From the Guidelines
Gender dysphoria can become known to individuals at various ages, typically between ages 3-7, but the average age of formal recognition or diagnosis varies significantly, often influenced by factors such as access to information, cultural environment, and individual psychological development. The age at which individuals become aware of their gender dysphoria can range from early childhood to adulthood, with some people recognizing their feelings during puberty (ages 11-13) and others not acknowledging them until later in life 1. It's essential to understand that gender identity development is highly individual, and there is no single "correct" age when gender dysphoria should become apparent. Some people may experience gender dysphoria throughout their lives but lack the terminology or supportive environment to identify and express these feelings until much later in life, sometimes even in their 40s, 50s, or beyond 1.
Key factors influencing the timing of gender dysphoria recognition include:
- Access to information about gender identity
- Cultural and family environment
- Individual psychological development
- Availability of supportive environments for expression and identification of gender dysphoria
The experience of gender dysphoria is distinct from the diagnosis of Gender Dysphoria, which is a controversial diagnosis in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders 1. Gender identity and gender expression are separate concepts and are not confined to binary definitions, but rather exist on a spectrum that may change over time 1. Understanding the current terminology pertaining to transgender and gender-diverse medicine is critical, including terms such as "transgender," "gender identity," "gender expression," and "gender dysphoria" 1.
Research has shown that transgender and gender-diverse individuals experience unique healthcare disparities, including lack of access to healthcare, lack of knowledgeable healthcare professionals, discrimination, and gaps in medical and mental health research 1. These disparities can lead to poorer health outcomes, including higher rates of mental health issues, such as depression, anxiety, and suicidal ideation 1. The relationship between minority stressors and mental health conditions appears to be mediated by individual cognitive, interpersonal, and emotional psychological processes, which can be addressed through gender-affirmative psychological interventions 1.
Overall, the recognition and diagnosis of gender dysphoria can occur at various ages, and it's crucial to provide supportive and affirming care to individuals experiencing gender dysphoria, regardless of their age or stage of development.
From the Research
Age of Onset of Gender Dysphoria
- The age at which gender dysphoria becomes known to a patient can vary, but research suggests that it typically manifests in early childhood 2.
- A study published in 2021 found that most transgender men (78%) and women (73%) reported experiencing gender dysphoria for the first time between the ages of 3 and 7 years 2.
- The mean age of onset was 6.17 years for transgender men and 6.71 years for transgender women 2.
- Another study published in 2020 examined the age at which US transgender adults first experienced gender dysphoria and found similar results 3.
Persistence of Gender Dysphoria
- Gender dysphoria can persist untreated for many years before individuals commence gender transition 2.
- The mean years of persistent gender dysphoria before the start of gender transition were 22.9 years for transgender men and 27.1 years for transgender women 2.
- Early diagnosis and management during childhood and adolescence can improve quality of life and survival 2.
Treatment and Care
- Treatment-seeking adolescents with gender dysphoria often present with considerable psychiatric comorbidity 4.
- Clinicians can provide hormone therapy to bring sex hormone levels to the range associated with the patient's gender identity 5.
- Guidelines exist for the endocrine treatment of transgender individuals, but systematic formal training is needed to implement high-quality gender-affirming health care 5.