Summary

Dutch clinicians followed 127 children referred to their gender clinic before age 12 and checked who still had gender dysphoria (distress about a body/gender mismatch) in their mid-teens. 37% still had it and sought medical transition. The other 63% did not come back and were counted as desisters (no longer dysphoric); those who answered questionnaires reported little or no distress. Girls persisted more often than boys (50% vs 29%). Children with more intense distress, who said they were (not wished to be) the other sex, who were older when referred, or who had socially transitioned (new name, clothes or pronouns) were more likely to persist. Anxiety, behaviour and friendships did not predict this. An important study, but desistance was assumed for non-returners, all came from one clinic, and the older diagnosis included milder cases.

Key findings

• 在12岁前被转介的127名儿童中，47人（37%）在青少年时期仍有性别焦虑，80人（63%）被视为已度过这一阶段。
• 女孩比男孩更常持续：48名女孩中有24人（50%），79名男孩中有23人（29%）。
• 童年时痛苦的强烈程度影响最大：持续者中91%至96%符合完整的儿童期诊断，而未持续者中为39%至58%。
• 说自己是另一种性别的儿童比说希望成为另一种性别的儿童更可能持续，作者称之为“是”与“希望成为”的区别。
• 童年时的社会性过渡与持续有关，总体几率高出约5倍，男孩中高出约22倍。但进行过渡的男孩痛苦也更强烈，因此无法将过渡本身的影响分离出来。
• 由父母和老师评价的儿童总体心理健康和友谊状况，不能预测谁会持续。
• 几乎所有持续者都被自己的出生性别所吸引，而未持续者中大多数女孩和约三分之一的男孩被异性吸引。

Abstract

To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence. The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (<12 years of age) and followed up in adolescence. We examined childhood differences among persisters and desisters in demographics, psychological functioning, quality of peer relations and childhood GD, and adolescent reports of GD, body image, and sexual orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls.

Conclusion

Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD.