Monograph Matters

Commentary on deMayo, B. E., Gallagher, N. M., Leshin, R. A., and Olson, K. R. (2025). Stability and Change in Gender Identity and Sexual Orientation Across Childhood and Adolescence https://doi.org/10.1111/mono.12479

About the Author

Anne Fausto-Sterling

Brown University

Dr. Anne Fausto-Sterling is the Nancy Duke Lewis Professor Emerita of Biology and Gender Studies in the Department of Molecular and Cell Biology and Biochemistry at Brown University, and founder and former director of the Science & Technology Studies Program at Brown University. She is currently focused on applying dynamic systems theory to the study of gender differentiation in early childhood. Her ambition is to restructure dichotomous conversations — inside the academy, in public discourse, and ultimately in the framing of social policy — in order to enable an understanding of the inseparability of nature/nurture. She asserts that Dynamic Systems Theory permits us to understand how cultural difference becomes bodily difference.

Dr. Fausto-Sterling is a frequent commentator and reference for journalists in some of the world’s leading media outlets, such as The New York Times and PBS. She regularly writes blog posts for the Boston Review, The Huffington Post and Psychology Today. She has spoken widely throughout the United States and abroad about topics within her realm of expertise and has considerable experience as a workshop leader on college campuses interested in integrating the insights of feminist scholarship into science curriculum.

Out of the fog, some clarity: Science amid social conflict

On June 18, 2025, the United States Supreme Court upheld a law, enacted in the state of Tennessee, that banned the use of hormones and puberty blockers in the health of transgender minors. The Tennessee law operates from the belief that expressing a gender identity that is not concordant with the sex assigned at birth (based on external genitalia) is a psychiatric condition, and it forbids health care providers from using hormones and puberty blockers to treat such psychiatric diagnoses. The same pharmaceuticals banned for transgender children may be used for medical conditions affecting reproduction and growth in cis binary-developing. For example, a child who identifies as a girl and who was so- identified at birth because she had female genitalia but who, during early adolescence experiences unwanted, male-pattern facial hair growth, may legally use a puberty blocker to reduce testosterone production. In contrast, a trans child, identified at birth as male, with male genitalia, who similarly does not want male-pattern facial hair growth is legally forbidden access to the same treatment (Justia, 2024). Over half of U.S. states currently have laws restricting both the medical (e.g., use of blockers) and self-care (e.g., expressing felt gender/sex via clothing and grooming, use of bathrooms that match expression, and name changes) choices of trans youth (Reed, 2025 March 25).

State laws restricting transgender people’s medical access to affirming care, the freedom to dress as they please, and the ability to use public bathrooms, are rooted in the premise that the “invented designation” of gender and gender identity are part of a feminist plot to obscure the immutable biology of sex differences. Nowhere is the attack on feminist concepts of gender clearer than in the January 20, 2025, Presidential Executive Order (EO) entitled “Defending women from gender ideology extremism and restoring biological truth to the federal government” (Trump, 2025). The EO decrees out of existence the developmental and psycho-social concepts of gender and gender identity. While accusing feminists and others of trying to impose on the populace a scientifically false ideology of gender, the EO spells out its own governmentally sanctioned ideology (Yourish et al., 2025, March 7). As of January 2025, “gender has been banished, both as a noun or adjective and a concept… from government websites. The EO ideologues are even trying to prevent academic journals from publishing research on these topics.” (Fausto-Sterling 2025 February 8; 2025 February 20; 2025 March 19; Morabia, 2025).

The lawmakers who have passed laws outlawing affirmative care for trans youth lean heavily into a new “science war”, focused on who speaks the truth about the “helps and harms” of affirmative care (for background on the science wars of the 1990s see: https://en.wikipedia.org/wiki/Science_wars; Perillán, 2025). In this science war the policy reports are important persuasive weapons. Reports such as the Cass Review (Cass, 2024) or the French Guidelines on hormones and puberty blockers during adolescence (Brezin, 2024) include critiques that purport to bring coherence to a literature consisting of small, poorly-designed studies and reports of individual cases, that examines the value of early social transition for younger youth and the effectiveness of puberty blockers and hormone treatments on adolescents’ mental health. While some of these reports support affirmative care, others ignore or dismiss findings suggesting that such care benefits trans youth. (Noone et al, 2025; Reed, 2025 June 12). Despite significant pushback about the scientific quality of such reports from medical experts in fields related to pediatric gender development, state legislators consistently cite them to make legislative changes. Given such deep dispute about what is appropriate health care for trans children one might think the call to action would be to collect better data. Instead, the NIH has adopted the ideology of the EO. Citing “biological reality”, it has cancelled grants on transgender development and affirmative care (Reardon, 2025).

Given this national ruckus over transgender children, it was thrilling to read “Stability and Change in Gender Identity and Sexual Orientation Across Childhood and Adolescence”, a monograph published by the Society for Research in Child Development Monographs Series that contributes significantly to our understanding of gender/sex/uality during child development. The monograph reports the results of the first 10 years of a longitudinal study—The Trans Youth Project–that followed transgender, cisgender, and gender diverse children and youth (deMayo, Gallagher, Leshin and Olson, 2025). At first interview, the median age of the youths was 8.1 years, and at last reported visit 14.3 years. The researchers focused on young children in families supportive of their gender identities. Many of the study subjects had begun to socially transition. At the time of the monograph’s writing, the older subjects had entered adolescence, and if the study continues, it should offer the kind of well-defined data, thoughtful statistical analyses, and careful interpretation needed to cut through the impasse that now traps both lay and medical opponents and advocates of affirmative care.

In contrast to a May 2025, Department of Health and Human Services report that considers the terms “gender” and “gender identity” to be too poorly defined to use in their review of best practices for affirmative care (DHHS, 2025), the Trans Youth Project considers assigned sex at birth, gender, gender identity and sexuality to be developmentally essential phenomena. deMayo and colleagues recruited and compared three groups of children identified at first interview as transgender (317), cis-gender siblings (218), or cis-gender youth age and gender matched to a specific already-recruited transgender individual (377). The researchers called these groups “recruited as…”, because they did not assume a priori that a subject would maintain their gender throughout the decade-long study. Even these first few details signal how refreshingly this investigation departs from the standard developmental psychology (SDP) belief that a child is born with a sex, for the most part properly identified at birth, and that a permanent, static gender shows up at about three years of age. SDP has also operated on the premise that normal development is binary—either you are a boy or a girl. Most studies in this genre simply never mentioned non-binary or trans development (see for example Ruble, Martin and Berenbaum 2006; Blakemore, Berenbaum and Liben, 2009). By tracking over 900 subjects and their parents, via home visits, interviews, and assessments with questionnaires, the authors have taken a significant forward step in describing gender identity and sexual orientation as a dynamic, living, and multiply-varied trait.

Having initially recruited cis girls, cis boys, trans girls and trans boys– deMayo and colleagues faced a problem: over the decade of their study, many, but especially young people, have expanded the number of possible gender identities that they might use to self-label. To accomplish their goal of assessing stability and change over time while acknowledging the changing landscape of identity naming and expression, deMayo et al. derived a  “gender-at-visit” label for each subject. At each visit they used ten different measures, including multiple choice questionnaires and open-ended self-descriptions, some responded to by the children, and some by their parents. The authors processed the raw results to create the code — “gender at visit”. They arrived at five categories—boy, girl, gender diverse (non-binary or agender), boy-expansive (children who said they were a boy but gender diverse) and girl-expansive (children who said they were a girl, but gender diverse). Figure 1 (a reprint of Figure 5 from the Monograph) sums the gender-at-visit scores for each of the youth and gives a sense of gender variability over time).

This Monograph is so chockfull of new information, that I cannot do it justice. But, remembering that the study is ongoing, here are some current headlines.

Figure 1: a reprint of Figure 5 from deMayo et al.

• The numbers of non-cis subjects? are high. From 6-12% of the study’s recruits identified as gender diverse. Even among those “recruited as” cisgender, almost 4% later at “gender at visit” identified as binary transgender. Furthermore, 60% of binary transgender and 33% of cisgender identified as queer (not straight).
• Gender and sexuality interact. Gender diverse teens were “more likely to be bisexual, pansexual or queer than binary transgender or cisgender teens.” (p. 129)
• Gender identity was mostly stable but. Between 10 to 20% changed gender during the study. The finding that socially transitioned binary trans kids were  as likely to change gender identity as cis youth throws a different light on the claim that affirmative care forces changes that many youth later regret (see also Baum, 2025).
• Early gender preferences may predict later identity.: In the authors’ own words, “we sometimes, but not always, found evidence linking childhood gender development to current identity and sexual orientation“. This  suggests that these researchers have not yet collected enough data to reach statistically firm conclusions and additional well-designed studies will help to answer this predictive question.
• It’s not the parents. First, cis siblings did not have a higher rate of gender non-conformity than controls from other families. Second, videos and images from the trans youths’ first year of life did not reveal parental “cross-gender” signs (clothing, crib toys, etc.). Third, the parents themselves noted how early their child expressed gender interests that were at odds with their birth announcement.

If gender identity is not caused by biology or by parental desire what then? deMayo and colleagues suggest that as part of development, youth translate something in their internal experience of familial and societal gender expressions into gender identity. Although they do not offer specifics about the translation process, others are thinking about this piece of the puzzle (Fausto-Sterling, 2025; Fausto-Sterling, manuscript under review; Fausto-Sterling, book manuscript in preparation).

Whether or not we have a strong, evidence-based origin story to tell about gender/sex/uality and identity variation in young people, such children are in our families; they are friends with our children, and their numbers are increasing. Many of my friends are grandparents and it is not unusual at a social gathering to be approached by one of them, knowing that I study gender development,  with a question: “My grandchild/son/daughter just came out as non-binary/trans/queer/agender. What does this even mean?” My only answer is simply “ask them!” A series of Pew Research Polls have shown that in the last decade, terms, categories, and identities have changed rapidly. A 2024 the Pew poll reported that percentage of those polled who were familiar with the idea of a non-binary person was highest among teenagers and declined with each generation. The puzzled grandparental generation was the least likely to have encountered a non-binary person (Minkin and Brown, 2021, Horowitz, 2025).

Given how fast gender/sex has changed, a powerful backlash probably shouldn’t have surprised me. But the fury, meanness, and lack of empathy even for small children have shocked me. Some would like to return us to the 1950s, when a lesbian could be arrested for wearing men’s clothing and sex between consenting adults of the same sex was a felony. Can the forces arrayed against a gender/sex expansive Pandora stuff multiple sexes and genders back into her box? I don’t know, but research such as that reported in this Monograph are an essential part of the solution. Here are a few things scientists and non-scientists alike can also do.

Fund and defend honest scientific inquiry. “Stability and Change in Gender Identity…” offers a model of serious scientific inquiry aimed at understanding how gender varies during child development. And there are, or at least there were, hundreds of other projects studying transgender populations, gender/sex/uality identity, and diversity that have had their NIH and NSF grants cancelled midstream (Kozlov and Malapaty, 2025). Too many colleges and universities are obeying in advance by refusing to help scientists in their employ contest cancellations or sign off on new support applications. This must stop. Individuals, universities, and professional organizations must advocate for a return to ethical, rigorous research standards. They need to lend a hand to current graduate students, postdocs, and assistant professors, lest we end up with a missing generation of scientists (see for example Reardon, Mervis, Jacobs and Stokstad, 2025) .

Speak up for the children. In the past several years some government officials have referred to familial support, such as that given to the children reported on in this study, as child abuse. Some states have threatened to remove supported trans children from their loving families. The American Psychological Association and the Society for Research on Child Development (which published deMayo et al., and my comments on it) oppose the idea that raising a trans child is abusive (APA, 2023; SRCD, 2022). Treating children as political pawns, as youth who do not know enough to be in the conversation, is wrong. States and the federal government would do well to butt out and instead encourage everyone, including those grandparents puzzled by the strange ways of young people, to listen to and love their grandchildren.

References

American Psychological Association (2025) Criminalizing gender affirmative care with minors: suggested discussion points with resources to oppose transgender exclusion bills. https://www.apa.org/topics/lgbtq/gender-affirmative-care

Baum, S. (2025, June 11) Largest Trans Survey Ever: Top Reason Trans People Stop Transitioning Is Transphobia. Erin in the Morning Substack https://www.erininthemorning.com/p/largest-trans-survey-ever-top-reason

Blakemore, J. Berenbaum, S. and Liben, L. (2009). Gender Development. Psychology Press.

Cass, H. (2024). The Cass Review.https://cass.independent-review.uk/home/publications/final-report/

Department of Health and Human Services (2025, May 1) Treatment for Pediatric Gender Dysphoria Review of Evidence and Best Practices. https://opa.hhs.gov/gender-dysphoria-report

DeMayo, B., Gallagher, N., Leshin, R. and Olson, K. (2025) Stability and Change in Gender Identity and Sexual Orientation Across Childhood and Adolescence. Monographs of the Society for Research in Child Development. In press.

Fausto-Sterling, A. (2025, February 8) Biological truth? WTF? (Part 1): On sex, gender, men, women, identity, ideology, science and truth. Gender/sex and science – Gender/sex and Science. Substack https://sterlinga.substack.com/p/a-few-responses-to-biological-truth

Fausto-Sterling, A. (2025, February 20) Biological truth? WTF? (Part 2):Shell game: a fraud or deception perpetrated by shifting conspicuous things to hide something else. Gender/sex and Science. Substack https://sterlinga.substack.com/p/biological-truth-wtf-part-2

Fausto-Sterling, A. (2025, March 02) Biological Truth? WTF? (Part 1.5) Bio-Battle: the Judges Rule. Gender/sex and Science. Substack https://sterlinga.substack.com/p/biological-truth-wtf-part-15

Fausto-Sterling, A. (2025, March 19) Biological truth? WTF? Part 3: The Government’s Gender Ideology Extremism. Gender/sex and Science. Substack https://sterlinga.substack.com/p/biological-truth-wtf-part-3

Fausto-Sterling, A.Rethinking Gender/Sex Identity. American Journal of Human Biology, 2025; 37:e70044 1 of 14 https://doi.org/10.1002/ajhb.70044

Fausto-Sterling, A. (2025) Throwing like a girl: a critique of past approaches and an illustrated proposal for a path forward. The Biology of Sex Differences. Manuscript under review.

Fausto-Sterling A. (2025) The Future of Identity: gender/sex, race and human development. Book manuscript in preparation

François Brezin et al., Endocrine management of transgender adolescents: Expert consensus of the french society of pediatric endocrinology and diabetology working group  Archives de Pédiatrie, https://doi.org/10.1016/j.arcped.2024.08.003

Horowitz, Juliana Menasce (2025, January 4) U.S. teens are less likely than adults to know a trans person, more likely to know someone who’s nonbinary.  https://www.pewresearch.org/short-reads/2025/01/24/us-teens-are-less-likely-than-adults-to-know-a-trans-person-more-likely-to-know-someone-whos-nonbinary/

Justia (2024) 2024 Tennessee Code Title 68 – HEALTH, SAFETY AND ENVIRONMENTAL PROTECTION (§§68-1-101 — 68-221-1319) Health (§§ 68-1-101 — 68-60-101)Chapter 33 – [HEALTH AND WELFARE OF MINORS] (§§ 68-33-101 — 68-33-110)Section 68-33-101 – Findings. https://law.justia.com/codes/tennessee/title-68/health/chapter-33/section-68-33-101/ . 

Minkin, R., & Brown, A. (2021, July 27). Rising shares of U.S. adults know someone who is transgender or goes by gender-neutral pronouns. Pew Research Center. https://www.pewresearch.org/short-reads/2021/07/27/rising-shares-of-u-s-adults-know-someone-who-is-transgender-or-goes-by-gender-neutral-pronouns/ ;

Morabia, A. (2025) AJPH and the Threat of Political Interference in Scientific Publishing. American Journal of Public Health. 115, 626-627 https://doi.org/10.2105/AJPH.2025.308100

Noone, C., Southgate, A., Ashman, A. et al. Critically appraising the cass report: methodological flaws and unsupported claims. BMC Med Res Methodol 25, 128 (2025). https://doi.org/10.1186/s12874-025-02581-7

Perillán, José G. (2025) Science Wars to Wars on Science. Isis. 116:2, 355-360. https://doi.org/10.1086/735721

Reardon Sarah.(2025) NIH kills existing grants on transgender issues. Science. Mar 14;387(6739):1136 doi: 10.1126/science.adx3896. Epub 2025 Mar 13. PMID: 40080590.

Reardon S, Mervis J, Jacobs P, Stokstad E. The human impact. Science. 2025 May 8;388(6747):581-583. doi: 10.1126/science.ady7726 .

Reed, E. (2025 March 25) Anti-trans national risk assessment map: march edition. Erin in the Morning. Substack. https://www.erininthemorning.com/p/anti-trans-national-risk-assessment

Reed, E. (2025 June 12) The Moderate Case Against Trans Youth Healthcare Bans. Erin in the Morning. Substack. https://www.erininthemorning.com/p/the-moderate-case-against-trans-youth

Ruble, D. N., Martin, C. L., & Berenbaum, S. A. (2006). Gender development. In N. Eisenberg (Ed.), Handbook of Child Psychology (6th ed., Vol. 3, pp. 858-932). John Wiley and Sons.

Society for Research on Child Development (2022). SRCD Governing Council Denounces Texas Anti-Trans Directive, Urges Policymakers to Look at Evidence. March 2. https://www.srcd.org/news/srcd-governing-council-denounces-texas-anti-trans-directive-urges-policymakers-look-evidence

Trump, D. (2025). Defending women from gender ideology extremism and restoring biological truth to the federal government. https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/

Yourish, K., Damiel, A., Datar, S. White, I. and Gamio, L. (2025) These words are disappearing in the new Trump administration. The New York Times. https://www.nytimes.com/interactive/2025/03/07/us/trump-federal-agencies-websites-words-dei.html

Citation:
Fausto-Sterling, A. (2025). Out of the fog, some clarity: Science amid social conflict. [Peer commentary on the article “Stability and Change in Gender Identity and Sexual Orientation Across Childhood and Adolescence” by Benjamin E. deMayo, Natalie M. Gallagher, Rachel A. Leshin, and Kristina R. Olson]. Monograph Matters. Retrieved from https://monographmatters.srcd.org/2025/07/15/commentary-fausto-sterling-90.1-3/