How many children experience a desire to be the opposite sex—a feeling known as gender dysphoria? Of those who do, how many continue to experience it as they get older? A recent paper provides answers based on a longitudinal study of 2,200 children in the Netherlands that was carried out between 2001 and 2015:
As you can see, gender dysphoria was most common at age 11 and fell steadily until age 19, at which point it plateaued. The authors found that, overall, 78% of the children never experienced gender dysphoria; 19% experienced gender dysphoria that declined with age; and 2% experienced gender dysphoria that increased with age.
By age 25, the share of people who felt gender dysphoria "always" was 0.75% for men and 0.5% for women.
Both increasing and decreasing gender dysphoria were associated with mental health issues:
Low global self-worth was found to be associated with having an increasing or decreasing gender non-contentedness trajectory throughout adolescence.... Individuals with an increasing trajectory of gender non-contentedness had significantly higher YSR/ASR total problem scores at all timepoints
Since this is a longitudinal study, the same children participated in all six waves from age 11 to age 25.
Obviously we need further research, but my initial take is that any permanent gender procedures should be done at 18 and not before and laws that do this help more people than they hurt.
Think harder. Republicans like to shout that gender reassignment treatments wreak permanent, irreversible changes on people. They neglect to mention that puberty does, too. If someone is going to change their gender, they had better do it before puberty - otherwise they will have noticeable dysphoric physical traits forever. They won't be able to "pass".
BUT, if we are going to treat people before puberty, then that means taking the word of a minor on an issue of profound, permanent import. And we now know that only about 1/4 of those minors who report gender dysphoria will still feel the same way about it as adults.
Endocrinologist do, and should, insist that minors who report gender dysphoria must be insistent, persistent, and consistent about it before providing treatment. Even so, the chances of error are high, and the consequences of error are severe - whether that error is providing unneeded treatment or denying needed treatment.
This is why I am really glad not to be an endocrinologist. The issues they face are profound, and the profession is still in the early days of learning about it.
The possibility of "passing" depends very much on genetics. I recently had some dealings with a teenaged physical female who identified as male. The problem was that (s)he was small even for a girl, and even the most vigorous hormone treatments were not going to change that very much. The child was going to grow up too short and too slender to ever be convincingly male.
Regrettably, the problem did not mature because the child didn't; (s)he committed suicide at age 15, despite incredibly supportive parents.
If the population feeling dysphoric drops from 14% to 0.5%, treating children with hormones to help the tiny fraction who have persistent dysphoria is a terrible choice.
Remember, treating children with puberty blockers followed by X-sex hormones has very high risks of sterility and an inability to have an orgasm. There's no way for a child to provide informed consent for such procedures.
And these procedures also require a lifetime of taking X-sex hormones.
There's a reason why the UK NHS just stopped providing puberty blockers to children, and why Norway, Sweden, Finland and France have all essentially stopped these treatments: there's no good evidence that they help reduce dysphoria.
The curve does seem to bottom out at around 18 years, but it will be interesting to see what happens after 25 years of age. An oft cited factoid is that the brain doesn't stop developing until 25 years old. There are some detransitioners who transitioned ~ 18 years and about 7 years later were done with the experiment.
But I'd go further ... There really shouldn't be any concessions/affirmations of trans identity until at least 18 years old. Why? Its path dependency. Start telling a 12 year old they are trans and they'll stick with it during formative years of identity and not let go... and this means that, per that chart, roughly 10% of 12 year olds would be incorrectly tracked, sent down a path of permanent intervention for what is, for most, a temporary condition.
Kevin, your link to the original paper appears to be broken, hopefully temporarily. Please fix if you can. Thanks.
https://link.springer.com/article/10.1007/s10508-024-02817-5
"502 Bad Gateway: Registered endpoint failed to handle the request."
I wonder. Questions like this didn't exist when I was a child, but I wonder how my answer would have been taken when I was a pre-teen. I despised typical boy-like behavior, I hated being a boy and being forced to associate with other boys, I thought girls were much nicer people, I sometimes wished I was a girl, but only so that I wouldn't have to be put with the boys. And I never thought I actually was a girl. So is that gender dysphoria or not?
For me this is the larger issue. I think we can safely assume that teens have felt like this for millenia. And they dealt with it and grew up and found their place in the world - because there was no other choice. Gender dysphoria is but one of many dissatisfactions in life ... tall/short, wide/thin, light/dark, etc.
The observation of today is that a kid like you is pushed towards the trans identity b/c it is the solution du jour and that if not you'll have ptsd and kill yourself (which ... the numbers don't support. at all). Which is to say that today you might be robbed of the chance to work through your identity and just grow up like everyone else in history.
How much of this "gender" thing is based on a rejection of current stereotyped sex roles? One would think there would be a lot of women who longed to be men, prior to the 1970s. In fact, there are a few prominent cases of women who lived the lives of men, having to masquerade as men to do so, even in Victorian times.
Now, "we have the technology!!" to actually change women to men and vice versa, and apparently permit women to sire children and men to bear them. Which is interesting.
But if a significant part of the "problem" or discomfort, or whatever is just based on what society expects a person to wear, to act like, to do as an occupation, wouldn't it make sense to start loosening up some of these dumb rules?
Full disclosure: I grew up in the 1950s, which was a crappy time to be non-male or non-white.
"...wouldn't it make sense to start loosening up some of these dumb rules?"
You really think these rules have not been extraordinarily loosened up over the past few decades? Social norms are currently less binding now then they ever have been.
No, we don't have the technology to actually change women to men and vice versa, and permit women to sire children and men to bear them. What we do have is cosmetic surgery that can extend the ostensible appearance of sex difference from clothes and cosmetics to actual body parts, and also drugs that can change behavior and body development. This does not go as far as the internal organs which do actually determine biological sex and reproductive role.
This does bring up an interesting point. As there are efforts to reduce ostensible differences between sexes - for example having "boy" toys and "girl" toys and complete different supposed color preferences, and some things such as sports being considered male and vice versa, now there are also efforts to allow children to choose between gender roles. What if childhood were really unisex - if the adult roles were not forced on children in anticipation of stereotyped adult roles? Would there still be a need for children to change gender roles? Are gender roles in childhood of biological or cultural origin?
I liked your speculations about "unisex" childhoods! On the other hand, if men still can't bear children, why do we have to keep insisting they not only can, but do, and are doing it? You know, all the "pregnant people" verbiage that's become so mandatory on NPR (at least).
I think the most likely outcome of raising children unisex is that the group consisting of bigger, stronger and more aggressive children would abuse the group of smaller, weaker and more emotionally vulnerable children, including acting out their somewhat inchoate adolescent desires.
Certainly the isolated attempts at this kind of thing have been failures. https://en.wikipedia.org/wiki/David_Reimer
"How much of this "gender" thing is based on a rejection of current stereotyped sex roles?"
Between 1900 and 1950 the percentage of left-handed Americans tripled. This roughly coincided with the cultural shift towards accepting left-handed people as normal.
Keep this in mind when pondering the dramatic growth in gender nonconforming people.
No, we don't have the technology to turn men into women or vice versa. We have the technology to force a body to generate some of the secondary sex characteristics of their non-birth sex.
I grew up in the 60s and 70s, and amazingly enough, the solution to not liking forced gender roles was, surprise(!), not limiting yourself to those gender roles. Apparently it is news to today's medical professionals that you don't have to mutilate yourself to work in a field populated primarily by people of the opposite sex.
Personalities can also lean toward either what society calls "male" or "female" traits.
My hairdresser is an INFJ, and the guy looks gay but has two kids and three ex-wives. I have an ENTJ personality and I feel very male, which is good, because I am male. However, I've talked to a number of female ENTJs and they all tell me that they feel like a man inside. They act like men, too, as does my ESTJ sister.
This, of course, is very different from feeling like you were born into the wrong body. This is merely feeling like you were born into a society with screwed-up expectations.
One fascinating topic of science fiction is the possibility of switching genders back and forth, at any time, without penalty.
If this were possible, it would transform society.
It would be nice to live in a society in which a person isn't penalized for things which are beyond their control.
The study measured "gender non-contentedness" not "gender dysphoria" These are not the same, not at all.
Hell, I had gender non-contentedness as a kid. Why did I have to do X or Y because it's "manly". "Don't cry, be a man" was a big one. That doesn't make me trans.
Seriously, this is so, so wrong. Let me share with you what one trans woman (a lawyer) wrote:
Kevin, you don't know any trans people (that you are aware of). You haven't heard their stories. I really, really wish you would take the time to get to know one or two, or at least engage with some of the material out there, and find out how they experience life.
At that point, by all means, go back to making charts. Just use data that actually makes sense, and is relevant.
Yes, this graph is mislabeled.
Let me second Doctor Jay. The chart is mislabeled. It should be no surprise that a lot of kids have some gender discontent when young. Girls want to know why they cant play with Tonka trucks and some boys like dolls. However, that's a far cry from thinking they want to be the other sex. I would say this study is sort of interesting as it suggests most people end up accepting their assigned roles, but it doesnt say anything about gender dysphoria.
Steve
In the interest of providing the possibility of a better understanding of trans people and their situation, here's a great writer (Doc Impossible, the pen name of Zoe Ann Wendler. (https://stainedglasswoman.substack.com/p/oh-st-my-partner-just-told-me-theyre?utm_source=post-email-title&publication_id=1195855&post_id=142893840&utm_campaign=email-post-title&isFreemail=true&r=flqlf&triedRedirect=true&utm_medium=email)
This specific post is about transition in the context of an ongoing relationship. It talks about sex though not explicitly. I would recommend Zoe's Substack (which she says will always be free).
I would wonder about the possible difference between gender dysphoria and gender curiousity. I'm an entirely "normal" cis male, but around the age of puberty I certainly wondered what it would be like to be a girl. It would have been really easy for a researcher who was not very careful with the questions to decide that I was gender dysphoric.
Those statistics are for gender *non-contentedness*, which is not the same as gender dysphoria. Gender non-contentedness is simply wishing one were a different gender (for whatever reason), while gender dysphoria is a marked feeling that one's experienced gender is different than their biological sex.
From the paper:
"To illustrate the relation between these concepts; a young adolescent girl who mostly likes things seen as typical for boys and who dislikes the changes she goes through during puberty, might (temporarily) experience gender non-contentedness, although she might not experience gender dysphoria or wish to transition from female to male."
You might still identify as transgender without gender dysphoria, but you wouldn't be given hormone treatment or surgery.
Pingback: New study says nothing about gender dysphoria – DocBug