The number of children in England diagnosed with gender dysphoria has risen 50-fold over the past decade, research shows.
Analysis of NHS GP records suggests that more than 10,000 under-18s identified as transgender or struggled with gender distress in 2021, up from about 200 in 2011.
Gender dysphoria describes the sense of anxiety when people feel a mismatch between their biological sex and their gender identity, which prompts some to take steps to transition to the opposite sex using hormonal drugs or surgery.
The study, led by a team at the University of York, examined electronic GP records to determine trends in the number of children struggling with their gender identity. It showed prevalence had increased rapidly throughout the 2010s, from 1 in 60,000 under-18s in 2011 to 1 in 1,200 in 2021.
From 2015, the number of girls diagnosed with gender dysphoria began to increase much more rapidly than boys. By 2021, twice as many girls had been told they had the condition than boys.
The research, published in the journal Archives of Disease in Childhood, did not examine the causes of the increase. However, the authors said possible explanations include “social factors”, such as greater use of social media, as well as worsening mental health in children, particularly girls.
GP records show that levels of depression and self-harm are much higher in children struggling with their gender than in other groups of children. More than half of the children had anxiety, depression or self-harm recorded by their GP.
The study, which was funded by NHS England, said: “Levels of observed anxiety and depression have been increasing in children and young people in general over the last two decades for complex and contested reasons, challenging health, education and social services, and those experiencing gender dysphoria/incongruence are at particular risk.”
NHS England funded the study and the reasons for the increase were said to be “complex”
Of the number of those with gender dysphoria, 5 per cent were prescribed puberty blockers while 8 per cent were prescribed masculinising or feminising hormones. Last year, puberty blockers were made illegal in the UK because of a lack of evidence that they are safe or effective.
The rapid increase in the number of children identifying as transgender since 2011 led to a surge in referrals to NHS gender identity services. Until last year, the only service in England for under-18s was the controversial gender identity development service at the Tavistock and Portman NHS Foundation Trust.
In 2010, the clinic received 138 referrals. It increased to 2,383 in 2020 and doubled to just over 5,000 in 2021.
The clinic was shut down in March after a report by Dame Hilary Cass, a retired paediatrician, raised concerns that children were being rushed down a medical pathway. It is being replaced with a network of six new NHS specialist clinics, led by multidisciplinary teams that take into account other possible issues, including mental health problems or autism.
A report by Dame Hilary Cass last year raised concerns that children were being rushed into medical intervention
Cass’s report highlighted how changing “cultural norms”, peer pressure and the influence of social media are likely to have contributed to the rise in gender dysphoria.
Her report said distressed children must be seen as a “whole person and not just through the lens of their gender identity” and no longer hurried to medical intervention.
A team at the University of York were involved in the Cass review, reviewing data from 113,000 children in the biggest rethink of treatment for children struggling with their gender, examining 237 papers from 18 countries.
In a second study based on the feedback of those seeking gender identity treatment and their parents, access to care was a significant problem.
The researchers interviewed 14 teenagers referred to gender identity services, 12 of their parents and 18 people aged 19 to 30 who had previously sought treatment between March 2022 and December 2023. They were eager to start treatment and often felt disappointed by the medical delays.
“Accessing timely care, however, is a problem. Families talk about the difficulties of waiting, in which they have to manage without specialist support … Waiting created a sense of urgency for young people and a reluctance to explore their feelings at their initial meetings at [gender identity services]. They want to get on with their lives.
“For many parents, however, engagement with specialist care is more likely to reflect caution and doubt,” the researchers said.
