Gender dysphoria is not a single experience but a set of trajectories that can begin in childhood or emerge in adolescence. A new study published in Archives of Sexual Behavior analyzed 138 young women (aged 16 to 25) assigned female at birth and experiencing gender dysphoria, and found that the vast majority —79%— do not recall having symptoms in childhood.
Two pathways, two profiles
To classify the participants, the researchers used the DSM-5-TR criteria for childhood gender dysphoria. Those who recalled meeting at least six symptoms for a minimum of six months between ages 3 and 11 were considered early-onset; the rest were classified as late-onset. The result was striking: only 29 young women (21%) fit the first group, while 109 (79%) were classified as late-onset.
The two groups differed not only in when the distress appeared, but in how they experienced it. The early-onset group reported marked childhood gender nonconformity, more comorbid diagnoses, and more intense dysphoria, along with more anxiety. They also tended to endorse binary identities, such as man or male. The late-onset group, by contrast, showed little evidence of childhood nonconformity and were significantly more likely to identify as non-binary.
A shift from classic clinical data
The finding that nearly 80% of the sample follows the late-onset pathway is an almost complete inversion of clinical data collected between 2007 and 2011, when early onset predominated. The authors note that this profile resembles broader non-clinical samples and also people who have detransitioned, raising questions about the persistence of symptoms in this group.
Another striking result is the high prevalence of same-sex attraction: only about one in five participants considered themselves heterosexual, well below the population average. Unlike what is observed in males, here sexual orientation did not distinguish between the two onset types.
What it means for clinical practice
The authors stress that gender dysphoria in young women is heterogeneous in onset, severity, and comorbidity, and that these divergent profiles should be considered when assessing and supporting each person. The association between late onset and non-binary identity, not previously described, opens a line of research on the mental health and evolution of these young people.
The study, based on an online questionnaire with retrospective recall, acknowledges its limitations, but offers a useful picture of a population increasingly present in clinical settings.
Source: Archives of Sexual Behavior (2026). DOI: 10.1007/s10508-026-03571-6.
