The diagnoses replaced gender identity disorder in children, which had been present in the DSM since 1980 and ICD since 1990 but were considered stigmatizing towards transgender people.
[2] The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association in 2013 introduced a diagnosis of Gender Dysphoria in Children.
[3]: 512 The DSM-III, published 1980, included "Gender Identity Disorder of Childhood" for prepubertal children and "Transsexualism" for adolescents and adults.
[4] The DSM-V renamed the diagnosis to "Gender Dysphoria" to avoid stigmatizing transgender people's identities and focus on the distress some experienced.
Some studies have claimed the majority of children diagnosed with gender dysphoria "desisted", i.e. did not desire to be the other sex by puberty and mostly grew up to identify as gay, lesbian, or bisexual, with or without therapeutic intervention.
[12][13][16][15][17] However, these studies tracked gender nonconforming children due to relying on older definitions of dysphoria which didn't require identification with the opposite sex, included those who didn't meet old diagnostic criteria, and offered evidence that that statement of transgender identity in childhood predicted transgender identity in adolescence and adulthood, and the intensity of gender dysphoria in childhood likewise predicted its intensity later in life.
Additionally, some of the research since 2000 and all the research prior has been criticized for citing studies that used conversion therapy, a disproven method consisting of either discouraging social transition, explicitly trying to prevent or discourage the child from identifying as transgender as an adult by adulthood or adolescence, or actively employing techniques to limit their "gender-deviant" behavior.
[2][24] Delaying puberty allows for the child to mentally mature while preventing them from developing a body they may not want, so that they may make a more informed decision about their gender identity once they are an adolescent.
[24] Short-term side effects of puberty blockers include headaches, fatigue, insomnia, muscle aches and changes in breast tissue, mood, and weight.
[31] In its position statement published December 2020, the Endocrine Society stated that there is durable evidence for a biological underpinning to gender identity and that pubertal suppression, hormone therapy, and medically indicated surgery are effective and relatively safe when monitored appropriately and have been established as the standard of care.
Before any physical interventions are initiated, however, a psychiatric assessment exploring the psychological, family, and social issues around the adolescent's gender dysphoria should be undertaken.
[38] A 2020 survey published in Pediatrics found that puberty blockers are associated with better mental health outcomes and lower odds of lifetime suicidal ideation.
[43] Nevertheless, they recommend the use of puberty blockers for minors on a case-by-case basis, and the American Academy of Pediatrics state that "pubertal suppression in children who identify as TGD [transgender and gender diverse] generally leads to improved psychological functioning in adolescence and young adulthood.
– discuss] In 2024, NHS England endorsed the Cass Review of gender treatment for children and young people, which questioned the reliability of existing guidelines and made various recommendations.