In negative media coverage of cases involving gender variant children, one statistic seems omnipresent:
‘84% of childhood cases of gender variance do not persist into adult life’.
I wanted to take this opportunity to demonstrate why this is a flawed and inaccurate statistic, which should no longer be used as a proof point in the argument against treating children with gender variance.
In 2013, a study by a PhD student, Steensma TD, et al (http://www.jaacap.com/article/S0890-8567(13)00187-1/abstract) sought to address the issue of desistence and persistence of childhood gender dysphoria.
As part of the research, his 2010 study is quoted as the reference for the claim that 84% of children presenting with Gender Identity Disorder (GID) who had been followed into adolescence had ‘desisted’ – a phrase used to imply that they no longer fitted the diagnostic criteria for GID.
In fact, this 2010 study actually assessed just 53 out of 198 children who had been referred to the clinic when under the age of 12 and now qualified for inclusion in this study according to the methodology (age 14 and above, diagnosed with GID in childhood and be able to speak Dutch).
Of these 53 children, they found that 29 requested medical treatment at a later stage and as such they were deemed to be ‘persisters’. The other 24 (45%) did not reapply for treatment and it was assumed that their feelings of gender dysphoria had ceased.
The truth is that for some of these children, the medical outcome is unknown as they did not reapply for treatment. They may have sought treatment elsewhere, they may have been prevented from seeking treatment for other reasons, they may have committed suicide. We don’t know and still they were classed as ‘desisters’ and included in the study.
The other point of issue is whether all of the children studied fit the criteria for GID requiring medical intervention, these include:
A marked and persistent incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by at least 6* of the following indicators (including 1)
- A strong desire to be of the other gender or an insistence that he or she is the other gender
- In boys, a strong preference for cross-dressing or simulating female attire; in girls, a strong preference for wearing only typical masculine clothing and a strong resistance to the wearing of typical feminine clothing
- A strong preference for cross-gender roles in make-believe or fantasy play
- A strong preference for the toys, games, or activities typical of the other gender
- A strong preference for playmates of the other gender
- In boys, a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; in girls, a strong rejection of typically feminine toys, games, and activities
- A strong dislike of one’s sexual anatomy
- A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender
The 2010 study included children who met the above criteria but also children who fell outside of this criteria and who, rather than being diagnosed with GID would be more accurately described as exhibiting gender non-conforming behaviours.
If not all of the 53 children chosen for the study can be given a diagnosis of GID eligible for treatment, then it follows that they cannot be classed as ‘desisters’, in line with the conclusions drawn by the study, and subsequently by the media and anti-trans campaigners.
Other researchers who are cited in this 84% ‘desisters’ statistic include Zucker and Bradley, who believed that reparative treatments (in other words forcing children to accept their natal gender) could reduce gender dysphoria in adulthood. Zucker was a psychologist whose clinic was closed in 2015 after this conversion therapy was banned in Canada and such behaviour and treatments were apologised for.
The current understanding, which is also supported by these research papers, is that if children presenting with a strong feeling that their gender differs from the one society expects, and those feelings have been persistent through childhood and are still present as puberty commences, they are extremely unlikely to waver in these feelings.
Factors Associated With Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study Thomas D. Steensma, Ph.D., Jenifer K. McGuire, Ph.D., M.P.H., Baudewijntje P.C. Kreukels, Ph.D., Anneke J. Beekman, B.Sc., Peggy T. Cohen-Kettenis, Ph.D.
Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study – Thomas D. Steensma, Roeline Biemond, Fijgje de Boer, and Peggy T. Cohen-Kettenis. Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
Clinical Child Psychology and Psychiatry 16(4) 499-516 © The Author(s) 2010
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