• Madison Aitken, Thomas D Steensma, Ray Blanchard, Doug P VanderLaan, Hayley Wood, Amanda Fuentes, Cathy Spegg, Lori Wasserman, Megan Ames, C Lindsay Fitzsimmons, Jonathan H Leef, Victoria Lishak, Elyse Reim, Anna Takagi, Julia Vinik, Julia Wreford, Peggy T Cohen-Kettenis, Annelou L C de Vries, Kreukels Baudewijntje P C BP, and Kenneth J Zucker.
• Gender Identity Service, Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
• J Sex Med. 2015 Mar 1; 12 (3): 756-63.

IntroductionThe number of adolescents referred to specialized gender identity clinics for gender dysphoria appears to be increasing and there also appears to be a corresponding shift in the sex ratio, from one favoring natal males to one favoring natal females.AimWe conducted two quantitative studies to ascertain whether there has been a recent inversion of the sex ratio of adolescents referred for gender dysphoria.MethodsThe sex ratio of adolescents from two specialized gender identity clinics was examined as a function of two cohort periods (2006-2013 vs. prior years). Study 1 was conducted on patients from a clinic in Toronto, and Study 2 was conducted on patients from a clinic in Amsterdam.ResultsAcross both clinics, the total sample size was 748. In both clinics, there was a significant change in the sex ratio of referred adolescents between the two cohort periods: between 2006 and 2013, the sex ratio favored natal females, but in the prior years, the sex ratio favored natal males. In Study 1 from Toronto, there was no corresponding change in the sex ratio of 6,592 adolescents referred for other clinical problems.ConclusionsSociological and sociocultural explanations are offered to account for this recent inversion in the sex ratio of adolescents with gender dysphoria.© 2015 International Society for Sexual Medicine.

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