Regret and Detransition: A Rapid Review of Nih's Politicized Turn and Its Implications for Health Equity in Transgender Care and Research

Background and Purpose:
In early 2025, the Trump administration directed the National Institutes of Health (NIH) to prioritize research on “regret” and “detransition” following gender-affirming care, while simultaneously canceling over $180 million in transgender health research. This abrupt redirection reveals how federal science policy is increasingly shaped by ideological mandates rather than population health needs. This rapid review explores how “regret” has been constructed in transgender health literature, interrogates its deployment within shifting federal priorities, and examines the implications for research infrastructure, whose voices are seen as credible, and transgender embodiment within biomedicine.

Methods:
Using a rapid review approach, two reviewers independently analyzed peer-reviewed studies from 2010–2024 sourced from PubMed, PsycINFO, and Scopus, focusing on relevant and derivative keywords, including “gender transition,” “regret,” “detransition,” and “gender-affirming care.” Inclusion criteria prioritized empirical studies— such as peer-reviewed articles and book chapters—reporting on regret or detransition outcomes. We excluded grey literature and non-empirical commentary. The review focused on how regret and detransition are framed in transgender health research, particularly in relation to recent political discourse that characterizes these outcomes as widespread or inevitable in gender-affirming care. To further contextualize shifts in the research landscape, we also reviewed NIH policy announcements, funding, opportunity descriptions, and grant data to document discursive and institutional shifts in federal priorities. A critical interpretive synthesis approach guided our analysis, with particular attention to structural and ideological influences.

Results:
Findings reaffirm that regret after medical transition is exceedingly rare (<1%), and most often emerges from structural conditions such as familial rejection, stigma, or inadequate follow-up, not from the transition itself. Detransition is similarly non-pathological and frequently temporary. Yet the federal directive’s emphasis on regret— paired with stigmatizing language such as “mutilation”— reflects a deliberate reframing of transgender embodiment as inherently harmful. This shift consolidates organizational sensemaking around a narrow, pathologizing framework that marginalizes affirming scholarship, silences trans researcher voice, and disables funding pathways for justice-informed science. More than 180 previously funded NIH grants were terminated in late 2024 and early 2025, generating gaps in research on intersectional mental health, social affirmation, and community-led interventions.

Conclusions and Implications:
This politicized reframing of transgender health research constitutes a retraction of scientific legitimacy from trans people’s embodied experiences. The singular focus on regret obscures the robust evidence base demonstrating the protective mental health effects of gender-affirming care. Currently, the NIH’s redirected agenda constructs transness as a site of biomedical instability and organizational risk rather than resilience or autonomy. Social work researchers are uniquely positioned to push back against this narrowing of scientific inquiry by conducting research that centers on community voices, addresses structural inequalities, and prioritizes social justice. This moment calls for collective action not only to reclaim the narrative but also to preserve conditions under which trans scholarship can thrive. Our findings underscore the urgency of safeguarding inclusive research infrastructure and resisting ideological interference in knowledge production.