‘They Aren’t Confused’: Landmark Study Shows Transgender Children Have Consistent, ‘Deeply-Held’ Gender Identity

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Transgender children as young as 5 years-old demonstrate consistent gender identity across a variety of implicit gender-association measures, according to a landmark study to be published in the journal Psychological Science.

The study found that the responses of children who identify as transgender are indistinguishable from those of children who do not identify as trans, indicating “that the gender identity of these children is deeply held and is not the result of confusion about gender identity or pretense,” the authors said in a press release.

The paper, believed to be the first ever to focus on this group of children, is intended to launch the first large-scale, nationwide, longitudinal study of transgender children in the United States. The research is being led by Dr. Kristina Olson of the University of Washington, along with co-authors Dr. Nicholas Eaton at Stony Brook University and Aidan Key of Gender Diversity, a Seattle organization that provides training and runs support groups for families of gender-nonconforming children.

The research is part of the broader TransYouth Project, an initiative based out of the UW’s Social Cognitive Development Lab that seeks to engage collaborators nationwide to better understand gender development in gender-nonconforming youth. Dr. Olson ultimately hopes to recruit more than 100 children to participate in the research; families can sign up through the project’s website.

Dr. Olson, who also works as a specialist for transgendered youth at Children’s Hospital in Los Angeles, told CBS News that her patients often experience gender dysphoria. She defines this as “persistent unhappiness, discomfort, and distress about the incongruence between the gender that you are assigned, based on your anatomy at birth, versus the way you internally experience gender.” Her mission has always been to help combat this, as well as to give parents a better understanding of who their children are.

“Seeing how little scientific information there was, basically nothing for parents, was hard to watch,” she said in the press release. “Doctors were saying, ‘We just don’t know,’ so the parents have to make these really big decisions: Should I let my kid go to school as a girl, or should I make my kid go to school as a boy? Should my child be in therapy to try to change what she says she is, or should she be supported?”

In recent years, medical and psychological experts have strongly advocated for the latter, and Dr. Olson’s study shows why such support is warranted.

Explicit and implicit measures of gender identity

To investigate the stability of the gender identity of transgender children, Dr. Olson recruited 32 children, ages 5 to 12, who identify as transgender and came from environments that supported their choice to live as their identified gender. These children were specifically chosen because they had not reached adolescence, which allowed the researchers to determine that stable transgender identity associations can happen before the onset of puberty.

Dr. Olson and her colleagues used both self-report methods, along with implicit measures, in order to more clearly ascertain how deeply held gender identity is in these children. The researchers also recruited the cisgender (non-transgender) siblings of the 32 participants to serve as a control group for the analysis. A second control group of cisgender children were recruited from a database of families interested in participating in developmental psychology research studies. These cisgender children were age-matched to the transgender participants in order to compare responses.

Implicit measures during the testing were based on the commonly employed Implicit Association Test (IAT), used to measure the speed with which participants associated gender, both male and female, with concepts of “me” and “not me.” The underlying theory is that participants will respond more quickly to associations more deeply felt.The IAT has been used in many studies to investigate implicit attitudes related to various attributes, including gender and race, and brief versions of the IAT that use pictures instead of words have been validated for use with children.

The researchers found that the responses of transgender participants on the IAT were nearly identical to those of the two control groups — in other words, they just as quickly identified with their expressed gender as cisgender children did with their gender. “The data from transgender girls showed the same pattern as the data from cisgender girls and the data from transgender boys showed the same pattern as data from cisgender boys,” they report.

Explicit, self-reporting measures involved direct questioning of the children about their identity. Once again, the team found that transgender children showed the same pattern of results as their cisgender counterparts. Transgender girls, for example, reported preferring to hang out with girls as well as liking certain toys and foods that other girls liked.

“While future studies are always needed, our results support the notion that transgender children are not confused, delayed, showing gender-atypical responding, pretending, or oppositional — they instead show responses entirely typical and expected for children with their gender identity,” the researchers write.

“The data reported in this paper should serve as further evidence that transgender children do indeed exist and that this identity is a deeply held one,” they conclude. In other words, transgender children are just like all other children; they just weren’t born with the gender they identify with.

Support from early age is key for transgender youth

These findings are in line with other recent research, including a fascinating new study published earlier this month in which scientists identified the brain network underlying gender identity, providing one of the strongest biological explanations for transgender identification to date. Upon examining MRI images of subjects’ brains, the researchers observed significant differences in the microstructure of the brain connections between male and female control subjects; meanwhile, transgender persons took up a middle position between both genders. Past studies also point to a biological underpinning of transgender identification: In 1999, scientists identified anatomic brain differences between transgender and cisgender people, while more recent research indicates that genetics likely have a mild to moderate effect on transgender development.

Yet, many people still believe that transgender children and adolescents are simply going through a ‘phase’, often leading to misguided efforts by parents to change the gender identity of their children. Many religious groups also promote the concept that an individual can change his or her gender identity, either through prayer or other religious efforts, or through so-called “reparative” or “conversion” therapy. The limited research on such efforts has disproven their efficacy, and also has indicated that they can be affirmatively harmful.

Beyond studies focused solely on reparative therapy, broader research clearly demonstrates the significant harm that societal prejudice and family rejection has on transgender people, particularly youth. Furthermore, there is significant anecdotal evidence of harm to transgender people resulting from attempts to change their gender identity. On the other hand, research also shows that family support can have tremendously positive effects in the lives of transgender children.

“We know that among trans people, there are high rates of depression, anxiety, social isolation, [and] suicide attempts. All of these things we see dramatically increased in trans youth,” Dr. Olson told CBS. “But young people that I’ve seen, who socially transition in childhood and have support of their families, they have a very different experience.”

That’s why Dr. Olson says it is so important to develop a better understanding of transgender development. She plans to recruit at least 100 more transgender children and follow them into adulthood. In doing so, she hopes to see how living as their identified gender from youth will positively affect the individuals in adulthood. This will be the first large-scale study of its kind, consisting of children from all over the United States.

“We have absolutely no idea what their lives will look like, because there are very few transgender adults today who lived as young kids expressing their gender identity. That’s all the more reason why this particular generation is important to study. They’re pioneers,” she said.

By allowing children to freely identify with who they truly are at a young age, Dr. Olson says there is more hope of creating within these children the longstanding sense of self-respect and security that all individuals deserve.