Most Children Who Underwent Early Social Transition Maintain Their Gender Identity

When Kristina Olson began studying children who had socially transitioned from one gender to another in the early 2010s, there were very few of them. The very idea of social transition—living in a new gender without medical intervention—was controversial for minors. But gradually a new understanding took hold: transgender children know who they are, and there is no reason to delay acknowledging it. Increasingly, parents supported this choice and allowed their children to change social identity, sometimes as early as age three.

To study the consequences, Dr. Olson and her colleagues assembled a cohort of hundreds of such early social transitions, along with their families, with the goal of tracking them over many years. They also created two control groups: siblings of children who identified as transgender but remained cisgender at the start of the study, and a separate group of children, mostly from Washington State, where Olson then worked (she is now a professor at Princeton University).

The TransYouth Project, as it later became known, is today the largest and most influential long-term study of early childhood social transitions worldwide. In 2018, Kristina Olson received a MacArthur Fellowship—the so-called “genius grant”—for this work. The latest findings underscore the complexity of the subject and reveal how differently experts in a deeply polarized field interpret the same statistical evidence.

In July, the journal Monographs of the Society for Research in Child Development published a study titled “Stability and Change in Gender Identity and Sexual Orientation in Childhood and Adolescence.” Its central finding is that most children who underwent social transition at an early age maintained a stable gender identity over time. The average age of transition in the sample was six and a half, with follow-up by Olson’s research team occurring seven years later. A full 82% of participants remained steadfast in their identity.

The remaining 18% experienced at least one shift—either reverting to their biological sex or, more commonly, identifying as “gender diverse,” meaning neither cisgender nor transgender boys or girls. The more widely used term for this category is “nonbinary.”

The fact that nearly one-fifth of the children in the study did not maintain a stable gender identity should prompt advocates of irreversible medical interventions to pause. It also complicates the interpretation of another of Olson’s findings. In 2022, she published early results in the journal Pediatrics based on the same cohort: at that point, only 7% of children who had undergone early social transition had changed their identity within five years. Taken together, the two studies suggest that over time a significant share of participants may reassess their understanding of gender. The most recent survey wave included teenagers with an average age of 15—well before adulthood.

“The longer the observation period, the more instability,” notes Dr. Stephen Levine of Case Western Reserve University’s School of Medicine, who has worked for decades with transgender adults and youth. Laura Edwards-Leeper, another expert critical of what she sees as overly hasty approaches to adolescent transition, stresses that if reversals of gender identity become more common with age, “this may be a strong argument for approaching early social transition with caution.”

The new study also touches on another sensitive issue—the role of external factors. Citing earlier research, the authors mention “a common view in the literature that parents in some way contribute to or reinforce gender nonconformity in children.” But they cast doubt on this, noting that most siblings of transgender participants remained cisgender. “If parents generally encouraged gender nonconformity, it would be logical to expect a higher number of transgender identities among siblings.”

However, Zhenya Abruzzese, co-founder of the Society for Evidence-Based Gender Medicine, which takes a skeptical view of medical transition for young people, interprets the data differently. She points out that “strikingly, 23% of sisters of transgender children identified as transgender in the course of the study.” That share is far higher than among unrelated participants: 9% of boys and 10% of girls, and also higher than among brothers of participants (9%). This comes in a period of rapid growth in the number of young people declaring transgender identities—most of them, often 60% or more, assigned female at birth.

All these figures are well above estimates of transgender prevalence in the general population, such as those provided by the US Centers for Disease Control and Prevention—around 1%. Clearly, young people interpret concepts like “gender” differently from their parents. But it remains uncertain to what extent these labels reflect deep and enduring identities, and to what extent they capture temporary experiences that may later evolve into more familiar forms of sexual orientation and gender self-definition. As data accumulates, this will inevitably shape policy on early gender transitions.

What do the study’s authors themselves make of these findings? In an email, one of the researchers, Benjamin deMayo, “politely” declined to discuss the subject. “Not interested, thanks,” Olson added.