Sex Ratio in Children and Adolescents Referred to the Gender Identity Development Service in the UK (2009–2016)
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.
- Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the child behavior checklist and revised child behavior profile. Burlington: Department of Psychiatry, University of Vermont.Google Scholar
- de Graaf, N. M., Cohen-Kettenis, P. T., Carmichael, P., de Vries, A. L. C., Dhondt, K., Laridaen, J., … Steensma, T. D. (2017). Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: A clinical comparison study between four clinics. European Child and Adolescent Psychiatry. https://doi.org/10.1007/s00787-017-1098-4.PubMedGoogle Scholar
- de Vries, A. L., Steensma, T. D., Cohen-Kettenis, P. T., VanderLaan, D. P., & Zucker, K. J. (2016). Poor peer relations predict parent-and self-reported behavioral and emotional problems of adolescents with gender dysphoria: A cross-national, cross-clinic comparative analysis. European Child and Adolescent Psychiatry, 25, 579–588.CrossRefPubMedGoogle Scholar
- Di Ceglie, D., Freedman, D., McPherson, S., & Richardson, P. (2002). Children and adolescents referred to a specialist Gender Identity Development Service: Clinical features and demographic characteristics. International Journal of Transgenderism, 6(1). Retrieved August 3, 2013, from http://www.symposion.com/ijt/ijtvo06no01_01.htm.
- Harris, A. (2004). Future girl: Young women in the twenty-first century. New York: Routledge.Google Scholar
- Kaltiala-Heino, R., Sumia, M., Työläjärvi, M., & Lindberg, N. (2015). Two years of gender identity service for minors: Overrepresentation of natal girls with severe problems in adolescent development. Child and Adolescent Psychiatry and Mental Health, 9(1), 9. https://doi.org/10.1186/s13034-015-0042-y.CrossRefPubMedPubMedCentralGoogle Scholar
- Lesko, N. (2012). Act your age! A cultural construction of adolescence. New York: Routledge.Google Scholar
- Lessof, C., Ross, A., Brind, R., Bell, E., & Newton, S. (2016). Longitudinal study of young people in England: Cohort 2: Health and wellbeing at Wave 2. London: Department for Education.Google Scholar
- Reisner, S. L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S., Shumer, D., et al. (2015). Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study. Journal of Adolescent Health, 56, 274–279. https://doi.org/10.1016/j.jadohealth.2014.10.264.CrossRefPubMedPubMedCentralGoogle Scholar
- Shiffman, M., VanderLaan, D. P., Wood, H., Hughes, S. K., Owen-Anderson, A., Lumley, M. M., … Zucker, K. J. (2016). Behavioral and emotional problems as a function of peer relationships in adolescents with gender dysphoria: A comparison with clinical and nonclinical controls. Psychology of Sexual Orientation and Gender Diversity, 3, 27–36.CrossRefGoogle Scholar
- Steensma, T. D., Cohen-Kettenis, P. T., & Zucker, K. J. (2018). Evidence for a change in the sex ratio of children referred for gender dysphoria: Data from the Center of Expertise on Gender Dysphoria in Amsterdam (1988–2016) [Letter to the Editor]. Journal of Sex and Marital Therapy. https://doi.org/10.1080/0092623X.2018.1437580.PubMedGoogle Scholar
- Steensma, T. D., Zucker, K. J., Kreukels, B. P., VanderLaan, D. P., Wood, H., Fuentes, A., et al. (2014). Behavioral and emotional problems on the Teacher’s Report Form: A cross-national, cross-clinic comparative analysis of gender dysphoric children and adolescents. Journal of Abnormal Child Psychology, 42, 635–647.CrossRefPubMedGoogle Scholar
- Wood, H., Sasaki, S., Bradley, S. J., Singh, D., Fantus, S., Owen-Anderson, A., … Zucker, K. J. (2013). Patterns of referral to a Gender Identity Service for Children and Adolescents (1976–2011): Age, sex ratio, and sexual orientation [Letter to the Editor]. Journal of Sex and Marital Therapy, 39, 1–6. https://doi.org/10.1080/0092623X.2012.675022.CrossRefPubMedGoogle Scholar