Desistance studies in children with Gender Dysphoria
Twelve studies have been conducted looking at whether gender dysphoria persists throughout childhood. From these studies, on average around 85% of children change their minds and do not continue into adulthood as transgender. Some of these studies are very old, the first being published in 1968 and others in the 1980s. This was a time before the global trans activist movement began directly targeting children through online social media platforms and teaching resources and visits to schools.
Parents had also not been encouraged to see their child as ‘transgender’ or believe that children have a ‘gender identity’ that is innate and present at birth.
At that time children were not called ‘transgender’ and they weren’t ‘affirmed’ as the opposite sex and socially transitioned. Children who expressed an opposite sex identity were recognised as children and treated with a developmentally-informed approach. The general term was ‘watchful waiting’ but children were given individual care if deemed necessary, such as family therapy. These older studies therefore represent a ‘natural’ desistance rate before cultural beliefs began to influence both the response to children by adults, and children’s understanding of themselves.
The children in the earlier studies were also younger, and mostly boys. This was a time before the explosion of adolescent-onset ‘trans’ identity largely affecting teenage girls, which began to appear around the same time as social media platforms and smart phones.
A search of the literature (Korte, 2008) found:
Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism.
An analysis of 10 published studies can be seen here.
The later studies confirm earlier findings that gender dysphoria in early childhood does not persist in most children past puberty.
This Dutch study (Steensma 2013) followed 127 children who were referred to the Gender Identity clinic in Amsterdam under the age of 12. The study looked to see if these children were still gender dysphoric by the time they reached adolescence at age fifteen. 37% of these children had persisted. However 64% of children had either desisted or were no longer traceable. Since there is only one Gender Identity clinic for children in Holland it can be assumed that the latter no longer required support and so had also desisted.
By 2013 the term ‘gender dysphoria’ was being used and the incidence of social transition was increasing. The study found that a diagnosis of gender dysphoria and social role transition were significant indicators of adolescent persistence of gender dysphoria.
Social role transition accounted for the largest portion of unique variability (12%), whereas each of the other significant predictors accounted for 6% to 7% of unique variability in persistence of GD.
The Cass Review (2024) says:
Later studies, which showed higher rates of persistence at 37% (for example Steensma et al., 2013b) did use formal diagnostic criteria, but by that time a greater proportion of the referrals had socially transitioned prior to being seen. [p.163]
The table using data from the Steensma study shows clearly that no child who was socially transitioned in early childhood desisted:
The most recent study of children who were not routinely socially-transitioned was a study of boys (Singh, 2021) which confirmed the findings of earlier studies:
Of the 139 participants, 17 (12.2%) were classified as persisters and the remaining 122 (87.8%) were classified as desisters.
This study also looked at earlier studies and concluded: “Across all studies, the percentage of persisters was 17.4% (total N = 235), with a range from 0 to 29.1%”
This study is useful as probably the last study of children who were not ‘affirmed’ or socially transitioned. Only one boy in the study had socially transitioned (and he was a persister). The study concludes:
The persistence-desistance rates found in this study and the ones preceding it can be used as a comparative benchmark for samples in which a social transition took place prior to puberty.
We do have a comparative study now (Olson 2022) of children who were socially transitioned from early childhood. The Trans Youth Project followed a total of 317 ‘binary socially transitioned transgender children’ for five years, ‘208 initially transgender girls’ (ie.boys) and ‘109 initially transgender boys’ (ie. girls). Children were recruited for the study between July 2013 and December 2017. For inclusion:
children had to be between 3 and 12 years of age and had to have made a “complete” binary social transition, including changing their pronouns to the binary gender pronouns that differed from those used at their births.
Only 2.5% of children in this study desisted – a very stark contrast to the days of ‘watchful waiting’ when the majority desisted. Of the 97.5% who persisted in a ‘trans’ identity, 3.5% had shifted from an opposite sex identity to ‘non-binary.’ The conclusion was:
transgender youth who socially transitioned at early ages continued to identify that way.
The study reflected:
Increasing numbers of children are socially transitioning to live in line with their gender identity, rather than the gender assumed by their sex at birth, a process that typically involves changing a child’s pronouns, first name, hairstyle, and clothing.
The biggest difference between then and now is the change in approach from watchful waiting to social transition. The fact that some children changed their identity to ‘non-binary’ (a social category that has emerged only very recently) clearly shows the role of cultural influence on these children. The parents were clearly active in facilitating their child’s social transition, and ‘many parents in this study did not believe that [diagnoses of gender dysphoria] were either ethical or useful.’
Activists claim that historic high desistance rates are unreliable because the children had not been diagnosed with ‘gender dysphoria’ so they weren’t ‘really trans’, they were just gender non-conforming children. But many children in this recent group were also not clinically diagnosed with ‘gender dysphoria.’ Yet they were called ‘transgender’ and socially transitioned from an early age.
The children would have been fully aware of puberty blockers and cross-sex hormones as a normal progrssion:
As part of the larger longitudinal study, parents and youth were regularly asked about whether they had begun using puberty blockers and/or gender-affirming hormones.
11.7% of the cohort had already begun puberty blockers before beginning this study.
Among those who had begun puberty blockers and/or gender-affirming hormones, only 1 had retransitioned to live as cisgender (and this youth had begun blockers, but not gender-affirming hormones).
The study authors suggest some reasons why the results of this study differ so markedly from past studies, including that:
participants in those studies were children between the 1960s and the 1990s, and many features of society have changed since then, including greater rates of acceptance and acknowledgment of transgender identities.
We would suggest that what has been forgotten is that these are children, whose understanding of reality is built by what adults tell them, particularly parents.
The Trans Youth Project is an ongoing study, and more data about this cohort of children was published in a further study in 2024. This study revealed that of the original cohort of 317, so far a total of 269 had reached the age of 12 or over and begun medical transition. The study looked at the satisfaction rates of 87% of this group (235 children), including a main sample of 220 children who had completed the 2023 survey.
The study revealed, unsurprisingly:
high levels of satisfaction and low levels of regret; the overwhelming majority (97%) continued to access gender-affirming medical care.
All published studies show that the majority of children who progress to puberty blockers continue on the medical pathway. The Tavistock GIDS Early Intervention study showed that 98% of participants persisted in a cross-sex identity and went on to take opposite sex hormones (See the Puberty blockers page).
Conclusion
There is strong evidence that the majority of children with gender dysphoria will grow out of it and come to feel comfortable with their bodies. All previous published studies show that gender dysphoria naturally resolves for most children by the end of adolescence. However, persitence rates have increased as the practice of socially transitioning children has increased over the past decade. The evidence shows that if adults ‘affirm’ a child as the opposite sex, the child will hold on to that belief for longer. This increases the number of children who want to medically transition with puberty blockers followed by cross-sex hormones and surgeries. These children will become lifelong medical patients, with all the associated and accumulating health risks.
Commonsense, knowledge of child and adolescent development, and existing studies all tell us the same thing: that children grow out of these feelings if we leave them to grow up without undue influence from adults telling them they are ‘transgender’ and facilitating their ‘social transition.’ We don’t yet know how many children in The Trans Youth Project will regret their medical transition in adulthood, but what is clear is that none of them will have the experience of growing up in a healthy, medically undamaged body to compare.
In this article published in 2016, Jesse Singal examines the early published persistence/desistance studies.