Caitlyn Jenner has perfected the art of cashing in on each step of gender transition. A few short weeks before the release of his new book, Jenner acknowledges the boys are now gone. Adios to his life-long companions in gender reassignment surgery (known as bottom surgery).

Jenner is wealthy and can cash in on celebrity, but a large portion of the transgender population remains lost and unaccounted for. Did they die, detransition, or commit suicide?  All we know is the attempted suicide rate for transgender people has remained above 40 percent for many years.

Doctors jam trans kids with puberty blockers and trans adults with cross-gender hormones, then recommend irreversible genital surgery, all without having long-term systematic studies of the effectiveness of such invasive treatment. Parents of trans kids don’t have the benefit of trustworthy information on the probable outcomes of up to 90 percent of gender changers.

Research about transgender people is biased toward reporting success. Studies lose track of many participants, often the majority, and there is no mechanism for tracking those who are dissatisfied after gender-change treatment. My transition back to male hasn’t been tallied in the negative column of any study. Ditto for the trans people who reach out to me.

Huge Numbers of Study Subjects Are Lost to Follow-Up

One limitation of long-term transgender research is that many participants who were present at the beginning of the study can’t be located at its end. In medical parlance, they are “lost to follow-up.” A 2007 textbook titled “Principles of Transgender Medicine and Surgery” explains the limitations of the studies: “A large proportion of patients (up to 90%) are lost to follow up… [which]…complicates efforts to systematically study the long-term effects of gender reassignment surgery.”

Another review of more than 100 international medical studies of post-operative transsexuals conducted in 2004 by the University of Birmingham’s aggressive research facility, Arif, warned “the results of many gender reassignment studies are unsound because researchers lost track of more than half of the participants. For example, in a five-year study of 727 post-operative transsexuals published last year, 495 people dropped out for unknown reasons.”

Since the scientific community reports up to 90 percent of transsexuals are lost to follow-up and therefore not counted in study results, I’m skeptical when I hear the LGBT soundbite that says only a tiny percentage are dissatisfied after changing gender. The missing 90 percent could have given up on gender change and gone back to their birth gender or even committed suicide. No one knows, because they dropped out of sight. Too many hormones, too much surgery, and too many are lost.

Media reports about transgender outcomes is also biased positive because the research is also. Arif found “most of the medical research on gender reassignment was poorly designed, which skewed the results to suggest that sex change operations are beneficial.” Arif also reported “no robust scientific evidence that gender reassignment surgery is clinically effective.”

None of the people who have contacted me over the past 11 years about going back to their birth gender will be counted as having undesirable outcomes. That’s because the LGBTQ studies purposefully exclude anything that would reflect badly on their overblown trans agenda.

Sex Changes Have Been Unsound Since Their Inception

From the start, the effectiveness of treating transgender people by affirming their non-biological identity was based on falsified evidence. Dr. Harry Benjamin will be known as the founder of transsexualism, but the real madness we see today reflects the legacy of Dr. John Money, a psychologist. During his time at Johns Hopkins University Hospital in the 1960s and ‘70s, Mooney launched the tragic trajectory of surgical transgenders, suicides, and regrettable outcomes.

Money made a name for himself with research on a set of twin boys, one of whom had his penis ruined in a botched circumcision. When the boy’s distressed parents contacted Money for help, he saw an opportunity to conduct research on the cultural versus biological determinants of gender. Money recommended that doctors remove the remnants of David’s injured genitalia and his parents raise him as a girl. They followed Money’s advice, and at the age of two David Reimer became Brenda.

Over the years, Money met with the Reimer twins and wrote articles touting the success of his gender experiment and how well Brenda was adapting. His results fueled the acceptance of gender reassignment in the medical community.

The problem was, Money fabricated the results. The truth didn’t come out until the twins were in their 30s. David had been suffering for most of his life from severe depression, followed by financial instability and a troubled marriage. Money withheld information the medical community and public needed to know about gender reassignment, and replaced it with lies.

When David Reimer and his twin brother broke their silence, they exposed Money as a fraud and pedophile. They told how Money had taken photos of them together naked in sexual poses when they were only seven years of age. Money did not stop with snapping photos. The twins described sexual abuse, saying Money forced them to engage in incestuous sex play with each other while he watched.

The twins’ outcome was grim. David died of suicide at age 38, and his brother died a few years later of a drug overdose. This foundation of gender reassignment surgery was based on fraudulent, fabricated research, and this form of treatment all too frequently ends in suicide or suicide attempts.

When a High-Profile Trans Person De-Transitions

Once in a while, a high-profile trans person reveals discontent with life after changing genders. Alexis Arquette, of Hollywood’s famous Arquette family, began life as Robert and achieved fame as a transgender actress. In the media tributes that followed his death at age 47 last September, few mentioned that Alexis had detransitioned and stopped living as a woman. However, The Hollywood Reporter did write of Arquette’s view of gender change:

In 2013, amid increasing health complications, Alexis began presenting herself as a man again, telling [close friend] Ibrahim that ‘gender is bullshit.’ That ‘putting on a dress doesn’t biologically change anything. Nor does a sex-change.’ She said that ‘sex-reassignment is physically impossible. All you can do is adopt these superficial characteristics but the biology will never change.’ That realization, Ibrahim suspects, was the likely source of her deep wells of emotional torment.

Clearly, even a well-known and talented transgender individual who is embraced and accepted in his chosen identity can struggle and decide to return to his birth sex. But he is not counted in any study.

As one who transitioned, lived as a woman for eight years, and returned to life as a male, I hope more people will speak publicly about the reality of life after changing gender—the doubts and questioning, the fatigue of living a masquerade, and the desire to go back to one’s birth gender. Transgender people write to me confidentially, yet frankly, about their gender struggles and the desire to de-transition, but they find the idea of once again changing their appearance and identity daunting.

When People Speak Openly About Their Sex Change

People who write to me aren’t counted in any ongoing studies, but they give insight into the minds of those who undergo gender transition. Here are two stories from folks I corresponded with in 2010.

Regret arrived quickly for a male who transitioned to female and wrote to me four months post-op:

I recently had the sex change surgery, and although I thought I was completely sure of what I was doing, I began to regret the decision a mere three weeks after the operation.

Some might say I was experiencing post-op depression, but it was definitely more than that. I also suspect that many of the other patients at the hospital who had the same operation experienced similar feelings based on my discussions with them.

What really drove the point home for me was the realization that it required eight hours on an operating table to make my genitalia appear to be female.

That pretty much tells me that I’m NOT female at all. If I were female, why wasn’t I born with female genitalia? Sure, there are some intersexed people with ambiguous genitals, but I’m not at all intersexed. My chromosomes are the normal male XY, with absolutely no abnormalities.

The reality is that I’m male, and no amount of surgery changes that fact. I’m now four months post-op, and I’ve begun to transition to live as a male again. I feel it’s the only way to be honest with myself and with society.

If you are considering this surgery, think very carefully about the consequences. Make sure that the doctor or counselor that’s approving you for the surgery is qualified to evaluate whether you need the operation or not.

The second email comes from a man who regretted his gender transition a mere year and a half after surgery. It shares a father’s painful revelation of wanting to return to being a man and father again.

I am 46 and 1.5 years post op MTF [male to female]. I struggled with my gender identity most of my life. I am so miserable and every day I struggle to get thru the next minute. I have to pray for the strength not to go to the gun store. Every minute is filled with suicidal thoughts. I can’t live like this anymore. Please help me. Guide me what to do medically, surgically to fix this mess.

I am so glad I came across your website. After 10 months of post-op psychotherapy, I know sadly now my problems were great depression, unresolved issues as you said (I was sexually abused by my grandfather at 3 years old, father was killed in the line of duty when I was 5, grew up thinking I must be gay, had sex with men and was disgusted, and cross dressed most of my life.) My new therapist is calling it a transvestic fetish that went terribly wrong, coupled with GID.

Why couldn’t we get to this pre-op? It’s just a sick money making industry as I see it. I have already removed the breast implants, and will be restarting testosterone soon. I have destroyed my career, my finances and my marriage and alienated my family.

The pain as you know is so great! It feels like a knife in my heart. I can’t sleep. I am so disgusted with myself. How could a smart, successful guy get so lost? I had it all. Now I’m watching it slowly fade away. You and all the people that give me words of encouragement are the only thing keeping me going. I have rope, and I know when and where all the next guns shows are; I don’t want to live like this. My therapist is going to recommend me to gender therapists; to get a surgical solution I can live with. At 46 years of age I just hope I have the strength to get there; my batteries are drained. I have not read your book; but I am willing to listen to your thoughts and ideas.

(Taken from “Gender, Lies and Suicide,” by Walt Heyer. p. 73-76.)

Red flags against gender-change surgery abound. Up to 90 percent of gender changers in studies cannot be located for follow-up, lowering the quality and credibility of the activist trans agenda. Scientific evidence showing that gender reassignment surgery is clinically effective is lacking.

A founder of the modern surgical gender change model of treatment, Dr. John Money, falsely reported success to promote himself and advocate for transgender surgery. Performer Alexis Arquette de-transitioned back to Robert, said “Gender is bullshit,” and blew the whistle on the madness and futility of gender change.

Letters in my inbox relate first-person accounts that the LGBTQ lobby will not even acknowledge exist and that poke holes in the often-told myth that regret is rare. Jenner has said adios to his boys, while far too many transgender people have said adios to family and friends and cannot be found.