94 % se 5 let po rané sociální tranzici stále identifikovalo jako trans – ale chyběla srovnávací skupina

Genderová identita 5 let po sociální tranzici

Kohortové & registry studie Vymizení dysforie v dětství

Authors: Kristina R. Olson, Lily Durwood, Rachel Horton, Natalie M. Gallagher, Aaron Devor
Journal: Pediatrics
Year: 2022
Source: https://doi.org/10.1542/peds.2021-056082

Summary

The Trans Youth Project followed 317 US and Canadian children who had fully socially transitioned (changed name, pronouns and presentation) between ages 3 and 12. About five years later, 94% still identified as trans, 3.5% as nonbinary and 2.5% as their birth sex; 7.3% had changed identity at least once. By the end, about 60% had started puberty blockers or cross-sex hormones. The authors concluded that switching back is uncommon. Children in supportive, mostly well-off volunteer families usually kept their new identity. But there was no comparison group of similar children who did not transition, so the study cannot say whether this reflects the children or the transition itself. Zucker and others argue early social transition may itself lock in identity, a question the Cass Review's evidence review treated as unresolved.

Key findings

317 dětí (208 trans dívek, 109 trans chlapců), které plně prošly sociální tranzicí, se připojilo ke studii ve věku 3 až 12 let (průměr 8) mezi lety 2013 a 2017.
Asi 5,4 roku po první tranzici se 94 % identifikovalo jako trans chlapci nebo dívky, 3,5 % jako nebinární a 2,5 % (8 mladých lidí) se svým pohlavím při narození.
7,3 % změnilo identitu alespoň jednou, včetně 1,3 %, kteří se později vrátili k trans identitě.
Děti, které prošly tranzicí před 6. rokem věku, se později častěji identifikovaly se svým pohlavím při narození (5,6 % oproti 0,5 %); většina těchto změn nastala před 10. rokem věku.
Na konci 92 zahájilo blokátory puberty (léky, které pozastavují pubertu) a 98 hormony opačného pohlaví, asi 60 % skupiny bylo na lékařské cestě.
Rodiny se připojily v průměru 1,6 roku po tranzici dítěte a 26 rodin (8 %) nebylo v kontaktu v předchozích dvou letech.
Při sledování bylo ve věku 14 let nebo starších jen 70, takže většina výsledků byla měřena před adolescencí nebo na jejím počátku.

Abstract

BACKGROUND AND OBJECTIVES: Concerns about early childhood social transitions among transgender youth include that these youth may later change their gender identification (ie, retransition), a process that could be distressing. The current study aimed to provide the first estimate of retransitioning and to report the current gender identities of youth an average of 5 years after their initial social transitions. METHODS: The current study examined the rate of retransition and current gender identities of 317 initially transgender youth (208 transgender girls, 109 transgender boys; M = 8.1 years at start of study) participating in a longitudinal study, the Trans Youth Project. Data were reported by youth and their parents through in-person or online visits or via e-mail or phone correspondence. RESULTS: We found that an average of 5 years after their initial social transition, 7.3% of youth had retransitioned at least once. At the end of this period, most youth identified as binary transgender youth (94%), including 1.3% who retransitioned to another identity before returning to their binary transgender identity. A total of 2.5% of youth identified as cisgender and 3.5% as nonbinary. Later cisgender identities were more common among youth whose initial social transition occurred before age 6 years; their retransitions often occurred before age 10 years. CONCLUSIONS: These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way. Nonetheless, understanding retransitions is crucial for clinicians and families to help make retransitions as smooth as possible for youth.

Conclusion

These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way. Nonetheless, understanding retransitions is crucial for clinicians and families to help make retransitions as smooth as possible for youth. The authors caution against over-interpreting differences from older desistance studies, note that identities 'should not be interpreted as final', and say parents and clinicians should be informed that not all youth will continue on the same trajectory.

Methodological limitations

No comparison group: There was no group of similar gender-nonconforming children who did not socially transition, so the study cannot show whether transition changes how likely children are to stay trans. The Cass Review's evidence review (Hall and colleagues, 2024) noted no study in this area had a suitable comparison group.
Transition may cause persistence: Zucker (2020) and others argue that full early social transition is itself a powerful intervention that likely makes children more likely to stay trans. The high rate fits that concern as well as the authors' reassuring reading.
Hand-picked volunteers: Families signed up through community networks. 66% earned over $75,000 a year and 68% were white, and the children's depression levels were near normal, unlike children seen at clinics.
Early switchers missed: Families joined on average 1.6 years after transition, so children who switched back quickly were unlikely to be included, as the authors admit.
No diagnosis: Children were not assessed for gender dysphoria (distress about one's sex), so comparing with older clinic studies, where many children grew out of it, is not like-for-like.
Identity judged by pronouns: Identity was mainly judged by the pronouns the child used, as reported by parents and children, not by a standard or clinical assessment.
Short follow-up, young children: Follow-up averaged about 5 years after transition (3.8 years after joining), and only 70 were 14 or older. Past research suggests many children stop feeling trans during or after puberty, and adult detransition is not captured.
Lost contact: 26 families (8%) had no contact in the two years before data ended. If families of children who changed course were less likely to stay in touch, switching back would be undercounted.
Medical steps muddy the picture: About 60% had started blockers or hormones by the end, which may further fix identity. The study cannot separate the effects of social and medical steps.
Parents' support and expectations: All parents had approved and supported a full social transition, and many rejected treating it as a diagnosis. This setting may shape both what children say and how they develop.
Funding and research focus: Funders included the NIH, NSF, the Arcus Foundation (an LGBT-advocacy funder) and the MacArthur Foundation. The authors declare no conflicts, but the lead author's research program is built around socially transitioned children.

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Summary

Key findings

Abstract

Conclusion