Young children who are transformed into a new gender with social change – adopting new names, pronouns, haircuts and clothing – will likely continue to be identified with that gender after five years, according to a report released Wednesday. This is the first study.
The data comes from the Trans Youth Project, a well-known initiative that tracks 317 children in the United States and Canada who have gone through so-called social change between the ages of 3 and 12. Participants have moved in an average of six and a half years.
According to the survey, the vast majority of the group still identified with their new gender five years later, and many began taking hormone medications in their teens to bring about biological change according to their gender identity. The survey found that only 2.5% of participants were re-identified as their assigned gender at birth.
As tensions rise in U.S. courts and state legislatures over health care for transgender children, there is little hard information about their long-term development.
New research provides one of the first large datasets in this group. Researchers want to continue following participants for 20 years after the start of their social transition.
“There is a thesis that kids will start this thing and then change their minds,” said Christina Olson, a psychologist at Princeton University who led the study. “And at least in our sample we can’t find it.”
Olson and other researchers noted, however, that the study may not be generalized to all transgender children. Two-thirds of participants were white, for example, and parents had higher incomes and higher education tendencies than the general population. All parents have provided support to facilitate a complete social transition.
Since the study began nearly a decade ago, it is unclear whether it reflects current patterns, when many more children identify as trans. Two-thirds of the study participants were transgender girls who were assigned to boys at birth.
In recent years, however, gender clinics for young people around the world have reported that adolescents have been assigned to adolescent girls who have recently been identified as trans or non-binary boys.
The group has a high rate of mental health problems, including autism and ADHD (Attention Deficit Hyperactivity Disorder), according to Laura Edwards-Lipper, a clinical psychologist who specializes in caring for transgender children in Oregon. “It’s really the group I’m most concerned about right now,” he said.
“I would say this study says nothing about our children,” added Edwards-Lipper. “That’s the difference.”
Researchers at the Trans Youth Project began recruiting participants in 2013, traveling to more than 40 families in the United States and two Canadian provinces to interview families. Such in-depth data are rare in such studies, which are usually obtained from children referred to in online surveys or gender clinics, who are usually older and from more limited geographical areas.
Previously published project work showed that children who were supported by their parents during social transition were almost equal to Sisgender children in terms of depression rate, with some anxiety rates.
A new study published in the journal Pediatrics follows these children as they reach a milestone almost five years after their initial social transition. The study found that 94% of the group still identified as transgender even after five years. Another 3.5% were identified as non-binary, meaning they did not identify as boy or girl. That label was not widely used when researchers began researching it as it is today.
By the end of the study period in 2020, 60% of children had started taking adolescent-blocking drugs or hormones. Researchers are still collecting data on how many teenage participants underwent penis surgery, Olson said.
Eight babies, or 2.5%, returned to their assigned sex at birth. Seven of them made social transitions before the age of six and returned before the age of nine. The eighth child, 11 years old, reversed the process after starting to use adolescent-blocking drugs.
The new study suggests that transgender children, when supported by their parents, improve their identity. However, it is possible that some children who are still identified as transgender at the end of the study – or their parents have felt some pressure to continue the path they started.
“I think, depending on the perspective, people might interpret this data differently,” said Amy Tischelman, a clinical psychologist at Boston College and lead author of the chapter on child care standards at the World Professional Association for Transgender Health.
“Some people may say that children go in and out of this developmental trajectory, and medical interventions may be irreversible and they may regret it,” he said. “Other people will say that children know their gender, and they are happy when they support their gender.”
While most physicians agree that social transformation may be helpful for some children who question their assigned gender, it is also important to support those who change their minds, Tischelmann said.
It’s really important for kids to be able to feel that it’s okay to be fluid, to keep exploring.
Translated by Luiz Roberto M. Gonzalves