Summary
Dutch clinicians followed 127 children referred to their gender clinic before age 12 and checked who still had gender dysphoria (distress about a body/gender mismatch) in their mid-teens. 37% still had it and sought medical transition. The other 63% did not come back and were counted as desisters (no longer dysphoric); those who answered questionnaires reported little or no distress. Girls persisted more often than boys (50% vs 29%). Children with more intense distress, who said they were (not wished to be) the other sex, who were older when referred, or who had socially transitioned (new name, clothes or pronouns) were more likely to persist. Anxiety, behaviour and friendships did not predict this. An important study, but desistance was assumed for non-returners, all came from one clinic, and the older diagnosis included milder cases.
Key findings
- من بين 127 طفلاً أُحيلوا قبل سن 12، استمر لدى 47 (37%) عدم الارتياح الجندري في سن المراهقة، وعُدّ 80 (63%) قد تجاوزوه.
- استمرت البنات أكثر من الأولاد: 24 من 48 بنتاً (50%) مقارنة بـ 23 من 79 ولداً (29%).
- كانت شدة الكرب في الطفولة هي الأهم: 91–96% ممن استمروا كانوا قد استوفوا التشخيص الكامل في الطفولة، مقابل 39–58% ممن لم يستمروا.
- كان الأطفال الذين قالوا إنهم من الجنس الآخر أكثر عرضة للاستمرار من الذين قالوا إنهم يتمنون ذلك، وهو ما يصفه المؤلفون بـ «الكينونة» مقابل «تمني الكينونة».
- ارتبط التحول الاجتماعي في الطفولة بالاستمرار، بنحو 5 أضعاف في الاحتمالات إجمالاً ونحو 22 ضعفاً لدى الأولاد. لكن الأولاد الذين تحولوا كان لديهم أيضاً كرب أشد، لذا تعذّر فصل أثر التحول نفسه.
- لم تتنبأ الصحة النفسية العامة للأطفال وصداقاتهم، كما قيّمها الأهل والمعلمون، بمن سيستمر.
- كان تقريباً كل من استمروا ينجذبون إلى جنسهم عند الولادة، بينما كانت معظم البنات ونحو ثلث الأولاد ممن لم يستمروا ينجذبون إلى الجنس الآخر.
Abstract
To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence. The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (<12 years of age) and followed up in adolescence. We examined childhood differences among persisters and desisters in demographics, psychological functioning, quality of peer relations and childhood GD, and adolescent reports of GD, body image, and sexual orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls.
Conclusion
Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD.