Few transgender children change their minds after 5 years, according to a study

Young children who transition to a new gender with social changes – by taking on new names, pronouns, haircuts, and clothes – are likely to continue to identify as that gender five years later, according to one. relationship published Wednesday, the first study of its kind.

The data comes from the Trans Youth Project, a well-known effort that follows 317 children in the United States and Canada who have undergone a so-called social transition between the ages of 3 and 12. Participants passed the age of 6.5 on average.

The overwhelming majority of the group still identified with the new gender five years later, according to the study, and many had started giving hormone medications during their teens to induce biological changes in line with their gender identities. The study found that 2.5% of the group had reverted to identifying themselves as the sex assigned at birth.

As tension grows in courtrooms and state homes across the country about appropriate health care for transgender children, there is little hard data to draw from on their long-term development. The new study provides one of the first large data sets on this group. The researchers intend to continue following this cohort for 20 years later their social transitions began.

“There’s this kind of idea that kids are going to start these things and change their minds,” said Kristina Olson, a psychologist at Princeton University who led the study. “And at least in our sample, we don’t find it.”

Dr Olson and other researchers pointed out, however, that the study may not be generalized to all transgender children. Two-thirds of the participants were white, for example, and parents tended to have higher incomes and more education than the general population. All parents were supportive enough to facilitate full social transitions.

And since the study began nearly a decade ago, it’s unclear whether it reflects the patterns of today, when far more children identify as trans. Two-thirds of the study participants were transgender girls who were assigned males at birth. But in recent years, youth gender clinics around the world they reported a swelling of adolescent patients assigned at birth to girls who had recently identified themselves as trans male or non-binary.

This group also has a high rate of mental health problems, including autism and ADHD, noted Laura Edwards-Leeper, an Oregon clinical psychologist who specializes in caring for transgender children. “This is really the group I’m most worried about these days,” she said.

“I would say this study tells us nothing about those guys,” said Dr. Leeper added. “It’s just so different.”

Researchers from the Trans Youth Project began recruiting participants in 2013, traveling to more than 40 states and two Canadian provinces to interview families. Such in-depth data is rare in this type of research, which often comes from online surveys or through children targeting gender-specific clinics, who are typically older and often come from more limited geographic areas.

Previously published work project showed that children who were supported by parents during social transitions were roughly the same as non-transgender children in terms of rates of depression, with slightly elevated anxiety rates.

The new study, published in the journal Pediatrics, followed this cohort as they hit a milestone about five years after their initial social transitions. The study found 94 percent of the group still identified as transgender five years later. Another 3.5% identified themselves as non-binary, meaning they did not identify as male or female. That label wasn’t as widely used when the researchers started the study as it is today.

By the end of the study period, in 2020, 60% of children had started taking drugs or hormones that stop puberty. Researchers are still collecting data on how many of the adolescent participants have undergone gender surgeries, said Dr. Olson said.

Eight babies, or 2.5 percent, had reverted to their assigned sex at birth. Seven of them passed socially before age 6 and returned before age 9. The eighth child, aged 11, returned after starting to take puberty-blocking drugs.

Research from 90’s Other 2000s had suggested that many children diagnosed with gender dysphoria or gender identity disorder (a psychological diagnosis that no longer exists) would resolve their gender difficulties after puberty, typically from 10 to 13 years. Some of those earlier studies have been criticized because the children’s doctors advised their parents to remove them from a transgender identity.

In the decades since that job, society’s acceptance of gender diversity has grown, medical practice has changed, and the number of transgender children has increased significantly.

For these reasons, it makes no sense to compare the new study with previous research, said Russ Toomey, a professor of family studies and human development at the University of Arizona.

“It’s really comparing apples to oranges,” said Dr. Toomey said. Many of the children in the previous studies were effeminate teens whose parents were upset by their behavior, they said. “Many of these guys in these early studies that are often cited have never even labeled themselves or labeled themselves as transgender.”

The new study could suggest that transgender children, if supported by their parents, thrive in their identities. But it is also possible that some of the children still identified as transgender at the end of the study – or their parents – felt the pressure to continue the path they had started.

“I think, depending on your perspective, people are likely to interpret this data differently,” said Amy Tishelman, a clinical psychologist at Boston College and lead author of the World Professional Association of Transgender Health’s chapter on standards of care for children.

“Some people may say that babies follow this developmental trajectory and can’t get off and that medical interventions could be irreversible and they might regret it,” he said. “Other people will say that children know their gender and when they are supported in their gender, they are happy.”

While most doctors agree that social transitions can be beneficial for some children who question their assigned gender, Dr. Tishelman said, it’s also important to support those who change their minds. “It’s really very important that children can continue to feel like it’s okay to be fluid, to keep exploring,” she said.

Further data on the cohort as it continues into adolescence could reveal how many children choose detransition after starting hormone therapy.

Dr Olson said his group will soon publish a further qualitative study describing the experiences of the relatively small number of children in the cohort who have reverted to their original gender identity. These children did well, she said, when they were supported by their families.

“In our work we don’t just want to know which category they fall into today versus tomorrow,” said Dr. Olson said.

“I think of all these guys as different genders in different ways,” he added, “and we want to understand how to help their lives be better.”