Demographic and Clinical Features of Early-Onset versus Late-Onset Gender Dysphoria Among Adolescent and Young Adult Birth-Assigned Females.

This study examined differences in demographic and clinical features between early- and late-onset gender dysphoria (GD) in a sample of 138 birth-assigned female adolescents and young adults (AYAs) aged 16-25 years. Participants were recruited through social media and word of mouth and completed an online survey. Onset type was determined using retrospective self-report on adapted DSM-5-TR criteria for childhood GD. Results showed most participants (79%) were classified as late-onset. Late-onset participants were significantly more likely to identify as non-binary, while the early-onset group more frequently endorsed binary identities (e.g., man/male). Early-onset participants reported significantly more childhood gender nonconformity, comorbid diagnoses, and more severe GD and anxiety. Participants classified as late-onset reported limited evidence of childhood gender nonconformity. These findings support the notion that GD is heterogeneous with regard to onset, severity, and comorbidity in AYA birth-assigned females. Further research is needed to investigate these divergent pathways and their clinical implications.