Behind Florida\u2019s decision to block clinical services for transgender adolescents is a talking point \u2014 repeated by the state\u2019s governor and top medical authorities \u2014 that most cases of gender incongruence fade over time.<\/p>\n

The Florida Board of Medicine voted Nov. 4 to\u00a0approve a rule<\/a>\u00a0that barred physicians from performing surgical procedures on minors to alter \u201cprimary or secondary sexual characteristics\u201d and from prescribing them medication to suppress puberty and hormones. The rule included an exception for patients who were already receiving those treatments.\u00a0<\/p>\n

Two days later, Florida\u2019s Republican governor, Ron DeSantis, said gender-affirming care is \u201can example of ideology overtaking the practice of medicine,\u201d touting that he worked with the board to take a stand against it.\u00a0<\/p>\n

\u201cOver 80% of the dysphoria amongst teenagers resolves itself by the time they become older,\u201d DeSantis said during a Nov. 6 campaign event. \u201cSo why are you mutilating their body parts?\u201d<\/p>\n

Earlier in the year, the Florida Department of Health used the statistic as it\u00a0 advised against<\/a>\u00a0medical transitioning for minors. The department\u2019s April memo said that \u201c80% of those seeking clinical care will lose their desire to identify with the non-birth sex.\u201d\u00a0<\/p>\n

Dr.\u00a0 Hector Vila<\/a>, a Tampa anesthesiologist and member of the governor-appointed board, said he\u00a0 supported the rule<\/a>\u00a0because\u00a0a \u201csignificant percentage\u201d of transgender children will return to their assigned sex.<\/p>\n

PolitiFact consulted with experts and data to determine whether gender incongruence will \u201cresolve itself\u201d for a large cohort of teenagers.<\/p>\n

Those experts said Florida mischaracterized a statistic linked to an academic review from 2016. What\u2019s more, one of the researchers whose work is cited as the statistic\u2019s source has said the data he consulted is not \u201coptimal\u201d and can lead to \u201cwrong inferences.\u201d<\/p>\n

The public comment period for the rule ended Dec. 5.<\/p>\n

The 80% figure comes from a 2016 paper<\/a> published in the International Review of Psychiatry.<\/p>\n

Dutch health psychologist\u00a0 Thomas Steensma<\/a>\u00a0and Italian psychologist Jiska Ristori examined past studies on gender dysphoria, which describes the distress people may experience because of a discrepancy between their gender identity and the sex assigned to them at birth.<\/p>\n

Not all transgender people experience or are diagnosed with gender dysphoria. Gender dysphoria diagnoses focus on gender identity-related psychological distress, not gender identity itself.<\/p>\n

The researchers wanted to know whether people who experienced gender dysphoria as children still had it later in life. They looked at the outcomes for children involved with 10 studies conducted from 1968 to 2012 in the U.S., Canada, and the Netherlands.<\/p>\n

Their review of the studies said they showed that gender dysphoric feelings went away for 85% of children \u201caround or after puberty\u201d \u2014 while acknowledging several limitations.<\/p>\n

\u201cThere may be a number of arguments to nuance this high percentage of desistence,\u201d the review read<\/a>. \u201cThe lower persistence rates in the earlier studies, compared to the more recent studies after 2000, may be the result of the inclusion of less extreme cases in the earlier studies than in later studies.\u201d<\/p>\n

In other contexts, \u201cdesistence\u201d can refer to an apparent end of gender variance and a return to an identity that aligns with the sex assigned at birth. In the paper, the researchers meant the lifting of dysphoric feelings.<\/p>\n

Other experts mentioned concerns with the methodology of studies cited in the paper.<\/p>\n

Dr. Kristin Dayton, a pediatric endocrinologist, said the studies had a small share of children assigned female at birth \u2014 and are thus not representative samples of the population. Eight of the 10 studies examined only children assigned male at birth.<\/p>\n

At least six of the studies were conducted before the American Psychiatric Association developed a formal diagnosis for gender dysphoria in children. Some of the 10 studies did not include children who were referred to the studies by medical professionals.<\/p>\n

A\u00a0 1987 study<\/a>, for instance, used advertisements to recruit children. Only 30% of the children examined had \u201cfrequently\u201d stated a desire to be a girl. Experts said most of the children in that study wouldn\u2019t have met the current criteria for gender dysphoria.<\/p>\n

The diagnostic criteria<\/a> for the condition include a \u201cmarked incongruence\u201d between one\u2019s experienced gender and assigned sex at birth lasting at least six months and a \u201cstrong desire to be of the other gender or an insistence that one is the other gender.\u201d<\/p>\n

Florida\u2019s Department of Health and Board of Medicine misrepresented the review\u2019s conclusion by stating 80% of children will \u201close the desire\u201d to identify with a sex not assigned at birth.<\/p>\n

The 80% figure in the review\u00a0 did not reference<\/a>\u00a0children\u2019s gender identities; it centered on the persistence and desistence of gender dysphoria in adulthood. Steensma\u00a0 later wrote<\/a>\u00a0that \u201cusing the term desistence in this way does not imply anything about the identity of the desisters.\u201d<\/p>\n

Although the review noted the studies found that gender dysphoria in childhood is \u201cstrongly associated\u201d with a \u201clesbian, gay, or bisexual outcome,\u201d it did not say what percentage of people studied stopped identifying as transgender.<\/p>\n

\u201cThe 80% statistic, used by the Florida Department of Health and the state\u2019s leadership, is categorically false,\u201d Dr. Meredithe McNamara, an assistant professor of pediatrics at the Yale School of Medicine, told PolitiFact. \u201cAfter a close read of the scholarship cited by the state, the state\u2019s conclusion simply cannot be drawn in good faith.\u201d<\/p>\n

Steensma, who did not respond to PolitiFact\u2019s requests for an interview, has responded to\u00a0 criticism from colleagues<\/a>\u00a0about how his research is used to discourage social and medical affirmation for gender diverse adolescents.\u00a0<\/p>\n

\u201cWe want to stress that we do not consider the methodology used in our studies as optimal \u2026 or that the terminology used in our communications is always ideal,\u201d\u00a0Steensma\u00a0 wrote in 2018<\/a>. \u201cAs shown, it may lead to confusion and wrong inferences.\u201d\u00a0<\/p>\n

McNamara also said that Florida\u2019s reliance on a 2016 paper is a \u201cglaring problem\u201d because the state neglected to consider about six years of new research.<\/p>\n

A\u00a0 study published in July<\/a>, for instance, sought to develop an estimate of transgender children who later stop identifying with a gender that is incongruent with their assigned sex. It evaluated 300 transgender children over five years. To participate in the study, children must have already begun social transitioning, which often involves changing names, haircuts, and pronouns.\u00a0<\/p>\n

Researchers from Princeton University\u2019s TransYouth Project followed up with participants in person and online. At the end of the five years, 94% of participants still identified as transgender.<\/p>\n