ESPE Yearbook of Paediatric Endocrinology

Eur Psychiatry. 2019 Jan;55:61–66.

doi: 10.1016/j.eurpsy.2018.09.003. PubMed ID: 30390473

Is the prevalence of gender dysphoria today truly increasing, or do the increasing numbers result because today’s world is more open so that these individuals and families no longer hide in the closet? Or are methodological factors playing a role? Fact is that in Europe and North America numbers of adolescents seeking treatment for gender dysphoria have been markedly increasing in the past 10 years.

This large school-based survey in Finland addressed the questions: a) are questionnaires on gender identity in young people prone to dishonest responding, and b) does the prevalence of gender-sex divergence differ between early, middle and late adolescents. The findings clearly show that reporting on gender identity incongruence in youth is very susceptible to unreliable answering, more so in boys than in girls. Nevertheless, overall corrected prevalence of gender identity issues was higher than in previous studies (3% in boys and 4% in girls) and increased in boys from early to late adolescence, while in girls the opposite trend was observed. Also, more other/non-binary than opposite sex identification was reported suggesting a fluid rather than a binary development of gender identity in adolescents.

This study demonstrates the dilemma in clinical practice when taking care of gender dysphoric youth: does the adolescent seeking help show identity explorations as part of normal pubertal development or is he/she manifesting a consolidated gender identity problem? To answer this question, psychological assessment and counseling is compulsory before rushing into medical or even surgical treatments.