OBJECTIVE Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children. METHODS A community-based national sample of transgender, prepubescent children (n = 73, aged 3–12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures. RESULTS Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms. CONCLUSIONS Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.

Increasing numbers of gender-nonconforming children are socially transitioning—changing pronouns to live as their identified genders. We studied a cohort of gender-nonconforming children ( n = 85) and contacted them again approximately 2 years later. When recontacted, 36 of the children had socially transitioned. We found that stronger cross-sex identification and preferences expressed by gender-nonconforming children at initial testing predicted whether they later socially transitioned. We then compared the gender-nonconforming children with groups of transitioned transgender children ( n = 84) and gender-conforming controls ( n = 85). Children from our longitudinal cohort who would later transition were highly similar to transgender children (children who had already socially transitioned) and to control children of the gender to which they would eventually transition. Gender-nonconforming children who would not go on to transition were different from these groups. These results suggest that (a) social transitions may be predictable from gender identification and preferences and (b) gender identification and preferences may not meaningfully differ before and after social transitions.

OBJECTIVE Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children. METHODS A community-based national sample of transgender, prepubescent children (n = 73, aged 3–12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures. RESULTS Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms. CONCLUSIONS Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.

Parental anxiety confers risk for the development of an anxiety disorder in children, and this risk may be transmitted through children's stress reactivity. Further, some children may be more vulnerable to reactivity in the presence of parent factors such as anxiety. In this study, we examined whether parents' anxiety symptoms prospectively predict school-aged children's physiological reactivity following stress, assessed through their electrodermal activity (galvanic skin response) during recovery from a performance challenge task, and whether this varies as a function of children's temperamental fearfulness. Parents and their children (N = 68) reported on their anxiety symptoms at Time 1 of data collection, and parents characterized the extent to which their children had fearful temperaments. At Time 2 children completed the performance challenge and two recovery tasks. Greater parental anxiety symptom severity at Time 1 predicted children's higher electrodermal response during both recovery tasks following the failure task. Further, these effects are specific to children with medium and high fearful temperament, whereas for children low in fearfulness, the association between parent anxiety and child reactivity is not significant. Findings provide additional evidence for the diathesis-stress hypothesis and are discussed in terms of their contribution to the literature on developmental psychopathology.

Children, across cultures, show an early-emerging tendency to essentialize gender, viewing gender as inborn and predictive of stereotypical preferences. However, research has been limited to children whose own gender experience is largely consistent with the assumptions of gender essentialism. In contrast, transgender children have gender identities (and related stereotypical preferences) that differ from their sex assigned at birth, which therefore appear to challenge an essentialist view of gender. In the current study, we examined the degree to which transgender children (N = 97, 3–11 years) view a child’s sex at birth as predictive of their later gender-typed preferences. Additionally, we recruited two comparison groups: cisgender siblings of transgender participants (N = 59) and cisgender, age- and gender-matched controls (N = 90). In an adapted switched-at-birth paradigm, participants in all groups believed that a child’s sex at birth would predict their later gender-typed preferences; participants were especially likely to think so when the target character was reared in a socialization environment that aligned with the target’s own gender, rather than one where the socialization environment aligned with a different gender. Whereas cisgender participants showed a decline in essentialism with age, transgender children did not show any age-related changes in their beliefs. The current findings are the first to show that transgender and cisgender children, despite differences in gender experiences, might similarly essentialize gender. However, these findings also raise questions about how different participant groups might interpret measures differently.