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I am not making claims about that study. That is why I asked if you had retrospective information on their cases because you were claiming they were not trans, etc. which is a claim.
Since the criteria includes aspects of gender conformity it can relate to a diagnosis. However, my point is what you also acknowledge, that unless you have notation of characteristics that meet the criteria you don't know either way whether they would have.
So I asked if you had information that restrospectively looked at the criteria from case studies.
As to the historical changes in diagnostic criteria over time, desisters, the role of gender-noncomforming traits in childhood, etc. here is an article from Zucker discussing the issues primarily in regards to children, but also looking at the issue from a larger perspective.
https://www.researchgate.net/public...forming_children_by_Temple_Newhook_et_al_2018
A second issue noted by Temple Newhook et al.(2018) is that diagnostic criteria have changed overtime, between the DSM-III in 1980 and the DSM-5 in2013. That is true. Indeed, Temple Newhook et al.state that“...these studies included children who, by current DSM-5 standards, would not likely have been categorized as transgender (i.e., they would not meet the criteria for gender dysphoria) and therefore...it is not surprising that they would not identify as trans-gender at follow-up.”There is a lot to unpack in this statement. First, even using the earlier criteria for the diagnosis of gender identity disorder of childhood/gender identity disorder, not all of the referred children were threshold for the diagnosis (see below).
A note, he is here acknowledging a similar problem in a cited study of sub-threshhold inclusion.
Second, it is an empirical question about what the degree of overlap would be if one used DSM-III, DSM-III-R,DSM-IV, and DSM-5 criteria to classify children referred for possible gender dysphoria. I doubt that anyone will ever do such a study, so it is not worth ruminating about it. It is my clinical opinion that the similarities across the various iterations of the DSM are far greater than the differences (Zucker,2010)and, as part of the work done by the Subcommittee on Gender Identity Disorders for the DSM-IV, provided one example of this (Zucker et al.,1998). One minor point about changes in the diagnostic criteria: Temple Newhook et al. stated that “Evidence of the actual distress of gender dysphoria...was dropped as a requirement for [Gender Identity Disorder] in the DSM-IV...”This is wrong. Criterion D reads as follows:“The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning”(American Psychiatric Association,1994,p.538).Of course,how exactly one operationalizes distress is a complex matter, as I have discussed elsewhere(e.g., Zucker,1992,2005).
An important point discussed by Temple Newhook etal. (2018) is that not all children seen in the follow-up studies were threshold for the DSM diagnosis in childhood (see also Olson,2016). Indeed, they quoted from Drummond et al. (2008) the following:
...40% of the girls were not judged to have met the complete DSM criteria for GID [Gender Identity Disorder]at the time of childhood assessment...it could be argued that if some of the girls were subthreshold for GID in childhood, then one might assume that they would not be at risk for GID in adolescence or adulthood. (p. 42)
Since I was a co-author of Drummond et al., how could I disagree with this statement? Ten years later, here is how. On the one hand, the clinical reality is more complicated than this statement suggests. For example, there is ample contemporary clinical experience that there are many adolescents who come in the front-door for evaluation who meet the diagnostic criteria for gender dysphoria, but, retrospectively, would not have met the complete DSM-criteria in childhood (either by their own self-report, by their parent’s perspective, or both). Some of these adolescents would not have met any of the criteria. Other adolescents (particularly birth-assigned females in my opinion) had some degree of gender-variant behavior during childhood (sometimes markedly so),but not at the level where they would have been threshold for the diagnosis because they did not express the desire to be of the other gender or some alternative gender different from their assigned gender. Thus, I would argue that degree of gender-variant behavior in childhood (with or without the presence of gender dysphoria per see) is a potential predictor of gender dysphoria in adolescence or adulthood that should not be too readily dismissed (see, e.g., Scholin-ski,1997;BIO/INFO/CV).
He goes on at some length. For those wanting a review of the data on childhood desisters and some of the debates about interventions in childhood it would be good to read the whole article. It is a response to an article from the opposite perspective, which can also give information on the debate.
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