Thursday, May 12, 2022

Youth Who Transition to Another Gender Not Likely to Transition Back, Study Finds

Youth who socially transition to a gender other than the sex they were assigned at birth are likely to continue identifying as that gender five years later, according to a study published in Pediatrics.

“These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way,” wrote Kristina Olson, Ph.D., of Princeton University and colleagues. “Nonetheless, understanding retransitions is crucial for clinicians and families to help make them as smooth as possible for youth.”

Olson and colleagues used data from the Trans Youth Project, a longitudinal study involving 317 youth aged 3 to 12 years old. All participants were recruited between July 2013 and December 2017. Prior to joining the study, the youth had to have socially transitioned to a gender other than their sex assigned at birth—a process that typically involves changing their pronouns, first names, hairstyles, and clothing.

The authors used reports from youth and their parents to determine whether the youth retransitioned (meaning they transitioned again after their initial transitions) or if they continued to identify as their transitioned gender several years later. Participants were classified into three categories based on the pronouns they used: binary transgender (the child identified as the transitioned gender), nonbinary (the child used they/them pronouns), or cisgender (the child again identified as the sex they were assigned at birth).

An average of 5.37 years after their initial transitions, 94% of participants were living as binary transgender, 2.5% identified as cisgender, and 3.5% identified as nonbinary. The rate of retransitions among the participants was 7.3%, and four participants (1.3%) had retransitioned twice, to a nonbinary then back to transgender. Most retransitions occurred before the youth reached age 10. Youth who initially socially transitioned before age 6 were more likely to be living as cisgender five years later compared with youth who transitioned at age 6 or later.

Concerns that youth will experience regret after transitioning, particularly after starting hormone therapy, has led some physicians and even legislatures to question the ability of minors to consent to gender-affirming treatment, wrote Christina Roberts, M.D., M.P.H., of Children’s Mercy in Kansas City in an accompanying editorial. The “stability of transgender identity” five years after the initial transition, as evidenced in Olson’s study, should reassure physicians when recommending gender-affirming treatment, Roberts wrote.

She continued: “The low risk of regret should also inform the actions of legislators attempting to substitute their judgment for the judgment of patients, parents, and providers by denying transgender adolescents access to this evidence-based and potentially life-saving treatment.”

For related information, see the Psychiatric News articles “Record Number of Anti-Trans Bills Filed in States This Year” and “Psychiatrists Need to Prepare to Care for Gender-Variant Patients.”

(Image: iStock/Vladimir Vladimirov)

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