Zucker study:A Follow-Up Study of Boys With Gender Identity Disorder

[ItsAllGoingToBeFine]

www.frontiersin.org/articles/10.3389/fpsyt.2021.632784/full (open access)

Abstract:

This study reports follow-up data on the largest sample to date of boys clinic-referred for gender dysphoria (n = 139) with regard to gender identity and sexual orientation. In childhood, the boys were assessed at a mean age of 7.49 years (range, 3.33–12.99) at a mean year of 1989 and followed-up at a mean age of 20.58 years (range, 13.07–39.15) at a mean year of 2002. In childhood, 88 (63.3%) of the boys met the DSM-III, III-R, or IV criteria for gender identity disorder; the remaining 51 (36.7%) boys were subthreshold for the criteria. At follow-up, gender identity/dysphoria was assessed via multiple methods and the participants were classified as either persisters or desisters. Sexual orientation was ascertained for both fantasy and behavior and then dichotomized as either biphilic/androphilic or gynephilic. Of the 139 participants, 17 (12.2%) were classified as persisters and the remaining 122 (87.8%) were classified as desisters. Data on sexual orientation in fantasy were available for 129 participants: 82 (63.6%) were classified as biphilic/androphilic, 43 (33.3%) were classified as gynephilic, and 4 (3.1%) reported no sexual fantasies. For sexual orientation in behavior, data were available for 108 participants: 51 (47.2%) were classified as biphilic/androphilic, 29 (26.9%) were classified as gynephilic, and 28 (25.9%) reported no sexual behaviors. Multinomial logistic regression examined predictors of outcome for the biphilic/androphilic persisters and the gynephilic desisters, with the biphilic/androphilic desisters as the reference group. Compared to the reference group, the biphilic/androphilic persisters tended to be older at the time of the assessment in childhood, were from a lower social class background, and, on a dimensional composite of sex-typed behavior in childhood were more gender-variant. The biphilic/androphilic desisters were more gender-variant compared to the gynephilic desisters. Boys clinic-referred for gender identity concerns in childhood had a high rate of desistance and a high rate of a biphilic/androphilic sexual orientation. The implications of the data for current models of care for the treatment of gender dysphoria in children are discussed.

Zucker twitter thread on paper
twitter.com/ZUCKERKJ/status/1376412138227503104?s=19

Richard Green, an early mentor of mine, once said "The name of the game is follow-up." This particular paper is a long time coming, sitting around in my own queue for way too long. I pen some of my own thoughts about the paper here.

1. I was 24 years old when the first child patient was assessed in 1975. I am 70 now. To be sure, a different kind of persistence...

1. I think that this is the best follow-up study to date in terms of the sample size and the methods of assessment. It does, of course, have its flaws, but I think that the data speak for themselves.

1. I hope you enjoy some of the footnotes.

1. This will probably be the last follow-up study in the literature that tracks longer-term psychosexual development of children (i.e., those seen clinically for the first time between the ages of 3-12 years) during an era where "treatment"when there was treatmentcame in a...

variety of shapes and forms. But the one type of "treatment" (with one exception) that these children did not receive was what is now known as pre-pubertal social transition. Thus, this follow-up study can be used as a comparative benchmark with regard to the persistence and...

desistance of gender dysphoria for any new follow-up studies that look at persistence and desistance among children who socially transitioned prior to puberty. I have argued elsewhere (Zucker, 2018) and in the Discussion that pre-pubertal social transition (where it is...

implemented by parents, on their own, without any clinical input from "professionals" or at the suggestion of professionals, or in combination is a form of psychosocial treatment of gender dysphoria...just of a very different kind.

1. In contemporary times, there is now much more focus (and one sees this on Twitter and other social media outlets all the time) on adolescents with gender dysphoria, particularly those with what Littman (2018) has termed "rapid-onset gender dysphoria." I see these ...

adolescents all the time now in my clinical practice. My own perspective is that I do not think that the follow-up studies such as this one (with regard to persistence and desistance) speak directly to this new cohort of adolescent patients. If, indeed, these new adolescent...

patients did not...have gender dysphoriaor even marked gender-variant behavior in childhoodthey would have never been seen clinically at younger ages. The developmental course of rapid-onset gender dysphoria needs to be studied in its own right.

Of the 139 participants, 17 (12.2%) were classified as persisters and the remaining 122 (87.8%) were classified as desisters.

That says a lot.

Thank-you for linking OP. I haven't read it all yet but it's good to see research that casts doubt on the wisdom of social transition.

I'm not brilliant at reading the big words, but does that mean in that study most of the boys were gay or bi?

@CongealedCrags

Of the 139 participants, 17 (12.2%) were classified as persisters and the remaining 122 (87.8%) were classified as desisters.

That says a lot.

Nearly 90%

Blimey

Of the 139 participants, 17 (12.2%) were classified as persisters and the remaining 122 (87.8%) were classified as desisters.

Very interesting results when clinics are not blindly 'affirming' children at the behest of lobby groups.

thank you for posting this.... interesting that it tallies almost precisely with the figure of 90% desist ....

I wonder why there has been such a push to have the affirmation model everywhere, without any evidence that this is a good process. What is to be gained and why haven't very serious questions been asked.

Social hysteria driven by funding from organisations & individuals set to benefit?

I do wonder if we're going to look back on this as a period of mass delusion.

It would be interesting to follow them up again next year, 20 years later than the mean follow up year. When the mean age would be 40.

Some gay people aren’t going to like this as it potentially pathologises pre gay behaviour, framing it as a disorder.

Also it very strongly links stereotypical cross gender behaviour with homosexuality. The cross gender behaviours seem to emerge before sexual development. We’ve always known that of course but it’s problematic for many. I just find it interesting.

Why is cross gender behaviour associated with homosexuality? Does one always predate the other and is it developmental in some way? Is it cultural? Is it biological?

Why is cross gender behaviour associated with homosexuality? Does one always predate the other and is it developmental in some way? Is it cultural? Is it biological?

"Gender behaviour" or "sex role" is a real thing in animals. Animals of different sexes do behave differently. A certain proportion of humans' sex-typical behaviour will come from their animal nature, rather than being cultural.

And what's the biggest difference between in "sex role" between the sexes? Which sex they're attracted to. And that seems to have little or no cultural component.

So if someone is homosexual, then the biggest part of their "sex role" is cross-sex. It surely then is very likely that whatever genetic/developmental trigger flipped that is likely to have flipped some other sex-typical behaviour. It would be odd if sexuality was the only thing flipped, would it not?

(I've always maintained that if "ladybrain" was a thing, then its primary indicator would be being attracted to males, so gay men have it and lesbians don't. But I don't think it's a very useful way of looking at things.)

Obviously many behaviour traits don't flip with homosexuality, but I think enough do often enough that various stereotypes about gays and lesbians do hold true. And those things being picked up in childhood - the "ladybrain" or "boybrain" - are now being interpreted as "trans" rather than "gay". As Helen Joyce said - "they're sterilising gay kids".

Obviously many behaviour traits don't flip with homosexuality, but I think enough do often enough that various stereotypes about gays and lesbians do hold true.

That leads to an acknowledgement that there are some innate male and female behaviours and that some sex based stereotypes also hold true.

I'm fine with accepting that but so many feminists seem to believe that there are few, if any, inbuilt differences between the sexes.

90% desist? Jesus wept.

When will there be a public enquiry into what has been going on in the gender clinics?

Zucker's methodology is straight up conversion therapy.

Denial of identity, enforcement of stereotypes and norms and is flat abusive.

I see people say things like "let kids be kids," and "let kids do what they want," "let kids play with the toys they want." Zucker's whole premise is not doing that. It's about forcing kids to do things they don't want. Taking their toys away. Punishing them for liking the "wrong," thing and encouraging them to like the "right," thing.

I agree with you Necessary but we would be ostracised and condemned by many for such reasoning.

so many feminists seem to believe that there are few, if any, inbuilt differences

Some. I suspect said feminists are more interested in ‘saving the children’ than in any discussion of this nature.

Jeezo, 90%😕

You mentioned Zucker's methodology on another thread Hibari, and I asked you for links, because I couldn't find any information about this, but you never came back with them. Can you post some links now, please?

In childhood, the boys were assessed at a mean age of 7.49 years (range, 3.33–12.99)

That might explain why nearly 90% desisted.

@OldCrone

You mentioned Zucker's methodology on another thread Hibari, and I asked you for links, because I couldn't find any information about this, but you never came back with them. Can you post some links now, please?

Looking at anything to do with Zucker ruins my day. Looking at his research, digging through patient testimony etc. will fuck me up for days due to some similarities with personal experiences that I'm absolutely not going into detail with.

I have this on hand.
The attached image is in his own words and is an exert from here:
<a class="break-all" href="http://web.archive.org/web/20210322075229/www.researchgate.net/profile/Kenneth-Zucker/publication/296484556_Treatment_of_gender_identity_disorders_in_children/links/56d5b91008aee1aa5f730899/Treatment-of-gender-identity-disorders-in-children.pdf" rel="nofollow" target="_blank">web.archive.org/web/20210322075229/www.researchgate.net/profile/Kenneth-Zucker/publication/296484556_Treatment_of_gender_identity_disorders_in_children/links/56d5b91008aee1aa5f730899/Treatment-of-gender-identity-disorders-in-children.pdf

Any more will be re-finding stuff I read a long time ago and it'll been an all day activity I simply and I don't have the energy to be that angry and depressed. The fact that he's still allowed to "treat" children makes my blood boil.

I have mixed feelings about Zucker. He’s right in that an outcome that means someone not having to go through surgeries and lifetime of medication is desirable to some extent. But obviously there are other challenging aspects to his work. No one really knows the impact long term of what he does either.

So basically what he's said in that quote is what he's always said, which is that an adult happy with their unaltered body is a better outcome than one that is unhappy living in an unaltered body. And social ostracisation is not good for kids.

@Hibari

Zucker's methodology is straight up conversion therapy.

Denial of identity, enforcement of stereotypes and norms and is flat abusive.

I see people say things like "let kids be kids," and "let kids do what they want," "let kids play with the toys they want." Zucker's whole premise is not doing that. It's about forcing kids to do things they don't want. Taking their toys away. Punishing them for liking the "wrong," thing and encouraging them to like the "right," thing.

I had a Google for some old articles mentioning Zucker - since anything Pre-2010 is much more balanced than the complete woke dogma we see now.

And despite my disagreeing with every post of yours I've seen on here, Hibari, I actually agree - partly - with what you say about Zucker's methodology. According to this 2008 piece from the Atlantic he does indeed recommend locking up all things of the "wrong" sex for a child struggling with their gender: https://www.theatlantic.com/magazine/archive/2008/11/a-boys-life/307059/

I disagree with this methodology because colours, toys, clothes are not just for one sex or the other. Girls can play with trucks and wear blue. Boys can play with dolls and wear pink. Zucker's focus on denying that to children does indeed sound damaging.

Where he is correct, however, is when he says:

"If a 5-year-old black kid came into the clinic and said he wanted to be white, would we endorse that?” he told me. “I don’t think so. What we would want to do is say, ‘What’s going on with this kid that’s making him feel that it would be better to be white?’”

And:

"One has to think about the long-term developmental path. This kid will go through lifelong hormonal treatment to approximate the phenotype of a male and may require some kind of surgery and then will have to deal with the fact that he doesn’t have a phallus; it’s a tough road, with a lot of pain involved.”

So where he is sensible is in at least waiting and watching and, if possible, getting a kid to feel comfortable in their body (although I disagree with how he goes about doing that) because the reality is humans cannot change sex.

So the only other option is one of infertility-causing drugs, coming to terms with looking like the opposite sex but still not having a functioning female/male reproductive system (thus hugely limiting your pool of romantic partners), potentially not ever being able to have sex and/or undergoing dozens of surgeries, being a medical patient for the rest of your life etc.

Who on earth would want that for their child if the alternative - let them get to puberty and see what happens - could potentially mean they desist?

Anyway, the article is pretty balanced and worth a read.

Isn’t the point though that there aren’t inbuilt differences - the very existence of gender non-confirming behaviour and personalities shows that. So while there may be typical behaviours/personalities and ones that are more common in one sex than another (which may well be broadly based in nature differences connected with different sex roles - nurturing, impregnating) , there will still be people who have the typical characteristics of the opposite sex. In other words, it can be helpful for the purposes of class analysis, but it doesn’t work on the level of the individual.

It is also know that brains are not sexed - is there are no significant differences in things such as spatial awareness etc.