did not, and my lip was constantly aching.) So the holes closed up, but there are permanent indents under my lip.

I actually also have a tattoo that I regret. The tattoo is on my back, and I got it done a couple of weeks after my first shot of testosterone. It reads “done lying for a living” which are lyrics from a song that I like, and it was ironically meant to represent starting my “authentic” life (as a man). Why I regret it now should be obvious.

I could get it removed, but since I like tattoos (I have other ones), I’ll probably just have it covered up with another tattoo when I have the money. And it’s on my back, so I usually just forget that it’s there.

But when I compare that tattoo to the hormones/surgeries that I underwent, the “regret” as it relates to my tattoo and the “regret” as it relates to the irreversible changes that hormones/surgeries did to my body aren’t even close to the same thing.

So why don’t I blame my tattoo artist the way that I place blame on my doctors? This should be obvious.

My tattoo artist’s job was to put ink on my body; the result being that I have a tattoo at the end of it.

My doctor’s job was to provide me with health care and to “first, do no harm”; the result being that my distress around my gender is relieved with the care I am offered.

My tattoo artist did his job. My doctor did not.

I’ve said before that it was easier for me to get hormones than it was for me to get ADHD medication. A prominent trans activist once told me that it was because “hyperactivity isn’t a protected characteristic.” This makes the argument quite clear: trans activists believe that it is their human right to access hormones and surgeries and that any form of safeguarding (e.g., psychological assessment) to ensure that they won’t regret their decision interferes with their bodily autonomy.

But access to controlled substances (e.g., hormones) is not a human right. We aren’t allowed to have whatever we want, whenever we want, especially when the things that we want come with extreme health risks and few long-term studies. It’s even more sketchy when your entire reasoning is based on “because I said so” with no way of empirically determining whether someone actually needs hormones or not (i.e., we can’t do an MRI scan to determine who is “truly” transgender). Trans-identified patients are the only people who can essentially prescribe their own treatment and claim bigotry if their doctor doesn’t comply.

Regarding the claim that “you knew what you were getting into.” Yes, of course I knew that my surgeon was going to remove my breasts and that I would never have them again. When I had my hysterectomy, I knew that I would never be able to get pregnant. The problem is that the medical professionals who arranged my surgeries were authority figures whom I trusted, and they led me to believe that those surgeries were the best chance I had at relieving emotional distress around my gender. They were wrong, and now I must live with the consequences — which is that my flat chest and infertility cause me distress even worse than the dysphoria.

The existence of detransitioners makes it perfectly clear that having absolutely no form of safeguarding has the potential to do incredible damage to vulnerable people who were under the impression that their doctor was providing them with health care — not an aesthetic body modification.

The comparison between medical transition and tattoos/piercings erases all nuance when it comes to the subject of regret. It ignores doctors’ duty of care to their patients, which is nothing like the duty of an artist providing a one-time service. It ignores the potential for intense long-term risks when it comes to hormones (which are a controlled substance for a reason). It ignores the fact that medical transition “regret” is a lot closer to grief and mourning than regretting a tattoo or piercing that you don’t like anymore.

I lost my voice, my breasts, and my fertility. I will never get those things back.

I might not like the tattoo on my back anymore, but the feelings I have towards my tattoo are not even close to the pain of medical trauma.