Behind Florida鈥檚 decision to block clinical services for transgender adolescents is a talking point 鈥� repeated by the state鈥檚 governor and top medical authorities 鈥� that most cases of gender incongruence fade over time.
The Florida Board of Medicine voted Nov. 4 to聽聽that barred physicians from performing surgical procedures on minors to alter 鈥減rimary or secondary sexual characteristics鈥� and from prescribing them medication to suppress puberty and hormones. The rule included an exception for patients who were already receiving those treatments.聽
Two days later, Florida鈥檚 Republican governor, Ron DeSantis, said gender-affirming care is 鈥渁n example of ideology overtaking the practice of medicine,鈥� touting that he worked with the board to take a stand against it.聽
鈥淥ver 80% of the dysphoria amongst teenagers resolves itself by the time they become older,鈥� DeSantis said during a Nov. 6 campaign event. 鈥淪o why are you mutilating their body parts?鈥�
Earlier in the year, the Florida Department of Health used the statistic as it聽聽medical transitioning for minors. The department鈥檚 April memo said that 鈥�80% of those seeking clinical care will lose their desire to identify with the non-birth sex.鈥澛�
顿谤.听, a Tampa anesthesiologist and member of the governor-appointed board, said he聽聽because聽a 鈥渟ignificant percentage鈥� of transgender children will return to their assigned sex.
PolitiFact consulted with experts and data to determine whether gender incongruence will 鈥渞esolve itself鈥� for a large cohort of teenagers.
Those experts said Florida mischaracterized a statistic linked to an academic review from 2016. What鈥檚 more, one of the researchers whose work is cited as the statistic鈥檚 source has said the data he consulted is not 鈥渙ptimal鈥� and can lead to 鈥渨rong inferences.鈥�
The public comment period for the rule ended Dec. 5.
The 80% figure comes from published in the International Review of Psychiatry.
Dutch health psychologist聽聽and Italian psychologist Jiska Ristori examined past studies on gender dysphoria, which describes the distress people may experience because of a discrepancy between their gender identity and the sex assigned to them at birth.
Not all transgender people experience or are diagnosed with gender dysphoria. Gender dysphoria diagnoses focus on gender identity-related psychological distress, not gender identity itself.
The researchers wanted to know whether people who experienced gender dysphoria as children still had it later in life. They looked at the outcomes for children involved with 10 studies conducted from 1968 to 2012 in the U.S., Canada, and the Netherlands.
Their review of the studies said they showed that gender dysphoric feelings went away for 85% of children 鈥渁round or after puberty鈥� 鈥� while acknowledging several limitations.
鈥淭here may be a number of arguments to nuance this high percentage of desistence,鈥� the . 鈥淭he lower persistence rates in the earlier studies, compared to the more recent studies after 2000, may be the result of the inclusion of less extreme cases in the earlier studies than in later studies.鈥�
In other contexts, 鈥渄esistence鈥� can refer to an apparent end of gender variance and a return to an identity that aligns with the sex assigned at birth. In the paper, the researchers meant the lifting of dysphoric feelings.
Other experts mentioned concerns with the methodology of studies cited in the paper.
Dr. Kristin Dayton, a pediatric endocrinologist, said the studies had a small share of children assigned female at birth 鈥� and are thus not representative samples of the population. Eight of the 10 studies examined only children assigned male at birth.
At least six of the studies were conducted before the American Psychiatric Association developed a formal diagnosis for gender dysphoria in children. Some of the 10 studies did not include children who were referred to the studies by medical professionals.
础听, for instance, used advertisements to recruit children. Only 30% of the children examined had 鈥渇requently鈥� stated a desire to be a girl. Experts said most of the children in that study wouldn鈥檛 have met the current criteria for gender dysphoria.
The for the condition include a 鈥渕arked incongruence鈥� between one鈥檚 experienced gender and assigned sex at birth lasting at least six months and a 鈥渟trong desire to be of the other gender or an insistence that one is the other gender.鈥�
Florida鈥檚 Department of Health and Board of Medicine misrepresented the review鈥檚 conclusion by stating 80% of children will 鈥渓ose the desire鈥� to identify with a sex not assigned at birth.
The 80% figure in the review聽聽children鈥檚 gender identities; it centered on the persistence and desistence of gender dysphoria in adulthood. Steensma聽聽that 鈥渦sing the term desistence in this way does not imply anything about the identity of the desisters.鈥�
Although the review noted the studies found that gender dysphoria in childhood is 鈥渟trongly associated鈥� with a 鈥渓esbian, gay, or bisexual outcome,鈥� it did not say what percentage of people studied stopped identifying as transgender.
鈥淭he 80% statistic, used by the Florida Department of Health and the state鈥檚 leadership, is categorically false,鈥� Dr. Meredithe McNamara, an assistant professor of pediatrics at the Yale School of Medicine, told PolitiFact. 鈥淎fter a close read of the scholarship cited by the state, the state鈥檚 conclusion simply cannot be drawn in good faith.鈥�
Steensma, who did not respond to PolitiFact鈥檚 requests for an interview, has responded to聽聽about how his research is used to discourage social and medical affirmation for gender diverse adolescents.聽
鈥淲e want to stress that we do not consider the methodology used in our studies as optimal 鈥� or that the terminology used in our communications is always ideal,鈥澛燬teensma聽. 鈥淎s shown, it may lead to confusion and wrong inferences.鈥澛�
McNamara also said that Florida鈥檚 reliance on a 2016 paper is a 鈥済laring problem鈥� because the state neglected to consider about six years of new research.
础听, for instance, sought to develop an estimate of transgender children who later stop identifying with a gender that is incongruent with their assigned sex. It evaluated 300 transgender children over five years. To participate in the study, children must have already begun social transitioning, which often involves changing names, haircuts, and pronouns.聽
Researchers from Princeton University鈥檚 TransYouth Project followed up with participants in person and online. At the end of the five years, 94% of participants still identified as transgender.