Adolescent Gender Identity/Dysphoria

"These findings support that within a clinical context involving comprehensive psychosocial assessment and support, gender identity among adolescents is highly stable, and rates of reidentification with birth-assigned gender and cessation of [gender-affirming hormones] are low."

"Despite there being broad consensus among major medical organizations about the necessity of gender-affirming care, some government bodies continue to raise questions a bout access to gender-affirming care."

Recently-published Canadian study    Journal of Adolescent Health

 

"The study also found that no one who initially identified as non-binary returned to a binary gender aligned with their birth sex."

"For many youth, access to appropriate care is associated with improved well-being and mental-health outcomes."

"Other research has also reported low rates of detransition and treatment discontinuation, although findings vary depending on the population studied."

Daniel Metzger, paediatric endocrinologist, B.C. Children's Hospital, report first-author

 

"It's an open question whether the detransition rate of someone who started their transition in 2012 is going to be the same rate as someone who started their transition in 2020 or 2022."

"[The paper suggests that appropriately selected youth who undergo comprehensive holistic assessments] are likely to at least be persistent in the short- to medium-term."

"It could be that many of them are continuing to do great and if we reached out to them today, in 2025, they'd say; 'Hey, I'm doing great. Leave me alone'."

"Or we could reach out and they say, 'I desisted when I was 22'. We don't know. And we can't tell from this data." 

Dr. Laura Targownik, physician-scientist, professor of medicine, University of Toronto 

New Study Shows Trans Youth Are Extremely Unlikely to Detransition   them.us

 

Only 2.9 percent of teens -- in a social period of rapid gender-affirming medical interventions -- referred to one of four specialized pediatric gender clinics, changed back to their original gender identity; detransitioned, over a median followup study of 2.4 years. The study authors felt the findings suggest stability in teen gender identity where their study appears to prove that actual detransitioning is 'uncommon'. The results of their study, they wrote "may offer reassurance to those concerned that adolescents are too  young to understand their gender identity or make decisions about medical transition".

 

As with any scientific study addressing controversial issues, critics find the study has the effect of inflating persistence while presenting a skewed picture, taking into regard the short followup window to detect a verifiable transition rate. Moreover, the study's structure leaves the authors incapable of asserting with any certainty what occurred when youth moved from adolescence into adulthood, and how that maturation affects their identity perception at that juncture.

 

The study encompassed children between between the years 2012 and 2017 prior to the more recent spike in gender dysphoria cases, alongside changing demographics. At the present time, predominantly biological females, many with accompanying complex mental health problems, many identifying as non-binary, are being seen by doctors. "Considerable uncertainty" remains of benefits of gender treatment for children, two recent Canadian studies concluded. 

 

The number of children and teens seeking gender-affirming care almost tripled in Canada and the U.S. between 2017 and 2020, the study's authors note. Photo by Adobe Stock

 

The latest study research team involved reviewing 445 teens diagnosed with gender dysphoria and seen at gender clinics in Vancouver, Calgary, Ottawa and Halifax -- of which 74 percent were born female, most between the ages of 13 and 18 at time of referral, while the mean age of beginning gender-affirming hormone treatment was just over 16 years of age. At each visit, every six months, the teens were questioned about their gender identity and whether hormone use was being continued. 

 

Researchers looked at data in the youths' medical records between 2018 and 2020. There ensued at least one year of followup after each gender clinic visit. 95 percent -- 421 of the 445 -- continued with their presenting gender identity or re-identified as nonbinary: "from initial referral to end of the observation period". Of the 353 adolescents who began gender-affirming hormones, only one percent stopped taking them. Of the 24 that changed gender identity, 13 "returned to gender identity typically aligned with sex at birth".

 

Doctors have been sued by some detransitioners with the allegation that their wish for extreme interventions had never been challenged, nor were alternative treatments properly discussed. Detransitioners, surveys have found, may sometimes feel reluctant to inform their doctors, concerned they would waste people's time, even knowing that something was not quite right. Detransition "is very unlikely to occur even after 10 or more years identifying with [a] gender identity different than the identity aligned with birth sex", pointed out Dr. Lawson. 

 

Parents of transgender children and other supporters of transgender rights gather in an outdoor rotunda in Austin, Texas, to speak about transgender legislation being considered in the state House and Senate, on April 14, 2021.   Eric Gay / AP file

 

"I don't expect the detransition rate at a median two years to be terribly high, but if you follow these patients for five years, or 10 years, you might have a clearer picture."

"[The finding that most youth prescribed hormones] does provide some reassurance that they're not just starting patients on hormones and they're desisting right away."

"But [the researchers] don't talk about, were these patients seeing psychiatrists? Were they seen for other problems? Were they getting admitted to hospital for mental-health decompensation?"

"They're basically using persistence as a proxy for, 'Well, they're doing OK enough that they didn't have to abandon their transition or that their clinicians didn't feel that they were suffering from such a grievous harm that it had to be stopped."

Dr. Laura Targownik, transgender woman 

 

"Individuals who do not support gender-affirming medical care for adolescents are likely to look for reasons that might discount the findings of our study and publication."

"However, as principal investigator of this study, I can assure you that our study's methodology is extremely sound."

Senior study author Dr. Margaret Lawson, scientist emeritus, CHEO Research Institute 

 

Transgender Adolescents

"Echoing the U.K.'s landmark Cass Report, the authors [U.S. Department of Health and Human Services (HHS) report] call for gender dysphoria to be 'de-exceptionalized', meaning therapists need to approach treating these young people in the same way they would any other distressed patients."

"Instead of viewing them as 'transgender adolescents' in need of powerful hormones and drastic surgeries, the report suggests that therapists should help these young people 'develop self-understanding, engage with emotional vulnerability, and build practical strategies for managing distress'."

Mia Hughes, senior fellow, Macdonald-Laurier Institute 

White House Deputy Chief of Staff Stephen Miller called gender-affirming care for children "barbaric" at a press conference on Thursday. Press secretary Karoline Leavitt looks on. Evan Vucci/AP

A recently-released 409 page report issued by the U.S. Department of Health and Human Services examined the state of pediatric gender medicine, highlighting exceptionally fragile evidence that has been used in support of puberty blockers, cross-sex hormones and surgeries for young people who claim to identify as transgender. The report exposes the manner in which ideology has managed to eclipse science and persuade large segments of the skeptical public to trust the medical establishment that has failed in its duty to 'do no harm' with vulnerable youth.

 

The report, commissioned by executive order from U.S. President Donald Trump, does not echo his personal inflammatory, bombastic accusatory messaging. It relies instead on the cool-headed intelligence of medical specialists who rely on science and biology in the natural order of genetics and inheritance. Measured and reliant on evidence, it offers recommendations that align with the cautious, evidence-based reaction to gender-affirming care that much of Europe has now adopted in contradiction to major medical associations in the U.S. and Canada's ideological positions.

 

The report's (unnamed/unidentified) authors delved past the ideological screens and their slogans in their delivery of a methodical assessment of the state of pediatric gender medicine as it currently pertains in North America. An 'umbrella review' centers the report, synthesizing existing systematic reviews for interventions in question, reflecting reviews that have taken place in Sweden, Finland, England and Canada. Evidence cited for continuation of the status quo was deemed to be of 'very low' quality.

 

Methodologically weak, lacking control groups or long-term follow-up, this field of research, in particular in reference to claims that hormonal and surgical interventions improve mental health or reduce suicide ideation fail the test of reliability. Known risks of such interventions that include infertility, reduced bone density, disrupted psychosocial development, and impaired sexual function, are documented outcomes of these interventions. It has been found that every systematic review to date in pediatric gender medicine, concludes that risks outweigh any potential benefits.

 

Psychotherapy is one of the most vital sections of the report, in a cultural climate where talk therapy is frequently dismissed or derided as equivalent to gay conversion therapy. The HHS report states a strong belief for a non-invasive approach in place of life-altering medical interventions. The therapeutic approach in fact represents what leading European health authorities have implemented, reflecting a rising awareness that gender dysphoria among adolescents, particularly girls, is a complex symptom of deeper psychological distress.

 

Mounting evidence of a major medical scandal unfolding aside, Canada remains a holdout; not yet prepared to launch a review of the practices in its pediatric gender clinics. Guidelines in Canada are aligned with those of the World Professional Association for Transgender Health, a group discredited for its prioritizing ideological commitments over scientific rigour. Alberta is the first province in Canada to have taken concrete steps shielding vulnerable young people from a medical establishment that abandoned science and ethical principles.

 

Canada, like the United States, has seen a dramatic surge in referrals to gender clinics. Demographic shifts from young boys to predominantly adolescent girls, with Canadian gender clinics among the earliest and most likely to adopt experimental medical interventions. As the number of detransitioners rises there will arise lawsuits to add to the two already underway in a reflection of Canada's inaction on the issue, evidently satisfied to continue placing ideology before evidence, placing youth in harm's way. 

 

A report published this week is the latest in a series of actions—some of which have sparked protest—from President Donald Trump’s administration targeting gender-affirming care for trans individuals.  Stephanie Keith/Bloomberg via Getty Images

“The finger was already on the scale when this report was commissioned,” says Kellan Baker, a health services researcher who serves as executive director of the Whitman-Walker Institute for Health Research and Policy. In recent years, more than half of all states, including Florida and Tennessee, have implemented policies restricting or banning gender-affirming care for minors. Soon after taking office in January, Trump gave HHS a 90-day deadline to publish the review in an executive order titled “Protecting Children from Chemical and Surgical Mutilation,” which claimed without evidence that medical professionals in the United States “are maiming and sterilizing a growing number of impressionable children” and threatened to revoke federal funding from hospital clinics that provide gender-affirming care to minors.

ScienceAdviser