New research finds that young transgender children who have “socially transitioned” — living their lives under the gender they identify with — had positive mental health outcomes.

Until now, studies had shown significantly higher rates for depression and anxiety in transgender children. Nearly half attempt suicide by age 24.

Researchers at the University of Washington looked at 73 children ages 3-12 living as their identified gender and compared those children against two control groups — their own siblings and another group. They found average scores for depression and only slightly elevated anxiety rates.

“It puts out the possibility that being a transgender child doesn’t have to be associated with negative mental health outcomes in the way that to date the research has suggested,” said Kristina Olson, Ph.D., lead author of the study and director of the university’s TransYouth Project.  She hopes to follow these children for 20 years.

It is the first analysis of mental health outcomes in a group of socially transitioned transgender children. The study was published in the journal Pediatrics.

Parents who had suspected their children might be transgender and began research on their own would find depressing mental health outcomes, until now.

“Those felt like terrifying statistics to hold as a parent,” said Alison Pennington, 42, of Oakland, one of the families in the study. She and her partner have two children, an older girl and a second child, now 6, born as a boy.

By age 3 and a half “it became increasingly clear,” Pennington said, “that there was something going on … that was pulling him into the realm of traditional girliness, and as it continued, it grew in intensity and grew in its consistency.”

The intensity of gender identity was true of most kids in the study, “These are kids who are very persistent and insistent about their gender identity,” said Olson, “and those are the only kids that experts working in this area have advised that these social transitions might be useful for.”

Pennington and her partner began researching on their own and later with experts. While Pennington said she knew adults who had transitioned, “I had never heard of transgender children. I didn’t know it had the capability of dating back to such early childhood.”

Just before his 5th birthday her son asked to be called a girl. Pennington and her partner supported their child’s choice to live as girl. She already had a gender neutral name (which Pennington declined to share, for her child’s privacy) and began dressing as a girl.

“Now having a child who has lived in their identified gender for a year and a half, I have no doubt that we’re making the right decision,” Pennington said, adding that her daughter is well-adjusted at school and is accepted as a girl by her peers.

None of the children in the study had any medical or surgical treatments. “No one in the country does medical or surgical interventions with kids this young,” said Olson. Estimates of the rate of transgender children range from 0.3 to 0.8 percent of the population.

The group of children Olson is studying, initially 73, has now grown to 153. None has transitioned back. She said her project welcomes additional participants.

In an accompanying editorial, Ilana Sherer a pediatrician and assistant medical director of UC San Francisco’s Child and Adolescent Gender Center called the research “crucially important.”

“Olson and her colleagues give supporters of social transition evidence of what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety … up to 3 times higher for non-socially transitioned children.”

For the children in this study, family support appears to be key. But Olson pointed out that it’s a big decision for a family to take the step of supporting a socially-transitioned child, and not all families today are likely to make this decision.

“Probably there are some attributes about the families who have done this that are unique to them,” Olson said. She stressed the need for more research to illuminate whether it’s those “other qualities” or the social transition itself that promotes the positive mental health outcomes seen in this analysis.

Transgender Children Living Openly Are Doing Well, Study Shows 26 February,2016Lisa Aliferis

  • Bismarque

    Ok, first off great to see. It would be so hard as a parent to hear your child come out as transgender and all the evidence pointed to a lifetime of pain for that person. That being said, who the hell gives a THREE year old, a literal infant, the decision of choosing their gender? It seems like it has nothing to do with the child’s happiness and everything to do with the parents inability to delineate completely normal behaviour from a obsession with labels and categories. To these children, choosing a gender has more to do with things they like that we have given a label to and less to do with what category they want to be put in. Ms. Pennington is a bad parent. Not because she gave her kid freedom to choose, but because she bundled liking pink or blue with a life altering, sexually charged decision that her ward completely lacks the capacity to undestand. What drives me nuts is this: anywhere else Ms. Pennington’s decision would be considered child abuse. There is a clear cut reason why courts in Germany, Iceland and Australia have specific laws against naming your offspring something incredibly stupid like Hashtag. They will have their life altered and be judged based on their moronic parents’ decision. I guess what I’m saying is that by “letting them choose” parents are basically doing what stupid parents do: deluding themselves into believing they are somehow exceptional and edgy, when in reality their decision can be distilled to what toys they let them play with and making them wonder why they have to learn 30 distinct pronouns to describe themselves. Kids are kids and each resides on their own unique band of the gender spectrum. I am skeptical of the motives of parents like Ms. Pennington because it appears as though they are driven by some sort of competition to maximize the amount of (often manufactured) hardship they have to overcome because it makes them feel like a crusader. Worst of all this perspective detracts from people dealing with deadly serious hormone imbalances and physiological rejections of gender. A three year old has a little bit to go to reach pueberty. Ms. Pennington’s child likes stuff that falls under the category of what we traditionally refer to as female and that is both liberating and beneficial to society. However, by including children such as hers in the study, it endangers the health of the post-pueberty transgender by lumping together personal preferance (toys and colors) with biological realities (dysphoria and hormonal imbalances). Ms. Pennington is perfectly welcome to work herself up over her perceptions of her kid’s future. All good parents do. She does not get to trivialize actual transgender health issues by claiming her mf’ing 5 year old will be part of that group based on a decision they made at three and likely unconsciously influenced by her own opinions.

    • Emily Fravel

      My child is one in this study. She began showing signs at three that something was amiss. At 6, I asked her questions straight out. She began to transition at home at 7 and this year, at 8, she is living full time as a girl.
      I can not speak to what Pennington has gone through, but this is not standsomething that we’ve taken lightly, that we’ve done on our own (aside from being in this study, we also see a team of specialists) and this certainly has not been easy.
      I’m interested to know what qualifications you have to determine what is too young. I’m also interested to know what studies you have done and where they’ve been published.?
      As for “endagering the health of post-puberty transgerder” people. Do you know what endangers the health of those people? Puberty itself. By doing these studies, more children will be able to get help and care earlier. There is clear cut criteria for diagnosing a child with gender dysphoria and it has nothing to do with a preferred color or style of dress.
      Are you interested in understanding or ranting your (poorly informed) opinion so that you can feel superior?

      • Geena Phillips

        Thank you, Emily. Not only for being the kind of mom trans kids need, but also for putting that ignorant concern-troll “Bismarque” in their place.

        • Emily Fravel

          Thank you for your support. At 8, I have a child who already sometimes wants to die. Pretty much all of our family is gone. She’s terrified of puberty. Hormone blockers will keep her from having male puberty. The support of friends, medical professionals and even strangers helps her. Meeting other trans people ( she calls them “like mes”) helps.
          She’s an amazingly strong kid and absolutely hilarious. She says something funny every single day.
          This is incredibly hard and I often do wish we were going through it, but I’m confident we’ll come out on the other side, stronger, better more loving people.

      • WOW!!! **THANK YOU** for all you’ve done for her Emily!! 🙂 🙂 🙂

  • Vanessa

    So happy to read more stories of parents truly supporting and affirming their very young children. As most informed people know, this study has nothing to do with the types of toys a child plays with or the colors the child prefers. That would be pretty stupid, indeed. It takes quite more than those superficial qualities. Let’s see, you need a kid who absolutely, positively makes it clear all day to anyone who will listen that she/he/they are not the person you in your adult wisdom think they are. We’re talking toddlers and pre-schoolers trying to harm their own bodies, refusals to answer to pronouns of the opposite gender, depression or a feeling of being trapped in their own bodies that magically disappears when allowed to be their true selves, oftentimes repeated visits with therapists who confirm the diagnosis… Good job, Ms. Pennington. I’m certain this path wasn’t easy, and that you going to receive a lot of callous replies for your decision to mother with love and acceptance. I’m even more certain you didn’t wake up one morning and decide your life wasn’t complete without “crusader” on your motherhood resume. I’m glad your child has YOU, and I’m glad this study is taking into consideration the real qualifications of what it means to be a transgender child. One day, the post-puberty transgender community will thank you and your child, and I’m willing to bet the results from this are going to save a lot of lives. Because as anyone who knows anything about transgender issues knows…if you wait until puberty to address all these things…there’s a good chance it’s too late.

  • WHEEEEE!!! What a *blessing* 🙂 🙂 🙂

    I wish I could have transitioned as a young person. BUT I *have* transitioned!! I am *so blessed*, so blessed, so blessed to *be*!! 🙂


Lisa Aliferis

Lisa Aliferis is the founding editor of KQED’s State of Health blog. Since 2011, she’s been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including Dateline NBC and San Francisco’s CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for “Best Topical Reporting” from the Online News Association. You can follow her on Twitter: @laliferis

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