23

A Wall Street Journal article makes the following claim:

... a high percentage—up to 80% in a study of 44 gender-dysphoric boys—grow up to be not transgender, but bisexual, gay or lesbian adults.

Is this true? Are there any other studies to corroborate this? Does this also apply to girls?

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    The article is paywalled but the claim is unclear. Nothing prevents an adult from changing their gender. Does the claim mean that 80% never change their gender or that they either never change the gender or change it after adulthood? Also, what do they mean by adulthood, exactly? – Sklivvz Dec 17 '16 at 14:40
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    @Sklivvz This is the full text of the article: internationalpsychoanalysis.net/wp-content/uploads/2016/01/… – DavePhD Dec 18 '16 at 13:36
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    @Sklivvz Also, there are ways to see the article directly from Wall Street Journal, for example searching in Google in quotes "trucks and Meccano sets" and then clicking on the first hit. Then you bypass the paywall. – DavePhD Dec 18 '16 at 13:53
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    Extremely relevant Twitter thread (one of the replies has a reference that might be worth following up) twitter.com/transscribe/status/818085312236752897 – IMSoP Jan 8 '17 at 17:57
15

There are only a limited number of studies on this, with a limited sample size. None of them seem to check if children "changed their gender", but if they still match the criteria for GID.

Here is one looking at 25 girls, only 15 of which actually met the criteria for GID. At follow-up, 3 met the criteria (12% of the 25 girls total, some of which did not meet the criteria at the beginning either):

This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria. Regarding sexual orientation, 8 participants (32%) were classified as bisexual/homosexual in fantasy, and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The rates of GID persistence and bisexual/homosexual sexual orientation were substantially higher than base rates in the general female population derived from epidemiological or survey studies. There was some evidence of a "dosage" effect, with girls who were more cross-sex typed in their childhood behavior more likely to be gender dysphoric at follow-up and more likely to have been classified as bisexual/homosexual in behavior (but not in fantasy). A follow-up study of girls with gender identity disorder.

Another study looked at 59 boys and 18 girls. 30% did not respond to a follow-up, and 12 boys and 9 girls still met the criteria for GID at follow-up (20% and 50% respectively, or 30% and 64% excluding those that did not follow up):

At follow-up, 30% of the 77 participants (19 boys and 4 girls) did not respond to our recruiting letter or were not traceable; 27% (12 boys and 9 girls) were still gender dysphoric (persistence group), and 43% (desistance group: 28 boys and 5 girls) were no longer gender dysphoric.
[...]
Most children with gender dysphoria will not remain gender dysphoric after puberty. Children with persistent GID are characterized by more extreme gender dysphoria in childhood than children with desisting gender dysphoria. With regard to sexual orientation, the most likely outcome of childhood GID is homosexuality or bisexuality.Psychosexual outcome of gender-dysphoric children.

This is why the Endocrine Society currently recommends puberty blockers until age 16 instead of cross-sex hormones.

The study the WSJ is likely referring to is this one from 1985:

Two groups of males were evaluated on parameters of gender identity, initially in boyhood and later in adolescence or young adulthood. One group was composed of 66 clinically referred boys whose behaviors were consistent with the diagnosis of gender identity disorder of childhood. The other group consisted of 56 volunteers selected on the basis of demographic matching. Two-thirds of each group were reevaluated for sexual orientation; 30 of the 44 who previously had shown extensive cross-gender behavior and none of the 34 in the comparison group were bisexually or homosexually oriented.Gender identity in childhood and later sexual orientation: follow-up of 78 males

I don't have access to the full study, but the abstract doesn't seem to directly support the claim of the WSJ, as the study is about the percentage of boys who match the GID criteria and grow up to be bisexual or homosexual, not how many of them still match the GID criteria.

8

The quote from the Wall Street Journal article is misleading.

80% is not the correct number for "grow up to be not transgender"

The Handbook of Sexual and Gender Identity Disorders explains at page 390 that by age 18 only 1 of the 44 was "gender-dysphoric to the extent of considering sexual reassignment surgery".

In other words, the handbook explains that by age 18, 98% (43 out of 44) were not transgender and "75% to 80% were homosexual or bisexual".

The manual refers to the above study (Green, 1987) as the "most comprehensive long-term follow up" study, but gives data for other studies. It explains that other studies (Zucker and Bradley 1995 and Wallien and Kettenis 2007) found 20% remained gender-dysphoric upon follow-up, but follow-up was not to adulthood (average age 16.5 at follow-up for Zucker and Bradley; "mid-adolescence" for Wallien and Kettenis).

  • To clarify you say that only 1 was considering sexual reassignment surgery at the end of the study. However, did they study explicitly state that none had sexual reassignment surgery at some point during the study, rendering the need to consider having it moot? – dsollen Dec 30 '16 at 18:03
  • @dsollen it says "Green also reported on the gender identity status of the 44 previously feminine boys. He found that only one youth, at the age of 18 years, was gender-dysphoric to the extent of considering sex reassignment surgery." – DavePhD Dec 30 '16 at 18:07
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    I think you make a dangerous leap in your analysis, which you don't back with a quote, that "not gender-dysphoric to the extent of considering surgery" is the same as "not transgender". The 98% figure is interesting without this extra definition, but does not necessarily tell the whole story - for instance, how many of those 44 were receiving, or had already received, hormone treatments? – IMSoP Dec 31 '16 at 11:29
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    @IMSoP this was a 15 year study that ended by 1986. Were children really given hormone treatments back then? This is the book reporting the study books.google.com/… – DavePhD Jan 5 '17 at 3:30
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    @DavePhD The hormones weren't really central to my point. "Not considering surgery" is a very narrow definition of "not transgender"; it's like saying anyone not requesting an intravenous morphine drip isn't in pain. So we should be careful not to over-interpret the study. – IMSoP Jan 5 '17 at 9:35
-2

My information is out of date, so I'll only talk about the general case:

From birth on, children do a lot of experimentation. Unless discouraged by punishment, some of that experimentation will be gender-related (cross-dressing etc). If authority figures freak out, the child may be labeled and find himself getting a lot of unwelcome attention. It's usually "himself" because -- thanks to Freud -- nobody worries much about "boyish" behaviors and preferences in girls unless they Go On Too Long.

Usually, because experimentation is perfectly normal, the freak-out is unwarranted (and often harmful), and the kid grows up to be an unexceptional member of the sex assigned at birth.

How to quantify "usually" is difficult --there were numbers when I was in grad school, but that was ages ago and they were changing rapidly even then-- but it is probably in the 80-95% range simply because socialisation is very coercive and humans are very adaptable.

As to my SWAG'd numbers:

Drescher J, Pula J. Ethical issues raised by the treatment of gender-variant prepubescent children. Hastings Cent Rep. 2014 Sep;44 Suppl 4:S17-22. doi: 10.1002/hast.365.

On the subject of treating children, however, as the World Professional Association for Transgender Health notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls [emph. mine] treated in gender clinics showed persistence of their gender dysphoria into adulthood.

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    Do you have any references to back any of this up? – David Grinberg Dec 19 '16 at 15:56
  • Back what up? That children experiment? That part of the experiment will often be gender experiment? That it's harmful for authority figures to freak out? What? – user37372 Dec 19 '16 at 16:47
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    You make 0 citations in your entire answer, so can you backup any assertions you make? IE but it is probably in the 80-95% range simply because socialisation is very coercive and humans are very adaptable. You just pulled those numbers out of thin air. Also your entire freak out argument is odd and also comes from no reference. – David Grinberg Dec 19 '16 at 16:59
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    Welcome to skeptics! We operate a little differently from other stack sites, it is well worth you having a quick read of our welcome to new users to get a feel for the sort of references we expect in answers. – Jamiec Dec 19 '16 at 17:01
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    It sort of doesnt matter if you were Freud himself, we would still ask you to provide references for your answer. – Jamiec Dec 19 '16 at 17:39
-5

As an LGBT person, I can definitely say that allow, it may not be 80%, it's definitely a large number. In fact, according to a study done by a LGBT newspaper/magazine called Black & Pink, almost 98% of the gay population forgoes any sort of body modification to match their physical appearance to their gender. Some may cross-dress, but most don't actually go so far as to live their day-to-day lives as a member of the opposite sex, or have surgeries to make their appearance match their gender. However, speaking in more practical terms, most people with GID simply cannot afford the surgeries/hormones that are necessary for a full transition, and this is a often-discussed topic when someone decides to transition. This surgery/surgeries may cost up to $40,000, not to mention time lost from work and the cost of hormones and other medicines possibly necessary, such as blood pressure medication for the high blood that unfortunately, can be a side effect of estrogen therapy. All of this information comes from *Black & Pink, which yearly surveys it's readers and compiles the approximately 10,000 responses it gets into thesis format. The questions asked pertain not only to a person's current situation, but also about their past history and life experiences.

Some of the information contained in this post requires additional references. Please edit to add citations to reliable sources that support the assertions made here. Unsourced material may be disputed or deleted.

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    Hello Harlemme, and welcome to the Skeptics Stack Exchange. While personal experience is a valuable data point, it doesn't say anything about the numbers. Do you think you could dig up some references? Oh, by the way, have you taken the tour yet? – SQB Dec 30 '16 at 18:47

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