Category: Social transition
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Autistic young people are more likely to socially transition than those without autistic traits.
A cohort study of Australian children with trans identities1 found that the difference in rates of social transition between “trans” children with and without autistic traits was 11.7%.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084 ↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Social transition solidifies a transgender identity
A study1 of 317 trans-identifying youth found an average of five years after their initial social transition, 94% continued to identify as binary transgender, while 3.5% identified as non-binary.
In a 2022 longitudinal study by Olson et al., 317 trans-identifying youth were followed for an average of five years after their initial social transitions (mean age at start of study = 8.1 years). The findings showed that five years post-social transition, 94% of youth continued to identify as binary transgender, 3.5% identified as nonbinary, and 2.5% identified as cisgender. Avoiding the use of the DSM-5 criteria for gender dysphoria due to ethical concerns from parents, the study classified gender identities using initial visit data, which displayed signs of gender identification and preferences, along with parent-reported “cross-sex” preferences. The final identity was then established based on the most recent interaction with the youth or their parents before January 1, 2021.
- Olson, K. R., Durwood, L., Horton, R., Gallagher, N. M., & Devor, A. (2022). Gender identity five years after social transition. Pediatrics, 150(2). [Link] ↩︎
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In one survey, 50% of transwomen who tucked were concerned about negative health effects
A survey1 of transwomen who tucked (the process of reducing the visible male crotch bulge) reported that half were concerned about the health effects of tucking.
Their reported symptoms included itching (28%), rash (21%), testicular pain (17%), penile pain (14%), and skin infections (12%).
In addition, patients may be reluctant to seek medical care for testicular complaints and when they do, it may be already late to salvage the testis.2
- Poteat, T., Malik, M., & Cooney, E. (2018). Understanding the health effects of binding and tucking for gender affirmation. Journal of Clinical and Translational Science 2 (Suppl 1), 76. [Link] ↩︎
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
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One case study suggests that tucking can cause testicular torsion
A case study1 found that one transwoman had testicular torsion as a result of tucking.
Testicular torsion – the rotation of the testes and subsequent arterial constriction – can present as severe acute unilateral scrotal pain, nausea, and vomiting. If permanent ischemic damage results, delay in treatment may be associated with decreased fertility, or may necessitate orchiectomy2.
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
- Sharp, V. J., Kieran, K. & Arlen, A. M. (2013). Testicular Torsion: Diagnosis, Evaluation, and Management. Am Fam Physician 88 (12): 835-840. [Link] ↩︎
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While long-term study is lacking, one case study suggests that tucking can affect fertility
In a case study1 of one transwoman, tucking resulted in oligospermia – an abnormally low sperm count – affecting fertility. Elevation of the testes because of tucking may contribute to heat stress and consequent impairment of spermatogenesis.
After cessation of tucking and the provision of a new sperm sample, the sperm count in the patient was improved, and the semen had increased opacification.
A further study2 found that tucking could create a suboptimal environment for spermatogenesis.
- Trussler, J. T., & Carrasquillo, R. J. (2020). Cryptozoospermia Associated With Genital Tucking Behavior in a Transwoman. Reviews in urology, 22 (4), 170–173. [Link] ↩︎
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
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A study which looked at 27 different negative health effects of binding found that some do not show for years
A survey1 of 1800 females who used breast binders reported a number of negative health effects which develop over time. Some of these effects are felt immediately. However, in other cases, it can take years for the negative health effects to be fully seen:
- Peitzmeier, S.M., Silberholz, J., Gardner, I.H., Weinand, J. & Acevedo, K. (2021). Time to First Onset of Chest Binding-Related Symptoms in Transgender Youth. Pediatrics 147 (3). [Link] ↩︎
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There is evidence that chest binding has a statistically significant impact on lung function
A study1 found that:
Transgender individuals using chest binders have abnormal lung function. The acute effect of wearing the binder appears to be an overall volume reduction with little other change.
- Cumming, R., Sylvester, K. & Fuld, J.P. (2016). Understanding the effects on lung function of chest binder use in the transgender population. Thorax 71. [Link] ↩︎
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There is an array of negative health effects associated with chest binding
There is a range of negative effects which chest binding can cause1.
A survey2 of transmen who engaged in breast binding found that 68% were concerned about the health effects. The most common symptoms associated with binding were back pain (65%), shortness of breath (48.6%), bad posture (32%), chest pain (30%), and light-headedness (30%).
- Peitzmeier, S., Gardner, I., Weinand, J., Corbet A. & Acevedo, K. (2017). Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health & Sexuality 19 (1): 64-75. [Link] ↩︎
- Poteat, T., Malik, M., & Cooney, E. (2018). Understanding the health effects of binding and tucking for gender affirmation. Journal of Clinical and Translational Science 2 (Suppl 1), 76. [Link] ↩︎
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One study showed that, without social transition, nearly two-thirds of pre-teen gender-dysphoric males grow up to be gay or bisexual
A University of Toronto study1 found that 63.6% of boys with early onset gender dysphoria, who received ‘watchful waiting’ treatment and no pre-pubertal social transition, grew up to be gay or bisexual.
Only 12% of the study participants continued to identify as transfeminine.
- Singh, D., Bradley, S.J. & Zucker, K.J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder. Frontiers in Psychology 12. [Link] ↩︎
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More and more children have already socially transitioned – often including pronoun changes – by the time they present to gender clinics
Dutch data1 indicate that, between 2000 and 2004, 3.3% of children had completely socially transitioned (clothing, hairstyle, change of name, and use of pronouns) when they were referred to gender clinics, with 19% already living in the preferred gender role in clothing style and hairstyle, but not announcing that they wanted a name and pronoun change.
However, between 2005 and 2009, these percentages increased to 8.9% and 33.3% respectively, demonstrating that social transition is becoming more common before medical transition is investigated.
- Steensma, T.D. & Cohen-Kettenis, P.T. (2011). Gender Transitioning before Puberty? Archives of Sexual Behavior 40 (4): 649-50. [Link] ↩︎
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Social transition – changing names, pronouns, clothing and bathroom use – correlates with the persistence of transgender identity
Pediatric transition doctors in the Netherlands who first pioneered the use of puberty blockers in dysphoric children observe that social transition correlates with an increase in young people’s persistence when it comes to gender identity1. This led them to caution against social transition before puberty.
Another paper2 notes that gender dysphoria is more persistent into adolescence where social transition has occurred, and as such asserts that social transition is a “psychosocial intervention [which] might be characterized as iatrogenic” – a medical problem caused by the treatment itself.
There is evidence3 that social transition by the child was found to be strongly correlated with persistence for natal boys, more so than for girls.
- de Vries, A. L., & Cohen-Kettenis, P. T. (2012). Clinical management of gender dysphoria in children and adolescents: The Dutch approach. Journal of Homosexuality 59 (3): 301–320. [Link] ↩︎
- Zucker, K. J. (2019). Debate: Different strokes for different folks. Child and Adolescent Mental Health 25(1): 36-37. [Link] ↩︎
- teensma, T.D., McGuire, J.K., Kreukels, B.P., Beekman, A.J. & Cohen-Kettenis, P.T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. J Am Acad Child Adolesc Psychiatry. 52 (6): 582-90. [Link] ↩︎