Jesse Singal delivers a rare, unfiltered look at the most comprehensive longitudinal study on youth gender transition, exposing how the same data can fuel wildly divergent conclusions about the stability of gender identity in children. While the original publication was constrained by tight editorial space, this expanded commentary reveals a scientific landscape where experts are not just disagreeing on interpretation, but fundamentally questioning what "gender" means for a generation growing up in a rapidly shifting cultural moment.
The Data and the Divergence
Singal introduces the TransYouth Project, a massive effort led by Dr. Kristina Olson to track hundreds of children who socially transitioned at a young age. The study's headline finding appears straightforward: over an eight-year follow-up, 81.6% of participants remained unwavering in their gender identity. Yet, Singal highlights the nuance that often gets lost in headlines. "In some ways it's positive, in that it refutes some claims that when kids socially transition they stop evaluating their gender in any way," notes Amy Tishelman, a psychology professor who worked at Boston Children's Hospital. This observation challenges the notion that social transition locks a child into a permanent trajectory, suggesting instead that the process of self-evaluation continues.
However, the stability rate is not as absolute as it first appears. When comparing this long-term data to a 2022 study of a subset of the same group, which found only a 6% rate of identity change over five years, a stark contrast emerges. Singal points out that the difference between 6% and 18.4% suggests that as children age, the likelihood of their gender identity shifting increases. "The longer the observation the greater the instability!!!" exclaims Dr. Stephen Levine, a psychiatry professor who has studied this population for decades. This volatility is the crux of the debate: does social transition at age three or four cement an identity that might otherwise have evolved, or does it simply provide a vocabulary for a complex developmental process?
The longer the observation the greater the instability!!!
Critics of the "affirming" model argue that this instability is a warning sign. Dr. Laura Edwards-Leeper, a psychologist who helped draft the World Professional Association for Transgender Health's standards of care, suggests that a shift to a "nonbinary" identity might often be a transitional step rather than a final destination. She posits that it "might be easier for them to admit to themselves and everyone in their lives that they are JUST shifting to nonbinary, rather than back to cis — as a first step." This perspective implies that the current data may underestimate the rate of eventual desistance.
The Question of Social Influence
The commentary then pivots to a more contentious issue: the role of social influence. Singal notes that the study's authors express skepticism that parents or peers are driving these trends, citing the fact that most siblings of trans-identifying children remain cisgender. Yet, Singal brings forward a counter-interpretation from Zhenya Abbruzzese of the Society for Evidence-Based Gender Medicine, who points out that 23% of female siblings in the study eventually identified as transgender. "Clearly young people understand terms like gender differently than their parents," Singal writes, but the extent to which these labels reflect deep-seated traits versus social contagion remains an open question.
Dr. Kenneth Zucker, a researcher whose work on desistance rates has been controversial, argues that the act of social transition itself may increase the likelihood of persistence. "I would hypothesize that when more follow-up data of children who socially transition prior to puberty become available, the persistence rate will be extremely high," Zucker stated in a 2018 article. Singal presents this not as a settled fact, but as a hypothesis that the new data neither fully confirms nor refutes, leaving the field in a state of productive but frustrating uncertainty.
The UK's Cass Review is cited as a crucial reference point, noting that social transition should be viewed as "an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning and longer-term outcomes." This framing shifts the debate from whether transition is "right" or "wrong" to whether it is a medical or psychological intervention that requires rigorous long-term monitoring. Singal observes that despite the complexity, the researchers involved have been reluctant to engage with the social influence hypothesis. "Not interested, thanks," was Dr. Olson's response to a direct inquiry on the matter.
Bottom Line
Singal's expanded commentary succeeds in stripping away the certainty often projected in public debates, revealing a field where the data is still maturing and the definitions are in flux. The strongest part of the argument is the insistence that the 81.6% stability rate is not a final verdict, but a snapshot in a developmental process that may continue to shift well into young adulthood. Its biggest vulnerability, however, lies in the inability of the current cohort to speak for the long-term outcomes of a generation that has never known a world without the language of gender transition. As the observation window widens, the scientific community must remain open to the possibility that the "affirming" approach, while well-intentioned, may have unintended consequences that only time will reveal.