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Table 1 Variable descriptions for childhood gender dysphoria, bullying and social isolation

From: Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development

Gender dysphoria/gender incongruence in childhood (<12 years of age)
Childhood gender dysphoria/incongruence present Childhood gender dysphoria/incongruence not present
• explicit gender dysphoria or marked and persistent cross-gender identification on behavioural level even without explicit verbalization of one’s gender related thoughts and feelings in childhood • no signs of gender dysphoria/incongruence in childhood
Gender presentation, living in desired role
Classified as living in the desired role Not classified as living in the desired role
• the applicant had officially changed her/his name to a gender neutral one or arranged his/her registration in school, and being consistently called, by a name suggesting the desired sex; being always presented to new people as being of the desired sex; being treated by family, teachers/employers, friends, schoolmates as well as by new people as a member of the desired sex • the adolescent had not made any attempt to live and be treated in the desired role
• some of these young people had explicitly “come out” in school and openly made a transition to the desired role; some, with the support of some community key adults, had adults, had totally concealed their natal sex from the school/workplace • the adolescent dressed gender neutrally and asked the family to use a name indicative of the desired sex, but was actually not living in any social role outside the family due to isolation from social interactions
• some of the adolescents in this group were almost totally isolated in their homes (not going to school or work, not meeting peers), some attended school but were isolated from social interactions there and elsewhere
Bullying
Significantly subjected to bullying Not subjected to bullying
• the applicant and/or her/his parents considered that there had been significant and traumatic victimization. • no recollection of being bullied
• a) related to gender presentation or sexual identity: name-calling, spreading rumours and the like related to gender presentation/sexual identity • if ever bullied, the adolescent described it as non-significant (“maybe sometimes”, “not more than anyone else”).
• b) not related to gender or sexual identity: bullying was related to other issues like weight, interests, belonging or not belonging to a certain group etc.
Isolation
Periods of isolation No isolation
• periods of not having contact with peers outside of arranged study-related activities at school - or not even that, if not attending school • no interruptions in attending age appropriate daily programme (usually school), having age-appropriate contacts with peers
• having same-age contacts only with one’s own siblings
• keeping (tenuous, infrequent) contact with one or two peers only despite previously having been normatively engaged with peers
• contacts outside the family only via Internet