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Transgender children who receive support for their gender identity are no more likely to be depressed than are other children and had only slightly higher anxiety symptoms, a recent study found.
“Critically, transgender children supported in their identities had internalizing symptoms that were well below even the preclinical range,” reported Kristina R. Olson, Ph.D., and her associates in the department of psychology at the University of (Seattle) Washington (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-3223). “These findings suggest that familial support in general, or specifically via the decision to allow their children to socially transition, may be associated with better mental health outcomes among transgender children.”
The authors recruited 73 transgender children between the ages of 3 and 12 years. All the children identified as a gender different from the sex they were assigned at birth, used the pronouns associated with that gender, and presented in that gender in all social situations, including during everyday life, at school, and at home. Among the 22 born-females and 51 born-males, the average age of the children was 8 years.
The researchers compared these children’s mental health to that of 49 of their siblings and 73 age-matched control children with no history of cross-gender behavior. Approximately three quarters of the children across all three groups were white, and smaller numbers of children were Hispanic, Asian, or multiracial. Nearly all the children lived in homes with an annual family income above $75,000, and about half lived in homes with an annual income over $125,000.
Parents filled out assessments of their children’s symptoms of depression and anxiety. Scores for transgender children were similar to those of the general population in terms of depression and only slightly elevated for anxiety, although still below even the subclinical range. No statistical differences in depression symptoms existed between the transgender children and either their siblings or the control children, and again, anxiety levels were only slightly increased.
The authors point out that most previous studies of mental health among transgender people have focused on teens and adults and have consistently found “dramatically elevated rates of anxiety, depression and suicidality among transgender people.” These findings likely reflect “years of prejudice, discrimination, and stigma; conflict between one’s appearance and stated identity; and general rejection by people in their social environments, including their families,” Dr. Olson and her associates wrote. “There is now growing evidence that social support is linked to better mental health outcomes among transgender adolescents and adults.”
The findings of this study reveal that “socially transitioned transgender children showed substantially lower rates of internalizing symptoms than children with gender identity disorder reported in previous studies,” they said. “Allowing children to present in everyday life as their gender identity rather than their natal sex is associated with developmentally normative levels of depression and anxiety.”
A significant potential limitation of this study, however, is that the children transitioned at a young age when such transitions tend to be controversial and “yet did so anyway,” Dr. Olson and her associates pointed out. “Surely not all families with transgender children make this decision, meaning there are likely characteristics that are unique to these families,” they wrote. “In addition, the transgender children in this study all socially transitioned much earlier than nearly all transgender adults alive today in the United States and Canada.” The reasons for this also may play a role in the findings.
The Royalty Research Fund at the University of Washington, the National Institute of Mental Health, and the National Institutes of Health funded the research. The authors reported no relevant financial disclosures.
In this issue of Pediatrics, Olson and colleagues provide evidence in support of social transition, a completely reversible intervention associated with lower rates of depression and anxiety in transgender prepubescent children. Socially transitioned children, or those who have adopted the name, hairstyle, clothing, and pronoun associated with their affirmed, rather than birth gender, have become more visible in the media over the last several years. Although to date there has been no published evidence to support providers in suggesting social transition as a beneficial intervention, many families, often guided by mental health professionals, make that decision based on observational evidence in response to seeing how suffering can be alleviated by allowing the children to express their own sense of gender.
The rationale cited by those who oppose social transition are that children cannot possibly know their gender at such an early age and that social transition could encourage children to later seek out treatment of medical transition. Proponents have argued that social transition is useful both in improving function in those children who are intensely gender dysphoric and in helping to test the waters so to speak; that is, giving the child a completely reversible way to explore life in the other gender before committing to any medical interventions.
Olson and colleagues give supporters of social transition evidence that shows what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety internalizing psychopathology scores up to three times higher for non–socially transitioned children. Although it does not establish a causal relationship, this finding is crucially important to professionals who work with these children, as well as their families, in showing us that they are not likely to suffer any additional harm and may benefit from early social transition.
These comments were excerpted from a commentary by Dr. Ilana Sherer of the Palo Alto Medical Foundation in Dublin, Calif., and the Child and Adolescent Gender Center at Benioff Children’s Hospital at the University of California, San Fransisco (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-4358). The author reported no external funding and no relevant financial disclosures.
In this issue of Pediatrics, Olson and colleagues provide evidence in support of social transition, a completely reversible intervention associated with lower rates of depression and anxiety in transgender prepubescent children. Socially transitioned children, or those who have adopted the name, hairstyle, clothing, and pronoun associated with their affirmed, rather than birth gender, have become more visible in the media over the last several years. Although to date there has been no published evidence to support providers in suggesting social transition as a beneficial intervention, many families, often guided by mental health professionals, make that decision based on observational evidence in response to seeing how suffering can be alleviated by allowing the children to express their own sense of gender.
The rationale cited by those who oppose social transition are that children cannot possibly know their gender at such an early age and that social transition could encourage children to later seek out treatment of medical transition. Proponents have argued that social transition is useful both in improving function in those children who are intensely gender dysphoric and in helping to test the waters so to speak; that is, giving the child a completely reversible way to explore life in the other gender before committing to any medical interventions.
Olson and colleagues give supporters of social transition evidence that shows what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety internalizing psychopathology scores up to three times higher for non–socially transitioned children. Although it does not establish a causal relationship, this finding is crucially important to professionals who work with these children, as well as their families, in showing us that they are not likely to suffer any additional harm and may benefit from early social transition.
These comments were excerpted from a commentary by Dr. Ilana Sherer of the Palo Alto Medical Foundation in Dublin, Calif., and the Child and Adolescent Gender Center at Benioff Children’s Hospital at the University of California, San Fransisco (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-4358). The author reported no external funding and no relevant financial disclosures.
In this issue of Pediatrics, Olson and colleagues provide evidence in support of social transition, a completely reversible intervention associated with lower rates of depression and anxiety in transgender prepubescent children. Socially transitioned children, or those who have adopted the name, hairstyle, clothing, and pronoun associated with their affirmed, rather than birth gender, have become more visible in the media over the last several years. Although to date there has been no published evidence to support providers in suggesting social transition as a beneficial intervention, many families, often guided by mental health professionals, make that decision based on observational evidence in response to seeing how suffering can be alleviated by allowing the children to express their own sense of gender.
The rationale cited by those who oppose social transition are that children cannot possibly know their gender at such an early age and that social transition could encourage children to later seek out treatment of medical transition. Proponents have argued that social transition is useful both in improving function in those children who are intensely gender dysphoric and in helping to test the waters so to speak; that is, giving the child a completely reversible way to explore life in the other gender before committing to any medical interventions.
Olson and colleagues give supporters of social transition evidence that shows what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety internalizing psychopathology scores up to three times higher for non–socially transitioned children. Although it does not establish a causal relationship, this finding is crucially important to professionals who work with these children, as well as their families, in showing us that they are not likely to suffer any additional harm and may benefit from early social transition.
These comments were excerpted from a commentary by Dr. Ilana Sherer of the Palo Alto Medical Foundation in Dublin, Calif., and the Child and Adolescent Gender Center at Benioff Children’s Hospital at the University of California, San Fransisco (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-4358). The author reported no external funding and no relevant financial disclosures.
Transgender children who receive support for their gender identity are no more likely to be depressed than are other children and had only slightly higher anxiety symptoms, a recent study found.
“Critically, transgender children supported in their identities had internalizing symptoms that were well below even the preclinical range,” reported Kristina R. Olson, Ph.D., and her associates in the department of psychology at the University of (Seattle) Washington (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-3223). “These findings suggest that familial support in general, or specifically via the decision to allow their children to socially transition, may be associated with better mental health outcomes among transgender children.”
The authors recruited 73 transgender children between the ages of 3 and 12 years. All the children identified as a gender different from the sex they were assigned at birth, used the pronouns associated with that gender, and presented in that gender in all social situations, including during everyday life, at school, and at home. Among the 22 born-females and 51 born-males, the average age of the children was 8 years.
The researchers compared these children’s mental health to that of 49 of their siblings and 73 age-matched control children with no history of cross-gender behavior. Approximately three quarters of the children across all three groups were white, and smaller numbers of children were Hispanic, Asian, or multiracial. Nearly all the children lived in homes with an annual family income above $75,000, and about half lived in homes with an annual income over $125,000.
Parents filled out assessments of their children’s symptoms of depression and anxiety. Scores for transgender children were similar to those of the general population in terms of depression and only slightly elevated for anxiety, although still below even the subclinical range. No statistical differences in depression symptoms existed between the transgender children and either their siblings or the control children, and again, anxiety levels were only slightly increased.
The authors point out that most previous studies of mental health among transgender people have focused on teens and adults and have consistently found “dramatically elevated rates of anxiety, depression and suicidality among transgender people.” These findings likely reflect “years of prejudice, discrimination, and stigma; conflict between one’s appearance and stated identity; and general rejection by people in their social environments, including their families,” Dr. Olson and her associates wrote. “There is now growing evidence that social support is linked to better mental health outcomes among transgender adolescents and adults.”
The findings of this study reveal that “socially transitioned transgender children showed substantially lower rates of internalizing symptoms than children with gender identity disorder reported in previous studies,” they said. “Allowing children to present in everyday life as their gender identity rather than their natal sex is associated with developmentally normative levels of depression and anxiety.”
A significant potential limitation of this study, however, is that the children transitioned at a young age when such transitions tend to be controversial and “yet did so anyway,” Dr. Olson and her associates pointed out. “Surely not all families with transgender children make this decision, meaning there are likely characteristics that are unique to these families,” they wrote. “In addition, the transgender children in this study all socially transitioned much earlier than nearly all transgender adults alive today in the United States and Canada.” The reasons for this also may play a role in the findings.
The Royalty Research Fund at the University of Washington, the National Institute of Mental Health, and the National Institutes of Health funded the research. The authors reported no relevant financial disclosures.
Transgender children who receive support for their gender identity are no more likely to be depressed than are other children and had only slightly higher anxiety symptoms, a recent study found.
“Critically, transgender children supported in their identities had internalizing symptoms that were well below even the preclinical range,” reported Kristina R. Olson, Ph.D., and her associates in the department of psychology at the University of (Seattle) Washington (Pediatrics 2016 Feb 19. doi: 10.1542/peds.2015-3223). “These findings suggest that familial support in general, or specifically via the decision to allow their children to socially transition, may be associated with better mental health outcomes among transgender children.”
The authors recruited 73 transgender children between the ages of 3 and 12 years. All the children identified as a gender different from the sex they were assigned at birth, used the pronouns associated with that gender, and presented in that gender in all social situations, including during everyday life, at school, and at home. Among the 22 born-females and 51 born-males, the average age of the children was 8 years.
The researchers compared these children’s mental health to that of 49 of their siblings and 73 age-matched control children with no history of cross-gender behavior. Approximately three quarters of the children across all three groups were white, and smaller numbers of children were Hispanic, Asian, or multiracial. Nearly all the children lived in homes with an annual family income above $75,000, and about half lived in homes with an annual income over $125,000.
Parents filled out assessments of their children’s symptoms of depression and anxiety. Scores for transgender children were similar to those of the general population in terms of depression and only slightly elevated for anxiety, although still below even the subclinical range. No statistical differences in depression symptoms existed between the transgender children and either their siblings or the control children, and again, anxiety levels were only slightly increased.
The authors point out that most previous studies of mental health among transgender people have focused on teens and adults and have consistently found “dramatically elevated rates of anxiety, depression and suicidality among transgender people.” These findings likely reflect “years of prejudice, discrimination, and stigma; conflict between one’s appearance and stated identity; and general rejection by people in their social environments, including their families,” Dr. Olson and her associates wrote. “There is now growing evidence that social support is linked to better mental health outcomes among transgender adolescents and adults.”
The findings of this study reveal that “socially transitioned transgender children showed substantially lower rates of internalizing symptoms than children with gender identity disorder reported in previous studies,” they said. “Allowing children to present in everyday life as their gender identity rather than their natal sex is associated with developmentally normative levels of depression and anxiety.”
A significant potential limitation of this study, however, is that the children transitioned at a young age when such transitions tend to be controversial and “yet did so anyway,” Dr. Olson and her associates pointed out. “Surely not all families with transgender children make this decision, meaning there are likely characteristics that are unique to these families,” they wrote. “In addition, the transgender children in this study all socially transitioned much earlier than nearly all transgender adults alive today in the United States and Canada.” The reasons for this also may play a role in the findings.
The Royalty Research Fund at the University of Washington, the National Institute of Mental Health, and the National Institutes of Health funded the research. The authors reported no relevant financial disclosures.
FROM PEDIATRICS
Key clinical point: Transgender children can have positive mental health outcomes when supported in their gender.
Major finding: Depression symptoms were similar among transgender and nontransgender children, and anxiety symptoms were slightly higher but under preclinical ranges for transgender children.
Data source: A cross-sectional study of 73 transgender children aged 3-12 years from the Seattle area who consistently present in a gender opposite their natal sex in all social contexts, compared with 49 siblings and 73 control children.
Disclosures: The Royalty Research Fund at the University of Washington, the National Institute of Mental Health, and the National Institutes of Health funded the research. The authors reported no relevant financial disclosures.