Sex ratio in children and adolescents Referred to the Gender Identity Development Service in the UK (2009–2016)

Purpose: The increase in gender diverse young people referred to specialist gender services and a corresponding shift in sex ratio favouring assigned females is described in recent literature. The aim of this study was to investigate whether a similar trend is found in the UK. Methods: A retrospective review was conducted between 2009 and 2016, investigating assigned gender at birth, age at referral, ethnicity and psychological functioning. Gender differences were examined in 4148 children and adolescent referrals. Results: In adolescents, the sex ratio of referrals evidently favoured assigned females (1:2.1), whereas in childhood it slightly favours birth-assigned males (1.3:1). However, the average increase rate of referrals was higher for birth-assigned females in both children and adolescents. Conclusions: The gender differences found in this study highlight the importance of investigating whether birth-assigned females and birth-assigned males require different clinical input and pathways