A follow-up study of girls with gender identity disorder.

TLDR

The study examined the natural history of 25 girls diagnosed with gender identity disorder. Standardized assessments were administered in childhood (mean age 8.9 years) and at follow‑up (mean age 23.2 years) to evaluate gender identity and sexual orientation. At follow‑up only 12 % retained GID or gender dysphoria, yet 32 % reported bisexual/homosexual fantasy and 24 % bisexual/homosexual behavior, with persistence and sexual‑orientation rates exceeding general population norms and a dose‑response link to childhood cross‑sex behavior.

Abstract

This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria. Regarding sexual orientation, 8 participants (32%) were classified as bisexual/homosexual in fantasy, and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The rates of GID persistence and bisexual/homosexual sexual orientation were substantially higher than base rates in the general female population derived from epidemiological or survey studies. There was some evidence of a "dosage" effect, with girls who were more cross-sex typed in their childhood behavior more likely to be gender dysphoric at follow-up and more likely to have been classified as bisexual/homosexual in behavior (but not in fantasy).