March 16 (UPI) -- Transgender adults who undergo gender-affirming surgery may first begin questioning their biological sex as early as age 7, a new study has found.
In research published Monday by JAMA Network Open, the authors found that, among 210 transgender men and women, most first experienced gender dysphoria -- feeling their emotional and psychological identity to be opposite of their biological sex -- after their sixth birthday.
The study may be the first to provide insight into the age of initial experience of gender dysphoria among trans Americans, researchers said.
"For parents, these findings should provide some reassurance that what they're seeing in their children is natural, that it's not a 'phase,' as some have described it," study co-author Maurice Garcia, a urologist at Cedars-Sinai Medical Center in Los Angeles, told UPI. "And, if we as parents and society respond negatively or irresponsibly to what these children are going through, it can have lasting consequences."
To get their findings, Garcia and his colleagues interviewed 155 trans women with a mean age of 41 and 55 trans men with a mean age of 35, about half of whom were white and non-Hispanic. Nearly half of the participants, 48 percent, had an active or recent history of anxiety or depression and, among trans women, 7 percent were HIV positive.
For trans men, they found that the mean age of "earliest general memory" and age at first experience of gender dysphoria were 4.7 and 6.2 years, respectively. Among trans women, these ages were 4.5 and 6.7 years.
In all, 73 percent of the trans women and 78 percent of the trans men in the study first experienced gender dysphoria by seven years of age. Each lived for a mean of 22.9 and 27.1 years, respectively, with untreated gender dysphoria before beginning non-surgical gender transition.
"To be clear, we're not suggesting that all children who have feelings of gender dysphoria should undergo hormone therapy or surgery to affirm their gender," Garcia said.
"However, what our findings show is that gender dysphoria is as natural as being cisgender, and that we need to support young people who are going through this," he said. "That some of the adults in our study waited years before having gender affirmation procedures means that they were suffering unnecessarily."