How long have you known you’re trans? Additional findings on gender identity development

Zinnia JonesThe process of coming to self-awareness of our gender and putting a name to our identity takes a different course for every trans person, and it’s rarely a simple matter. Realizing that you’re feeling something in the first place, noticing what that feeling is about, and understanding what it means for our selves and our lives – all of these are significant challenges for any adult, let alone a young child. There are trans people who’ve found true self-recognition for the first time in every decade of life, yet this achievement may follow decades of uncertainty, confusion, and untreated gender dysphoria.

A recent study seeks to quantify the extent to which this impacts our lives. I’ve previously looked at research showing that trans women aged 16-29 became aware of their trans identity at an average age of 9.9 years, but did not disclose this to others until an average of 15.8 years of age, and did not start HRT until an average age of 20.4 years. Another study of trans youth aged 6-17 similarly showed that trans girls recognized their gender at an average age of 9.9 years, and trans boys at 10.7 years. The most recent research, by Zaliznyak, Bresee, & Garcia (2020), looks into the identity development timelines of 210 trans women and trans men attending consultation for genital surgery at the Cedars-Sinai Medical Center.

The subjects were older than those in the previous two studies, with trans women being an average of 41.3 years old and trans men an average of 35.4 years. When asked how old they were when they first experienced gender dysphoria, the majority reported being 7 years or younger at the time: 25% of trans women and 30% of trans men said they first recalled gender dysphoria between ages 2-4, while 48% of both trans women and men stated their first memory of gender dysphoria was during ages 5-7. At the same time, a minority reported recalling their first experience of dysphoria in adolescence or later. 11% of trans women and 10% of trans men said they first experienced this during ages 11-13, and 5% of trans women and 4% of trans men described their first memory of dysphoria as occurring between ages 14-24.

Altogether, 81% of trans women and 80% of trans men said that the experience of dysphoria was among their earliest memories. Information was also obtained on when the participants first began other-than-surgical transition, and from this, it was determined that trans women had experienced untreated gender dysphoria for an average of 27.1 years and trans men for an average of 22.9 years. However, a substantial proportion went without treatment for even longer: 23% of trans women and 14% of trans men experienced dysphoria for 40 years or more – some over 50 years – before transitioning. The authors note that these decades of unmanaged gender dysphoria are no small matter:

When we consider that life-years spent with any untreated condition are associated with morbidity and decreased quality of life, then the high number of life-years spent living with GD and its associated morbidities is striking. This large cumulative burden strongly supports the argument for early GD care, counseling, and education about transition-related options, both for patients and for their parents or guardians.

As this study shows, many trans people, perhaps a majority, have known they’re trans for all their life, while many others have not – but they are all trans just the same, and there is no wrong age to realize one’s transness. And whether we’ve always known or not, we can find ourselves living in deprivation for many agonizing years. Resources to facilitate awareness of trans identities, and earlier treatment of gender dysphoria, could spare many trans people from decades of discomfort and struggle in a body and life that don’t feel like their own. Seen in the light of the 20-plus years that trans people typically spend in the shadow of dysphoria, it’s easy to understand why so few of us regret transitioning: we’ve already had far too much time to regret not doing so.

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About Zinnia Jones

My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.
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