Actually, I believe that a large chunk of desisted people DO have physical damage, which is why I draw a blurry line between being "desisted" and "detrans" as a physical results matter. I would argue that a lot of desisted have irrepable damage inflicted on their body due to self harm. With all due respect, because I have gone through the same thing, the one thing I notice is that most detrans people have scars. Some will attempt to mutilate themselves, on genitals, without surgery. Some will have permanent nerve damage. Some will feel outcasted from society, unable to hide it. Some will get infections that can ruin the purpose of said limb. Some will be given up on entirely, because the system refuses to speak about this shit.
A lot of the time, detrans are often targeted at some vulnerable and confusing time in their life, normally their teens. As a teen, I definitely had a lot of time to be surrounded and let these communities take over my life, and everyone also went through quarantine as well. Trans Ideology centers itself around fear mongering when gaining new victims, and a large portion of that fear mongering is about death or harm to yourself.
Obviously, with the time you have on your hands to think about it, you have just as many hours to sit inflicting harm to yourself.
Self-inflicted scars are going to be visible every day, on the parts of your body you personally see often, a constant reminder of that era of your life. It is a physical change that you can not get rid of without treatment. For that reason, I believe that being desisted is more than just being desisted, or having a change of heart.