Toddlers who transition to a new gender with social changes — taking on new names, pronouns, haircuts, and clothes — are more likely to continue to identify with that gender after five years, according to the Report On Wednesday, it published the first study of its kind.
The data comes from the Trans Youth Project, a well-known effort that follows 317 children across the United States and Canada who underwent a so-called social transition between the ages of 3 and 12. Participants moved on, on average, to age 6.5.
The vast majority of the group are still identifying with their new gender after five years, according to the study, and many of them started taking hormonal medications in their adolescence to stimulate biological changes to align with their gender identities. The study found that 2.5 percent of the group reverted to the gender assigned at birth.
With tension rising in courtrooms and in state roles across the country over proper health care for transgender children, there hasn’t been a lot of hard and reliable data about their long-term development. The new study provides one of the first large data sets for this group. The researchers plan to continue following this cohort for 20 years later Their social transformations began.
“There’s kind of a notion that kids are going to start those things and they’re going to change their mind,” said Kristina Olson, a Princeton University psychologist who led the study. “And at least in our sample, we didn’t find that.”
Dr. Olson and other researchers noted, however, that the study may not be generalizable 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 transformations.
Because the study began nearly a decade ago, it is unclear whether it reflects the patterns of today, when many children identify as trans. Two-thirds of the study participants were transgender girls who were assigned boys at birth. But in the past few years, gender clinics for young people around the world reported hypertrophy of adolescent patients assigned girls at birth who were recently identified as transgender or non-intersex boys.
This group also has a high rate of mental health concerns, including autism and ADHD, noted Laura Edwards Lieber, an Oregon-based clinical psychologist who specializes in the care of transgender children. “This is really the group I’m most concerned about these days,” she said.
“I would say this study tells us nothing about these children,” Dr. Edwards Lieber added. “It’s completely different.”
Trans Youth Project researchers 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 is often obtained from online surveys or through children referred to specific gender clinics, who are typically older and often from limited geographic areas.
Previously published work It showed from the project that children who were supported by their parents during social transitions were roughly equal to non-transgender children in terms of rates of depression, with slightly higher rates of anxiety.
The new study, published in the journal Pediatrics, followed this group as they reached a milestone roughly five years after their initial social transformations. The study found that 94 percent of the group still identified as transgender after five years. Another 3.5 percent identified as non-binary, meaning they didn’t know they were either boys or girls. This term was not as widely used when researchers started the study as it is today.
By the end of the study period, in 2020, 60 percent of children had started taking medications or hormones that prevent puberty. Dr. Olson said researchers are still collecting data on how many teens have undergone gender-based surgeries.
Eight children, or 2.5 percent, returned to the gender they were assigned at birth. Seven of them transitioned socially before the age of six and moved again before the age of nine. The eighth child, aged 11, is back after he started taking puberty-preventing drugs.
research from 90s And 2000s It has been suggested that many children diagnosed with gender dysphoria or gender dysphoria (a psychiatric diagnosis that no longer exists) will resolve their sexual difficulties after puberty, usually by 10 to 13 years old. Some of these previous studies have been criticized for Pediatricians advised their parents to keep them away from their transgender identity.
In the decades since that work, societal acceptance of gender diversity has grown, medical practice has changed and the number of transgender children has increased dramatically.
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For these reasons, it doesn’t make sense to compare the new study with the old research, said Ross Tomei, professor of family studies and human development at the University of Arizona.
“It really compares apples to oranges,” said Dr. Tommy. They said that many of the children in previous studies were bisexual boys whose parents resented their behaviour. “Many of these children in these frequently cited early studies never self-identified or were classified as transgender.”
The new study could suggest that transgender children, when supported by their parents, thrive in their identities. But it’s also possible that some children who still identified as transgender by the end of the study – or their parents – felt pressure to continue on the path they started.
“I think based on your point of view, people are likely to interpret this data differently,” said Amy Tichelman, a clinical psychologist at Boston College and lead author of the Child Care Standards chapter in the Global Professional Association for Transgender Health.
“Some people might say that babies go down this path of development and can’t get off and that medical interventions may be irreversible and they may regret it,” she said. “Other people will say that children know their gender, and when they are supported in their gender, they are happy.”
While most clinicians agree that social shifts can be beneficial for some children who are questioning their exact gender, Dr. Tichelman said, it’s also important to provide support for those who change their minds. “It’s really important that kids continue to feel like it’s good to be flexible, and that they keep exploring,” she said.
More data on the group as it continues into adolescence could reveal how many children choose not to convert after starting hormone therapy.
Dr. Olson said her group will soon publish an additional qualitative study describing the experiences of the relatively small number of children in the group who reverted to their original gender identity. She said these children did well when their families supported them.
“In our work, we don’t just want to know which category fits them today versus tomorrow,” Dr. Olson said.
She added, “I think all of these kids are gender-different in different ways, and we want to understand how to help their lives be better.”