Study: Fewer Than 1/3 Children Were Diagnosed With Gender Dysphoria or Received Hormonal Treatment After Presenting as Gender Diverse

Fewer than one-third of children who expressed gender-diverse behavior during visits to three large health care systems received a gender-dysphoria related diagnoses or gender-affirming hormone therapy, according to a study published in the July 2021 Pediatrics. The study, “Progression of Gender Dysphoria in Children and Adolescents: a Longitudinal Study” (published online June 7) examined the likelihood and predictors of receiving a gender dysphoric- specific diagnosis and gender-affirming hormonal therapy by analyzing electronic health records between 2006-2014 from hospital systems in Georgia, Northern California, and Southern California. Researchers included 958 children in the analysis. Of those, 431 individuals were assigned male sex at birth and 527 individuals were assigned female sex at birth. The rates of diagnosis and initiation of gender-affirming hormone therapy differed across demographic categories of participants and tended to be higher in older adolescents, those assigned female at birth and in non-Hispanic Whites. Of the total analytic cohort, 29% of participants received a gender dysphoria-related diagnosis and 25% were prescribed gender affirming hormonal therapy during an average follow-up of 3 years. The authors suggested that one reason that those assigned female at birth were more likely to progress to gender dysphoria diagnoses and hormone therapy is that females typically enter puberty earlier. The authors suggest further research is needed to compare health outcomes and quality of life among gender diverse children and adolescents who began receiving care at different ages. Such data are needed to inform clinical practice and facilitate development of evidence-based guidelines.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.