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Published Online: 4 April 2024

Family Discordance in Gender Identification Is Not Associated with Increased Depression and Anxiety Among Trans Youth

Publication: LGBT Health
Volume 11, Issue Number 3


Purpose: We examined the relationship between parent- and child-reported gender identity of the youth with internalizing symptoms in transgender and gender-diverse (TGD) youth. In addition, we investigated differences in sex assigned at birth ratios and pubertal development stages in TGD and cisgender youth.
Methods: We analyzed longitudinal data from the Adolescent Brain Cognitive Development study (ABCD), corresponding to baseline and 1st-to-3rd-year follow-up interviews (n = 6030 to n = 9743, age range [9–13]). Sociodemographic variables, self- and parent-reported gender identity, and clinical measures were collected.
Results: TGD youth showed higher levels of internalizing symptoms compared with cisgender youth. However, this was not worsened by discordance in gender identification between TGD youth and parents. Over the 3-year follow-up period, the proportion of TGD participants increased from 0.8% (95% confidence interval (CI) [0.6–1.0]) at baseline to 1.4% (95% CI [1.1–1.7]) at the 3rd-year follow-up (χ2 = 10.476, df = 1, false discovery rate (FDR)-adjusted p = 0.00256), particularly among those assigned female at birth (AFAB) in relation to people assigned male at birth (AMAB) (AMAB:AFAB at baseline: 1:1.9 vs. AMAB:AFAB at 3rd-year follow-up: 1:4.7, χ2 = 40.357, df = 1, FDR-adjusted p < 0.0001).
Conclusions: TGD youth in ABCD reported higher internalizing symptoms than cisgender youth, although this was not affected by parental discordance in gender identification. A substantial increase over time in TGD children AFAB was documented. More research is needed to understand the clinical implications of these preliminary results, for which the longitudinal design of ABCD will be crucial.

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Published In

cover image LGBT Health
LGBT Health
Volume 11Issue Number 3April 2024
Pages: 193 - 201
PubMed: 37935035


Published online: 4 April 2024
Published in print: April 2024
Published ahead of print: 8 November 2023


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Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York, USA.
F. Xavier Castellanos
Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York, USA.
Aron Janssen
Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Argelinda Baroni
Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York, USA.


Address correspondence to: Luis Martinez Agulleiro, MD, Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY 10016, USA [email protected]

Author Disclosure Statement

L.M.A., F.X.C., and A.J. declare no conflicts of interest. A.B. has received travel support from Emalex Science for a project unrelated to this article.

Funding Information

L.M.A. was supported by a fellowship funded by the Fundación Alicia Koplowitz (Madrid, Spain).

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