Blijven transkinderen trans als ze volwassen worden?

Summary

In this 2016 blog post, Cantor asked whether children with gender distress stay trans as they grow up. He listed every follow-up study he knew of, 11 in all, from Lebovitz (1972) to Steensma and colleagues (2013). For each, he gave how many children still had gender distress and how many did not. He wrote that despite different countries, decades and methods, the studies agree: only a small minority still want to transition by adulthood, roughly 60% to 90% do not, and most of them turn out gay or lesbian. The post is a handy plain-language list of the older research, and its sources can be checked. But it is not a formal review. It has no search method, no quality rating and no combined figure. The studies used older diagnoses and were mostly of boys. The post also does not discuss published criticism of how 'growing out of it' was defined and counted.

Key findings

Cantor noemt 11 follow-upstudies van kinderen die werden gezien wegens gedrag dat niet aan genderverwachtingen voldeed of genderklachten, gepubliceerd van 1972 tot 2013, en zegt dat drie ervan groot waren.
De post concludeert dat ruwweg 60% tot 90% van de kinderen die in zulke klinieken worden gezien zich in hun tienerjaren of als volwassene niet meer als trans identificeerde.
In de grootste genoemde studies hielden de genderklachten aan bij 17 van de 139 (Singh, jongens uit Toronto), 47 van de 127 (Steensma en collega's, Amsterdam) en 21 van de 54 (Wallien en Cohen-Kettenis), oftewel ongeveer 12% tot 39%.
Cantor schrijft dat de meeste kinderen die over hun genderklachten heen groeiden homo of lesbisch opgroeiden in plaats van hetero.
De post werd in januari 2016 geschreven naar aanleiding van de sluiting van de kinderkliniek voor gender van CAMH in Toronto.
Verscheidene van de oudere studies zijn zeer klein (5 tot 16 kinderen) en de meeste bestudeerden alleen jongens; Drummond en collega's volgden 25 meisjes, en de twee Nederlandse studies omvatten beide geslachten.
De studie van Singh (2012) was toen nog een ongepubliceerd proefschrift; ze werd later in 2021 gepubliceerd door Singh, Bradley en Zucker in Frontiers in Psychiatry.

Abstract

Following the closure of the CAMH Gender Identity Clinic for children, this blog post reviews what the science says about whether children who identify as transgender remain transgender into adulthood. The post summarizes three large-scale follow-up studies and several smaller ones, all examining the outcomes of children referred to gender identity clinics. The studies span different countries, cultures, decades, and follow-up lengths and methods.

Conclusion

Despite the differences in country, culture, decade, and follow-up length and method, all the studies have come to a remarkably similar conclusion: Only very few trans- kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks. The exact number varies by study, but roughly 60 – 90% of trans- kids turn out no longer to be trans by adulthood.

Methodological limitations

Not checked by other experts: This is a personal blog post, not a journal article. Its claims did not go through editing or review by other experts.
Not a formal review: It does not say how studies were found, which were included, or how good they were. So relevant studies may have been missed, and it is unclear how they were chosen.
No combined figure: The 60% to 90% range simply describes individual studies. It is not a weighted average and says nothing about how uncertain the figures are.
Small groups, mostly boys: Many listed studies were tiny (5, 8, 10 and 16 children) and most only included boys. This limits what can be said about girls, who now make up most clinic referrals.
Older diagnoses: Most studies came before today's diagnosis (DSM-5, the current US psychiatric manual) and included children seen just for gender non-conforming behaviour or milder signs. Critics argue some would not meet today's diagnosis (Temple Newhook et al., 2018, Int J Transgenderism).
How missing children were counted: In the largest Dutch study (Steensma et al., 2013), the 80 teens who did not come back to the clinic were counted as having grown out of it. Temple Newhook et al. (2018) criticised this, and the original researchers defended it. The post does not mention this.
Results measured differently: Studies used different outcomes (wish to change sex, cross-dressing, uncertain, gay, straight). The post's table mixes categories like 'trans-/crossdress' and 'uncertain', so they cannot be compared directly.
Different treatment back then: Several groups had therapy aimed at reducing cross-gender behaviour, and one was a group of hospital in-patients. Almost none had socially transitioned. So the rates may not apply to children who socially transition or are treated today.
No mention of critics: The post presents the research as all pointing the same way. It does not engage with published criticism of the methods and ethics of these studies.
Author's position: Cantor is a well-known voice in debates on youth gender medicine and has since been an expert witness in court cases about youth gender treatment. The post is commentary from one side of a disputed debate.

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Summary

Key findings

Abstract

Conclusion