Most children grow out of gender confusion, long-term Dutch study indicates

Originally published in The Washington Times

A landmark Dutch study found that most adolescents ultimately outgrow their gender confusion, fuelling the growing unease over the advisability of treating those under 18 with gender-transition drugs and surgeries.

The newly published research in the Archives of Sexual Behavior tracking 2 772 adolescents into early adulthood said that 11% reported “gender non-contentedness” at age 11, a figure that decreased with age and fell to 4% by ages 24-26.

“Gender non-contentedness, while being relatively common during early adolescence, in general decreases with age and appears to be associated with a poorer self-concept and mental health throughout development,” said the paper by medical researchers at the University of Groningen.

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The study divided children into three trajectories based on their response to the statement: “I wish to be of the opposite sex.” The participants had three options: “never,” “sometimes,” or “often”.

The majority, or 78%, said they had no gender non-contentedness; 19% had decreasing gender non-contentedness over the course of the study, and just 2% had increasing gender non-contentedness.

Most of the study participants who expressed increasing gender dissatisfaction over the years were female. Those whose non-contentedness rose and fell were also more likely to have lower self-worth during adolescence than those without gender non-contentedness.

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“The results of the current study might help adolescents to realise that it is normal to have some doubts about one’s identity and one’s gender identity during this age period and that this is also relatively common,” said the paper.

The researchers warned that health care providers may want to be cautious in treating adolescents with gender dysphoria by “primarily seeing individuals with intense gender dysphoric feelings and give them a more comprehensive view on the range of developmental patterns in the general population and in children receiving youth psychiatric care.”

The findings reenergised the heated debate over treating patients under the age of 18 with gender dysphoria with puberty blockers, cross-sex hormones, and surgeries — treatments that are fuelling a booming sex-reassignment industry.

“These results strongly oppose rushing to transition kids who report gender dysphoria in the name of ‘gender-affirming’ care. Stay safe. Stay smart,” said Michael Guillen, a former Harvard physics instructor and author.

The study comes amid rising concerns about gender-transition procedures for minors in Western Europe, where countries such as Finland, Sweden and Norway are pulling back on their sex-reassignment protocols for youth.

The National Health Service in England banned last month puberty blockers for those under 18 outside of clinical trials, citing a lack of evidence of its effectiveness in treating gender dysphoria.

UK group Christian Concern said this week that puberty blockers should be completely banned in the UK, as a new report reveals major failures in gender care for adolescents.

A landmark review into NHS gender services says children have been “let down” by a lack of research and “remarkably weak evidence” on medical interventions – including drugs that can pause puberty.

The review, published on Wednesday by paediatrician Dr Hilary Cass, says health professionals working in the field are often too “afraid” to express their views, due to the “toxicity” of the public debate. It found there was no substancial evidence on the long term impacts of medical interventions and has criticised the use of affirmative care – which models affirming a person in their chosen gender.

The report concluded that for most young people, medical pathways may not be the best approach to managing gender-related distress. It has called for gender care to match the standards of other NHS care services with “holistic assessments” including screening for neurodevelopmental conditions such as autism, and a mental health assessment.

The debate is still playing out in the US where 22 states have banned or restricted medicalised gender-transition treatment for minors, while the Biden administration has extolled the benefits of “gender-affirming care” for those under 18.

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