Age of first experience of gender incongruence among transgender and non-binary individuals
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Objective Gender incongruence (GI) is a condition in which an individual’s gender identity, role, and expression differ from their assigned sex. This study aimed to evaluate when GI first arises in transgender and non-binary individuals seeking hormone therapy and their years living untreated in South Korea. Methods This retrospective study analyzed GI patients seeking gender-affirming hormone therapy (GAHT) or surgery between 2015 and 2021. The recorded data included gender identity, legal transition status, age of onset of GI, age at the initiation of therapy, and total therapy duration. Results In total, 337 patients were enrolled, including 149 (44.2%) transgender men, 153 (45.4%) transgender women, and 35 (10.4%) non-binary individuals. The mean age of onset of GI was 10.6 years (standard deviation, 5.1). Of the total patients, 29% had an onset of GI before age 6 years (preschool), 61% before age 12 (elementary-school), and 87% before age 15 (middle-school). Patients lived with GI for almost 14 years before GAHT initiation at a median age of 23.0 years. 90% of transgender men, 82.3% of transgender women, and 85% of non-binary patients disclosed their gender identities to their families. Regarding social transition, 31.5% of transgender men, 16.3% of transgender women, and none of the non-binary patients (P<0.005) changed their legal gender markers. Conclusion Many transgender and non-binary individuals experience GI early in life. These findings emphasized the need for early evaluation, timely gender-affirming care, and more accessible legal processes for gender marker changes in South Korea, aiming to enhance the safety and well-being of these individuals.
Abstract
Objective Gender incongruence (GI) is a condition in which an individual’s gender identity, role, and expression differ from their assigned sex. This study aimed to evaluate when GI first arises in transgender and non-binary individuals seeking hormone therapy and their years living untreated in South Korea. Methods This retrospective study analyzed GI patients seeking gender-affirming hormone therapy (GAHT) or surgery between 2015 and 2021. The recorded data included gender identity, legal transition status, age of onset of GI, age at the initiation of therapy, and total therapy duration. Results In total, 337 patients were enrolled, including 149 (44.2%) transgender men, 153 (45.4%) transgender women, and 35 (10.4%) non-binary individuals. The mean age of onset of GI was 10.6 years (standard deviation, 5.1). Of the total patients, 29% had an onset of GI before age 6 years (preschool), 61% before age 12 (elementary-school), and 87% before age 15 (middle-school). Patients lived with GI for almost 14 years before GAHT initiation at a median age of 23.0 years. 90% of transgender men, 82.3% of transgender women, and 85% of non-binary patients disclosed their gender identities to their families. Regarding social transition, 31.5% of transgender men, 16.3% of transgender women, and none of the non-binary patients (P<0.005) changed their legal gender markers. Conclusion Many transgender and non-binary individuals experience GI early in life. These findings emphasized the need for early evaluation, timely gender-affirming care, and more accessible legal processes for gender marker changes in South Korea, aiming to enhance the safety and well-being of these individuals.
참고문헌 (37)
- Coleman E, "Standards of care for the health of transgender and gender diverse people, version 8", Int J Transgend Health, 23(Suppl 1), pp.S1~S259 (2022)
- Cohen-Kettenis PT, "Adolescents with gender dysphoria", Best Pract Res Clin Endocrinol Metab, 29, pp.485~495 (2015)
- Korpaisarn S, "Etiology of gender identity", Endocrinol Metab Clin North Am, 48, pp.323~329 (2019)
- Steensma TD, "Gender identity development in adolescence", Horm Behav, 64, pp.288~297 (2013)
- Zaliznyak M, "Age at first experience of gender dysphoria among transgender adults seeking gender-affirming surgery", JAMA Netw Open, 3, pp.e201236~ (2020)
- Zaliznyak M, "How early in life do transgender adults begin to experience gender dysphoria? Why this matters for patients, providers, and for our healthcare system", Sex Med, 9, pp.100448~ (2021)
- Herman JL, "How many adults and youth identify as transgender in the United States?" (2022), The Williams Institute, UCLA School of Law
- Lim HH, "Gender affirmative care of transgender people : a single center's experience in Korea", Obstet Gynecol Sci, 62, pp.46~55 (2019)
- Connolly MD, "The mental health of transgender youth : advances in understanding", J Adolesc Health, 59, pp.489~495 (2016)
- Restar A, "Legal gender marker and name change is associated with lower negative emotional response to gender-based mistreatment and improve mental health outcomes among trans populations", SSM Popul Health, 11, pp.100595~ (2020)
- "The guidelines for the handling of petition for legal sex change permit of transgender people" (2020)[URL]
- Serbin LA, "Gender stereotyping in infancy : visual preferences for and knowledge of gender-stereotyped toys in the second year", Int J Behav Dev, 25, pp.7~15 (2001)
- Heylens G, "Psychiatric characteristics in transsexual individuals : multicentre study in four European countries", Br J Psychiatry, 204, pp.151~156 (2014)
- Subramanian T, "Mapping and size estimation of Hijras and other trans-women in 17 states of India : first level findings", Int J Health Sci Res, 5, pp.1~10 (2015)
- Grossman AH, "Parent’reactions to transgender youth’gender nonconforming expression and identity", J Gay Lesbian Soc Serv, 18, pp.3~16 (2005)
- Olson J, "Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria", J Adolesc Health, 57, pp.374~380 (2015)
- Kuper LE, "Exploring the gender development histories of children and adolescents presenting for gender affirming medical care", Clin Pract Pediatr Psychol, 7, pp.217~228 (2019)
- Nieder TO, "Age of onset and sexual orientation in transsexual males and females", J Sex Med, 8, pp.783~791 (2011)
- Burgwal A, "Health disparities between binary and non binary trans people : a community-driven survey", Int J Transgend, 20, pp.218~229 (2019)
- Spizzirri G, "Proportion of people identified as transgender and non-binary gender in Brazil", Sci Rep, 11, pp.2240~ (2021)
- Tatum AK, "Examining identity development and transition differences among binary transgender and genderqueer nonbinary(GQNB)individuals", Psychol Sex Orient Gend Divers, 7, pp.379~385 (2020)
- Johnson KC, "Invalidation experiences among non-binary adolescents", J Sex Res, 57, pp.222~233 (2020)
- Jones BA, "Gender congruence and body satisfaction in nonbinary transgender people : a case control study", Int J Transgend, 20, pp.263~274 (2019)
- Cohen-Kettenis PT, "Treatment of adolescents with gender dysphoria in the Netherlands", Child Adolesc Psychiatr Clin N Am, 20, pp.689~700 (2011)
- Zhang Q, "Epidemiological considerations in transgender health : a systematic review with focus on higher quality data", Int J Transgend Health, 21, pp.125~137 (2020)
- Martin A, "Lewis’s child and adolescent psychiatry: a comprehensive textbook" (2017), Lippincott Williams & Wilkins
- Roberts AL, "Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood : an 11-year longitudinal study", J Am Acad Child Adolesc Psychiatry, 52, pp.143~152 (2013)
- Gower AL, "Supporting transgender and gender diverse youth : protection against emotional distress and substance use", Am J Prev Med, 55, pp.787~794 (2018)
- Grossman AH, "Transgender youth : invisible and vulnerable", J Homosex, 51, pp.111~128 (2006)
- Olson KR, "Mental health of transgender children who are supported in their identities", Pediatrics, 137, pp.e20153223~ (2016)
- Rider GN, "The gender affirmative lifespan approach(GALA) : a framework for competent clinical care with nonbinary clients", Int J Transgend, 20, pp.275~288 (2019)
- de Vries AL, "Young adult psychological outcome after puberty suppression and gender reassignment", Pediatrics, 134, pp.696~704 (2014)
- Silberholz EA, "Disparities in access to care in marginalized populations", Curr Opin Pediatr, 29, pp.718~727 (2017)
- Rotondi NK, "Nonprescribed hormone use and self-performed surgeries : "do-it-yourself"transitions in transgender communities in Ontario, Canada", Am J Public Health, 103, pp.1830~1836 (2013)
- de Haan G, "Non-prescribed hormone use and barriers to care for transgender women in San Francisco", LGBT Health, 2, pp.313~323 (2015)
- Ehrensaft D, "Prepubertal social gender transitions: what we know; what we can learn-a view from a gender affirmative lens", pp.137~154 (2020), Today's Transgender Youth
- The report of the 2015 US transgender survey, "James SE", National Center for Transgender Equality, ~ (2016)