ABSTRACT
Over the past 15 years, there have been striking changes in the population of people seeking care for gender dysphoria. In addition to a marked increase in adolescents seeking care overall, there has been a disproportionate increase in natal female adolescents, so much so that the sex ratio has reversed from one favouring natal males to one favouring natal females. Clinicians have noted that there appears to be a new presentation of gender dysphoria, one in which natal females who did not have observable signs of gender dysphoria prior to puberty begin to experience gender dysphoria at or after puberty. Although a decrease in stigma and an increase in the availability of information about transgender issues may account for some of the increase in patient numbers, they would not explain the reversal of the sex ratio, the new late-onset presentation in natal females, or why the increases have occurred in adolescents but not older adults.
In response to recent demographic changes and the observation of accounts where multiple teens in the same friendship groups announced transgender identifications around a similar timeframe, an exploratory study was conducted that raised hypotheses around the possible roles of psychosocial factors such as trauma, psychiatric disorders, internalised homophobia, and social influence in the development of gender dysphoria for some adolescents and young adults. This chapter explores the emerging theories of gender dysphoria through a series of studies that include as participants parents of gender-dysphoric youth, individuals who transitioned and detransitioned, and individuals who identified as transgender and then re-identified with their natal sex.
