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Potential Causes of Gender Dysphoria:

1. Autogynephilia - erotic target location inversion, wish to project or be near to opposite sex genitalia lead to fantasy of genitals overlapping externally. Typical behaviour includes masturbatory crossdressing. NB. Real women almost never get aroused simply by putting on clothes. Reinforced by pornography. especially male interest in lesbian/solo female pornography or female interest in gay porn. pleasure seeking brain inserts self into sexual fantasy.

Lawrence AA. Autogynephilia: an underappreciated paraphilia. Adv Psychosom Med. 2011;31:135-48. doi: 10.1159/000328921. Epub 2011 Oct 10. PMID: 22005209.
Blanchard R. The concept of autogynephilia and the typology of male gender dysphoria. J Nerv Ment Dis. 1989 Oct;177(10):616-23. doi: 10.1097/00005053-198910000-00004. PMID: 2794988.
Blanchard R. Nonmonotonic relation of autogynephilia and heterosexual attraction. J Abnorm Psychol. 1992 May;101(2):271-6. doi: 10.1037//0021-843x.101.2.271. PMID: 1583219.
Blanchard R. Clinical observations and systematic studies of autogynephilia. J Sex Marital Ther. 1991 Winter;17(4):235-51. doi: 10.1080/00926239108404348. PMID: 1815090.

2. Homosexual repression - homosexual individuals tend to subconsciously adopt transsexual characteristics to be more attractive to potential partners. gay men naturally more effeminate, gay women naturally more masculine. shame around being gay e.g. religious pressure, glorification of heterosexuality.

Coleman E, Bockting WO, Gooren L. Homosexual and bisexual identity in sex-reassigned female-to-male transsexuals. Arch Sex Behav. 1993 Feb;22(1):37-50. doi: 10.1007/BF01552911. PMID: 8435038.

3. Trauma - girl repeatedly sexually assaulted as a toddler developed gender dysphoria because "if I were male this would not happen", similar effect due to harrassment, mysogyny, misandry, gender stereotypes, mistreatment. Desire to be safe from predation, criticism or unfair/unequal treatment.

Thoma BC, Rezeppa TL, Choukas-Bradley S, Salk RH, Marshal MP. Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents. Pediatrics. 2021 Aug;148(2):e2020016907. doi: 10.1542/peds.2020-016907. Epub 2021 Jul 5. PMID: 34226247; PMCID: PMC8344346.

3. Psychosis - exposure to related role models in transition, affirming therapy towards otherwise transient delusions

Barr SM, Roberts D, Thakkar KN. Psychosis in transgender and gender non-conforming individuals: A review of the literature and a call for more research. Psychiatry Res. 2021 Dec;306:114272. doi: 10.1016/j.psychres.2021.114272. Epub 2021 Nov 6. PMID: 34808496.
Hanna B, Desai R, Parekh T, Guirguis E, Kumar G, Sachdeva R. Psychiatric disorders in the U.S. transgender population. Ann Epidemiol. 2019 Nov;39:1-7.e1. doi: 10.1016/j.annepidem.2019.09.009. Epub 2019 Oct 4. PMID: 31679894.

4. Autism spectrum - overelate to desirable peers/ fit in with opposite sex peers or "trans" peers

Warrier V, Greenberg DM, Weir E, Buckingham C, Smith P, Lai MC, Allison C, Baron-Cohen S. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun. 2020 Aug 7;11(1):3959. doi: 10.1038/s41467-020-17794-1. PMID: 32770077; PMCID: PMC7415151.
George R, Stokes MA. Gender identity and sexual orientation in autism spectrum disorder. Autism. 2018 Nov;22(8):970-982. doi: 10.1177/1362361317714587. Epub 2017 Sep 15. PMID: 28914080.
Glidden D, Bouman WP, Jones BA, Arcelus J. Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature. Sex Med Rev. 2016 Jan;4(1):3-14. doi: 10.1016/j.sxmr.2015.10.003. Epub 2016 Jan 8. PMID: 27872002.
van der Miesen AIR, Cohen-Kettenis PT, de Vries ALC. Is There a Link Between Gender Dysphoria and Autism Spectrum Disorder? J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):884-885. doi: 10.1016/j.jaac.2018.04.022. PMID: 30392630.

5. Cluster B Personality [borderline, histrionic, narcissistic, antisocial] - Unstable sense of self, need for external gratification/validation, lack of concern or respect for how their behaviours affect others, disorderly mood. "Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences" (DSMV)

Anzani A, Panfilis C, Scandurra C, Prunas A. Personality Disorders and Personality Profiles in a Sample of Transgender Individuals Requesting Gender-Affirming Treatments. Int J Environ Res Public Health. 2020 Feb 27;17(5):1521. doi: 10.3390/ijerph17051521. PMID: 32120872; PMCID: PMC7084367.
Meybodi AM, Hajebi A, Jolfaei AG. The frequency of personality disorders in patients with gender identity disorder. Med J Islam Repub Iran. 2014 Sep 10;28:90. PMID: 25664291; PMCID: PMC4301205.

6. Desire for attention and unique social status with little effort or to emulate "successful" "trans" peers

Status: 1981 study of the dreams of women from 20 cultures found that “the higher social position of these women, the less they manifested penis envy fantasies in their dreams.” [Nathan SG. Cross-cultural perspectives on penis envy. Psychiatry. 1981 Feb;44(1):39-44. doi: 10.1080/00332747.1981.11024090. PMID: 7208716.]
Selkie E, Adkins V, Masters E, Bajpai A, Shumer D. Transgender Adolescents' Uses of Social Media for Social Support. J Adolesc Health. 2020 Mar;66(3):275-280. doi: 10.1016/j.jadohealth.2019.08.011. Epub 2019 Nov 2. PMID: 31690534.

7. Resentment towards role models of same sex/ attraction towards emulating opposite sex role models/ pressure from role models to adopt opposite sex characteristics (parent wanting opposite sex child)

8. Feminisation of culture - Women afforded more protection, attention, social recognition and emotional expression - both positive and negative as some young women may feel social pressure and thus take on gender dysphoria to avoid the attention

9. Anime girl fantasy addiction - exposure to idealised fantasy of teenage female innocence/expression with passive low-judgement sexuality

https://blogs.feministwiki.org/socjuswiz/2019/10/20/masculinity-anime-and-gender-dysphoria/

10. Pornography usage - fascination and identification with cross sex role model. lack of interest in same sex role model. instinct to imitate. male interest in lesbian/solo female pornography or female interest in gay porn.

11. Interest in strength or beauty - girls interested in strength/physical fitness often outcompeted/made to feel jealous of male counterparts. boys interested in beauty and social attraction often outcompeted/made to feel jealous of male counterparts.

12. Sexual exploration - girl repeatedly experiencing clitoral orgasm by masturbation may subconsciously desire 'bottom growth' to compensate/reflect active sexual role. man may grow subconsciously tired of repeated penile orgasm by masturbation and desire more passive sexual role/'bottom shrinkage' to compensate.
- Masturbatory dissonance - heterosexual male engaging in masturbation uncomfortable handling male anatomy + receiving sexual attention from male self creates feminine personality to offset this and vice versa

13. Desire to re-experience childhood/sexual immaturity/innocence. desire to embrace new family

14. Grass is greener on other side of fence/ self dissatisfaction/ want to escape body - associated with depression/anxiety/BPD etc.

15. Sexual deviance - desire to access women's private spaces e.g. bathrooms, changing rooms, in order to enact fantasies of exhibitionism, voyeurism, frotteurism/ sexual assault/harrassment

16. Social suggestibility/peer pressure/gender-specific bullying

17. Neurodevelopment differences

Zhou JN, Hofman MA, Gooren LJ, Swaab DF. A sex difference in the human brain and its relation to transsexuality. Nature. 1995 Nov 2;378(6552):68-70. doi: 10.1038/378068a0. PMID: 7477289.
Fernández R, Ramírez K, Gómez-Gil E, Cortés-Cortés J, Mora M, Aranda G, Zayas ED, Esteva I, Almaraz MC, Guillamon A, Pásaro E. Gender-Affirming Hormone Therapy Modifies the CpG Methylation Pattern of the ESR1 Gene Promoter After Six Months of Treatment in Transmen. J Sex Med. 2020 Sep;17(9):1795-1806. doi: 10.1016/j.jsxm.2020.05.027. Epub 2020 Jul 4. PMID: 32636163.

18. Eating disorders causing body dysmorphia ("failing at femininity or masculinity")

McClain Z, Peebles R. Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth. Pediatr Clin North Am. 2016 Dec;63(6):1079-1090. doi: 10.1016/j.pcl.2016.07.008. Epub 2016 Oct 12. PMID: 27865334; PMCID: PMC6402566.

19. Temperament - females on average more agreeable and higher in negative emotional sensitivity; males on average more disagreeable and lower in negative emotional sensitivity. person with atypical temperament vs sex may identify more with opposite sex+sexual expression. also trait openness makes self-identity change more readily.

https://www.researchgate.net/publication/255985047_Temperament_and_character_in_transsexuals
https://inspiredteentherapy.com/the-big-five-personality-traits-and-teen-onset-gender-dysphoria/
Olino TM, Durbin CE, Klein DN, Hayden EP, Dyson MW. Gender differences in young children's temperament traits: comparisons across observational and parent-report methods. J Pers. 2013 Apr;81(2):119-29. doi: 10.1111/jopy.12000. Epub 2013 Jan 11. PMID: 22924826; PMCID: PMC3532859.
Else-Quest NM, Hyde JS, Goldsmith HH, Van Hulle CA. Gender differences in temperament: a meta-analysis. Psychol Bull. 2006 Jan;132(1):33-72. doi: 10.1037/0033-2909.132.1.33. PMID: 16435957.

20. Prenatal toxic exposure

Swan SH, Liu F, Hines M, Kruse RL, Wang C, Redmon JB, Sparks A, Weiss B. Prenatal phthalate exposure and reduced masculine play in boys. Int J Androl. 2010 Apr;33(2):259-69. doi: 10.1111/j.1365-2605.2009.01019.x. Epub 2009 Nov 16. PMID: 19919614; PMCID: PMC2874619.
Yang CZ, Yaniger SI, Jordan VC, Klein DJ, Bittner GD. Most plastic products release estrogenic chemicals: a potential health problem that can be solved. Environ Health Perspect. 2011 Jul;119(7):989-96. doi: 10.1289/ehp.1003220. Epub 2011 Mar 2. PMID: 21367689; PMCID: PMC3222987.

21. Miscellaneous mental health (including ADHD)

(survey data + testimonials) https://docs.google.com/document/d/1wBW-gUrJo2hW2C5lBgl_Ash5fuTDbRki0Vqh0DcjU88/edit


NB: medical consequences/underreported side effects of transition/blocker hormones - permanent infertility, T2 Diabetes, thrombosis (including heart attack, stroke, embolism), gallstones, dyslipidaemia, polycythaemia, hyperkalaemia, polycystic ovaries, cardiomegaly, sudden cardiac death, liver disease (including enzyme disorders, cancer and hepatitis), cancer, heart disease, mood disorders, weight gain disorders, osteoporosis, spine disorders, pancreatitis, prostate hyperplasia (nocturia, polyuria etc.), voice disorders, early male pattern baldness, acne, tendonitis, cholesterol imbalance disorder (high LDL low HCL), hypertension, cardiovascular disorder, irritability, hyper-arousal, hyper-sexuality, abnormal sexuality (including pseudo-bisexuality), addiction, arthritis, fluid retention, muscle dystrophy, gut bloating, tenderness, swelling, nausea, cramping, headaches, indigestion, worsening depression+anxiety, appetite disorders

amos SG, Ingenito F, Mormandi EA, Nagelberg AJ, Otero PM, et al. (2020) High Prevalence of Altered Immunological Biomarkers
in a Transgender Population. Autoimmun Infec Dis 3(1): dx.doi.org/10.16966/2470-1025.125
Khan D, Ansar Ahmed S. The Immune System Is a Natural Target for Estrogen Action: Opposing Effects of Estrogen in Two Prototypical Autoimmune Diseases. Front Immunol. 2016 Jan 6;6:635. doi: 10.3389/fimmu.2015.00635. PMID: 26779182; PMCID: PMC4701921.
Desai MK, Brinton RD. Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan. Front Endocrinol (Lausanne). 2019 Apr 29;10:265. doi: 10.3389/fendo.2019.00265. PMID: 31110493; PMCID: PMC6501433.
Lasrado, N., Jia, T., Massilamany, C. et al. Mechanisms of sex hormones in autoimmunity: focus on EAE. Biol Sex Differ 11, 50 (2020). https://doi.org/10.1186/s13293-020-00325-4
Moulton VR. Sex Hormones in Acquired Immunity and Autoimmune Disease. Front Immunol. 2018 Oct 4;9:2279. doi: 10.3389/fimmu.2018.02279. PMID: 30337927; PMCID: PMC6180207.
Chan Swe N, Ahmed S, Eid M, Poretsky L, Gianos E, Cusano NE. The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review. Metabol Open. 2022 Mar 3;13:100173. doi: 10.1016/j.metop.2022.100173. PMID: 35282421; PMCID: PMC8907681.
Spanos C, Bretherton I, Zajac JD, Cheung AS. Effects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: A systematic review. World J Diabetes. 2020 Mar 15;11(3):66-77. doi: 10.4239/wjd.v11.i3.66. PMID: 32180895; PMCID: PMC7061235.
Seo D, Suh H, Lee JK, Jang DK, Kwon HY, Lee CH, Yoon SH, Roh JW, Park HS. Estrogen-induced acute pancreatitis: A case report and literature review. Obstet Gynecol Sci. 2017 Sep;60(5):485-489. doi: 10.5468/ogs.2017.60.5.485. Epub 2017 Sep 18. PMID: 28989928; PMCID: PMC5621081.
Am J Hosp Med 2018 Oct;2(4):2018.023 https://doi.org/10.24150/ajhm/2018.023
https://pancreas.imedpub.com/estrogeninduced-severe-acute-pancreatitis-in-a-male.php?aid=2791

GnRH (puberty blockers) side effects
https://www.fda.gov/media/159663/down....
https://www.ncbi.nlm.nih.gov/books/NB....
https://www.ncbi.nlm.nih.gov/pmc/arti...
https://pubmed.ncbi.nlm.nih.gov/24212...
https://www.ncbi.nlm.nih.gov/pmc/arti...
https://www.ncbi.nlm.nih.gov/pmc/arti...
https://www.ncbi.nlm.nih.gov/pmc/arti...
https://www.ncbi.nlm.nih.gov/pmc/arti...
https://www.ncbi.nlm.nih.gov/pmc/arti...

NO EVIDENCE OF LONG TERM MENTAL HEALTH BENEFIT + EVIDENCE OF OVERALL MENTAL HEALTH DETRIMENT

Bränström, R., & Pachankis, J. (2019). Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study. American Journal Of Psychiatry, 177(8), 727-734. https://doi.org/10.1176/appi.ajp.2019.19010080
Correction to Bränström and Pachankis. (2020), 177(8), 734-734. https://doi.org/10.1176/appi.ajp.2020.1778correction
Kalin, N. (2020). Reassessing Mental Health Treatment Utilization Reduction in Transgender Individuals After Gender-Affirming Surgeries: A Comment by the Editor on the Process. American Journal Of Psychiatry, 177(8), 764-764. https://doi.org/10.1176/appi.ajp.2020.20060803
Anckarsäter, H., & Gillberg, C. (2020). Methodological Shortcomings Undercut Statement in Support of Gender-Affirming Surgery. American Journal Of Psychiatry, 177(8), 764-765. https://doi.org/10.1176/appi.ajp.2020.19111117
Curtis, D. (2020). Study of Transgender Patients: Conclusions Are Not Supported by Findings. American Journal Of Psychiatry, 177(8), 766-766. https://doi.org/10.1176/appi.ajp.2020.19111131
Landén, M. (2020). The Effect of Gender-Affirming Treatment on Psychiatric Morbidity Is Still Undecided. American Journal Of Psychiatry, 177(8), 767-768. https://doi.org/10.1176/appi.ajp.2020.19111165
Malone, W., & Roman, S. (2020). Calling Into Question Whether Gender-Affirming Surgery Relieves Psychological Distress. American Journal Of Psychiatry, 177(8), 766-767. https://doi.org/10.1176/appi.ajp.2020.19111149
Ring, A., & Malone, W. (2020). Confounding Effects on Mental Health Observations After Sex Reassignment Surgery. American Journal Of Psychiatry, 177(8), 768-769. https://doi.org/10.1176/appi.ajp.2020.19111169
Wold, A. (2020). Gender-Corrective Surgery Promoting Mental Health in Persons With Gender Dysphoria Not Supported by Data Presented in Article. American Journal Of Psychiatry, 177(8), 768-768. https://doi.org/10.1176/appi.ajp.2020.19111170
Van Mol, A., Laidlaw, M., Grossman, M., & McHugh, P. (2020). Gender-Affirmation Surgery Conclusion Lacks Evidence. American Journal Of Psychiatry, 177(8), 765-766. https://doi.org/10.1176/appi.ajp.2020.19111130
“Why has mental illness increased among children and young people in Sweden?” Swedish (”Varför har psykiska ohälsan ökat hos barn och unga ?”) National Health Agency, 2018. Manuscript number: 18023-2. www.folkhalsomyndigheten.se https://www.folkhalsomyndigheten.se/contentassets/628f1bfc932b474f9503cc6f8e29fd45/varfor-psykiska-ohalsan-okat-barn-unga-18023-2-webb-rapport.pdf
Bremberg, S. & Dalman, C.. (2015). “Mental illness and psychiatric conditions in children and adolescents”. Swedish (”Psykisk ohälsa och psykiatriska tillstånd hos barn och unga”). Ministry of Health and Social Affairs, Swedish Research Council for Health, Working Life and Welfare. www.forte.se. Originally https://forte.se/app/uploads/2014/12/kunskapsoversikt-begrepp.pdf, available at https://web.archive.org/web/20200216123237/https://forte.se/app/uploads/2014/12/kunskapsoversikt-begrepp.pdf
Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A., Långström, N., & Landén, M. (2011). Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. Plos ONE, 6(2), e16885. https://doi.org/10.1371/journal.pone.0016885
Bränström, R., & Pachankis, J. (2020). Toward Rigorous Methodologies for Strengthening Causal Inference in the Association Between Gender-Affirming Care and Transgender Individuals’ Mental Health: Response to Letters. American Journal Of Psychiatry, 177(8), 769-772. https://doi.org/10.1176/appi.ajp.2020.20050599
Kaltiala-Heino, R., Bergman, H., Työläjärvi, M., & Frisen, L. (2018). Gender dysphoria in adolescence: current perspectives. Adolescent Health, Medicine And Therapeutics, Volume 9, 31-41. https://doi.org/10.2147/ahmt.s135432

Khorashad, B. S., Zucker, K. J., Talaei, A., Rajabzadeh, F., Hamed, Z., Akbarian, P., and Blanchard, R. Birth order and sibling sex ratio in androphilic males and gynephilic females diagnosed with gender dysphoria from Iran. Journal of Sexual Medicine, 2020, 17, 10995-1202.
https://www.researchgate.net/publication/23449293_Psychosexual_Outcome_of_Gender-Dysphoric_Children
Smith YL, van Goozen SH, Cohen-Kettenis PT. Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: a prospective follow-up study. J Am Acad Child Adolesc Psychiatry. 2001 Apr;40(4):472-81. doi: 10.1097/00004583-200104000-00017. PMID: 11314574.
Zucker, K. J. Children and adolescents with gender dysphoria. In Y. M. Binik and K. S. K. Hall (Eds.), Principles and practices of sex therapy (Sixth ed.). New York: Guilford Press, 2020.

LARGE SCALE STUDY SHOWING SOCIAL, HORMONAL, SURGICAL AND PSYCHOLOGICAL TRANSITION (including "coming out" to parents) DOES NOT ALLEVIATE GENDER DYSPHORIA
Li Y, Zheng L. Validation of Two Measures of Gender Dysphoria/Incongruence in Transgender and Cisgender Populations in China. Arch Sex Behav. 2023 Jan 3. doi: 10.1007/s10508-022-02517-y. Epub ahead of print. PMID: 36596906.
Wang Y, Feng Y, Su D, Wilson A, Pan B, Liu Y, Wang N, Guo B, Han M, Zucker KJ, Chen R. Validation of the Chinese Version of the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. J Sex Med. 2021 Sep;18(9):1632-1640. doi: 10.1016/j.jsxm.2021.05.007. Epub 2021 Jul 8. PMID: 34247955.
(also shows gender dysphoria is experienced by "cisgender" individuals)

Erosion of female sex-segregated sports:
https://shewon.org

Danger of Trans-identifying-males in female spaces:
Comparisons of official MOJ statistics from March / April 2019 (most recent official count of transgender prisoners):
76 sex offenders out of 129 transwomen = 58.9%
125 sex offenders out of 3812 women in prison = 3.3%
13234 sex offenders out of 78781 men in prison = 16.8%

https://www.youtube.com/watch?v=9NpIy...

~~~~~~ List of Trans Sex Crimes ~~~~~~
https://outofmypantiesnow.wordpress.c...

[REMOVED] https://theysaythisneverhappens.wordp...
(Alternative): https://www.tumblr.com/theysaythisnev...

https://mobile.twitter.com/WomenReadW...

https://mobile.twitter.com/historywom...

http://archive.is/gIz5d

https://downloads.frc.org/EF/EF16F27.pdf

https://transcrimeuk.com/category/sex...

~~~~~~ Science on Sex Crimes ~~~~~~
Transwomen are five times more likely to commit sex attacks:
https://www.thetimes.co.uk/article/se...

Transwomen 660% more likely to commit crimes than women:
https://fairplayforwomen.com/criminal...

Over half of all transwomen in UK prisons have been convicted of Class A crimes: https://fairplayforwomen.com/transgen...

Study showing gender inclusion means more women are victims: http://womanmeanssomething.com/target...

25% of serial killers of women are crossdressing males: https://www.researchgate.net/publicat...

Transwomen keep their male pattern violence: https://fairplayforwomen.com/criminal...

98% of sex offences are committed by men, including transgender males. 90% of sex crime victims are female. Source: Ministry of Justice.

Transgender males retain the same rates of criminality as other males, including for violent crime, according to the only long-term study (Dhejne et al, 2011). Fair Play for Women found that at least 40% of transgender prisoners in England and Wales are serving sentences for sex offences, a far higher proportion than the general prison population. These figures have since been corroborated by the Ministry of Justice.

Additional studies:
1] The RaRE Research Report https://www.transgendertrend.com/wp-content/uploads/2017/10/RARE_Research_Report_PACE_2015.pdf

[2] A Scientist Reviews Transgender Suicide Stats, Transgender Trend (2016) https://www.transgendertrend.com/a-scientist-reviews-transgender-suicide-stats/

[3] Private correspondence https://www.transgendertrend.com/wp-content/uploads/2020/09/Pace-study-emails.pdf

[4] Stonewall School Report (2017) https://www.transgendertrend.com/wp-content/uploads/2017/10/the_school_report_2017.pdf

[5] Private correspondence https://www.transgendertrend.com/wp-content/uploads/2020/09/Stonewall-study-email.pdf

[6] Stonewall School Report: What Does the 45% Attempted Suicide Rate Really Mean? Transgender Trend (2017) https://www.transgendertrend.com/stonewall-school-report-what-does-suicide-rate-mean/

[7] Young trans people in Britain, FullFact (2018) https://fullfact.org/health/young-trans-people/

[8] Transgender Adolescent Behaviour, Toomey et al, American Academy of Pediatrics (2018) https://pediatrics.aappublications.org/content/142/4/e20174218?fbclid=IwAR15Mu-PDgAgdRqegPSViOkNulpV8IEy_XsHi9K77RalV8t9IbxPdhSBtW4

[9] Attempted suicide by American LGBT adolescents, 4thwavenow (2018) http://4thwavenow.com/2018/10/23/attempted-suicide-by-american-lgbt-adolescents/

[10] Stonewall School Report: What Does the 45% Suicide Rate Really Mean? Transgender Trend (2017) https://www.transgendertrend.com/stonewall-school-report-what-does-suicide-rate-mean/

[11] Suicide by trans-identified children in England and Wales, Biggs, M, Transgender Trend (2018) https://www.transgendertrend.com/suicide-by-trans-identified-children-in-england-and-wales/

[12] Suicides among teenage girls and young women have almost doubled in seven years, figures show, Bulman, M., Independent (2020) https://www.independent.co.uk/news/uk/home-news/suicides-teenage-girls-young-women-rise-figures-a9698296.html

[13] NHS GIDS Evidence Base http://gids.nhs.uk/evidence-base

[14] Dr Polly Carmichael at ACAMH Conference ‘Gender in 2017: Meeting the needs of gender diverse children and young people with mental health difficulties’. Bristol (2017) https://soundcloud.com/user-664361280/dr-polly-carmichael-developments-and-dilemmas

[15] Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria, Letters to the Editor, Archives of Sexual Behaviour, Biggs, M (2020) https://www.transgendertrend.com/wp-content/uploads/2020/11/Biggs-10.1007@s10508-020-01743-6.pdf

[16] Psychological Support, Puberty Suppression and Psychosocial Functioning in Adolescents with Gender Dysphoria, Journal of Sexual Medicine, Costa et al (2015) https://www.jsm.jsexmed.org/article/S1743-6095(15)34443-X/pdf

[17] Puberty Suppression in Adolescents with Gender Identity Disorder: A Prospective Follow-up Study, deVries et al (2011) https://www.transgendertrend.com/wp-content/uploads/2020/11/de_Vries_Puberty_Suppression_in_Adolescents_with_GD.pdf

[18] Tavistock’s Experimentation with Puberty Blockers, Scrutinising the Evidence, Transgender Trend, Biggs, M (2019) https://www.transgendertrend.com/tavistock-experiment-puberty-blockers/

[19] Detransition, Transgender Trend https://www.transgendertrend.com/detransition/

[20] Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden, PLoS One, Dhejne et al (2011) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

[21] National Center for Transgender Equality, Preventing Transgender Suicide (2010) https://web.archive.org/web/20150213054306/http:/transequality.org/PDFs/NCTE_Suicide_Prevention.pdf

[22] Young people with features of gender dysphoria: Demographics and associated difficulties, Sage, Holt et al (2014) https://www.researchgate.net/publication/268879198_Young_people_with_features_of_gender_dysphoria_Demographics_and_associated_difficulties

[23] Assessment and support of children and adolescents with gender dysphoria, British Medical Journal, Butler et al (2018) https://adc.bmj.com/content/103/7/631.full?ijkey=HsMwyZDRtsKu83z&keytype=ref

[24] Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria, PLoS One, Littman, L. (2018) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330

[25] Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development, BMC, Kaltiala-Heino, R. (2015) https://capmh.biomedcentral.com/articles/10.1186/s13034-015-0042-y#Tab1

[26] Psychosocial and Psychological Vulnerability in Adolescents with Gender Dysphoria: A “Proof of Principle” Study, Journal of Sex and Marital Therapy, Bechard, M. et al (2016) https://www.tandfonline.com/doi/full/10.1080/0092623X.2016.1232325?src=recsys

[27] Psychiatrist: gender dysphoria spreads like an epidemic online, article republished by KIRJO (2019) https://www.ihmistenkirjo.net/blog/psychiatrist-gender-dysphoria-spreads-like-an-epidemic-online?s=03

[28] Swedish National Board of Health and Welfare report (translated by the Society for Evidence Based Gender Medicine for internal research purposes) https://www.transgendertrend.com/wp-content/uploads/2020/11/English-NBHW-report-002.pdf

[29] Female detransition and reidentification: Survey results and interpretation, guideonragingstars (2016) https://guideonragingstars.tumblr.com/post/149877706175/female-detransition-and-reidentification-survey

[30] Triptorelin side effects, NICE website https://bnfc.nice.org.uk/drug/triptorelin.html#sideEffects

[31] Media guidelines for reporting suicide, Samaritans https://www.samaritans.org/media-centre/media-guidelines-reporting-suicide/suicide-reporting-10-things-remember