by Dr. Jem Tosh
The Gender Identity Research and Education Society (GIRES) has awarded a collaborative article that I contributed to: 'A critical commentary on follow-up studies and 'desistance' theories about transgender and gender non-conforming children' published in the International Journal of Transgender Health (originally named the International Journal of Transgenderism).
GIRES is a UK based organisation that works towards improving the lives of trans, nonbinary, and agender people. It is made up of trans and non trans volunteers and members. It provides training, e-learning, and resources for trans folks and those who support them.
The article was featured in a special issue of the journal, entitled 'Today's Transgender Youth: Health, Well-Being, and Opportunities for Resilience' edited by Ryan Watson and Jaimie Veale, which has since been published as a book by Routledge.
The article came about through discussion amongst a group of researchers concerning the use of a troubling statistic in academic work regarding transgender youth - that over 80% 'desist' as they get older (i.e. they stop being gender nonconforming or de-transition). There are two main issues with this statistic that we wanted to address, (1) the problematic evidence base that led to its circulation, and (2) how the number was being used to discredit or invalidate trans people and their lived experiences of gender. This can lead to numerous other issues, such as being refused medical treatment and being pathologised. In our commentary we wanted to examine the problematic evidence base, showing the weaknesses and limitations of the research that were a cause for concern, and to discuss the implications of continuing to share this particular number in academic and clinical circles on the lives of trans people.
We concluded that:
“As we progress towards a fuller understanding of children’s gender in all its complexity, it will be important to move beyond longitudinal studies of identity that seek to predict children’s futures, and instead prioritise respect for children’s autonomy in the present. For all the resources devoted to studying these children, we have much more to learn by listening to them.”
Full list of authors and award winners: Julia Temple Newhook, Jake Pyne, Kelley Winters, Stephen Feder, Cindy Holmes, Jem Tosh, Mari-Lynne Sinnott, Ally Jamieson, & Sarah Pickett.
See the full abstract below:
Background: It has been widely suggested that over 80% of transgender children will come to identify as cisgender (i.e., desist) as they mature, with the assumption that for this 80%, the trans identity was a temporary “phase.” This statistic is used as the scientific rationale for discouraging social transition for pre-pubertal children. This article is a critical commentary on the limitations of this research and a caution against using these studies to develop care recommendations for gender-nonconforming children.
Methods: A critical review methodology is employed to systematically interpret four frequently-cited studies that sought to document identity outcomes for gender-nonconforming children (often referred to as “desistance” research).
Results: Methodological, theoretical, ethical, and interpretive concerns regarding four “desistance” studies are presented. The authors clarify the historical and clinical contexts within which these studies were conducted to deconstruct assumptions in interpretations of the results. The discussion makes distinctions between the specific evidence provided by these studies versus the assumptions that have shaped recommendations for care. The affirmative model is presented as a way to move away from the question of, “How should children's gender identities develop over time?” toward a more useful question: “How should children best be supported as their gender identity develops?”
Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health (WPATH), we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities.