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Young children who transition to a new gender along with social changes — taking on new names, pronouns, haircuts and clothes — will likely continue to define that gender five years later, according to one study. report The first study of its kind was published Wednesday.

The data comes from the Transgender Youth Project, a well-known effort that followed 317 children aged 3 to 12 in the United States and Canada who are going through a so-called social transition. Participants transitioned at an average of 6.5 years.

According to the study, the vast majority of the group still identified with their new gender five years later, and many began hormonal drugs during adolescence to accelerate biological changes to fit in with their gender identity. The study found that 2.5 percent of the group returned to identifying the gender they were assigned at birth.

As tensions escalate in courtrooms and government offices across the country over appropriate healthcare for trans children, little data is available on their long-term development. The new study provides one of the first large datasets on this group. The researchers plan to continue to follow this cohort. 20 years later social transitions.

“There’s an idea that kids will start this kind of thing and change their minds,” said psychologist Kristina Olson of Princeton University, who led the research. “And we don’t find that, at least in our sample.”

However, Dr. Olson and other researchers cautioned that the study could not be generalized to transgender children. For example, two-thirds of respondents were white, and parents tended to have higher incomes and more education than the general population. All parents were supportive enough to facilitate full social transitions.

And because the study began nearly a decade ago, it’s unclear whether it reflects today’s patterns, where many more children identify as trans. Two-thirds of those surveyed were transgender girls who were assigned a boy at birth. But in the last few years, youth gender clinics around the world have reported a swelling Proportion of adolescent patients assigned as female at birth and recently identified as trans male or nonbinary.

Laura Edwards-Leeper, a clinical psychologist specializing in the care of transgender children in Oregon, noted that this group also has a high incidence of mental health problems, including autism and ADHD. “This is the group I’m really worried about the most these days,” she said.

Dr. “I would say this study tells us nothing about those kids,” Edwards-Leeper added. “It’s just that different.”

Trans Youth Project researchers began recruiting participants in 2013 and have traveled to more than 40 states and two Canadian provinces to interview families. Such in-depth data are rare in such studies, often obtained from online surveys or through children referred to specific gender clinics, often older and often from more restricted geographic areas.

Previously published work showed that children from the project who were supported by their parents during social transitions were roughly equal to non-transgender children in terms of depression rates and had slightly higher rates of anxiety.

The new study, published in the journal Pediatrics, followed this cohort as they reached a milestone about five years after their first social transition. The study found that 94 percent of the group still identified as transgender five years later. Another 3.5 percent identified as non-binary, meaning they did not identify as either a boy or a girl. This label was not as widely used as it is today when the researchers started working.

By the end of the study period, by 2020, 60 percent of children had begun taking either puberty-inhibiting drugs or hormones. Dr. Olson said researchers are still collecting data on how many of the younger participants had undergone sex surgery.

Eight children, or 2.5 percent, had reverted to their assigned gender at birth. Seven of them transitioned socially before age 6 and returned before age 9. The eighth child was reinstated at age 11 after starting puberty-blocking drugs.

Research from 1990s and 2000s Many children diagnosed with gender identity disorder (a psychological diagnosis that no longer exist) typically develop after puberty. 10-13 years old. Some of the earlier work was criticized because pediatricians recommended their parents to distance them from trans identity.

In the decades since this study was conducted, acceptance of gender diversity has increased, medical practice has changed, and the number of transgender children has increased significantly.

For these reasons, comparing the new study with older research doesn’t make sense, said Russ Toomey, professor of family studies and human development at the University of Arizona.

Dr. “It’s really comparing apples to oranges,” Toomey said. Most of the children in previous studies were effeminate children whose parents were upset by their behavior. “Many of these children, often cited in these early studies, have never labeled themselves or been labeled as transgender.”

The new study may suggest that transgender children thrive on identity when supported by their parents. But it’s also possible that some of the children who still identified as transgender at the end of the study – or their parents – felt pressured to continue on the path they started.

“Depending on your point of view, people will likely interpret this data differently,” said Amy Tishelman, a clinical psychologist at Boston College and lead author of the World Professional Association of Transgender Health’s chapter on standards of care for children.

“Some people may say that children fail to get in and out of this developmental trajectory and medical interventions may be irreversible and they may regret it,” she said. “Other people will say that children know their gender and are happy when they are supported about their gender.”

While most clinicians agree that social transitions can be beneficial for some children who question their assigned gender, Dr. Tishelman said it’s also important to support those who change their minds. “It’s really important that kids can continue to feel that it’s okay to be fluent, to keep exploring,” she said.

More data on the cohort as they continue into puberty could reveal how many children choose to switch after starting hormone therapy.

Dr. Olson said her group will soon publish an additional qualitative study describing the experiences of the relatively small number of children who are reverting to their original gender identities. He said that these children are successful when they are supported by their families.

Dr. “In our study, we don’t just want to know what category they fit today and tomorrow,” Olson said.

“I think of all these children as gender diversity in different ways,” he added, “and we want to understand how we can help their lives be better.”