ESPE Yearbook of Paediatric Endocrinology

J Child Psychol Psychiatry. 2018 Dec;59(12):1228–1243.

doi: 10.1111/jcpp.12833. PubMed ID: 29071722

This comprehensive review summarizes the current knowledge on epidemiology, concomitant psychiatric diagnoses, behavioral characteristics and developmental trajectories of gender identity issues. It also reviews determinants of gender identity and expression, and the options and benefits of clinical approaches and treatments.

Reading this review will not only give you a nice overview on past and current understanding in topics of gender identity, it will also illustrate that (too) many questions are unanswered and further studies are needed in several themes. Studies of gender identity are challenging with regard to definitions, cultural themes, therapeutic options etc., and in addition they raise multiple questions on methodological issues, such as data reliability, study size, sample variability or quality and usefulness of currently available instruments (usually questionnaires) – just to mention a few.

With close to 1% of all youth having cross-gender identity questions and needs, it becomes more and more urgent to address these questions as it has been clearly shown that gender minorities are at high risk for depression, anxiety disorders and suicidality, likely due to unmet needs and societal exclusion. While the etiology of atypical gender identity remains unclear, it becomes more and more evident that both biological and psychosocial factors play a role.