Number of children who think they are wrong gender surges 50-fold

Sharp rise in girls suffering dysphoria, with twice as many cases as in boys, study of GP records in England shows

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A study by the University of York is the first to give a detailed picture of the scale of gender distress across England
A study by the University of York is the first to give a detailed picture of the scale of gender distress across England

Research suggests there has been a 50-fold rise in children who think they are the wrong gender in just 10 years.

Analysis of GP records suggests there were 10,000 diagnoses of gender dysphoria in England in 2021 – up from fewer than 200 cases in 2011.

The University of York study shows a sharp rise in the number of girls with such concerns, with twice as many cases as in boys.

More than half of those with a gender dysphoria diagnosis had anxiety or depression or had self-harmed, the research published in the Archives of Disease in Childhood found.

The study is the first to give a detailed picture of the scale of gender distress across the country.

Until now, most research has been based on small numbers going to specialist services, whereas this study is based on a large sample of GP records.

It follows the landmark Cass review, which warned that children who think they are transgender should not be rushed into treatment they may regret, and recommended the banning of puberty blockers for under 18s.

Researchers drew on anonymised electronic health records between 2011 and 2021 for those general practices in England contributing to the Clinical Practice Research Datalink database.

During this period, 3,782 children and young people up to the age of 18 had a diagnosis of gender dysphoria documented in their medical record.

Analysis of the data showed that between 2011 and 2021, incidence rates of recorded gender dysphoria rose from 0.14/10,000 to 4.4/10,000 person years in this age group.

If this pattern were repeated nationally, it would mean more than 10,000 people aged 18 and under had a diagnosis of gender dysphoria in 2021, equivalent to one in 1,200.

This compares with fewer than 200 cases in 2011, equivalent to one in 60,000.

Dr Hilary Cass warned that children who think they are transgender should not be rushed into treatment they may regret in her landmark review in 2024
Dr Hilary Cass warned that children who think they are transgender should not be rushed into treatment they may regret in her landmark review in 2024 Credit: Yui Mok/PA

The research shows that from 2015 onwards, the number of cases rose more rapidly in those recorded as female than those recorded as male by their family doctors, and were about twice as high by 2021.

Of the total number of those with gender dysphoria, almost 5 per cent were prescribed puberty blockers, 8 per cent were prescribed masculinising or feminising hormones; and 53 per cent had concurrent anxiety, depression, or self-harm recorded.

Prof Tim Doran, from the University of York, said increased awareness of gender differences and the rise of social media were amongst the factors behind the trends, which were accompanied by a steep rise in anxiety and depression.

He said it was not clear whether children with mental health problems were more likely to develop gender dysphoria, or whether the dysphoria was likely to lead to the distress, saying the evidence so far could not untangle a “chicken and egg” argument.

‘Mental health difficulties’

Researchers wrote: “Levels of observed anxiety and depression have been increasing in children and young people in general over the last two decades for complex and contested reasons, challenging health, education and social services, and those experiencing gender dysphoria/incongruence are at particular risk.

“There is an urgent need to tackle vulnerability to mental health difficulties and improve mental health support for children and young people experiencing gender dysphoria/incongruence.”

A small, in-depth study of those seeking gender identity treatment interviewed 14 teens referred to gender identity services, 12 of their parents, and 18 people aged 19 to 30 who had previously sought treatment.

The responses indicated that young people experiencing dysphoria were eager to start treatment straight away, and often felt disappointed by the medical delays and frustrated by their parents, who were more cautious about medical treatments.