Summary

The Trans Youth Project followed 317 US and Canadian children who had fully socially transitioned (changed name, pronouns and presentation) between ages 3 and 12. About five years later, 94% still identified as trans, 3.5% as nonbinary and 2.5% as their birth sex; 7.3% had changed identity at least once. By the end, about 60% had started puberty blockers or cross-sex hormones. The authors concluded that switching back is uncommon. Children in supportive, mostly well-off volunteer families usually kept their new identity. But there was no comparison group of similar children who did not transition, so the study cannot say whether this reflects the children or the transition itself. Zucker and others argue early social transition may itself lock in identity, a question the Cass Review's evidence review treated as unresolved.

Key findings

• 317 名完全進行過社會性過渡的兒童（208 名跨性別女孩、109 名跨性別男孩），在 2013 至 2017 年間於 3 至 12 歲（平均 8 歲）加入研究。
• 在首次過渡約 5.4 年後，94% 認同為跨性別男孩或女孩，3.5% 認同為非二元性別，2.5%（8 名年輕人）認同為出生性別。
• 7.3% 至少轉換過一次認同，其中包括 1.3% 後來又回到跨性別認同。
• 在 6 歲之前就進行過渡的兒童，日後更可能認同出生性別（5.6% 對 0.5%）；這些改變多數發生在 10 歲之前。
• 到研究結束時，92 人已開始使用青春期阻斷劑（暫停青春期的藥物），98 人已開始使用跨性別荷爾蒙，約 60% 的人走上醫療路徑。
• 家庭平均在孩子過渡後 1.6 年加入，26 個家庭（8%）在前兩年沒有聯絡。
• 追蹤時只有 70 人年滿 14 歲或以上，因此多數結果是在青春期之前或早期衡量的。

Abstract

BACKGROUND AND OBJECTIVES: Concerns about early childhood social transitions among transgender youth include that these youth may later change their gender identification (ie, retransition), a process that could be distressing. The current study aimed to provide the first estimate of retransitioning and to report the current gender identities of youth an average of 5 years after their initial social transitions. METHODS: The current study examined the rate of retransition and current gender identities of 317 initially transgender youth (208 transgender girls, 109 transgender boys; M = 8.1 years at start of study) participating in a longitudinal study, the Trans Youth Project. Data were reported by youth and their parents through in-person or online visits or via e-mail or phone correspondence. RESULTS: We found that an average of 5 years after their initial social transition, 7.3% of youth had retransitioned at least once. At the end of this period, most youth identified as binary transgender youth (94%), including 1.3% who retransitioned to another identity before returning to their binary transgender identity. A total of 2.5% of youth identified as cisgender and 3.5% as nonbinary. Later cisgender identities were more common among youth whose initial social transition occurred before age 6 years; their retransitions often occurred before age 10 years. CONCLUSIONS: These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way. Nonetheless, understanding retransitions is crucial for clinicians and families to help make retransitions as smooth as possible for youth.

Conclusion

These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way. Nonetheless, understanding retransitions is crucial for clinicians and families to help make retransitions as smooth as possible for youth. The authors caution against over-interpreting differences from older desistance studies, note that identities 'should not be interpreted as final', and say parents and clinicians should be informed that not all youth will continue on the same trajectory.