Fetishistic Transition: A Detransitioned Man’s Case Study 

Note: This article discusses explicit fantasies. Reader discretion is advised.

This is the concerning story of a young male-to-female (MTF) transgender woman with autogynephilia (AGP) named Ethan who has recently detransitioned. His name and identifying information have been changed for anonymity, and I want to thank Ethan for sharing his story.

As a child, Ethan was gender non-conforming, and his authoritarian, conservative father took immediate notice. His father, who Ethan now believes has an undiagnosed narcissistic personality disorder, was emotionally and psychologically abusive to Ethan and his family from a young age. His father made frequent denigrating comments about Ethan’s effeminate tendencies and did other psychologically manipulative and abusive behaviors that caused Ethan to not speak to him from the ages of 15 to 16 even though they lived in the same house.

Apart from the effects of the abuse on his self-esteem, Ethan was a bright, average American boy in most ways. But at age 11, while looking at a Victoria’s Secret catalog, he had his first experience of viewing himself sexually as a woman. While looking at the women in the catalog, he felt like he wanted to be those women and imagined what it would be like if an older girl started instructing him on how to be a sexy woman. He imagined if he was taught how to “be sexy for men”, visualizing getting attention from older men, including his father, for the provocative displays he imagined. Around 12, he tried on his older sister’s thong, stealing it to wear many times. He said wearing the thong was “the most powerful feeling I’ve ever felt.”

At age 15, when he got his first iPod Touch, he discovered online porn.  He started off with softcore sex scenes on YouTube and reading written erotica on nifty.org. The subject matter of these erotic stories always focused on elements of forced submission and obedience. Many were about teens and young boys getting raped by a pack of wolves and having to submit to the pack. Soon his preference became “forced feminization” stories, where a young boy would be forcibly coerced into becoming a submissive, “sissy” for older males. The narratives would involve a gradual progression of feminization in which older men would physically force or emotionally manipulate the boy into taking estrogen pills or shots, being castrated, and having to unwillingly submit to the feminization process.

The older males would make sexually demeaning comments about the boys’ feminized bodies, and they would sometimes wake up suddenly without a penis or testicles, having had a vagina surgically created without their knowledge or consent. The young boys would be forced to wear women’s clothes, makeup, wigs, bras, and thongs to the liking of the older man to “turn him into a woman.” If the male genitalia wasn’t surgically removed, it would be mostly ignored and the focus would be on engaging in forced anal sex or pleasuring the dominant male.

Around this time, Ethan had a female romantic partner who would comment that he was “very metrosexual” due to his effeminate behavior. He didn’t mind borrowing his girlfriend’s clothes and wearing them, and he was still wearing thongs and masturbating to the thought of being a woman. During high school, he also had confusing sexual tension with his close male friends, one of whom was straight, the other bisexual.

Around 19 Ethan began watching “hypno sissy porn”— hypnotizing videos and gifs of forced feminization with flashing text that encouraged boys to submit to being turned into women. Throughout his teen years, he had been smoking marijuana and cigarettes and drinking alcohol, but when he was around 19, these behaviors escalated, and he tried psychedelic mushrooms and LSD. The combination of the increased risk-taking behavior, drug use, and porn inspired Ethan to impulsively buy estrogen from Amazon.com. He didn’t think it would really work since it was from the internet, but he was curious whether it could help him feminize and didn’t care either way what happened because he “wanted tits and ass for the boys.”

He bought a product online called “Major Curves” which was supposed to increase butt size, and within a few weeks began noticing effects. After a few months, Ethan saw that his butt was growing “fuller and rounder”, and his hips looked like they were widening due to fat redistribution. He began to feel depressed about being “disfigured” because he had been athletic and skinny before, but now felt too fat and regretted the feminization. Despite his shame, he continued to take estrogen and other drugs on and off because it was sexually gratifying, but he inevitably went through cycles of pleasure and shame. His testicles “felt like they were dropping and un-dropping”, and he felt scared at what was happening, but he “mentally felt more feminine” and started accepting the feminization and being a woman.

He wore women’s clothing at home, but always dressed in men’s clothing in public. He escalated his sexual gratification by going on the subreddit r/traps where he would upload nudes and provocative photos of himself as a trans woman to get compliments from men. He loved the positive attention he received from men online who would constantly send him messages, compliments, and ask to meet, although some of the men were clearly predatory and pedophiliac. He got a lot of validation for being a trans woman when he went on the anonymous live video chat service Omegle.

Around age 21, he was in and out of college, smoking pot and drinking every night, and growing mushrooms for personal use in his father’s house. During his mushroom trips, he experienced intense “ego death” where he would turn off all the nights and experience a psychedelic trip in total darkness, leading to an experience he described as “simulated sex”— a visceral fantasy of himself having sex in a female body. “In my mind’s eyes I was very much a woman…it was magical,” he said. At college he gained a lot of weight from drinking and began having symptoms of a binge eating disorder. His feminine curves turned him on and he would masturbate to himself in the mirror, but then feel ashamed of his overweight body.

On 4chan, he learned that if you take your off-label hormones from the internet to an endocrinologist and tell them you’re already on them, they will prescribe you the real testosterone blockers and estrogen. Due to fear of needles, and his alcoholism, Ethan was often sloppy with taking the drugs, and because the estrogen he was ordering online came in small glass ampules which needed to be broken open to get the fluid into the syringe, bits of broken glass would often end up in the fluid and he would inject it into his body. Many of the drugs were also expired, and Ethan had little knowledge of what he was taking.

When he visited the doctor, the endocrinologist did not question the safety nor source of the off-label drugs and gave him the estrogen and t-blocker prescriptions he was seeking. By age 24, Ethan was now taking regular estrogen shots which sped up the feminization process by giving him softer and smoother skin, larger and more sensitive nipples, and more developed breasts. People viewed him as more womanly, but he experienced increased mood swings, crying spells, and decreased libido. He also developed low blood pressure, leaving him feeling chronically weak and fatigued. When questioned by the endocrinologist about his low blood pressure, Ethan lied about his severe symptoms to ensure that his estrogen dose would not be lowered.  

He was “grossed out” by his weight. In an attempt to avoid gaining any more, he began intermittent fasting and chewing food but not swallowing it. At 24, he had legal trouble due to his alcohol use and stopped drinking. Regarding his transition and future, he says that he was “hopeful to look like a woman someday and live as a woman in the near future” but he was “still in a childish mindset and wanted to magically look like a woman.”

He briefly saw a therapist because he “just wanted to talk to someone,” but he felt hurt when she did not affirm his trans woman identity and instead suggested that he might be homosexual. He was offended that she didn’t believe that his hips were widening, as he was determined to believe they had, and saw her for only two months. At 24, he saw another therapist who did not specialize in gender dysphoria but “was leftist” and affirmed his transition and helped write his prescriptions.

At 25, while working as a customer service associate at Walmart, Ethan was groped repeatedly by a female manager. He was also groped and sexually harassed by several male customers, and he felt like he “was a borderline sex worker the way people would interact with me. It made me feel like I needed to take a shower.” Ethan had been sexually exploited and felt deep shame, self-loathing, embarrassment, and anxiety when at work or in public. He felt like people were constantly judging him and he was fixated on whether he was successfully passing as a woman or being rejected for being trans.

When the COVID-19 pandemic hit, he took time off from work and set a goal of trying as many different drugs as possible. His drug repertoire included weed, LSD, shrooms, amphetamines and methamphetamines, a variety of benzodiazepines, Valium, the psychedelics 2C-B and psilocybin mushrooms, Ketamine, dozens of research chemicals, Adderall, Ambien, cocaine, fentanyl, DMT, GHB, alcohol, and continued on-and-off use of estrogen, testosterone blockers, and butt lift. Even amidst his drug abuse, Ethan decided he never wanted to go back to Walmart and committed to finishing his college degree online. He began feeling proud of himself for the first time in a while, but he still felt incredibly sad, too — not to mention traumatized from the sexual abuse and harassment he received at work.

By this point, although he had changed his name and pronouns and was wearing more feminine clothing in public, Ethan still felt like he didn’t pass. He had major voice dysphoria, and it was worsened by having to wear a face mask. Being preoccupied with drugs and college, he burned through his savings and continued to “prioritize drugs over food.” This chaos meant he could not focus as much on the transition. During this time, he isolated himself from all his online interactions for trans or fetish materials, and had a decreased sex drive. He isolated himself and started considering detransition “for pragmatic reasons” such as a lack of respect, challenges passing, possible impact on his future career goals, and regaining male privileges.  “Accepting that I wasn’t a woman; I just wanted to be one,” he says, led him to detransition.

Now, at 27, he is close to finishing his degree, has quit Walmart, and has been detransitioned for 6 months. He is cutting back on his drug use and plans to get sober. He has stopped taking estrogen and testosterone blockers and has gone back to using male pronouns, presenting as male in public, and using his male name. He is unhappy about the return of oily skin and acne from increased testosterone levels and reports an increased sex drive. He is considering visiting an endocrinologist to assess his hormone levels but has not yet been to a physician or received mental health treatment for detransition, addiction, or trauma.

This case study is a worrying example of what can happen when medical transition is easy to access and normalized in casual conversation in online spaces.  It’s why we need to talk openly about autogynephilia and other paraphilias of male sexuality. Ethan now has female breasts, potentially impacted fertility, and years’ worth of psychological trauma from sexual harassment, an identity crisis, and comorbid mental health issues that were neglected while medical treatment was conveyor-belted along with no regard for his history of childhood abuse, eating disorders, or drug abuse.

Ethan has severe levels of shame for his paraphilia and transition. This is worsened by the knowledge that most who might be compassionate to female detransitioners are not so when it comes to the confounding transition variable of AGP in males. Ethan has not sought support online due to fear of judgment for AGP and has not yet pursued a therapist because he is skeptical that clinicians would understand his paraphilia or situation. He believes that AGP is a fundamental part of his sexuality that he cannot control and considers himself bisexual. He laments that if he could pass as a woman, he would likely still be trans, but he has accepted that this is impossible.

I wanted to write this story because I have known Ethan for several years and have seen his issues firsthand. Ethan has never been diagnosed with any mental health disorders nor received proper treatment for his mental health besides medical feminization. It is my belief that he should be screened for C-PTSD, substance abuse disorder, body dysmorphia, and anorexia, depression, and anxiety. It is unknown whether childhood abuse contributed to his autogynephilia, but it seems clear that the abuse from his father contributed to his self-destructive behavior and self-disregard across his lifetime, including the reckless and impulsive use of drugs like estrogen.

In some narratives, a trans woman like Ethan would not be questioned at all; in fact, his endocrinologist suggested to him at one point that he remove his testicles because of the production of testosterone, with no regard for the psychological effects of his past, incredibly unhealthy state of his present, or his potential success in later life.

This should not be happening.  

There are dozens of stories shared online by detrans males who were once vulnerable boys like Ethan, who have been exposed to internet pornography and groomed by older male pedophiles, only to become fixated on escaping their male experience and trying to achieve an unobtainable reality as a woman. Ethan was delusional about what taking hormones would or would not do for him. He mindlessly went along the transition process, encouraged by a plethora of substances, online fetish communities, doctors, and his own subconscious self-loathing stemming from psychological abuse.

Although AGP is a contentious subject of debate, we need to examine the paraphilia critically and think dialectically about its impact on young boys and men, the effect on the rest of society when those young boys and men declare that they are women, and the role trauma plays in male transition.