Desistance

  • Social transition – changing names, pronouns, clothing and bathroom use – correlates with the persistence of transgender identity. Expand
    Social transition – changing names, pronouns, clothing and bathroom use – correlates with the persistence of transgender identity.

    Pediatric transition doctors in the Netherlands who first pioneered the use of puberty blockers in dysphoric children observe that social transition correlates with an increase in young people’s persistence when it comes to gender identity [1]. This led them to caution against social transition before puberty.

    Another paper [2] notes that gender dysphoria is more persistent into adolescence where social transition has occurred, and as such asserts that social transition is a “psychosocial intervention [which] might be characterized as iatrogenic” – a medical problem caused by the treatment itself.

    There is evidence [3] that social transition by the child was found to be strongly correlated with persistence for natal boys, more so than for girls.

    REFERENCES

    [1] de Vries, A. L., & Cohen-Kettenis, P. T. (2012). Clinical management of gender dysphoria in children and adolescents: The Dutch approach. Journal of Homosexuality 59 (3): 301–320. [Link]

    [2] Zucker, K. J. (2019). Debate: Different strokes for different folks. Child and Adolescent Mental Health 25(1): 36-37. [Link]

    [3] Steensma, T.D., McGuire, J.K., Kreukels, B.P., Beekman, A.J. & Cohen-Kettenis, P.T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. J Am Acad Child Adolesc Psychiatry. 52 (6): 582-90. [Link]

  • One study showed that, without social transition, nearly two-thirds of pre-teen gender-dysphoric males grow up to be gay or bisexual. Expand
    One study showed that, without social transition, nearly two-thirds of pre-teen gender-dysphoric males grow up to be gay or bisexual.

    A University of Toronto study [1] found that 63.6% of boys with early onset gender dysphoria, who received ‘watchful waiting’ treatment and no pre-pubertal social transition, grew up to be gay or bisexual. 

    Only 12% of the study participants continued to identify as transfeminine. 

    REFERENCES

    [1] Singh, D., Bradley, S.J. & Zucker, K.J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder. Frontiers in Psychology 12. [Link]

  • Gender-related distress will alleviate for around 80% of pre-teen children once they become teenagers. Expand
    Gender-related distress will alleviate for around 80% of pre-teen children once they become teenagers.

    Evidence from 10 available prospective follow-up studies [1] from childhood to adolescence indicates that childhood gender dysphoria will recede with puberty in ~80% of cases. A Dutch paper [2] notes that follow-up studies show the persistence rate of gender identity disorder to be about 15.8%, or 39 out of the 246 children who were reported on in the literature.

    In one study [3] of 54 children referred to a clinic in childhood because of gender dysphoria and then later investigated by a follow-up study, only 21 (39%) still had gender dysphoria.

    A different study [4] of Canadian boys with gender identity disorder showed that 87.8% desisted, with only 12.2% — fewer than 1 in 8 — persisting in their transgender identity.

    An ~80% desistance is not universally found [5]. Thorough investigations of the claims and counter-claims appear in two 2018 studies [6, 7].

    REFERENCES

    [1] Kaltiala-Heino, R., Bergman, H., Työläjärvi, M., & Frisén, L. (2018). Gender dysphoria in adolescence: current perspectives. Adolescent health, medicine and therapeutics 9, 31–41. [Link]

    [2] Steensma, T.D. & Cohen-Kettenis, P.T. (2011). Gender Transitioning before Puberty? Archives of Sexual Behavior 40 (4): 649-50. [Link]

    [3] Wallien, M.S. & Cohen-Kettenis P.T. (2008) Psychosexual outcome of gender-dysphoric children. J Am Acad Child Adolesc Psychiatry 47 (12): 1413-23. [Link]

    [4] Singh, D., Bradley, S.J. & Zucker, K.J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder. Frontiers in Psychology 12. [Link]

    [5] Temple Newhook, J., Pyne, J., Winters, K., Feder, S., Holmes, C., Tosh, J., Sinnott, M., Jamieson, A., & Picket, S. (2018). A critical commentary on follow-up studies and “desistance” theories about transgender and gender non-conforming children. International Journal of Transgenderism 19 (2). [Link]

    [6] Steensma, T.D. & Cohen-Kettenis, P.T. (2018). A critical commentary on “A critical commentary on follow-up studies and “desistence” theories about transgender and gender non-conforming children”. International Journal of Transgenderism. [Link]

    [7] Zucker, K. J. (2018). The myth of persistence. International Journal of Transgenderism 19 (2): 231-45. [Link]

  • Young people who desist from a trans identity are disproportionately likely to grow up to be non-heterosexual. Expand
    Young people who desist from a trans identity are disproportionately likely to grow up to be non-heterosexual.

    A Dutch paper [1] notes that, for gender dysphoric children, the more likely psychosexual outcome in adulthood is a homosexual sexual orientation without gender dysphoria.

    Evidence [2] suggests that many boys whose childhood gender dysphoria recedes with puberty will grow up to be bisexual or homosexual. Another study of males [3] indicates that bisexual/homosexual orientation is far greater than base rates in the general male population, with 63.6% of boys with gender identity disorder being same-sex attracted.

    This suggests that a non-heterosexual orientation is particularly likely among gender dysphoric boys.

    REFERENCES

    [1] Wallien, M.S. & Cohen-Kettenis P.T. (2008) Psychosexual outcome of gender-dysphoric children. J Am Acad Child Adolesc Psychiatry 47 (12): 1413-23. [Link]

    [2] Kaltiala-Heino, R., Bergman, H., Työläjärvi, M., & Frisén, L. (2018). Gender dysphoria in adolescence: current perspectives. Adolescent health, medicine and therapeutics 9, 31–41. [Link]

    [3] Singh, D. (2012). A follow-up study of boys with gender identity disorder. Doctoral thesis, University of Toronto. [Link]