TY - JOUR
T1 - Epidemiology of gender dysphoria and gender incongruence in children and young people attending primary care practices in England
T2 - retrospective cohort study
AU - Jarvis, Stuart William
AU - Fraser, Lorna K.
AU - Langton, Trilby
AU - Hewitt, Catherine Elizabeth
AU - Doran, Tim
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
PY - 2025
Y1 - 2025
N2 - Objective: To examine trends in diagnosis of gender dysphoria and related conditions in children and young people attending primary care practices in England. Design: Longitudinal analysis of electronic primary care records from the Clinical Practice Research Datalink (CPRD) Aurum database linked to hospital and Index of Multiple Deprivation data. Setting: Primary care practices in England between 2011 and 2021. Participants: 3782 patients aged 0-18 years with a recorded history of gender dysphoria/incongruence and matched comparators with autism spectrum conditions or eating disorder. Main outcome measures: Incidence rates and prevalence of gender dysphoria/incongruence; prescribing rates for medical treatments; co-occurrence of anxiety, depression and self-harm. Results: Between 2011 and 2021, incidence rates of recorded gender dysphoria/incongruence increased from 0.14 (95% CI 0.08 to 0.20) to 4.4 (95% CI 4.1 to 4.7) per 10 000 person years, and from 2014 the rate increased more rapidly in recorded females than males. There was no significant association between gender dysphoria/incongruence and area level deprivation. Of the 3782 children and young people with a record of gender dysphoria/incongruence, 176 (4.7%) were prescribed puberty suppressing hormones; 302 (8.0%) were prescribed masculinising/feminising hormones; and 1994 (52.7%) had a record of anxiety, depression or self-harm. Compared with matched comparators, those experiencing gender dysphoria/incongruence had similar recorded rates of anxiety and higher rates of depression and self-harm. Conclusions: Recorded prevalence of gender dysphoria/incongruence increased substantially in children and young people between 2011 and 2021, particularly in recorded females. Levels of anxiety, depression and self-harm were high, indicating an urgent need for better prevention and treatment of mental health difficulties in these patients.
AB - Objective: To examine trends in diagnosis of gender dysphoria and related conditions in children and young people attending primary care practices in England. Design: Longitudinal analysis of electronic primary care records from the Clinical Practice Research Datalink (CPRD) Aurum database linked to hospital and Index of Multiple Deprivation data. Setting: Primary care practices in England between 2011 and 2021. Participants: 3782 patients aged 0-18 years with a recorded history of gender dysphoria/incongruence and matched comparators with autism spectrum conditions or eating disorder. Main outcome measures: Incidence rates and prevalence of gender dysphoria/incongruence; prescribing rates for medical treatments; co-occurrence of anxiety, depression and self-harm. Results: Between 2011 and 2021, incidence rates of recorded gender dysphoria/incongruence increased from 0.14 (95% CI 0.08 to 0.20) to 4.4 (95% CI 4.1 to 4.7) per 10 000 person years, and from 2014 the rate increased more rapidly in recorded females than males. There was no significant association between gender dysphoria/incongruence and area level deprivation. Of the 3782 children and young people with a record of gender dysphoria/incongruence, 176 (4.7%) were prescribed puberty suppressing hormones; 302 (8.0%) were prescribed masculinising/feminising hormones; and 1994 (52.7%) had a record of anxiety, depression or self-harm. Compared with matched comparators, those experiencing gender dysphoria/incongruence had similar recorded rates of anxiety and higher rates of depression and self-harm. Conclusions: Recorded prevalence of gender dysphoria/incongruence increased substantially in children and young people between 2011 and 2021, particularly in recorded females. Levels of anxiety, depression and self-harm were high, indicating an urgent need for better prevention and treatment of mental health difficulties in these patients.
KW - Child Health
KW - Epidemiology
KW - Primary Health Care
UR - http://www.scopus.com/inward/record.url?scp=85216181942&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2024-327992
DO - 10.1136/archdischild-2024-327992
M3 - Article
AN - SCOPUS:85216181942
SN - 0003-9888
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
M1 - archdischild-2024-327992
ER -