This story is from the comments listed below, summarised by AI.
Authenticity Assessment: Not Suspicious
Based on the provided comments, the account appears to be authentic.
There are no serious red flags suggesting it is a bot or a bad-faith actor. The user demonstrates:
- Deep, consistent medical knowledge of endocrinology and transition/detransition care.
- A coherent, long-term professional identity as a doctor who treats both transgender and detransitioning patients.
- Personal nuance and opinion, including admitting to autism, discussing professional mistakes, and expressing a non-political, patient-centered philosophy.
- Appropriate passion for the subject, including frustration with medical misinformation and the harm caused to patients, which aligns with the expected perspective of a caring professional in this contentious field.
The account's behavior is consistent with a real medical professional engaging with a community relevant to their practice.
About me
I'm a doctor who used to believe medical transition was the clear answer for gender dysphoria. I started seeing more patients wanting to detransition, which made me realize for many, it was a choice to cope with other issues like autism or social pressure, not a biological necessity. I was terrified I had caused harm, so I completely changed my practice to aggressively search for reversible medical causes first. Now, I help people detransition by restarting their natural hormones and reversing surgeries, offering a safe place for them to heal. I walk a difficult middle line, but I have to do what I believe is ethically right for each patient.
My detransition story
My journey with transition and detransition is deeply personal and complicated. I am a doctor who treats both transgender and detransitioning patients, and my own perspective is shaped by that medical experience, as well as my own neurodivergence. I am autistic, which I believe gives me a very direct, black-and-white way of seeing the world and the human body. I often refer to the body as a "meat sack" because to me, the real person is the consciousness inside the brain; the physical vessel is just the carrier.
I started my medical career wanting to help people with gender dysphoria. For a long time, I believed transition was a clear-cut medical solution for a specific medical problem. I saw patients, both men and women, who I believed had a brain structure that didn't match their birth sex, often due to hormonal issues during development. For them, hormones and surgery seemed to bring immense relief and were clearly the right path.
But over the years, I began to see a different group of people. My rate of patients wanting to detransition started to climb, from maybe one a year to one or two a month. This shift forced me to re-evaluate everything. I started to see that for some, transition wasn't about an innate brain-sex mismatch, but was a solution to other problems. I saw feminine gay men who had internalized homophobia and transitioned to escape societal pressure. I saw young people, especially those who are autistic like me, who were struggling to fit in and found an identity in being trans. For them, transition was a choice, often influenced by online communities and a lack of proper psychiatric gatekeeping, and it was the wrong choice.
This realization was terrifying to me as a doctor. The oath is to first do no harm, and I became paranoid that I might have inadvertently harmed people by approving them for hormones without digging deeper. I now believe there are two broad groups: those who have a biological, hormonal reason for their dysphoria and genuinely benefit from transition, and a larger-than-expected group who are doing it for psychological or social reasons and will likely regret it.
Because of this, I've completely changed my approach. Now, for any new patient, especially teens, I aggressively look for any underlying, reversible cause for their dysphoria before ever considering hormones. I check for hormone imbalances, genetic issues like MTHFR mutations, and other metabolic anomalies. I’ve had significant success, particularly with young women, by putting them on androgen blockers and other supplements to correct these imbalances; about half of them find their dysphoria resolves and they decide not to transition. I make sure any teen who does transition still gets normal genital development, because I think what’s been done to some kids with long-term puberty blockers is criminal.
My goal is no longer to affirm first and ask questions later. It's to ensure that transition is an absolute last resort, only after every other option has been exhausted. And for those who have transitioned and realized it was a mistake, I have made my practice a safe haven for detransition. I help them with the medical reversal process, using specific drug protocols to restart their natural hormone production and fertility. I also help them access surgeries like FFS or vocal feminization to reverse the permanent changes. I tell them there is no shame in changing your mind; trying on an identity and realizing it doesn't fit is a part of life.
I don't regret helping people who truly needed to transition. I've seen it save lives. But I deeply regret that the medical and therapeutic community became so afraid of being called transphobic that they abandoned their duty to gatekeep. The lack of rigorous questioning and the push for immediate affirmation has, in my opinion, led to a lot of the harm I now spend my days trying to fix. I walk a middle line, which makes me a target from both sides—the trans community calls me a transphobe and a Nazi, and the detrans community is often suspicious of me. But I have to be able to sleep at night, knowing I did my ethical best for each individual person who trusted me with their care.
| Age | Event |
|---|---|
| (Not specified in my comments) | Began medical career treating transgender patients. |
| (Not specified in my comments) | Noticed a rise in detransitioning patients, prompting a change in my approach. |
| (Ongoing) | Began aggressively searching for reversible causes of dysphoria (hormonal, genetic) before prescribing HRT. |
| (Ongoing) | Started openly offering and providing medical care for detransitioning patients. |
Top Comments by /u/Drwillpowers:
It's between 2 and 3% of my practice.
I've got about 3,000 transgender patients so that should tell you with a fair level of honesty how many I have detransitioned.
It is really not common. But it does happen.
I will say though that the rate that it is happening is considerably higher now than it was 10 years ago. 10 years ago I was detransitioning maybe one person per year. Now I'm doing one to two per month.
So while it is probably around the neighborhood of 1 to 2%, that's a shitload higher than it ever was.
I'm here because I care about treating people. I don't care about the politics of transgender anything. I care about my patients being happy and healthy and that's all I ever gave a shit about the first place. I do not take a political stance on transition or detransition. It's a medical problem, and sometimes people are misdiagnosed. As a result of that misdiagnosis, sometimes people are harmed by the treatment and I do what I can to undo that harm.
I do think that the level of detransitioners will continue to rise because of the complete lack of gates now in society towards transition. There are way too many people transitioning now. Way more than there should ever have been. And it's not just because of societal acceptance.
It depends on the situation for the individual human. It depends how far along in the transition they got. Someone need surgery, some hair removal, hormonally many of them are pretty screwed up and it takes me a little while to get everything back to normal. Restoration of fertility and normal function can take a while and sometimes has to be assisted with drugs.
Pellets are actually an interesting situation. They cannot be removed. If you were to go in there and try and find them, they're mostly a pile of mush. So unless they just got placed in like the past week or two, it's very unlikely that you'll be able to remove them. Typically I have to use SERMS or AR blockers.
Tell them today.
We don't care. We took an oath to do no harm. I would vastly prefer somebody tell me immediately that they were having doubts rather than just keeping on with something for months doing more damage if it's not the right thing for them.
I'm being a little more vocal about this lately because it needs to happen. I'm detransitioning too many people.
Transition is right for some, it is. It is a medical therapy for people that have a medical problem and need it.
It's not right for everybody, and some people will accidentally get it as a mistake in the same way that people accidentally get various plastic surgeries that they think they want and then after they get they are disappointed in.
Tell your doctor. It's okay. If they won't help you, find someone who will, like me. But if they are a doctor worth their salt, that they will be more than happy to help you.
This is the very reason why I started offering detransition care even to people I'd never seen as a patient.
I will say though in regards to this letter, if this is the endo, it's not really their fault. It's not our job to figure out whether or not somebody is appropriate for HRT. That's psychiatry's job. I do my best to try and catch the ones that slipped through psychiatry and shouldn't have, but it's not what I'm trained to do best.
But if this was their therapist or a psychiatrist, then they failed this patient.
This is my greatest fear as an endocrine provider, I rely on psychiatry and mental health to figure out whether or not these people really need this care or if they're improperly diagnosed. I just can't trust them to do this well anymore. There's too much affirmation and not enough gates at this point and people like this woman are falling through the cracks and then basically abandoned by the system that provided them this care.
Hopefully you find this useful.
Blockers if anything would have caused you to grow taller not shorter. I've had four Guinness world record cats and all of them were neutered at about 8 weeks old. There's a reason why.
Sex hormones close growth plates. So being on blockers that long would if anything make you taller. You just had bad height genes or malnourishment or took accutane or any other reason that can arrest height.
In regards to the genital development, I use a very low dose of a topical testosterone on the genitals of my teens with this problem and it's worked out fairly well. Usually about 0.25% testosterone once a week. You don't want to use a super potent testosterone or you'll get the same effect that puberty does. Rapid growth and then it's over. A growth spurt so to speak. Low and slow is the way to go.
Assuming you are off blockers and producing testosterone naturally, this may occur naturally on its own.
Take this with a grain of salt because it's just my clinical experience, but I've seen many many people in your situation.
So just anecdotally, those who start on a low dose and take a low dose for a long time, the larynx tends to tip forward and elongate before ossification which results in a much more natural sounding deep voice.
The transgender men whose doctors start them on very high doses of testosterone, like male physiologic levels instantly on day zero, this causes premature ossification of the larynx which results in that "We welcome you to the lollipop guild" voice.
I figured this out many years ago because those that came to me pre-masculinized, by having intersex disorders or whatever, they ended up getting better voices in the long run. Since that time, for my FTMs, I start them on much much lower doses. I also like to do this in general because it allows people time to feel how the drug affects their system, and how they feel mentally about transition. That way, it takes a few years until they really get to the irreversible point. This helps sort out some of the people who mistakenly decided to start testosterone for the wrong reason.
and to be clear, I support people in the subreddit who have detransitioned and I support people who choose to transition. I medically treat both to the best of my abilities. I'm a moderate on the topic. So I'm not going to be anti-trans here but at the same time I'm pointing out the fact that not everybody really needs HRT who has dysphoria.
This is probably about me.
I've commented on your posts before.
I'm well aware of who your therapist was. And I don't work with them anymore. I'm not even sure they are still licensed. We don't speak.
My job is to do what I do as an expert in hormone management. I do not do the psychiatric clearance. I rely on mental health providers to do that because that is not my specialty.
Once somebody comes to me with a the psychiatric clearance, And they tell me this is what they want, it's my job to help them do that safely.
You don't even have to do the psychiatric clearance in most places anymore. It's something I look into carefully with the people that start hormones with me. Particularly young ones. For children, the level of scrutiny that they have to go under makes them rarely ever my patient. I'm sort of meticulous about this. Mostly to prevent eventualities like this.
In the same way that I participate in those trans communities, I'm very active in the detrans and other subreddits. If you weren't aware of it, there's a large amount of hatred for me in those communities simply because I speak here as well.
I am assuredly not part of the whole political movement. I never have been. I'm autistic and pretty much neutral on it. I don't really care much for being politically correct. I openly detransition people as much as I transition them. In fact as far as I'm aware, I'm the only doctor that openly admits to doing this. It's not my job to decide if transition is right for somebody, but ultimately, it is right for some, and it's not for others. For those who made a mistake, I do my absolute best to reverse whatever it was that occurred to them to the best of my ability. I'm currently trying to get a paper published on transgender fertility restoration. It's a specialty that I've sort of mastered to try and get people back the fertility that they had before they started hormones.
Additionally, if you read my subreddit, I've been trying to figure out the causes of why people turn out to be transgender, and I've been lambasted lately for discovering that there are certain ways to correct some of the hormonal or other anomalies that some people have that causes their gender dysphoria to go away.
I particularly try and do this in children, to prevent a kid from having to transition who otherwise wouldn't have to if I could correct the underlying metabolic anomaly. In short, I think that transition is something that's deeply personal, right for some and not others, and should be considered as sort of the end boss of going through the whole process after other alternatives have failed. I have made posts on the subreddit to this effect. Again as far as I know, I am the only doctor to ever come here, and offer to be yelled at and explain how I try and help people detransition.
I'm sorry that things worked out for you the way that they did. I would be happy to see you again and help you as much as I possibly could. Because that's just what I do for a job. That's what I tried to do when I saw you for the first time I'm sure. That's what I do for everyone. Not violating HIPAA there, as genuinely, if you were my patient, I know that I did my absolute best to help you to the fullest of my ability as I do for everyone.
As far as YoumaCon goes which is what I'm sure you're probably referencing, I'm just a weeb dude. I love anime and video games. I've been playing tears of the Kingdom in between seeing patients. Lately I've been catching up on the more recent seasons of My hero academia and trying to figure out if I want to make a different cosplay this year than Cloud Strife. My office is themed around video games and anime. Literally each and every room is decorated around a particular series. A lot of times doctors get looked at as these sort of ultra-professional humans that exist only inside of a concrete box with artificial lights that tell you what you can and can't have. I'm not that. I'm a real person. I hope you wouldn't feel uncomfortable going to that event knowing that I would be there, because honestly, if you came up to me, I would want to do nothing but give you a hug and tell you that I'm sorry that things didn't work out for you. I would want to help you as much as I could. That's my genuine feelings on the topic.
Over stuffed kielbasa, but yes, that is a quote of mine. when the corpora cavernosa do not atrophy but the skin does, and you get an erection, there literally is not enough skin to deal with the expansion and it causes pain and skin splitting.
I don't speak with the usual decorum of the doctors that you may encounter simply because it's not effective in talking to regular people. Sometimes people who are so used to that decorum are unable to recognize that I'm just trying to talk to them like my peer instead of down to them.
Also your body is just a meat sack. Everything that is you exists inside of your head. You are a bag of thinking meat. The real person exists in collectiveness of the neurons inside of your brain. Everything else is just meat. It could be swapped out and replaced and it wouldn't matter. But what really would matter is losing a piece of yourself aka your brain.
What was the reason you wanted to go on it in the first place?
What made you realize you had made a mistake?
If you don't mind me asking. No worries if you don't feel like answering. I'm just trying to phenotypically recognize what makes you different from other people and hear some stories so that I can recognize it better and be a better doctor.
Bicalutamide is approved for treatment of female hirsutism in europe.
Studies are currently being done on bica in the USA to get this approval from the FDA. It is commonly used off label.
https://pubmed.ncbi.nlm.nih.gov/11915584/
That being said, if you think that using a drug off label is "concerning" then I have some bad news for you. Literally, the majority of doctors are writing 20% of the drugs they write off label.
This is the sort of culture of medicine stuff that people do "cursory research" on and make opinions about when they lack the foundational understanding of how medicine as an institution works.