Archives of Sexual Behavior

, Volume 47, Issue 5, pp 1301–1304 | Cite as

Sex Ratio in Children and Adolescents Referred to the Gender Identity Development Service in the UK (2009–2016)

  • Nastasja M. de GraafEmail author
  • Guido Giovanardi
  • Claudia Zitz
  • Polly Carmichael
Letter to the Editor


Over the last decade, several child and adolescent gender identity services have reported an increase in young people who seek help with incongruence between the experienced gender identity and the gender to which they were assigned at birth (Aitken et al., 2015; Wood et al., 2013). Many of those, but not all, would meet the diagnostic criteria for gender dysphoria (GD) (APA, 2013). It has been suggested that this increase is mostly due to an influx of birth-assigned females coming forward. Aitken et al. (2015) reported a significant temporal shift in the sex ratio of clinic-referred gender-diverse youth to Toronto and Amsterdam, from a ratio favoring males prior to 2006, to a ratio favoring assigned females from 2006 to 2013.

The national Gender Identity Development Service (GIDS) in the UK is the largest child and adolescent specialist gender service in the world, seeing young people up to the age of 18. Historically, more birth-assigned males were presenting to GIDS in...


Compliance with Ethical Standards

Conflict of interest

The authors declare there is no conflict of interest. There was no sponsor involved in this Letter. The authors disclose that there are no prior publications or submissions with any overlapping information of this kind.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nastasja M. de Graaf
    • 1
    • 2
    Email author
  • Guido Giovanardi
    • 1
    • 3
  • Claudia Zitz
    • 1
  • Polly Carmichael
    • 1
  1. 1.Gender Identity Development ServiceTavistock and Portman NHS Foundation TrustLondonUK
  2. 2.Department of Medical Psychology, Center of Expertise on Gender DysphoriaVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Dynamic and Clinic Psychology, Faculty of Medicine and PsychologySapienza University of RomeRomeItaly

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