Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental Health of Transgender Children Who Are Supported in Their Identities. Pediatrics, 137(3) Til tidsskriftet

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SEGM Summary

This is a cross-sectional 2016 study that used the data from TransYouth Project. The study compared parent-reported measures of depression and anxiety, obtained through questionnaires, in a community sample of 73 socially transitioned prepubertal children (ages 3-12) to age and gender-matched community controls and their own non-GD siblings.

Results showed that socially transitioned gender-dysphoric children did not differ on depression scores and had only marginally higher anxiety scores as compared to the controls.

It should be noted that in 2017, TransYouth Project's data was used again in a study by Durwood et al., evaluating children aged 9-14, and had similar findings.

It is important to note these authors' own statements in these two related papers:

• that prepubescent social transition for GD children is controversial.

• that there is “little known about the well-being of socially transitioned transgender children.”

• That there are numerous limitations to their own findings, including the acknowledgement that the study design does not allow one to draw a causal inference that social transition in prepubescent GD children improves mental health outcomes.
  

SEGM Plain Language Conclusion:

This is the key empirical study quoted by those arguing for social transition of children. Its findings showed that gender-dysphoric prepubertal children who underwent social gender transition had psychological functioning similar to their gender-normative peers.The authors of the study contrast this high level of function to the typically lower-level of psychological function in gender-dysphoric children in other studies.

However, the study has a number of serious methodological limitations, and cannot be used to assert that social transition produces psychological benefits, or that the benefits outweigh the potential risks: 

• The data source is TransYouth Project, an initiative targeting highly involved gender-affirming parents interested in tracking their children's outcomes overtime. A high level of function found in such children may or may not be related to their social transition status

• One other obvious limitation of the TransYouth Project data is that parents whose children stop identifying as transgender are not likely to stay in this longitudinal project. Thus, the potential negative outcomes of a premature social transition for desisting children are likely not captured. Since historically, the majority of prepubertal children have eventually desisted from transgender identification, the study is unable to provide any information about the risks, or weigh the benefits vs the risks.

• Further, a reanalysis of the Olson et al. study (Wong et al., 2019) that controlled for additional variables (including peer relations) with a multivariate analysis failed to demonstrate that social transition was associated with positive outcomes. Rather, the positive function was accounted for by positive peer relations. The study by Wong et al. concluded, "Socially transitioned children appear to experience similar levels of psychosocial challenges as CGV [gender-variant but not socially transitoned] children.

The study authors themselves warn against concluding that pediatric social transition improves psychological outcomes.