New evidence underscores that a GD diagnosis in adolescence is an unreliable basis for medical interventions.
By Léor Sapir - Manhattan Institut
30 august 2024
It is widely recognized that most children with gender dysphoria (GD) will come to terms with their sex and not live as transgender adults. Transition advocates contend, however, that administering irreversible endocrine and surgical interventions to adolescents is not a problem because, unlike childhood-onset GD, adolescent GD almost never remits.
This view is encapsulated in a quote from Stephen Rosenthal, a notable U.S. gender physician, in an article for Nature Reviews Endocrinology, one of the highest-ranked peer-reviewed medical journals: “Longitudinal studies have indicated that the emergence or worsening of gender dysphoria with pubertal onset is associated with a very high likelihood of being a transgender adult. This observation is central to the rationale for medical intervention in eligible transgender adolescents” (emphasis added).
Like many assertions in youth gender medicine, the claim about the near-permanence of adolescent gender dysphoria (GD) has never been properly tested. (How these studies are designed makes them incapable of answering this question, which is probably why Rosenthal uses the vague word “indicate[s].”) So we decided to test it ourselves. Our findings, from an ongoing Manhattan Institute analysis of an all-payer, all-claims national insurance database, challenge this “central” belief underpinning youth gender medicine. In fact, the rate of persistence of the gender dysphoria diagnosis for youth over seven years is 42.2 percent to 49.9 percent, with the trend line suggesting likely future declines.
Our findings are highly significant for the debate over youth gender medicine. Treatments with permanent effects, and that include negative impacts on health and functioning, should not be offered to patients—especially not minors—with a diagnosis likely to disappear after a few years.
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