Durwood, L., McLaughlin, K. A., & Olson, K. R. (2017). Mental Health and Self-Worth in Socially Transitioned Transgender Youth. Journal of the American Academy of Child & Adolescent Psychiatry, 56(2), 116-123.e2 Til tidsskriftet

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SEGM Summary

The 2017 study by Durwood et al. used the data from TransYouth Project, collecting both parental and self-reports of depression, anxiety and self-worth measures for children ages 9-14. The findings broadly confirmed those of the first study using the data from TransYouth Project (Olson et al., 2016), finding that social transition was associated with better psychological function.

It is important to note these authors' own statements in these papers:

a) that prepubescent social transition for GD children is controversial.

b) that there is “little known about the well-being of socially transitioned transgender children.”

c) That there are numerous limitations to their own findings, including the acknowledgement that the study design does not allow one to draw a causal inference that social transition in prepubescent GD children improves mental health outcomes.

SEGM Plain Language Conclusion:

This is one of two key empirical studies quoted by those arguing for social transition of children (the other study is by Olson et al., 2016, both used the same data source known as TransYouth Project).

The study findings showed that gender-dysphoric children ages 9-14 who underwent social gender transition had psychological functioning similar to their gender-normative peers. The authors of the study contrast this high level of function to the typically lower-level of psychological function in gender-dysphoric children in other studies.

However, the study has a number of serious methodological limitations, and cannot be used to assert that social transition produces psychological benefits, or that the benefits outweigh the potential risks: 

• The data source is TransYouth Project, an initiative targeting highly involved gender-affirming parents interested in tracking their children's outcomes overtime. A high level of function found in such children may or may not be related to their social transition status.

• One other obvious limitation of the TransYouth Project data is that parents whose children stop identifying as transgender are not likely to stay in this longitudinal  project. Thus, the potential negative outcomes of a premature social transition for desisting children are likely not captured. Since historically, the majority of prepubertal children have eventually desisted from transgender identification, the study is unable to provide any information about the risks, or weigh the benefits vs the risks.

• Further, a reanalysis of the subset of the data from TransYouth Project (Wong et al., 2019) that controlled for additional variables (including peer relations) with a multivariate analysis failed to demonstrate that social transition was associated with positive outcomes. Rather, the positive function was accounted for by positive peer relations. The study by Wong et al. concluded, "Socially transitioned children appear to experience similar levels of psychosocial challenges as CGV [gender-variant but not socially transitoned] children.

The study authors themselves warn against concluding that pediatric social transition improves psychological outcomes.