Overwhelming majority of children who socially transition still identify as trans years later, study finds

A person holds up a sign that reads "Gender Diversity is Beautiful" during a rally supporting trans youth

Most kids who socially transition continue to identify as trans five years later, according to a trailblazing study of trans youth.

The report, which was published in the journal Pediatrics, used data from the Trans Youth Project – the first, large-scale, national, longitudinal study on the lives of trans kids. Researchers followed the lives of 317 kids aged between three and 12 who had already socially transitioned living in 40 states and two Canadian provinces over five years.

Social transition can be when an individual changes their name, pronouns, hairstyle or clothing to align with their gender identity. For this study, researchers defined social transition as when one of the participants changed their pronouns to the “binary gender pronouns that differed from those used at their births”. 

The study found that 94 per cent of participants still identified as either a trans girl or boy during the five years between 2013 and 2017. The remaining young people had ‘retransitioned’ – what the study referred to as when a young person changed their gender identity – and 3.5 per cent identified as non-binary. 

The researchers reported that 2.5 per cent of the study’s participants were using “pronouns associated with their sex at birth and could be categorised as cisgender” at the time when the final data for this study was collected. 

Dr Kristina Olson, the first author of the paper and a professor of psychology at Princeton University, told NBC News that the study was interesting as not only showed that a small number of trans youth had ‘retransitioned’ but also how “our understanding of gender is changing”. 

Olson said that, when the study started, no families were “contacting us who had kids who use they/them pronouns” and “almost no one” identified as non-binary in the “community of families we were working with”.

“This is one of the interesting things about a prospective study, of tracking a cohort over time — not only are they developing and getting older and having a sense of maybe changes or not of their identity, but also culture is changing,” Olson said. “Our words are changing, our understanding of gender is changing.”

The study comes amid legislative efforts in several US states to limit how transgender youth can access gender-affirming medical care. ArkansasTennesseeArizona and Alabama have all passed laws restricting trans healthcare or treatments for minors. 

In April, Florida’s health department recommended against young people being able to socially or medically transition in the state

The chilling guidance argued that “anyone under 18 should not be prescribed puberty blockers or hormone therapy” in the state. It also indicated that social transition “should not be a treatment option for children or adolescents”.

The Florida guidance flew in the face of federal guidance and guidance from the World Professional Association for Transgender Health, which both state the importance of gender-affirming care for trans people.

Florida’s guidance followed a directive released by Texas governor Greg Abbott earlier this year. Abbott ordered state officials to investigate supportive families of trans youth for “child abuse” if they helped their child access gender-affirming healthcare. 

The controversial order has been widely condemned by LGBTQ+ advocatescelebs, families and the international queer community. 

An ongoing legal battle has temporarily upheld an injunction stopping the state from carrying out “child abuse” investigations on the parents of trans youth. Texas attorney general Ken Paxton has appealed to the state’s Supreme Court to overturn the ban on such investigations. 

Dr Hussein Abul-Latif, a paediatric endocrinologist at the University of Alabama, told ABC News that the study reflects his “experience” working with trans youth and their families. 

He described how he’s been shocked by anecdotes of trans youth frequently retransitioning as that’s not what he’s experienced in his medical practice.

Abul-Latif recalled how one trans boy in the clinic recently started testosterone despite his father’s initial misgivings, but he said the dad quickly changed his mind when he saw how happy his son had become. 

“The father made a point of sharing that he had been hesitant at first but having seen his son and how much happier he is — more open and interactive — he is so happy he decided to do this,” Abdul-Latif said. “I think about those smiling faces, and I think, what will happen to them?”

Olson told NBC News that the research team plans to follow the study’s cohort for at least 20 years, tracking their life experiences into adulthood and seeing the impact it has on their mental health.