Search Engines, Algorithms, & Detransition
A closer look at how search results differ between Google and DuckDuckGo
Introduction
With the most recent closure of the Tavistock Gender Clinic, Maya Forstater winning her case that “gender critical” beliefs should be protected under the Equality Act, the ongoing trial of Kiera Bell and potentially thousands of other families’ of children taking legal action—it has become clear that the tide is turning for transgender healthcare and legislation in the UK. This is also the case in France, Finland, and Sweden. In the US, the FDA has issued a warning against the use of puberty blockers, we are beginning to see detransitioners and transsexuals testifying that it is not possible for minors to provide informed consent with these experimental medical practices, especially as the trend in detransitioners telling their stories continue to rise. Even Dr. Marci Bowers, a transsexual surgeon who has performed around 2,000 vaginoplasties, including Jazz Jennings, is raising concerns. Some are predicting that we are on the precipice of a large wave of detransitioners in the coming years, which likely means more lawsuits. The medical establishment has already profited so much off of individuals seeking gender care services, and because of this, there is a much more cynical prediction of a “detransition industrial complex” and devastating predictions of suicides. We are already beginning to see hints of professionals in the gender industry pivoting to include detransitioners. The future of the trans community will likely be the voices of the detransitioners that have been previously silenced.
This has been a very contentious issue being censored in various ways, such as journalists being removed from Twitter for “misgendering” someone, the banning of books on Amazon, and most famously, the public defaming of J. K. Rowling. In the time of covid era politics, our first data-driven pandemic and the rise of a social media infodemic, it is easy for individuals to find themselves consuming misinformation and propaganda, or even entirely blocked out of objective and credible data. For example, searching the same subject in different search engines can provide very different results. Though most people have become much more technologically literate in the last generation, many still have very low data literacy or research skills. Additionally, with the rise of new media such as podcasting and peer-to-peer information (Reddit, etc), we have entered a new age of accessing information and are beginning to see the effects this has on society. In this article, I would like to demonstrate what happens when seeking information on the subject of detransition compares between different search engines and take a closer look at the difference in results.
What is detransition?
Detransition is when a person that previously sought out medical interventions in order to present their gender as the opposite sex, decide to stop these medical interventions, and revert their gender presentation back to their birth sex. These medical interventions might include cross sex hormones, surgeries, and puberty blockers. For those on the r/detrans Subreddit and the detrans discord, which are the primary places that the growing community of detransitioners use to communicate, it is also described as “a process, and detaching from an ideology/mindset”. Depending on how far they have gone into medical transition and for how long, this process can be difficult. This might also mean legally detransitioning, an often expensive bureaucratic process to revert their legal identity and documents back to their natal sex and/or birth name. Some may seek out more medical interventions to reverse the often irreversible effects that medical transition has had, whether for cosmetic or for health reasons. Some may even have irreversible, long-term damage and health risks. For those that have gone far enough into the medical transition process and no longer have the option to medically detransition, might consider themselves psychologically detransitioned, meaning that they no longer hold the same beliefs about their identity that they had at the beginning of their transition, yet for practical reasons (to avoid further medical trauma/cosmetic alterations, or their bodies are no longer able to naturally produce hormones), continue being a medically transitioned person. Medical transition is also a very heavy medical burden, with many potential risks for one's health (osteoporosis, bone density loss, infertility, vaginal atrophy, erythrocytosis, incontinence, surgeries with extremely high complication rates), and has little evidence that it results in positive outcomes or lowers risk for suicide. It is reasonable for an individual to seek other methods or treatments for gender dysphoria, as to avoid being a lifelong medical patient, and it is unfortunate that transition is often presented as the only option (ie. “would you rather want to have a dead child or a trans child?”).
Upon transitioning, some thought that this would resolve all their problems. Many feel harmed by the healthcare system that did not question their motivations or examine why they might be experiencing gender dysphoria. In many cases, they may have overlooked co-morbidities causing them to seek medical transition in the first place such as autism, OCD, ADHD, and eating disorders. Some have even noted that transition made their symptoms worse, and when detransitioning they lacked clinician support. There are not many long-term studies on medical transition, let alone long-term studies on childhood or adolescent transition. There is also evidence that about 80% of people that experience gender dysphoria as children, outgrow it during puberty. What used to be watchful waiting, is now the affirmation model. It is unknown what the long-term ramifications of these new healthcare practices will be to individuals' long term mental and physical well-being. However, the recent increase in detransitioners may be a sign of what is to come.
Misinformation & detransition
Detransition is usually described as people repressing their true identity, or pausing hormone replacement therapy, to later retransition. While there may sometimes be situations where a person detransitions due to being in an environment that is prejudiced against gender non-conforming individuals, and later retransitions when they feel they can do so again safely, it is also a dishonest representation of what it means for an individual to break away from a set of beliefs that are tied to the socially or medically transitioned identity. Of the studies that do take the possibility of detransition into consideration, the sample population is usually taken from people from within the trans community that are still trans-identifying. This is not an accurate representation of detransitioners, as detransitioners that no longer hold the same beliefs in gender identity, will usually leave the trans community, and sometimes even be rejected by their peers that still hold the same beliefs.
There are also claims that detransitioning or people being unhappy with their transition is very rare. The reality is that it is extremely difficult to know the rate of detransition because most detransitioners do not return to their providers, as providers are currently ill-equipped to appropriately serve their needs. There is also very little evidence that medically transitioning has long-term positive outcomes, especially because many of the studies that have been conducted have high drop out rates. Some have noted that many of the current studies being conducted have an ideological bias, and have a reasonable distrust in the medical establishment. Researchers have also found that when individuals decide to detransition, most seek advice through online networks and communities instead of clinicians.
It goes without saying that the discussions around childhood transition and adult transition will and should be different. It should also be considered that the demographics of people seeking transition has also shifted dramatically in recent years, from mostly young boys and older men to a vast increase in teenage girls. There may be an image that detransition is something new, or is only happening to young people. While we are seeing more of this phenomenon today, it is likely because medical transition has become more common and public, especially with the use of social media. However, there have been individuals that transitioned in previous generations to also experience transition regret or transition ambivalence.
“The Algorithm”
It is a common census that there is something sinister about the algorithm. My interest in this subject likely began because of the algorithm. The YouTube algorithm, to be precise. Ironically, it is the same algorithm that allows many trans-identifying youth to begin learning about the possibility of transition, as social media often plays a large role in the lives of trans-identifying youth. During the pandemic, like so many others, I began watching YouTube more regularly, clicking on recommended videos and falling into various intellectual rabbit holes. Going on random internet research binges and anthropological explorations online were not new to me, I have been interested in the sociology of the internet for some time now. I was working on a master’s degree in information studies and taking many courses in medical librarianship and health science information. If you’re not familiar with this both niche and broad discipline: there is a heavy focus on data science, evidence-based practice, information and user behavior. During this time, I was also working as a research assistant for a team focusing on misinformation and coronavirus in the Canadian media, where many of the team’s studies were analyzing data from social media. Perhaps this new focus in my life is why my algorithm veered me in this direction, I can only speculate.
I cannot remember the exact order in which things occurred but a Jordan Peterson video was recommended to me, I clicked on it out of curiosity. I was a bit surprised (and confused) that I did not disagree with everything he was saying. I was told by the Canadians that he was a nazi. Abigail Shrier and Debra Soh’s Joe Rogan interviews appeared. I was immediately disturbed to learn that doctors and clinicians were being censored and felt they could not adequately do their job because this issue was so politicized. I also did not know that childhood medical transition had become much more available in recent years, and was pretty shocked by how volatile the discourse and dishonesty around these treatments were. It does not seem that we are hearing about it much at all, and if we are—there is a whole other side and many layers to the conversation. From there I began listening to heterodox transsexuals such as Buck Angel and Blaire White who are also critical of childhood transition. Eventually, I was binge-watching videos of detransitioners, interviews of the top psychologists working around this topic (Ray Blanchard, Kenneth Zucker, Michael Bailey, Anne Lawrence, James Cantor, Sasha Ayed, and Stella O’Malley to name a few), as well as endocrinologists and other researchers focusing on this subject (Dr. William Malone, Dr. Lisa Littman, Carole Hooven). I also recommend learning about Dr. John Money, who was one of he first doctors to integrate ideas of gender roles and identity into his practice, and was responsible for the childhood transition, and consequentially, the detransition and eventual suicide of David Reimer.
I would be curious to know the exact path in which YouTube’s algorithm brought me to this issue, but until it did, it was as if there was an invisible barrier preventing me from hearing this information. I often wonder if there will be a moment in the future similar to when the Berlin Wall fell and we will no longer be living in information apartheid. The algorithms used online function beyond just recommended content, they also determine which content appears when one seeks it out.
Algorithms & search engines
Social media and search engine algorithms are a way that these platforms sort through information and organize it in such a way for a user to access within their news feeds, suggestions, and searches. This means that they will determine what information a user is more likely to see first, and therefore what information they are more likely to consume. Most social media algorithms function on suggesting the most relevant content to our current or previous searches, as well as most viewed content by other users. Neither of these criterias necessarily mean that the information suggested will be more accurate, and certainly does not mean it will be unbiased. While this seeks to personalize users’ experience, it will also often show a one-sided view of a topic. As a consequence, it has not only increased political polarization, but it has also shifted society’s cognition.
Not all algorithms are made the same. Well-known search engines will often produce different results for the same search. This is certainly the case when considering a controversial and often censored topic, such as detransition. I will now demonstrate how a search of the word “detransition” differs between Google and DuckDuckGo. I will screenshot the first pages of each search and then provide a qualitative study of these results. It should also be noted that I will be conducting these searches in English, with my iPad geography set to the US. However, I am currently located in France, which could also influence my results.
The first result on Google is Wikipedia, which is an online encyclopedia written and maintained by a community of volunteers. While Wikipedia can be a good source for a generalized knowledge of a topic, in order to begin a research process, it is not considered a credible source by information professionals. In its inception, the goal of Wikipedia was “neutrality”, since then Larry Sanger, one of the creators has even said that he no longer trusts the website he created due to its ideological bias. A “credible source” is usually considered academic or commercial publications, while materials outside of this criteria such as news articles, reports, and government documents, are considered “grey literature”. By these measures, most results from any search engine would likely be considered grey literature.
After the first result, we see a list of most common questions asked relating to the subject. It is important to note the source of their answers. When looking at the answers regarding the rate of detransition, we are provided with an out of context statistic. As previously stated, it is very difficult to know the exact rates of detransition due to a number of reasons. Similarly, the answer to whether people regret transitioning, states that it is only a minor population that experiences regret. Though the source to this answer is from a systematic review, we would have to take a closer look at the details of the populations being studied. Again, while scholarly research is considered the most credible information, we also know that many of these studies taking detransitioners into account have high drop out rates, as many detransitioners do not return to their providers, and instead often detransition independantly and in private. These answers show a skewed perspective at what we currently know about detransition.
When scrolling down further, questions are asked about the irreversibility of medical transition. While the answer to whether top surgery is reversible is accurate, ie. it is not reversable, the answers regarding puberty blockers and hormone replacement therapy are not the most honest. Depending on how long one is taking cross sex hormones, effects are not fully reversable and infertility is a risk. Particularly in the case of natal females taking testosterone, hair growth and voice changes will not be reversable. While not enough is known about the long term effects of puberty blockers, there is evidence to suggest that they affect longterm sexual function, fertility, bone-density loss, as well as brain function, as they not only stop physical development, but also brain development.
Scrolling down further, we continue to find out of context statistics, the accuracy in how those statistics were founded can of course be debated. There is an NBC News article about how discussions of detransition are fueling misconceptions about trangender… Next there is what might appear to be the first formal study on the factors causing detransition. Then there is an article by Fenway Health suggesting that the most common factors contributing to detransition are stigma, discrimination, and family pressures. There is an article published by Stonewall “dispelling myths around detransition” and that detransition does not necessarily mean regret. Their bias is clear, as they are one of the leading organizations in the lobby pushing for affirmation, self-ID, and transgender medicine.
Finally, at the bottom of the page of this search, we are offered results from SEGM (Society for Evidence Based Gender Medicine) and Transgender Trend (with a Psychology Today article and the French Wiki on this subject in between), two organizations seeking for a more nuanced look at what is currently known about medical transition and gender dysphoria, and offering information and support to parents, academics, and individuals that seek alternative information than the current bias of the affirmation perspective.
DuckDuckGo
Similarly to Google, the first thing that appears on DuckDuckGo is the definition that can be found on Wikipedia. However, the first result is Detrans Voices, a resource for those that have detransitioned or desisted from transgender self-identification and an organization that is led by two desisted and one detransitioned women. Following this is the Wikipedia article and then an article by SEGM.
Scrolling down, we are suggested a source from GenderGP, which offered some out of context statistics on my initial Google search. Then there is a Substack article by Parents with Inconvenient Truths about Trans. Next there is an article by The Stranger that appears to reference how the shift in identity might contribute to an individual detransitioning, as well as the health risks involved in medical transition. After this there is another article by Detrans Voices.
There is a Daily Wire suggestion, a conservative source, posting first-hand accounts by detransitioners. Finally, at the bottom of the first page of results we are suggested the r/detrans Subreddit, which as discussed previously, is a primary place where detransitioners communication with one another and seek help in their process.
Discussion
When comparing the results between Google and DuckDuckGo, it is clear there were more news articles in the results from Google. While on DuckDuckGo there was more likely to be suggestions from organizations in support of detransitoners, as well as more resources offering first-hand accounts from detransitioners themselves. Google also had more of an emphasis on showing related questions asked in searches by other’s, though many of the answers to those questions can be disputed and further questioned. Google was also more likely to show statistical information. While it is a quick and convenient way to get data on a subject, this kind of information requires context to get a full understanding. While it is true that data is objective, the context in which data is gathered and/or is displayed can often be quite subjective. The difference in the order of results should also be considered, results from organizations with any focus or sympathy for detransitioners were much fewer and more likely to be at the bottom of the page on Google. While Google was the only one that had any non-grey literature results, it was still extremely few.
There were also less results on the first page of the DuckDuckGo search. This could be a difference in design and user-experience, or it could be because unlike Google, DuckDuckGo does not show search results from content farms, ie. companies that employ freelance writers to produce a large amount of (often low-quality) content in order to influence algorithms for the purpose of generating advertisement revenue. As a consequence, I experienced a lot less information overload while using this search engine. The difference in information provided between these two platforms is concerning, particularly because Google is the primary and default search engine for most people. While a lot could be speculated about why this is occurring for this issue in particular, we should always be skeptical about too much conspiracy-like thinking. However, I do believe we need to question further the industries that are profiting off of the bias and censorship of this divisive issue.
I would also like to mention that I have previously compared searches between Google and DuckDuckGo on this subject (within the past year and a half). Since, more events have occured to bring some attention to the issue of detransition and the potential risks of medicalization. Though there is still bias and censorship occurring, I can already notice a shift in the results and information suggested since the last time I searched “detransition”. I also looked through the Wikipedia article on detransition, and noticed that since the last time I read this, more nuance on the subject has also been added. Whereas previously the perspective was that detransition was simply extremely rare, and to suggest its occurrence was essentially a far-right dog whistle, akin to supporting conversion therapy (even though, it can be argued that for some, transition is a version of conversion therapy for gender non-conforming individuals suffering from internalized homophobia). It would be interesting to take a closer look into this page’s edit history to analyze the timeline of these changes, which I may do so for a future article.
Conclusion
There are complex reasons why social media and search engines are currently engineered as they are. Undoubtedly, there is a medical scandal happening and information in regards to this is being suppressed. Though Megyn Kelly recently released a deeper investigation on the phenomenom of detransitioning and the New York Times is beginning to at least acknowledge that there is a valid debate to be had, conservative networks have been primarily the ones shedding light on these medical malpractices and the harm detransitioners have experienced. The medical establishment is not yet speaking about this in an open and honest way, other than the individuals and detransitioners whistleblowing about this public health crisis and the few organizations dedicated to detransitioners and their families. To find this information, it is not easy to know where to look when most institutions stand by the affirmation model and that regret is rare. Hopefully, in the coming years, we can expect to see this change as more awareness is brought to this subject. As well as a bigger emphasis on improving society’s data literacy and access of information, as more is revealed about the accuracy of the medical information disseminated to the public.
To note
This article was a very informal study of a subject that has been on my mind for a while. I would be interested to learn more about this topic, and hope that there will be more formal and in depth studies on the intersection of transition/detransition and search engine/social media algorithms in the future. Not enough is known about detransitioners, as we are only beginning to see studies being published on this demographic. In addition, not enough is known about the influence of the internet and social media in regards to this issue. I am in no way an expert on detransition, I have never been trans-identifying, and I am not a clinician.
As I was writing this, I took careful consideration into the language being used, as there are different perspectives of political correctness, as well as tensions between political language versus medical language on this subject. For example, I chose to use the word “transsexual” in certain instances because it holds a more medicalized context, while the word “transgender” is now primarily defined as an umbrella term for anyone trans-identifying. I also used it in some cases because some individuals I referred to self-identify as transsexual.
I tried my best to provide good resources, which includes both scholarly literature and interviews with detrans and trans individuals, as well as researchers and clinicians. You can find below a list of websites and organizations that provide more information/resources/other support to individuals that struggle with gender issues and their families. I have also provided a list of podcasts that have done a fantastic job at documenting the many perspectives and fostering discussion on this subject.