A critical commentary on “A critical commentary on follow-up studies and “desistence” theories about transgender and gender non-conforming children”

Abstract

The article entitled “A critical commentary on followup studies and “desistence” theories about transgender and gender non-conforming children” by Temple Newhook et al. (2018) is a plea to abandon longitudinal studies on the development of gender variant children as they do not respect children’s autonomy. A few relatively recent studies are criticized and it is concluded that conducting longitudinal psychosexual outcome studies and acknowledging the children’s feelings are contradictory. We agree that the longitudinal studies currently available have their limitations. We do, however, strongly disagree with the authors that studies on gender variant children’s development should be abandoned and that our studies do not take children’s needs and voices seriously or are unethical. Before we address and discuss a number of specific criticisms in their paper, we first have two general, but crucial, remarks. The authors claim in the very beginning of their paper that the 80% desistence rate of gender dysphoria (GD) is a number that is largely drawn on estimates from four follow-up studies: one from Canada (Drummond, Bradley, Peterson-Badali, & Zucker, 2008) and three from the Netherlands (Steensma, Biemond, de Boer, & Cohen-Kettenis, 2011; Steensma, McGuire, Kreukels, Beekman, & Cohen-Kettenis, 2013; Wallien & Cohen-Kettenis, 2008). Unfortunately, the authors do not seem to be entirely aware of the history behind the prevalence numbers. The first comprehensive and inclusive summary of historical follow-up studies on the psychosexual outcome in gender variant children was provided by Zucker and Bradley (1995). Later, these numbers were updated in Steensma et al. (2011) and updated again and further discussed in Ristori and Steensma (2016). Important to mention here is that in the calculation of the overall persistence rate in the literature the two studies by Steensma et al. (2011, 2013) were never used. Including the two Steensma et al. studies in the discussion about persistence rates by the authors (particularly in Table 1 in Temple Newhook et al. 2018) is in our view an odd choice and a methodologically incorrect one. The reason why both studies were not included is obvious: both studies did not aim to report on the prevalence of desistence or persistence of GD. The qualitative study in 2011, conducted among 25 participants, aimed to: