Förblir transbarn trans när de växer upp?

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 listar 11 uppföljningsstudier av barn som sågs för könsöverskridande beteende eller könsrelaterat lidande, publicerade 1972 till 2013, och säger att tre var stora.
Inlägget drar slutsatsen att ungefär 60 % till 90 % av barnen som sågs på sådana kliniker inte längre identifierade sig som trans i tonåren eller vuxen ålder.
I de största listade studierna fortsatte det könsrelaterade lidandet hos 17 av 139 (Singh, pojkar i Toronto), 47 av 127 (Steensma och kollegor, Amsterdam) och 21 av 54 (Wallien och Cohen-Kettenis), eller cirka 12 % till 39 %.
Cantor skriver att de flesta barn som växte ifrån könsrelaterat lidande växte upp som homosexuella snarare än heterosexuella.
Inlägget skrevs i januari 2016 som svar på stängningen av CAMH:s barnkönsklinik i Toronto.
Flera av de äldre studierna är mycket små (5 till 16 barn) och de flesta studerade bara pojkar. Drummond och kollegor följde 25 flickor, och de två nederländska studierna omfattade båda könen.
Singh-studien (2012) var då en opublicerad doktorsavhandling. Den publicerades senare 2021 av Singh, Bradley och Zucker i 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