Regret is a word that is never far off when it comes to transgender care. Everyone is always afraid of regret, while regret has never been shown to be a problem in the care of trans people. The studies that are available show that regret is rare. And if it does occur, it is usually not a matter of regretting the transition, but rather of an intervention that turns out differently or causes more problems than expected.

And now regret has knocked on our door too. Before I tell you about this, a small disclaimer: I have asked Sietse to write this and publish it and he thinks that is completely okay. Everything I share publicly, I share with his permission.

Okay, back to the regrets. Well, then I actually have to go back to about a year ago. Sietse came to talk to me. About his possibilities to have children with his own eggs. He absolutely does not want to be pregnant himself, so we talked extensively about what it takes to mature his eggs and how they are harvested afterwards. It means stopping testosterone and starting lots of female hormones resulting in the return of menstruation. After the conversation he was resolute: that is not an option. Immediately followed by the announcement that he wanted to have his uterus and ovaries, which we call the Hen House, removed.

Sietse arranged a consultation with the gynecologist at the local hospital through his endocrinologist and was operated on surprisingly quickly on Thursday 15 July 2021. A day I will never forget. My healthy child was dying of nerves waiting for an operation that was not even medically necessary. Still, he wanted this surgery, because he had experienced the menstruation as intensely traumatic. It was only then that I realized how traumatic it must have been for him if you chose to do this after 6 years of not menstruating. I walked with him to the door of the OR and there I let him go after a big hug.

What followed after the operation was total hormonal anarchy in Sietse’s body with all the emotional consequences. From intense crying to intense anger outbursts. And it destroys him. Repeat blood draws and adjust the dose. A few weeks ago he was very sad again and when the tears had dried I asked him if he regretted the surgery. His answer came immediately: yes.

Regret is a word that has an enormous negative connotation in this society. It means you made a mistake and making mistakes is either stupid or you haven’t tried hard enough. Regret gnaws at your soul. Sietse would currently give everything to undo the operation, but that is not possible. Let’s not beat around the bush: it hurts.

We talk about it every now and then and it makes for good conversations. He sees that in his case the regret does not have to be permanent. That if his hormones come back under control and he balances that his regrets can disappear. It is a very instructive time for me. With all the medical knowledge I have and all the energy I always put into researching and preparing everything, I have not been able to avoid the regrets that Sietse now has. My own mother already said that I set the bar too high for myself and that’s true. But it also makes it so very clear that regret is something that can always arise. Because no matter how careful everyone is, life doesn’t always go the way we expect. And there I named the second word ‘carefulness’.
In transgender care it is always said that one wants to be careful to avoid regret. My lesson: regret is never 100% preventable. Regret hurts and gnaws, but it is a normal part of life. And, regret can really go away. Not all regrets last.

Sietse and his hormones will be fine, I have no doubts about that. Now let’s make sure that we all start to see regret as a normal part of life. That we regret not accusing someone of making the wrong choice or of having insufficiently prepared, but that we stand next to someone with regret, put an arm around that person and say: “I’m here for you.” .

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