Summary

This US study asked children who had socially transitioned (living fully as the other gender, with family support) to rate their own depression, anxiety and self-worth. It compared them with matched children and with their brothers and sisters. The trans children reported normal levels of depression and self-worth and slightly more anxiety; parents reported similar results. The authors contrasted this with earlier clinic studies of gender-nonconforming children who had not transitioned, which found much more distress. But families were found through support networks, were mostly well-off and supportive, and children did not need a diagnosis of gender dysphoria. With nothing measured before transition, the study cannot show social transition caused the good mental health. Later careful reviews rate this kind of evidence as low quality.

Key findings

• 63名9至14岁已进行社会性过渡的跨性别儿童、63名配对儿童和38名兄弟姐妹，使用简短问卷自评了抑郁和焦虑。
• 各组之间抑郁没有差异，跨性别儿童的得分与美国平均水平相符。
• 跨性别儿童报告的焦虑略多，不过这一差异可能是偶然；家长报告的焦虑明显多于其他儿童，且高于美国平均水平。
• 116名6至14岁的跨性别儿童的自我价值感与其他儿童或其兄弟姐妹没有差别。
• 跨性别儿童的家长报告的焦虑比儿童自己略多，作者将此视为家长没有隐瞒问题的迹象。
• 这些家庭是通过跨性别儿童家庭的支持团体、夏令营和网络论坛找到的，高收入家庭的比例要高得多。
• 作者说，他们不能断定社会性过渡导致了这些结果，而且随着孩子长大，问题可能会出现。

Abstract

OBJECTIVE: Social transitions are increasingly common for transgender children. A social transition involves a child presenting to other people as a member of the "opposite" gender in all contexts (e.g., wearing clothes and using pronouns of that gender). Little is known about the well-being of socially transitioned transgender children. This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children. METHOD: As part of a longitudinal study (TransYouth Project), children (9-14 years old) and their parents completed measurements of depression and anxiety (n = 63 transgender children, n = 63 controls, n = 38 siblings). Children (6-14 years old; n = 116 transgender children, n = 122 controls, n = 72 siblings) also reported on their self-worth. Mental health and self-worth were compared across groups. RESULTS: Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728). CONCLUSION: These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems.

Conclusion

These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems. In the discussion the authors add that they cannot conclude social transition caused the outcomes, that the children may face greater issues as they mature, and that the high-income skew of the sample limits generalisation; they suggest the results provide converging evidence that early family support is associated with positive mental health in transgender children.