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 歲以前被轉介的 127 名兒童中，47 人（37%）到青少年時期仍有性別焦慮，80 人（63%）被視為已脫離性別焦慮。
• 女孩持續的比例高於男孩：48 名女孩中有 24 人（50%），79 名男孩中有 23 人（29%）。
• 童年時期痛苦的強烈程度最為關鍵：持續者中有 91–96% 符合完整的兒童期診斷，未持續者則為 39–58%。
• 表示自己就是另一個性別的兒童，比表示希望成為另一個性別的兒童更可能持續，作者稱之為「是」與「希望成為」的差別。
• 童年時期的社會性過渡與持續有關，整體機率約高出 5 倍，男孩約高出 22 倍。但進行過渡的男孩痛苦也更強烈，因此無法把過渡本身的影響分離出來。
• 由家長與老師評估的兒童整體心理健康與友誼，無法預測誰會持續。
• 幾乎所有持續者都被自己的出生性別所吸引，而未持續的女孩大多數、男孩約三分之一則被異性所吸引。

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.