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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.<\/jats:p>","DOI":"10.1007\/s10508-026-03571-6","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:30:34Z","timestamp":1789839034000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Demographic and Clinical Features of Early-Onset versus Late-Onset Gender Dysphoria Among Adolescent and Young Adult Birth-Assigned Females"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9493-7029","authenticated-orcid":false,"given":"Hollie","family":"Hammond","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Daly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Morandini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"issue":"6","key":"3571_CR1","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1080\/0092623X.2022.2150346","volume":"49","author":"E Abbruzzese","year":"2023","unstructured":"Abbruzzese, E., Levine, S. 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