Purpose of Review

Review evidence in the controversial management of prepubertal gender dysphoric children where some clinicians and parents advocate transition to live as a child of the non-natal sex.

Recent Findings

Earlier reports, primarily of males, demonstrated that most cross-gender behaving children, with what was called Gender Identity Disorder, matured into gay or lesbian adults, and only a small minority were transgender. However, recent practice by some clinicians advocates gender transition for prepubertal children believed to be sufficiently gender dysphoric to live as the non-natal sex. Can the subgroups be distinguished for this decision to be made? Can clinical judgment result in short term and longer term benefit to those who transition? Are there risks to facilitating gender transition as well as efforts to promote more comfort with natal sex?

Summary

Many unknowns pervade the advocacy of transitioning prepubertal gender dysphoric children and the advocacy of promoting more comfort with natal sex. Complex research designs will help answer these questions.