This position statement from the American College of Pediatricians (ACPeds) offers a comprehensive review of the research on mental health outcomes in adolescents whose gender identity does not align with their biological sex. The statement finds that adolescents who identify as transgender have significantly higher rates of depression, anxiety, suicidal ideation, and other psychiatric conditions compared to their peers. These mental health challenges are frequently present before a gender dysphoria diagnosis, suggesting that pre-existing psychological trauma and adverse childhood experiences may play a major contributing role. After reviewing the evidence on social transition, puberty blockers, cross-sex hormones, and surgery, ACPeds concludes that no long-term studies demonstrate mental health benefits from these interventions, and that several studies from Denmark, Finland, and Sweden suggest psychiatric needs remain elevated or worsen after treatment.
The statement also highlights that, historically, 80-90% of gender-dysphoric youth who were not medically-transitioned became comfortable with their biological sex after progressing through natural puberty, and that detransition rates are likely higher than commonly reported.
To conclude, the American College of Pediatricians opposes medical and surgical interventions and supports intensive psychotherapy as the appropriate first-line response for gender-distressed youth and their families.