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

• 研究檢視了轉介到多倫多（328 名青少年，1976–2013 年）和阿姆斯特丹（420 名青少年，1989–2013 年）門診的 748 名因性別焦慮就診的青少年。
• 在多倫多，1999–2005 年每轉介 1 名女孩約有 2 名男孩（36 名男孩、17 名女孩）。在 2006–2013 年，這顛倒過來，每 1 名男孩約有 1.8 名女孩（73 名男孩、129 名女孩）。
• 在阿姆斯特丹，1989–2005 年每 1 名女孩有 1.4 名男孩（109 名男孩、77 名女孩）。在 2006–2013 年，顛倒為每 1 名男孩有 1.7 名女孩（86 名男孩、148 名女孩）。
• 在多倫多因其他問題被轉介的青少年中，比例幾乎沒有改變（每 1 名女孩約 2.2 名男孩，之後為每 1 名女孩 2 名男孩），因此這項轉變是性別轉介所特有的。
• 1976 至 2013 年間，多倫多的轉介人數逐年大幅上升。
• 在多倫多，出生時為女性、且並非只被女性吸引的青少年比例，從 2006 年前的 11.4% 升至 2006–2013 年的 36.0%。
• 作者提出了造成這項顛倒的社會與文化原因，但沒有加以檢驗。

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.