The Myth of “Desistance”: Why the 80 Percent Claim Does Not Hold Up

Do they know themselves?

Einleitung: Eine Behauptung mit enormen Folgen

Introduction: A Claim With Enormous Consequences

Few arguments appear as often in debates about trans youth as this one: that most children will “lose” their trans identity over the course of puberty. It is often claimed that around 80 percent of all trans youth will later live as cisgender after all.

This claim has enormous political and medical consequences. It is used to justify banning puberty blockers, delaying gender-affirming treatment, and, more broadly, defending a highly restrictive approach to trans youth. The message behind it is clear: support is framed as dangerous, while waiting is presented as the sensible option.

But that seemingly scientific certainty falls apart remarkably quickly under closer scrutiny.

A systematic literature review published in 2022, titled Defining Desistance: Exploring Desistance in Transgender and Gender Expansive Youth Through Systematic Literature Review, examined the scientific basis of this entire narrative. ¹ Its conclusion was clear: the research surrounding “desistance” is methodologically weak, conceptually vague, and historically shaped by pathologizing assumptions.

What Does “Desistance” Even Mean?

The basic question sounds simple, but it is central: what exactly is supposed to “go away”?

The literature review shows that there is no consistent answer. Across the publications examined, very different things were grouped together under the term “desistance”: the disappearance of gender dysphoria, a shift in gender identity, the end of distress, or simply the absence of medical treatment.

But these definitions do not describe the same thing. Gender dysphoria is a form of psychological distress arising from the mismatch between body, social role, and gender identity. A trans person may experience dysphoria, but does not have to. Likewise, a person may be trans or nonbinary without ever wanting medical intervention.

Even so, many studies treated these things as interchangeable. If a person no longer reported dysphoria or stopped attending a clinic, researchers often concluded that the person was now cisgender. ¹ That is where the scientific problem begins.

The review identified a total of 30 different definitions of “desistance” in the literature it examined, which could be grouped into four broader themes:

1. The disappearance of a gender dysphoria diagnosis after puberty begins

2. A shift in gender identity from trans or gender-expansive to cis

3. The disappearance of distress related to gender identity and bodily incongruence

4. The disappearance of the desire for medical intervention

The Famous “80 Percent” Figure

The often-cited claim that around 80 percent of trans children later “desist” is based on a small number of older follow-up studies. The literature review analyzed four key quantitative studies involving a total of 251 participants. From this, a weighted average of roughly 83 percent “desistance” was calculated. ¹

At first glance, that sounds impressive. But the real question is not what number came out. It is how that number was produced. And that is exactly where the credibility of these studies collapses.

Methodological Problems in the Studies

The author of the review judged all of the relevant quantitative studies to be methodologically weak. Not a single one was rated as high quality. ¹ There are several reasons for this.

1. Clinical preselection: not all participants were trans

Many of the children in these studies were not even clearly trans. Some studies included children who simply displayed gender-nonconforming behavior, such as boys perceived as feminine or girls perceived as masculine. That means not all participants identified as trans in the first place.

Older studies in particular blurred the line between gender identity, gender roles, and sexual orientation. A feminine boy was automatically treated as a possible “case.” The review explicitly notes that early studies often investigated homosexuality more than trans identity. ¹ If you study children who were never really trans to begin with, it is hardly surprising that many of them do not later live as trans.

2. Loss of participants as a methodological flaw

Several studies automatically counted people as “desisted” if they could no longer be reached for follow-up or no longer attended the clinic. That is a serious methodological problem, because people disappear from studies for many different reasons: moving away, family conflict, fear of stigma, bad experiences with the medical system, financial problems, or psychological distress. Yet some studies automatically classified them as “no longer trans,” which heavily distorted the results.

For example, the study by Wallien and Cohen-Kettenis from 2008 directly assigned participants who no longer appeared at the clinic to the “desistance” group without actually determining their gender identity. ²

3. Historical context and pathologizing assumptions

An especially important point is the historical context of this research. The early studies were conducted between the 1960s and 1980s. At that time, both homosexuality and trans identities were still widely treated as mental disorders. Some studies actively tried to reduce or prevent gender-nonconforming behavior. The literature review describes participants being subjected to psychological interventions intended to suppress “gender-deviant” behavior. ¹

In other words, the research was not neutral. It took place in a social climate that viewed trans identities as an undesirable outcome from the outset. Results from that context can hardly serve as a sound basis for current clinical decision-making.

4. Lack of representativeness

The studies focused almost entirely on white children from middle- and upper-class backgrounds. Intersectional factors such as race or socioeconomic status, which can strongly shape a person’s ability to explore and express gender, were rarely taken into account. ¹

The Term Itself Is Problematic

There is another issue that rarely gets mentioned: the word “desistance” itself is ideologically loaded. The literature review explains that the term originally comes from criminology, where it refers to the cessation of problematic or criminal behavior. ¹ Later it was also used in connection with oppositional behavior in children.

That origin alone reveals the underlying assumption: that trans identity is something a person should ideally “move away from.” Anyone using the term “desistance” has already assumed that the end of a trans identity is a positive outcome. That shapes not only the research, but the entire clinical and public conversation around it.

The Problem With Binary Thinking

The studies analyzed in the review worked almost exclusively with rigid binary ideas of gender. A person was treated as either trans or cis. Nonbinary, genderfluid, or other gender identities were practically absent.

The review explicitly criticizes this research for rendering complex gender identities invisible. ¹ That leads to absurd situations. A person might later live as nonbinary, want no medical intervention, and still be classified in these studies as “desisted,” even though they still do not identify with the gender assigned at birth. The reality of human identity is flattened into an artificial either-or model.

The Political Use of This Research

All of this becomes especially troubling in light of how these numbers are used politically. The literature review points to U.S. legislative efforts and a court ruling in the United Kingdom that relied on exactly these narratives to restrict or ban gender-affirming care for youth. ¹

The argument is often presented as though the science were settled: “Most of them will regret it later.” But that certainty does not exist in the research. On the contrary, the author concludes that the evidence base is weak overall and that the term “desistance” itself should be removed from clinical and scientific discourse. ¹

What Does the Research Actually Say About Persistence?

When the studies are examined more carefully, a more nuanced picture emerges. Studies that make a clearer distinction between children with pronounced gender dysphoria and children who merely display gender-nonconforming behavior report much higher persistence rates. The Steensma et al. study from 2013 found that children with more intense dysphoria, an early social transition, and a clear identification with another gender were much more likely to continue living as trans adolescents and adults. ³

More recent research based on much clearer inclusion criteria also suggests that children who identify clearly and consistently as trans continue to do so into adulthood in the overwhelming majority of cases. ⁴

What Should the Focus Be Instead?

The literature review proposes a fundamentally different approach: the focus should not be on predicting future identities, but on supporting young people in their development.

That is an important difference. At its core, the “desistance” debate tries to construct a kind of authenticity test: who is “really” trans? Who will remain trans permanently? Who should be allowed access to medical support? That way of thinking leads directly to gatekeeping. Young people are expected to prove their identity by appearing consistent, unambiguous, and binary.

But that is not how human beings always work. Identity can develop. Feelings can change. Language can shift. That does not mean earlier experiences were false. The literature review puts it clearly: for many people, gender may be an ongoing process of exploration, and changes do not invalidate earlier identities. ¹

What Is Often Missing From the Public Debate

Public debate often acts as though there are only two options: immediate irreversible medical intervention or complete inaction. Reality is different. Gender-affirming care consists of many individual steps: conversations, social transition, psychological support, puberty blockers, hormones, and possibly later surgery. These steps do not happen all at once, and they do not happen automatically.

Puberty blockers in particular are often badly misrepresented. Their purpose is precisely to create time: time to think, time to develop, time without the added pressure of an unwanted physical puberty. Ironically, the very treatment meant to create room for exploration is often banned on the grounds that young people need more time.

The Real Question

Perhaps the most important insight from this research is not that every medical decision is simple. Of course there are uncertainties. Of course risks must be weighed carefully. Of course adolescents need good support. But uncertainty is not an argument for rejection, especially not when that same body of research shows that the basis for the “80 percent” claim does not hold up scientifically.

The decisive question, then, is not: “Will this identity last forever?”It is: “How do we create conditions in which young people can develop safely?”

Closing Thought

At first glance, the story that trans youth will largely “grow out of it” sounds scientific. On closer inspection, something very different appears: vague definitions, weak studies, historical assumptions, pathologizing perspectives, and political instrumentalization.

In the end, the research itself reaches a strikingly clear conclusion: the term “desistance” does not help us understand young people better. Above all, it helps sort them into categories and deny them care.

Maybe it is time to stop doing that.

Yours, Lizbeth

Sources

1. Karrington, B. (2022). Defining desistance: Exploring desistance in transgender and gender expansive youth through systematic literature review. Transgender Health, 7(3), 189–212.

2. Wallien, M. S. C., & Cohen-Kettenis, P. T. (2008). Psychosexual outcome of gender-dysphoric children. Journal of the American Academy of Child and Adolescent Psychiatry, 47(12), 1413–1423.

3. Steensma, T. D., McGuire, J. K., Kreukels, B. P. C., Beekman, A. J., & Cohen-Kettenis, P. T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: A quantitative follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 52(6), 582–590.

4. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20153223.