{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:19:06Z","timestamp":1793978346922,"version":"4.8.0"},"reference-count":40,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NHS England"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"accepted":{"date-parts":[[2024,11,29]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine trends in diagnosis of gender dysphoria and related conditions in children and young people attending primary care practices in England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Longitudinal analysis of electronic primary care records from the Clinical Practice Research Datalink (CPRD) Aurum database linked to hospital and Index of Multiple Deprivation data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Primary care practices in England between 2011 and 2021.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>3782 patients aged 0\u201318 years with a recorded history of gender dysphoria\/incongruence and matched comparators with autism spectrum conditions or eating disorder.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Incidence rates and prevalence of gender dysphoria\/incongruence; prescribing rates for medical treatments; co-occurrence of anxiety, depression and self-harm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2011 and 2021, incidence rates of recorded gender dysphoria\/incongruence increased from 0.14 (95% CI 0.08 to 0.20) to 4.4 (95% CI 4.1 to 4.7) per 10 000 person years, and from 2014 the rate increased more rapidly in recorded females than males. There was no significant association between gender dysphoria\/incongruence and area level deprivation. Of the 3782 children and young people with a record of gender dysphoria\/incongruence, 176 (4.7%) were prescribed puberty suppressing hormones; 302 (8.0%) were prescribed masculinising\/feminising hormones; and 1994 (52.7%) had a record of anxiety, depression or self-harm. Compared with matched comparators, those experiencing gender dysphoria\/incongruence had similar recorded rates of anxiety and higher rates of depression and self-harm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Recorded prevalence of gender dysphoria\/incongruence increased substantially in children and young people between 2011 and 2021, particularly in recorded females. Levels of anxiety, depression and self-harm were high, indicating an urgent need for better prevention and treatment of mental health difficulties in these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2024-327992","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T06:40:15Z","timestamp":1737700815000},"page":"612-621","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Epidemiology of gender dysphoria and gender incongruence in children and young people attending primary care practices in England: retrospective cohort study"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8447-0306","authenticated-orcid":false,"given":"Stuart William","family":"Jarvis","sequence":"first","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1360-4191","authenticated-orcid":false,"given":"Lorna K","family":"Fraser","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trilby","family":"Langton","sequence":"additional","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-3536","authenticated-orcid":false,"given":"Catherine Elizabeth","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7857-3704","authenticated-orcid":false,"given":"Tim","family":"Doran","sequence":"additional","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"2025071802100775000_110.8.612.1","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2019.1667429"},{"key":"2025071802100775000_110.8.612.2","doi-asserted-by":"publisher","DOI":"10.1093\/jsxmed\/qdac034"},{"key":"2025071802100775000_110.8.612.3","doi-asserted-by":"crossref","unstructured":"Twenge JM , Wells BE , Le J , et al . 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