Gender incongruence and timing of puberty: a population-based cohort study

To study whether the timing of puberty in adolescents who reported gender incongruence (incongruence between birth-assigned sex and self-identified gender) was different from those adolescents who reported gender congruence. Population-based cohort study using data from the Danish National Birth Cohort. Not applicable. Birth-assigned boys and girls born between 2000 and 2003, who self-reported gender incongruence at 11 years (N = 10,046) and their pubertal developmental stages from age 11 years to every 6 months throughout puberty were included. Not applicable. Mean age differences in months at reaching Tanner stages 2–5 for breast or genital development and pubic hair, voice break, first ejaculation, menarche, axillary hair, acne, and the average difference at attaining all pubertal milestones (primary outcome). In total, 549 (5.5% ) adolescents reported part or full gender incongruence at 11 years. Tendencies toward earlier timing of puberty were observed in adolescents who reported part gender incongruence (average difference, birth-assigned boys: −3.2 months [95% confidence interval {CI}: −6.7; 0.3]; birth-assigned girls: −2.0 months [95% CI: −3.9; −0.1]). Tendencies toward earlier timing of puberty were observed in adolescents who reported full gender incongruence (average difference, birth-assigned boys: −2.4 months [95% CI: −5.0; 0.4]; birth-assigned girls: −1.9 months [95% CI: −5.1; 1.2]). The results from this study indicated that birth-assigned boys and girls who reported either part or full gender incongruence tended to reach puberty slightly earlier than those adolescents who reported gender congruence at 11 years of age. Knowledge on the timing of puberty among adolescents who experience gender incongruence is essential to inform mutual decision-making in clinical settings. Incongruencia de género y momento de la pubertad: un estudio de cohorte basado en la población. Estudiar si el momento de la pubertad en adolescentes que reportaron incongruencia de género (incongruencia entre el sexo asignado al nacer y el género autoidentificado) fue diferente de aquellos adolescentes que reportaron congruencia de género. Estudio de cohorte poblacional utilizando datos de la Cohorte Nacional de Nacimiento de Dinamarca. No aplicable. Se incluyeron niños y niñas asignados como tales en el momento del nacimiento, nacidos entre 2000 y 2003, que autoinformaron incongruencia de género a los 11 años (N=10.046), y sus etapas de desarrollo puberal desde los 11 año