Why are more girls than boys presenting to gender clinics?

For decades, more young men than young women presented to doctors and psychiatrists with gender dysphoria.  But that has all changed in recent years.

As reported in a 2015 article in the Journal of Sexual Medicineresearchers in Canada and the Netherlands examined data from 748 total clinic referrals in the two countries across several decades. The flip-flop in the boy-girl ratio is obvious, as seen in the  below graph from this quantitative study. As always, a picture is worth at least 1000 words.

Aitken sex ratio graph

The dramatic uptick in girls and women presenting to gender clinics from 2006-13 is abundantly clear–and there seems to be no end in sight.

Starting in 2006, we noted that the number of  referred female adolescents with GD was now  exceeding the number of referred male adolescents with GD in the Toronto clinic. Thus, there appears to be an emerging inversion in the sex ratio of adolescents with GD which, to our knowledge, has not been documented formally in the empirical literature.

The sex ratio of adolescents from two specialized gender identity clinics was examined as a function of two cohort periods (2006–2013 vs. prior years). Study 1 was conducted on patients from a clinic in Toronto, and Study 2 was conducted on patients from a  clinic in Amsterdam.

Results. Across both clinics, the total sample size was 748. In both clinics, there was a significant change in the sex ratio of referred adolescents between the two cohort periods: between 2006 and 2013, the sex ratio favored natal females, but in the prior years, the sex ratio favored natal males.

This reversal of the boy-girl ratio seems to be the case in other Western countries as well. Two other studies, one from Germany, the other from Finland, corroborate the findings from the Toronto and Amsterdam clinics.

In the German study (2014)

Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts.

And in the Finnish study (2015), which looked at referrals from 2011-2013:

The number of referrals exceeded expectations in light of epidemiological knowledge. Natal girls were markedly overrepresented among applicants. Severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.

…The natal girl:boy ratio among the adolescent SR applicants was very high. In prepubertal children referred to gender identity services, boy:girl ratio is reportedly 3–6:1, with some variation across countries presumably due to cultural reasons [5,13]. Previously a more even boy:girl ratio has been suggested in adolescents seeking sex reassignment than among child samples [13]…

What could be causing this undeniable increase in referrals of girls with gender dysphoria?

The German and Finnish studies offer no explanation, other than to say “cultural factors” likely play a part. In the larger Toronto-Amsterdam paper, Aitken et al posit

It is well-known that cross-gender behavior in children is subject to more social stigma (e.g., peer rejection and peer teasing) in males than in females, in both clinic-referred adolescents with GD and in the general population [26–30]. Thus, it could be argued that it is easier for adolescent females to “come out” as transgendered than it is for adolescent males to come out as transgendered because masculine behavior is subject to less social sanction than feminine behavior. … Given that a transgendered identity as an “identity option” has become much more visible over the past decade, it is conceivable, therefore, that such an identity option is easier for females to declare than it is for males because it does not elicit as much of a negative
response. .. there are greater costs for a male to adopt a female gender identity in adolescence than it is for a female to adopt a male gender identity.

I find the authors’ explanation lacking for several reasons. One, this is nothing new. Girls who are “tomboys” are more socially acceptable than “sissy” or effeminate boys. This didn’t start in 2006. But more to the point, I think the authors’ reasoning is exactly backwards. If it is more acceptable for girls to be tomboys, why would those tomboys think they need to change their gender? It would seem that boys who are effeminate would feel a much greater sense of urgency about changing their sex, because they would face constant disapproval about their behavior from parents, schoolmates, and anyone else they encountered, especially in more conservative families and regions. Girls, on the other hand, would presumably feel more comfortable continuing to present as “gender nonconforming” or “tomboyish.”

I am not the first blogger to contemplate this question. GenderTrender, for one, has been blogging for years about the phenomenon of young, primarily lesbian young women “transitioning.”  Others have written in elegaic terms about the near eradication of less conventionally “feminine” lesbians, with so many now choosing “transition” instead of the fomerly proud and celebrated butch identity as in the bygone Second Wave era. The loss of womens’ bookstores, support groups, and other spaces, as well as role models (both in real life, and in movies, TV, and other media consumed so much by young people) is also key. Homophobia/lesbophobia is most certainly a factor. I have written several posts pointing out the influence of social media in glamorizing transition, with video logs and journals chronicling the FTM transition and the profound (and partially permanent) changes wrought by testosterone.

And what of the straight girls who transition to then become gay men? What motivates these young women to abandon the relatively easier path of heterosexuality? The current cultural expectation seems to be that girls look, act and dress like–to put it bluntly–porn stars, so a girl who eschews makeup and the other accoutrements  of “femininity” could be drawn to the relative freedom of a man’s life.

None of this fully explains the inversion in the ratio of girls to boys. But whatever the reason (and please share your own thoughts and theories in the comments), the increasing number of girls dis-idenitifying with their own bodies is an undeniable and growing trend–and to observers like me, an emergency.

I am haunted by the the words of a detransitioned woman, who recently wrote that when she was active in transgender circles, the only voices to be heard amongst both MTFs and FTMs were testosterone-deepened. Women’s voices were gone.

The voices of too many young women are being lost. Figuratively, as these young women no longer identify with their natal gender and join the chorus of male opinion. And literally: their female voices silenced and transformed by testosterone.

26 thoughts on “Why are more girls than boys presenting to gender clinics?

  1. Lesbians dare to tell patriarchy to fuck off, and that is unforgivable. Hence the attempt to erase us. We lesbians owe it to ourselves and our misguided sisters to resist this annihilation.

    Liked by 3 people

  2. “What motivates these young women to abandon the relatively easier path of heterosexuality?” Heterosexuality is not easy for women. There are high rates of male violence against women in het relationships. Being a woman in this world gay or straight is not easy.

    Liked by 4 people

    • Yes, but I don’t think it is necessarily easy to be a gay trans man, either. I’ve read quite a few accounts by trans men who (for pretty obvious reasons) aren’t fully accepted by the gay male community. Or who have a hard time finding steady partners, although they don’t have too much trouble finding sex. And then there is homophobia to deal with. I don’t think trans men get to escape the difficulties of being involved with men after “transition.” And not all heterosexual relationships are oppressive, and they certainly are deemed more socially acceptable.

      Liked by 2 people

      • Technically, a FTM who is into men is a straight female. It’s -sexuality, not -genderality. It’s the transactivists saying that a genetically female person can become a gay man; I do not accept that analysis.

        Just like the MTFs claiming to be “lesbian”. Actual lesbians would disagree. There are some who self-identify as lesbian but I’m sorry, if you’re attracted to someone who was born with a penis, you’re bisexual. That’s not the first time bisexuals have been confused about what lesbianism means though. My daughter’s father’s most previous ex-wife told him she was a lesbian when they met. And then they married. And then later she left him for–wait for it–another guy. So… yeah… a mite confused there.

        Liked by 4 people

      • Part of what I was pointing to in my comment is the fact that these newly minted gay “men” are not fully accepted by most actual gay men. The reasons are pretty obvious. Of course, then those actual gay men get accused of “transphobia” for actualLy having (and acting on) a sexual preference based at least partially on genitalia. Although I notice you don’t see trans activists picketing gay male spaces or places, demanding access for FTMs. Funny that.

        While I agree that females cannot be turned into males, there’s no doubt that a “gay” FTM would still get to experience homophobia by the general public–on top of not being accepted by the gay male community. A double whammy.

        Liked by 3 people

      • yes, but when they are making the decision to transition, these women dont yet know that they will never be allowed by males to join male culture, will never be treated like a full man, and likely will also be repulsed anyway by the realities of male culture. Having been a girl/woman their whole lives, they believe on faith alone that they can be accepted as men in male cultures, and that once there they will still want to.

        And young girls being convinced that they are trans have even less insight into that issue… they just want to opt out of sub-human status. Understandable. /i think the rates show that normal girls/women, all along, have wanted to optout of subhuman status… they were just never led to believe there wa any option to do it, before the trans madness.

        Liked by 5 people

  3. I agree. I think the dissapearance of lesbians does not correspond for gay men, thus gender nonconforming girls who would otherwise be lesbians no longer see that as a viable choice.
    There is an all out war of “sexual freedom” happening, where gay male culture and trans culture and queer culture and pornified women all fit in to to the male sexual freedom logic. Lesbians do not. Neither do radfems.

    I do think that the more extreme porn gets and thus girls’ perceptions of what women must be for them equally as extreme, the higher number of girls will come to take issue with it sooner. Boys have always seen porn as a right of passage, i do not feel young tween girls were exposed to porn as a matter of course the way they are now. combined with the extreme erasure of lesbian identity…..it only makes sense.

    The belief that you can become a boy is a way to extend childhood/adolescence, where you don’t have to be prepared to face and fight the truth about the meaning of being a woman in our society yet. To face that at a young age is rightly terrifying.

    While tragic, I feel the hordes of future detransitioned youth could only strengthen feminist critique and with the permanent unflappable ,radical, understandings of gender they will be forced to learn about via learning that you can never become a man.

    Liked by 6 people

    • Good post, Shannon. I can picture girls (who’ve never had had sex) seeing porn (which is totally mainstream now) for the first few times, and thinking, “Ugh. Not me.”
      In porn, women always sound like they’re being murdered — not pleasured. Women in porn always have their boundaries crossed. The next new fetish is always something women have to endure, not enjoy.
      Oh, but if you’re a girl and aren’t “down for anything,” you’re shamed as a prude. And yet, men of all types still reserve the right to slut shame you in retaliation of …whatever.
      No wonder they get confused. Mainstream feminism used to be a refuge for this shit (back in the ’70s), but now mainstream feminism (thanks to lefty dudebros) supports porn and prostitution. That’s what happens when you let guys take over.

      Liked by 4 people

    • There *are* gay men disappearing–future gay men. Parents are being encouraged to transition their feminine boys now rather than accept that they’re just femmey gays. It’s a different sort of being-disappeared though. I can’t help but see these young butch women as escaping something intolerable. Or they think they are.

      Liked by 1 person

      • It’s a very effective gay reperation therapy 2.0. One day the big gay orgs will wonder why there are so few young lesbian and gay people. Perhaps they will realize that letting the t steamroll over them was a bad idea.

        Liked by 1 person

    • There is so much I agree with in this blog post and the comments. So much insight. I agree with the comments regarding porn. When I was a kid I never saw porn, other than a glimpse or two of my older brother’s girlie magazine — which was laughably tame compared to what’s available these days for any kid to see any time they want. I can easily see a girl not wanting to become an emotionless, robotic, man-pleasing f*ckbag.

      I agree that becoming a boy is a method of holding onto childhood a little longer. I agree that girls are being bullied and seduced into declaring that they’re trans. I agree that tumblr and YouTube play a part. I agree that there is peer pressure. I can easily see how a girl who has been physically abused would desire to become a male.

      There are lots of negative situations which can be avoided by being a boy rather than a girl. I totally understand why these girls want to opt out of abuse and degradation and become more powerful and privileged. But I also agree that men will never allow F2Ts into the boys club — because F2Ts are not males.

      To these girls it might seem like becoming male (or trying to) is the best solution and makes the most sense, but down the road they will regret it when they realize becoming a male is impossible, and even if it were possible, it’s not really going to solve their problems.

      I agree that the community needs to step in and show these girls (and the public in general) that there are many types of females, and submitting to cultural stereotypes is not required. There is so much to be done.

      Liked by 2 people

  4. Well, that chart really nailed home the point for me. A huge culturally-induced trend aided and abetted by the medical field.

    I was caught up in trends during my teenaged years. The pictures of myself in trendy hairstyles and clothing during that time period literally make me cringe. I don’t know what possessed me to think this was cool.

    These teens and young adults will be dealing with a lot more than embarrassing pictures, though, when this trend fades.

    Liked by 3 people

  5. One thing that has bothered me for some time is how early the surgical procedures are being done. I’d always thought that any “cosmetic” (for lack of a better comparison) surgical procedure should never be done on people under the age of 18…so why are kids as young as 12 or 13 years of age being encouraged to change their bodies before they’re physically AND mentally mature?

    It’s frightening, to say the least…

    Liked by 2 people

  6. I think the role of porn is almost underemphasized here. For years now, clothing for little girls has been unacceptably sexualized; toys for girls unacceptably feminized. When I listen to these girls who wants to transition, it seems to me that again and again their rationale for transitioning was that they didn’t fit the feminine mold: cheerleader or prom queen. Their child-brains are apparently oblivious to the fact that are approximately eleventy zillion ways to “woman” and each of the are awesome. They simply decided to opt out because they didn’t feel drawn to being ultra-femmy. Wow. I think so much of this is due to the left’s embrace of porn and porn culture.

    What’s so weird is that the left has eagerly and fulsomely embraced the ultimate personal expression of conservatism: rigid gender roles. Women don’t transition to male, they transition to “dude.” Men don’t transition to female, they transition to “femmiest fem evah!”

    Liked by 4 people

    • “their child-brains are apparently oblivious to the fact that are approximately eleventy zillion ways to “woman” and each of the are awesome.”

      This is a failure of communities these kids live in. These girls need to have real life role models—not in movies, not on the internet, not in books, in REAL life— and access to and exposure to real, normal women who are “doing womanhood” in cool ways.

      I think girls need to SEE, in flesh and blood and human interaction, women who are living as women and doing it without embracing femininity in order to SEE for themselves that women can be awesome. If all you’ve ever been exposed to are women who are compromising with femininity more than you yourself can ever imagine doing, of course you will feel like you have to escape womanhood.

      We need a community of women to help these girls; it isn’t just a matter for mothers. Mothers and feminist women need to actively network and get these kids some exposure to women who can inspire them and show them that living as a woman is doable for them. And that it doesn’t mean accepting or collaborating in subhuman status and sexualization.

      Liked by 1 person

  7. I don’t know if you have seen this blog…….ttps://dawnofkali.wordpress.com/2015/07/12/questioning-my-dead-best-friends-gender-identity-part-2/#comments

    A young woman who befriended on-line a trans man who went on to commit suicide and the effects that this had on her. She writes beautifully, nuanced prose and her blog is also her story of self discovery. The story of her on line friend is harrowing….”“If I hadn’t been female,” he told me, “my father wouldn’t have been attracted to me. If only I had been muscular, stronger than my father, I could have fought him off. I could have stopped my mother. I could have rescued my siblings sooner. We wouldn’t be living with this trauma, with recurring nightmares, with eating disorders. None of this wouldn’t have happened if I wasn’t a girl.”

    ”Shame, resentment, embarrassment, helplessness, despair, anger… this is how Lucien felt about his femalehood.”

    This abuse happened when Lucien was only 7 years old.

    Whilst this is probably, hopefully, an extreme example, it is an example all the same. Women, trying to overcome childhood trauma, or peer pressure, or homophobia feel that the answer is to become male. When society installs and idealizes what being ”feminine”, ”woman” is all about in a glamorized and fetishistic manner what hope have young women? That last comment by gaeeg just about sums it up…”We need a community of women to help these girls; it isn’t just a matter for mothers. Mothers and feminist women need to actively network and get these kids some exposure to women who can inspire them and show them that living as a woman is doable for them. And that it doesn’t mean accepting or collaborating in subhuman status and sexualization.”

    Liked by 2 people

  8. Pingback: UK pediatric transition referrals DOUBLE in SIX months, girls far outnumber boys, most under 10 years old | 4thWaveNow

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  10. As a counter-example, I am a not-particularly feminine woman. My kid was a lot more feminine than me. My kid determined to be bisexual at about 15 (was suspecting it many years earlier, but saw mixed views on whether bisexuality was a legitimate sexuality). At 16 started exploring gender, first tried living as genderqueer, at 17 decided to present as male, changed legal name and gender, started hormone therapy – and is still owns more skirts than I do (that’s easy, I don’t have any) and paints his toenails (he didn’t learn that from me either). His transition isn’t about disliking femininity, it’s about finding peace with his body.


    • Rachel–I wish you and your child the best. I think we all have the same goal; for our children to be happy in their bodies. It is my belief that we should strive for kids finding happiness in their bodies without medical treatments. As you know, the hormones cause permanent changes, and there are health risks involved with extended use of testosterone. I believe that the vast majority of people who struggle with gender identity do not need medical intervention. This treatment is only appropriate in the most extreme situations. The reality is that many teens who are questioning or struggling with this issue in some way are being pushed to transition instead of being encouraged to examine why they feel the way they do. For a lot of these kids, comorbid psychological conditions are being ignored and treatment not provided because of gender issues. Teens are being pushed into a one-size-fits-all treatment plan, and parents are being told to support transition or their child will die.

      Liked by 1 person

  11. Pingback: My first article- “A Mum’s Voyage Through Transtopia” | Lily Maynard

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