More people seeking gender-affirming care at younger age: study

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More people are seeking medical treatment for “gender-affirming care” — and they’re asking for it at a younger age, according to a new study that combed through the health records of 42 million people.

Of those patients between the ages 4 to 65, a total of 66,078 — 80% of them from the US — had received a diagnosis of gender dysphoria, a condition many transgender people report experiencing before they transition.

The authors of the new study, published in the journal General Psychiatry, analyzed data for the five years from 2017 to 2021 for gender dysphoria.

People assigned female at birth seek professional help at about age 11 on average, while those assigned male at birth seek help at about age 13, the study reported. Previous studies found that the average age for a gender dysphoria diagnosis was about 26 years old.

Even within that short timeframe, the study results were striking: Researchers reported a “significantly increased” number of people diagnosed between 2017 and 2021.

Also referred to as gender identity disorder, gender dysphoria is defined by the US Department of Health and Human Services as “clinically significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”

Overall, the study authors estimated that for every 100,000 people, there are 155 who identify as transgender — in contrast to the “much higher” 600 out of 100,000 reported in a 2019 study.

“Our study demonstrated a climbing prevalence of gender dysphoria especially in those assigned female at birth,” lead author Dr. Ching-Fang Sun, a resident at the Virginia Tech Carilion School of Medicine in Roanoke, told UPI.

Indeed, the research revealed some key differences between those assigned female at birth and those assigned male at birth.

chart showing increase in rates of gender dysphoria diagnoses
The rates of people seeking professional help with gender dysphoria have climbed significantly since 2017, according to researchers.
General Psychiatry/BMJ Journals

For example, those assigned female at birth were more likely to be diagnosed with gender dysphoria earlier, according to the study.

“We found that the estimated prevalence of gender dysphoria in [assigned female at birth] sharply increased at the age of 11, peaked at 17–19, and then decreased … at 22,” the authors wrote.

By comparison, males were typically diagnosed later than females, perhaps because the onset of puberty is usually somewhat later in males.

“The estimated prevalence of gender dysphoria in [assigned male at birth] started to increase at the age of 13, peaked at 23, and then gradually decreased,” they wrote.

The age differences and gender ratios might also be explained by the media and by social attitudes toward gender.

doctor wearing a trans-friendly heart pin
Medical professionals continue to urge caution with gender-affirming care, especially with minors.
Getty Images/iStockphoto

Young females who display tendencies traditionally seen as masculine are “more likely to be accepted by peers, even categorized as the leader of their class,” the study authors wrote.

“By comparison, gender non-congruent [males] are more likely to face bullying and rejection, which suggests effeminate characteristics are less tolerable in [males] than masculine characteristics” are in females.

And the trend toward a younger age for diagnosis was significant: In 2017, the average age for a diagnosis of gender dysphoria was 31.49. By 2021, that age had dropped to 26.27.

These findings are sure to add fuel to the fiery debate over transgender rights and gender-affirming care.

While many people agree with the study authors’ claim that “the concept of gender is a cultural construct rather than a genetic fact,” others — including many medical experts — urge caution with gender-affirming care, especially for minors.

According to a recent commentary in the British medical journal BMJ, Sweden’s National Board of Health and Welfare determined in 2022 that the risks of puberty blockers and hormone treatments “currently outweigh the possible benefits” for minors.

In Finland, the Council for Choices in Health Care, a group that monitors the country’s public health services, issued similar guidelines and called for psychosocial support as the first-line treatment.

Significantly, both Sweden and Finland restrict transgender surgery to adults only.

doctor holding hormone vials
Medical interventions for gender dysphoria, including hormonal treatments, continue to generate controversy.
Getty Images

The British National Health Service recently found that there was “scarce and inconclusive evidence to support clinical decision making” for minors with gender dysphoria.

Furthermore, the BMJ commentary added, for most prepubescent minors gender dysphoria will be a “transient phase” and doctors should focus on psychological support.

Individual cases like that of Kayla Lovdahl highlight the risks of early gender-affirming care.

By age 12, Lovdahl was allegedly prescribed puberty blockers and testosterone, and at 13, she had her breasts removed in a double mastectomy.

She is now suing Kaiser Foundation Hospitals and four doctors, seeking unspecified damages for causing “deep physical and emotional wounds and severe regret.”

Last month, a Washington Post-KFF poll found that 57% of American adults believe gender is based on the sex “assigned” at birth, while 43% say a person could change their gender later in life.

More than a dozen US states — including Alabama, Florida, Oklahoma and Texas — have passed laws banning transgender care, and more are considering such laws, sparking President Joe Biden to claim recent measures passed by Republican-led legislatures were based in “fear.”

But doctors like Aaron Samuel Breslow of the Montefiore Transgender Health Program in New York City believe that the new study reveals how society now supports young people with gender dysphoria.

“This is critical given ongoing crises of mental health concerns and suicidality among trans and nonbinary young people, as well as systematic legislative attacks on access to healthcare for transgender people,” Dr. Breslow told UPI.

“We are living in a time when there is an organized, concerted effort to criminalize gender-affirming care, especially for young people, so I find these results to be very reassuring,” Breslow added.

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