New long-term study finds desire to be the opposite sex in adolescence is common, temporary, and declines with age
A recent Dutch study has found that the majority of adolescents who expressed a desire to be the opposite sex no longer felt that way in adulthood.
A new Dutch study relying on long-term data found that the majority of adolescents expressing a desire to be the opposite sex no longer felt that way in adulthood. This adds to a growing body of research showing that gender dissatisfaction in adolescence is often temporary and declines with age.
Research on youth experiencing gender dysphoria often lacks long-term data, leading to significant disagreement about the most ethical ways to support these individuals. The authors drew attention to this research gap, observing that most studies focused on clinical samples from specialized gender clinics with only one follow-up assessment.
Their objective was to investigate the development of gender dissatisfaction in a sample comprising both clinical (youth psychiatric care) and general populations. They sought to explore associated factors such as sex, sexual orientation, self-concept, and mental health.
Their study included 2772 participants, with 53% being male, and provided a rare view of long-term data on dissatisfaction with one’s sex among youth. Spanning over 15 years, it followed individuals from late childhood to early adulthood, covering ages 11 to 26.
The study introduced the concept of “gender non-contentedness,” defining it as feeling unhappy with one's sex. The authors explained that this might be observed in a young adolescent girl who prefers activities typically associated with boys and feels discomfort with the physical changes of puberty.
To measure gender non-contentedness, the study relied on responses to the statement: "I wish to be of the opposite sex.” This question was part of a self-report survey provided by TRAILS, a long-term research project in the Netherlands tracking the development of adolescents and young adults through regular assessments. Data from this question was collected and analyzed from participants at six different time points between 2001 and 2020.
Additionally, the researchers measured behavioral and emotional problems using various survey instruments. Global self-concept, an assessment that measures self-esteem, self-confidence, and self-value, was evaluated at age 11, and sexual orientation was assessed at age 22 through self-report.
Key Findings
Findings revealed that approximately 11% of participants reported gender non-contentedness in early adolescence, with the prevalence decreasing to 4% by the last follow-up around age 26. Only 3 individuals, representing 0.1% of the total sample, consistently reported gender non-contentedness throughout adolescence and adulthood.
A majority of adolescents surveyed conformed to three identifiable trajectories: those who consistently reported never experiencing any gender non-contentedness (78%), those who reported gender non-contentedness in early adolescence that did not persist into adulthood (19%), and those who demonstrated the opposite pattern, with reports of gender non-contentedness increasing with age (2%).
Gender non-contentedness was most prevalent around age 11, and girls were more likely than boys to report it at ages 13 and 16. By approximately age 25, individuals on the decreasing gender non-contentedness trajectory no longer reported experiencing these feelings.
The authors posit that the large percentage of individuals with “temporary, declining gender dissatisfaction” may be attributed to the extended duration of the study, unlike typical research in this field, which often involves short-term follow-ups. Consequently, the study found “a clear declining trend in gender non-contentedness with age.” This was consistent with other studies, like a study from Taiwan, which found 8% (of 1806 children) who experienced gender dissatisfaction around age 13 no longer did by around age 22.
The study showed that individuals with both an increasing and decreasing trajectory of gender non-contentedness had lower global self-worth, more behavioral and emotional problems, and more often had a homosexual or bisexual sexual orientation compared to individuals without gender non-contentedness.
The authors find it noteworthy that both groups experiencing increasing and decreasing gender non-contentedness had lower self-esteem at age 11 compared to those who did not indicate gender non-contentedness, aligning with findings from previous studies. They suggest a connection between feeling dissatisfied with one's sex and having a negative self-perception applies not only to children seeking help at gender clinics, but also to the general population.
Acknowledgements of research on ROGD and desistance
The authors of this study made several important acknowledgements regarding research that is often overlooked or disregarded by activist researchers and clinicians. They identified a group that began reporting gender non-contentedness in mid to late adolescence, confirming that these feelings may emerge after puberty, supporting late-onset gender dysphoria or rapid-onset gender dysphoria (ROGD).
The authors also acknowledged research indicating that children who socially transitioned in early childhood were more likely to have persisting feelings of gender dysphoria. Socially transitioning children can have significant iatrogenic effects that solidify a child’s transgender identity, increasing the likelihood of seeking medical interventions. A review by the National Health Service England stated that social transition is not a “neutral act” and could have significant effects on psychological functioning.
The authors recognized the existing longitudinal studies in gender clinics showing that the vast majority (61-98%) of individuals who experienced early childhood gender dysphoric feelings did not have those feelings persist into adolescence and adulthood. They also recognized clinical research indicating that childhood gender dysphoria is linked to a homosexual orientation in adulthood, and that studies on childhood gender nonconformity tended to show a bisexual or homosexual sexual orientation later in life. Their new study corroborated these findings, showing that a decreasing trajectory of gender non-contentedness was a significant predictor of a homosexual or bisexual identification in adulthood.
Study Impact
The authors acknowledge that general population studies are scarce, and much of the existing research relies on clinical samples with only one follow-up assessment. Because this study draws from both clinical and general population groups over an extended period of time, it offers "more reliable epidemiological knowledge" about how prevalent feelings of dissatisfaction with one’s sex are among adolescents, as well as new insights into the association with mental health problems.
The researchers conclude that their study results should reassure teenagers who feel unsure about their identity and desire to be the opposite sex during adolescence, that this is a normal and common experience. Additionally, they hope their findings will “provide some perspective” to clinicians who mainly treat teenagers with “intense gender dysphoric feelings.” This understanding could give them a broader view of how common it is for young people, both in the general population and those receiving mental health care, to question their sex.
Broader Implications
Importantly, the findings from this study challenge commonly held beliefs promoted
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