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

• 该研究考察了因性别焦虑被转介到多伦多（328名青少年，1976至2013年）和阿姆斯特丹（420名青少年，1989至2013年）诊所的748名青少年。
• 在多伦多，1999至2005年每转介1个女孩约有2个男孩（36个男孩，17个女孩）。2006至2013年这一比例反转为每1个男孩约有1.8个女孩（73个男孩，129个女孩）。
• 在阿姆斯特丹，1989至2005年每1个女孩有1.4个男孩（109个男孩，77个女孩）。2006至2013年反转为每1个男孩有1.7个女孩（86个男孩，148个女孩）。
• 在因其他问题转介的多伦多青少年中，男女比例几乎没有变化（约每个女孩2.2个男孩，之后是每个女孩2个男孩），因此这一转变是性别转介所特有的。
• 多伦多的转介数量在1976年至2013年间逐年大幅上升。
• 在多伦多，出生时为女性且并非只被女性吸引的青少年所占比例，从2006年之前的11.4%升至2006至2013年的36.0%。
• 作者提出了社会和文化方面的原因来解释这一反转，但没有对其进行检验。

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.