Summary

Researchers from gender clinics in Toronto and Amsterdam checked whether the mix of boys and girls referred for gender dysphoria in their teens had changed. Across 748 referrals, both clinics showed the same pattern. Before about 2006 more teens born male were referred. From 2006 to 2013 teens born female clearly outnumbered them. Among Toronto teens referred for other mental health problems, the balance of boys and girls hardly moved, suggesting something specific to gender referrals. Referral numbers also rose steadily. This was one of the first published reports of the shift later seen around the world. It reliably shows a change in who was referred to two clinics, but cannot say why. The authors suggested social and cultural reasons, but did not test them.

Key findings

• Nghiên cứu xem xét 748 thiếu niên được giới thiệu vì phiền muộn giới đến các phòng khám ở Toronto (328 thiếu niên, 1976–2013) và Amsterdam (420 thiếu niên, 1989–2013).
• Ở Toronto, giai đoạn 1999–2005 có khoảng 2 bé trai được giới thiệu cho mỗi bé gái (36 bé trai, 17 bé gái). Trong 2006–2013 điều này đảo ngược thành khoảng 1,8 bé gái cho mỗi bé trai (73 bé trai, 129 bé gái).
• Ở Amsterdam, giai đoạn 1989–2005 có 1,4 bé trai cho mỗi bé gái (109 bé trai, 77 bé gái). Trong 2006–2013 nó đảo ngược thành 1,7 bé gái cho mỗi bé trai (86 bé trai, 148 bé gái).
• Trong số thiếu niên ở Toronto được giới thiệu vì các vấn đề khác, sự cân bằng hầu như không thay đổi (khoảng 2,2 bé trai cho mỗi bé gái, rồi 2 bé trai cho mỗi bé gái), nên sự thay đổi chỉ đặc trưng cho các lượt giới thiệu về giới.
• Số lượt giới thiệu ở Toronto tăng mạnh năm này qua năm khác từ 1976 đến 2013.
• Ở Toronto, tỷ lệ thiếu niên sinh ra là nữ không chỉ bị thu hút bởi nữ giới tăng từ 11,4% trước năm 2006 lên 36,0% trong 2006–2013.
• Các tác giả gợi ý các lý do xã hội và văn hóa cho sự đảo ngược, nhưng không kiểm chứng chúng.

Abstract

INTRODUCTION: The number of adolescents referred to specialized gender identity clinics for gender dysphoria appears to be increasing and there also appears to be a corresponding shift in the sex ratio, from one favoring natal males to one favoring natal females. AIM: We conducted two quantitative studies to ascertain whether there has been a recent inversion of the sex ratio of adolescents referred for gender dysphoria. METHODS: The sex ratio of adolescents from two specialized gender identity clinics was examined as a function of two cohort periods (2006-2013 vs. prior years). Study 1 was conducted on patients from a clinic in Toronto, and Study 2 was conducted on patients from a clinic in Amsterdam. RESULTS: Across both clinics, the total sample size was 748. In both clinics, there was a significant change in the sex ratio of referred adolescents between the two cohort periods: between 2006 and 2013, the sex ratio favored natal females, but in the prior years, the sex ratio favored natal males. In Study 1 from Toronto, there was no corresponding change in the sex ratio of 6,592 adolescents referred for other clinical problems. CONCLUSIONS: Sociological and sociocultural explanations are offered to account for this recent inversion in the sex ratio of adolescents with gender dysphoria.

Conclusion

In both the Toronto and Amsterdam clinics the sex ratio of adolescents referred for gender dysphoria inverted from favouring natal males before 2006 to favouring natal females in 2006–2013, with no matching change among adolescents referred to the Toronto service for other clinical problems. The authors offer sociological and sociocultural explanations for this recent inversion.