Gender dysphoria in children and adolescents: A retrospective analysis of cases in Singapore

Introduction: The understanding of gender dysphoria (GD) in children and adolescents is limited in Singapore. This study aims to review the presentation of GD in an outpatient psychiatric clinic, to gain insights into its prevalence and associated factors. Method: We conducted a retrospective review of medical records for patients diagnosed with GD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth and Fifth editions, at the clinic between 1 January 2017 and 31 December 2021. We collected and analysed demographic, medical and other GD-specific clinical variables. Results: The study included 107 participants (mean age 16.6 years), comprising 47 natal males and 60 natal females. The prevalence of GD was found to be 1:5434 (0.019%). Incidence rates increased from 2.17 to 5.85 per 100,000 population between 2017 and 2021. The mean age of diagnosis was 15.6 years, with an average delay of 5 years between experiencing gender identity-related concerns and seeking formal assistance. Approximately 45% of participants reported social and physical transitions, and 20.6% reported self-harm or suicidal thoughts. Conclusion: The study highlights the presentation of GD in an under-researched Asian setting. Supporting individuals with GD in Asia requires sensitivity to cultural and societal factors with a holistic approach to individual well-being.