New study on trans women’s developmental milestones: Self-awareness precedes disclosure by several years

I’ve previously criticized Lisa Littman’s study of the alleged condition of “rapid onset gender dysphoria” – since corrected as “perceived to show signs of a rapid onset of gender dysphoria” – on the grounds that its methodology, solely relying on the reports of parents about their children’s history of gender identity expression, will by design entirely fail to capture the developmental processes that trans people experience prior to expressing their gender externally in a way that would be perceived by others. The suggestion that their transgender identity should be regarded with suspicion as a mere passing phase or transient interest rather than a genuine expression of gender dysphoria, and that any kind of affirmation of their “newly” expressed gender is therefore likely to be premature or inappropriate, may thus be unwarranted. The study’s corrected title much more accurately describes the limits of this methodology: parents may indeed perceive that their child’s transness has simply appeared rapidly. But this is just an incomplete picture – it does not account for trans people’s experiences of gender dysphoria before coming out, and this limitation does not therefore mean that these experiences never took place. It is a study of parents’ secondhand perceptions, not trans people’s firsthand realities, and asserting that there must have been an actual “rapid onset” of gender dysphoria based solely on the former is a mistake.

A recent study in Transgender Health provides further information on those unseen developmental processes of gender identity in trans people, and it does so via the appropriate method: by asking trans people themselves.

Restar et al. (2019) surveyed 298 young trans women (age 16-29) in Chicago and Boston, originally participating in a trial for reduction of HIV risk behaviors, about when in their lives they reached a number of key developmental milestones related to their gender identity. If gender dysphoria were indeed commonly something that appeared “rapidly” and contemporaneously with family members learning of it, there would be little or no time between that internal recognition and external expression. But the experiences of these trans women show something very different from this: a developmental course spread out over many years, with their own recognition of their gender long preceding their disclosure of this to anyone else.

The trans women in the study reported an “initial self-awareness of transfeminine identity” at an average age of 9.9 years, and “transfeminine expression in private” at 12.9 years. This private awareness was typically followed by voicing themselves as transgender several years later: the participants reported their first “transfeminine identity disclosure to others” at a mean age of 15.8 years, and “transfeminine expression in public” at 17.4 years. Among those who took feminizing HRT, they did not begin until an average age of 20.4 years – over a decade on average after initially becoming aware of their transness.

What does this mean in the context of parent reports of “rapid onset gender dysphoria”? If the current study had instead relied only on reports from parents, those parent respondents may well have reported that their child’s transness simply appeared, suddenly and out of the blue, at an average age of 15.8 years – when these trans women first disclosed their identity to someone else. Those hypothetical parents may well be reporting their perceptions entirely accurately and honestly. And at the same time, their children would have been aware of their own transness for several years already. Both of these things can be true – but applying the methodology of the “ROGD” study would mean leaving out crucial information relevant to understanding the gender identity development of these trans people. Parents of trans people may claim never to have noticed any “signs” of a child’s transness. Meanwhile, trans people themselves had already seen the signs for years. ■