Most transgender children do not grow up to be transgender adults.
This article on the Science of Us is an excellent summation of the research: studies consistently show that the majority of transgender children do not grow up to be transgender adults; the two largest studies show that two-thirds and 90%, respectively, stopped being transgender.
Now, of course, some gender dysphoric people don’t transition. But look at those numbers! Even if you assume half of them are non-transitioning gender dysphorics, there’s still a high chance– somewhere between a third and two-fifths– that the child will grow up to be cisgender.
To be clear, I completely support the current standards of care for transgender children. Social transition is easily reversible: all you have to do is tell everyone “hey, I’m going back to using my old name and pronouns.” And gender dysphoric children are distressed by being their assigned gender. You don’t have to justify alleviating a child’s distress by saying “also they will continue to want this thing for the rest of time!” Like, imagine if a parent said “I’m not going to give my children any toys, because when they’re adults they probably won’t like playing with toys!” That’s clearly absurd.
As for physical transition, the gender dysphoric child is given puberty blockers to give them more time to make a decision. Puberty blockers are used to treat children who have puberty at a very young age, and are generally considered safe and effective. When the child is older, they can make a decision about which puberty to go through. Since even under the most conservative estimates a gender dysphoric child has something like a hundred times the chance of being a gender dysphoric adult, these treatments make sense. (I do worry that puberty is what eases childhood gender dysphoria, in which case preventing puberty has little effect. I would really like someone to do a randomized controlled trial about this. Until then, I think the harm of wrong-gender puberty to trans people outweighs the harm of possibly transitioning to cis people.)
However, I do think that this research is important and needs to be more widely known.
Right now, the parent of a trans child gets a narrative like this: “if your child is gender dysphoric, they’re going to be gender dysphoric for the rest of their lives, because their unchangeable gender identity is different from the one they were assigned at birth. The chance of detransition is minuscule and only happens if the child has made a mistake.”
Since there is, in fact, a very large chance that a gender dysphoric child will not grow up to be a gender dysphoric adult, this narrative harms gender dysphoric children. Imagine being a gender dysphoric child, knowing that your parents have fought with the school and the doctors and their family to let you transition, and feeling your gender dysphoria lessen. Would they think “oh, guess I’m my assigned gender at birth after all”? Or would they think “but I used to be a different gender! I felt that really strongly! Probably this is just a fluke”? Would they worry about the disappointment of their parents, the feeling that all their parents’ work was wasted, the embarrassment of being ‘mistaken’?
I’ve had the wrong puberty. I wouldn’t wish it on anyone.
What if instead our narrative was: “many gender dysphoric children do not grow up to be gender dysphoric adults. Gender dysphoric children should socially transition, because children’s pain matters. But when they’re teenagers, it will change: some of them will become transgender, and some of them will become cisgender. There’s nothing we can do to make one outcome or another happen; all we have to do is wait and see what happens.”
That would be a much kinder and more compassionate narrative for trans children.
Frankly, I think trans adults need to take a long, hard look in the mirror. That narrative didn’t appear out of nowhere. It was the product of a lot of trans people talking about our childhoods. The born this way narratives we peddle to gain acceptance are hurting gender dysphoric children.
I would not have met criteria for gender dysphoria as a child. Oh, there’s a way I can bend, spindle, fold, and mutilate my past to make it look like I was gender dysphoric, but I wasn’t. I was a child who was very proud of my gender and who was also autistic and not very good at gender roles. I was looking forward to puberty! And then it happened and I was trapped in this body that was wrong and this social role that was wrong and I didn’t understand what was going on except that suddenly my body didn’t belong to me anymore.
I don’t think my narrative is uncommon.
Of course, some trans adults are trans children– after all, trans children are something like a hundred times more likely to become trans adults. But many trans adults were not gender dysphoric as children. That’s okay. The legitimacy of our genders should not be based on whether we were playing with dolls when we were six. Those of us who became trans in adolescence need to talk about it. And those of us who were trans as children but are cisgender as adults need to talk about it too– and trans people cannot shout them down claiming that their experiences are transphobic.
Gender dysphoria in children and gender dysphoria in adults are related, but distinct conditions. Many people have one but not another. It’s okay to say that. And the ethical treatment of transgender children depends on it.
Thing of Things 
This is interesting to me. My impression is that the studies that show trans kids don’t grow up trans aren’t really basing it on children’s experience of dysphoria as much as on gender non-conformity. I may be wrong, but from what I’ve seen, the actual conclusion here is something more along the lines of “2/3 to 90% of gender non-conforming children are in fact still cisgender”. Which is a different sort of thing.
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That’s addressed in the Science of Us post: the studies are of mostly gender dysphoric children, and anyway GNC kids and gender dysphoric kids have a statistically identical chance of growing up to be gender dysphoric adults.
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Ok cool. Thanks for clarification. That is super interesting!
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I’m still not convinced, for the simple reason they are not splitting on the one sure criteria: a serious desire to take cross-sex hormones a year or so after the time of puberty.
In other words, even if 99% of children who meet the criteria for childhood gender dysphoria go on to be cisgendered adults, that does not tell us how many children who seriously desire hormones at age twelve will go on to be cisgendered. That is the kind of number we want if making a decision about HRT for adolescents.
I haven’t read the entire Singh study, but it begins thus:
So the study is looking at children with a mean age of 7.49, and as low as 3 (and yes, as high as 12).
From table 11, if I am reading it correctly, we see that the mean childhood age of the “persisters” was 8.85, for the “desister-gay,” 6.96, and for “desister-straight,” 7.49. I have no idea if these are significant, but the fact that the “persisters” were on average more than a year older during the first phase of the study is unsurprising, and supports my assertion.
Anyway, it seems as if these studies contain a fair number of 6-8 year olds who meet the criteria for gender dysphoria. Most of them do not go on to be trans. Fine. But a thirteen-year-old, waiting on hormone blockers, desperate to begin puberty — this study tells us nothing about those kids.
I support the use of hormone blockers. Sixteen seems like a decent age, except that puberty begins much earlier now than when I was a teen. I dunno. This data provides zero evidence that says we should never make an exception for a thirteen-year-old.
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> I think the harm of wrong-gender puberty to trans people outweighs the harm of possibly transitioning to cis people.
I am curious about this. It’s not a question I’d specifically considered, but my intuition disagrees – I’d expect them to be equally bad, except that the transitioned cis people then also have to deal with societal stigma they otherwise would have avoided.
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Well, we don’t know that puberty is what triggers gender dysphoria in adults– it could just be growing older. Given that one is a certainty and the other is a risk, I’d rather worry about the certainty. (Also, it might be that gender dysphoric kids on blockers become happy trans adults, and gender dysphoric kids who aren’t on blockers become happy cis probably-LGB adults, in which case it’s not obvious to me which is better.)
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I think the weighting gets changed by the fact that a trans person being forced to go through the wrong puberty against their stated wishes is an added harm in addition to thediscomfort of the puberty itself.
Meanwhile, a cis person who transitioned, and subsequently detransitions has at least had their wishes and preferences respected throughout that process, which actually could have a lot of positive consequences for them feeling respected by and heard by their parents and other authority figures and help them develop a good ability to state their needs and expect them to be respected in the rest of their lives.
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In accounts from people who have detransitioned, they sometimes express the sentiment that their decision was forced by external pressure; for example, they could live as a suicidal, lonely cis butch lesbian, or a straight trans man recovering from a medical problem that the local community understood and respected. The most obvious example of direct forcing occurs in Iran where trans medical treatment is legal and homosexuality is not.
To be clear, I don’t mean to state that people undergoing trans medical treatment and presented as straight are always in a position safer than others, especially not in the Western countries where it seems this research occurred (i got a little confused by the references to cities instead of countries). The issue of social position is rather distinct from the scope of the original post.
Another common sentiment is that anatomical dysphoria can be a severe body focused disorder that should be taken seriously, but without political consequences, like, you can learn to love your body the way it is and stop thinking about it, with CBT or whatever. Again, not saying that any dysphoric person is obligated to do this. But I’ve read accounts where 100% of the answer to “I have experienced a long lasting desire to cut off my breasts” is “you were born with dysphoria, you will always live with dysphoria unless you Get Treatment, you will die someday and either be happy with your treatment or suicide from your untreated dysphoria”.
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My conscious gender dysphoria did not begin until I was about 18. That said, I began having cross-sex fantasies even before puberty. The thing was, I wasn’t able to connect the dots. I just figured, being a girl was obviously better than being a boy, and girls are so pretty, and I wished that I was one, and I knew not to talk about these things, for the same reason I knew not to talk about masturbation.
Everyone masturbates (I believed), but you do not talk about it. If you do, you get beat up.
Every guy wishes he was a girl (I believed), but you do not talk about it. If you do, you get beat up.
(I got beat up a lot until I figured the first one out. I seldom even hinted at the second.)
Being a neuro-diverse clusterfuck of failure didn’t help either. Looking back, I cannot really separate out “being trans fucked me” from “being spergy fucked me.” I’m not even sure if they are entirely separate things. All I know is, as an adolescent, I could not “boy” for shit. I tried. It was disastrous. Furthermore, cuz I liked girls, I had no “in” into gay subculture, which might have helped me. (On the other hand, this was the early 80s, so it might have killed me. Blah.)
There is no way I could have figured out on my own to take puberty blockers. I don’t even know. I cannot imagine being a kid now, in a more trans-aware culture, what I might have done. Would I have figured it out? Could I have processed the knowledge?
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This is all correct, but there’s absolutely zero, nil, NO FUCKING CHANCE that most cis parents can be made to accept that. What they’ll hear instead is “oh, it’ll pass, don’t let your kid get any of these stupid fancies/just beat it out of them”. I fucking guarantee it.
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Well, most people are insane, and will screw parenting up in plenty of different ways. But most people reading this article will understand.
Well, at least I’m cis*, and I’m going to follow this advice if I ever have children with that kind of problem.
*by default, actually. But that might make it even harder to sympathize, because I have no idea what a gender identity even feels like.
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I wonder if some people are transgender as children because gender identities are complicated and difficult to navigate, so they misdiagnose what would actually make them most happy. That could explain why they settle on being cisgender later in life when they have more knowledge and experience. If this is true, it would suggest that giving them stronger guidance about what their gender probably is and how to perform it could prevent some dysphoria before it starts. Of course, we would have to treat adults differently, but leaving decisions up to adults that we take out of the hands of children is what we already do with education, finances, &c.
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Hypothesis: most of the children aren’t actually gender dysphoric, they’re just exploring gender presentation and identity.
Argument: the dysphoria isn’t about gender per se, it’s about the autonomy surrounding gender presentation and identity. Trying to force a particular presentation/identity will result in negative affect association with the particular presentation/identity (because the force causes pain), causing gender dysphoria where none previously existed (as well as exacerbating dysphoria from loss of autonomy).
Test: let children experiment with gender presentation/identity freely.
Expected result: most of them will settle on being cisgender (bonus hypothesis: more likely if they have a good cis male role model and a good cis female role model in their lives), and will be all around happier than if any attempt to force them to present/identify a specific way had occurred, regardless of whether they settle on being cis or trans.
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Rmember that family a few years back that wanted to raise their kid “without” gender? I wonder how that’s going.
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You can find some articles here: https://www.google.com/search?client=ubuntu&channel=fs&q=Witterick+Stocker&ie=utf-8&oe=utf-8
Some are as recent as 2015. Evidently the family is self-reporting bliss. I dunno.
From one article:
https://www.thestar.com/life/parent/2013/11/15/remember_storm_we_check_in_on_the_baby_being_raised_genderneutral.html
I’m not sure how much we can really learn from this situation, except that some people are preposterously weird hippies. That said, it sounds like a nice enough way to grow up. I guess. I know some kids who grew up in “weird” homes, but who turned out basically happy. I know a few who did not.
I have no idea what happens when you send your “gender free” kid to a typical school, surrounded by the typical gender pressures. I would expect it would not work quite as well. On the other hand, I’m not actually opposed to the “figure out your gender on your own” model. I suspect that, if we tried it, most kids would end up with a “gender expression” kind of matching their birth sex, but with a fair amount of kids landing in various grey areas.
To me that sounds better than disapproving grandparents trying to force little girls into dresses and mean-ass jerks beating up young boys for being “sissies.”
Of course, there is a lot of reasonable compromise between “gender utopia” and “gender hell.”
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They do seem to be the kind of family almost guaranteed to self-report bliss. No disagreement with the rest of your post, either.
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Corollary Hypothesis: Children who experiment freely with their gender identity will get beat up a lot (or at least ostracized), and most will stop rather quickly, with the rest learning a lot of martial arts and becoming loners.
So I suspect this will only work as a thought experiment…
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>
Of course, some trans adults are trans children
Personally, I’d render the copula as “were”. My first thought was just, adults aren’t children!
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>Personally, I’d render the copula as “were”. My first thought was just, adults aren’t children!
Some totally, totally are =P. Even putting age dysphoria aside.
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I’m not sure when it happened, exactly, but I’m pretty sure this is the blog among those which I follow who I appreciate the most.
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I really appreciate this post. When I wrote about my identity as currently cisgender, but being so convinced when I was growing up that I was the wrong gender that I looked (and even enlisted my sister to help) for a zipper out of my “wrong skin”.
For all the narratives I have heard about trans adults being trans children, I have never heard a narrative like mine. I pretty much assumed I wasn’t the only one with this sort of childhood belief that fell into cisgender as an adult, but I question how much of that was because the social default was easier. If I had the option to transition as a 14-15 year old, I would have probably taken it. And I probably would have been more or less as happy/unhappy about my gender and performance thereof. I have the occasional moments of what may or may not be dysphoria, where I don’t seem to match inside and outside, but I wouldn’t transition now. Not to say either that that won’t change in my future either.
As we know, gender is complicated, but I really and truly appreciate this post. Thanks.
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There is still no real cite that can even backup the claim that transgender is even real. What i just stated here is that not even science can come up with any facts, proofs, or even a truth that can even prove the myth or what it is called a lie told just to please all the liberal who have no integrity at all. now would be the time to even send me one once of a cite that does have any fact, proof, or truth that transgender is even real. That is my challenge to all those who believe in this phony idea about transgender. there is no proof that a person is even born in the wrong body. Now can you prove it?
I will look at everything that is sent to me.
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Just as an update to this issue, Transadvocate has published a response to the Singal article, here: http://transadvocate.com/the-new-york-magazine-lies-to-parents-about-trans-children_n_18875.htm
A couple points. First, I don’t personally like the tone of the Transadvocate article. It comes across as argumentative. They way they use the term “VOID” lacks subtlety. However, to me that indicates, largely, that Singal is a better persuasional writer than the Transadvocate folks. However, keep in mind, we trans folks are a tiny minority. We are almost certainly outnumbered by notably transphobic cis people, including “good liberal” cis people (who would publicly deny being transphobic even while they work against us). The point is, we’re picking our best writers from a smaller pool.
Rationalists should be aware that, on any controversial topic, the side with a larger share of skilled persuasive writers will tend to sound better.
This doesn’t mean they’re wrong, of course.
The second point is more technical. According to the Transadvocate article, the studies quoted by Singal were using an outdated version of the DSM diagnostic criteria. Now, I don’t think this totally invalidates these studies. They give us some knowledge. However, it does mitigate the idea that they provide a slam dunk argument in favor of widespread disistance. The point is, children diagnosed under today’s diagnostic criteria will be a different slice of the population. Different standards, different statistics. We need new studies.
Singal should have known this. He certainly wishes to present himself as a journalist with a particular interest in the topic. Either he failed to do his job, or he concealed known information.
He is a good writer. He is convincing. He left out an important and obvious proviso. My conclusion: rationalists should be particularly skeptical of his claims.
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Let me add, if we want to talk about the issues around hormone blockers, full HRT, and minimum age requirements, we need studies that focus on adolescents in puberty who, at that age, have a diagnosis of gender dysphoria under the current standards. As I pointed out in my earlier post, knowing that children diagnosed at age 8 may later desist tells us nothing about the circumstances of a thirteen-year-old begging for HRT so they can go through puberty with their peers.
I understand the desire for caution. But caution is not free. Who decides? Who pays the costs for those decisions?
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I found this very interesting
I’m 19 and only accepted the fact and came out as transgender 5 months ago
Gender dysphoria sucks and being born and raised to be a girly girl when I believe I am a guy is very difficult now I can live the life I want to and not forced into a stereotype!
I now have an amazing partner (also transgender MTF) who is also my best mate !! – super supportive
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As I understand the issue, the reason hormone blockers are prescribed is to give the individual a chance to decide, which is a good thing, IMO. Then, before hormones of the opposite sex are prescribed, the child must have lived for at least one year. A psychiatrist determines whether that condition is met. In addition, there are tests which distinguish between a female brain and a male brain and these are important as well. It all of the criteria are met, then the hormones are administered. Surgical reassignment must wait til age 18. However, the effects of hormones over several years is irreversible. The procedure seems adequate to me. The only problem is the social stigma and lack of parental support – especially.
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From this:
Not a RCT, only a correlational study, though.
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Since the study is observational, it’s difficult to rule out explanations like “people who are going to desist decide they don’t want blockers.”
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Well, yes, obviously, but this is still Bayesian evidence for the “puberty ease dysphoria” hypothesis, which is why I thought it was commentworthy.
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