{
  "abstract": "Importance. The literature on paediatric gender-affirming care has paid little attention to non-binary young people’s clinical presentations, including their desires for gender-affirming interventions.\n\nObjective. To describe the gender-related presentation of non-binary children and adolescents first attending a paediatric gender clinic, exploring differences based on birth-registered sex and between young people with non-binary and binary identities.\n\nDesign. In this cross-sectional study, young people and a parent/caregiver completed online questionnaires prior to their first appointment between Feb 2017-Dec 2023. Analyses were conducted in January 2025.\n\nSetting. Multidisciplinary gender clinic at a public children’s hospital in Victoria, Australia. Participants. Of those attending an initial appointment (n=2,303), those included in the analytic sample had available questionnaire data (n=2,138) and reported a gender identity that discorded with their birth-registered sex (n=1,745).\n\nMain Outcomes and Measures. Validated measures assessed gender dysphoria, body image, embodiment goals, gender-diverse behaviour, voice dysphoria and chest dysphoria. Gender identity was assessed on the Gender Slider, and social transition via reported changes to presentation, name and pronouns.\n\nResults. The ratio of non-binary to binary young people increased over time, from 1:6 in 2017 to 1:1.6 in 2023. The non-binary group exhibited high levels of body dissatisfaction (m=3.3; 95% CI=3.3,3.4) and gender dysphoria (m=42.0; 95% CI=41.2,42.8). They reported similar levels of gender dysphoria to binary young people (m diff=0.3; 95% CI=-2.3,2.9) and slightly less body dissatisfaction (m diff=-0.3; 95% CI=-0.4,-0.2). Among non-binary people, medical/surgical change to breasts was desired most frequently of all body characteristics (90.1%, n=263). Fewer non-binary than binary individuals reported desires to medically/surgically change their body characteristics [e.g. breasts (% diff=-7.5; 95% CI=-11.1,-3.9)]. Some differences were also observed between non-binary young people assigned female at birth and assigned male at birth [e.g., desire to change body hair (% diff=-39.1; 95% CI= -51.7,-26.5)]. Further between-group differences were observed regarding gender-diverse behaviour and social transition.\n\nConclusions and Relevance. Non-binary children and adolescents accessing gender-affirming care experience significant gender dysphoria, body dissatisfaction and desires for medical/surgical affirmation. While it is important for clinicians to be aware of potential differences in clinical presentation based on gender identity, an individualized, person-centered approach remains priority.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Pip Buckingham"
    },
    {
      "name": "Denise Chew"
    },
    {
      "name": "Sam Hay"
    },
    {
      "name": "Tahlia de Ieso"
    },
    {
      "name": "Zeffie Poulakis"
    },
    {
      "name": "Michelle Tollit"
    },
    {
      "name": "Dr Kenneth Pang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dzv2k30914f5f.bib",
  "cited_by": 0,
  "doi": "10.31234/osf.io/t48g2_v2",
  "fulltext_url": null,
  "id": "dzv2k30914f5f",
  "issns": [],
  "landing_url": "https://osf.io/preprints/psyarxiv/t48g2_v2/",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "bepress",
      "Adolescence"
    ],
    [
      "bepress",
      "Clinical Psychology"
    ],
    [
      "bepress",
      "Developmental Psychology"
    ],
    [
      "bepress",
      "Early Childhood"
    ],
    [
      "bepress",
      "Gender Dysphoria"
    ],
    [
      "bepress",
      "Middle & Late Childhood"
    ],
    [
      "bepress",
      "Social and Behavioral Sciences"
    ],
    [
      "openalex",
      "3207|LGBTQ Health, Identity, and Policy"
    ]
  ],
  "openalex": "W7223019955",
  "pdf_url": "https://osf.io/t48g2/download",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dzv2k30914f5f.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:17Z",
      "native_id": "t48g2",
      "source": "osf",
      "url": "https://osf.io/preprints/psyarxiv/t48g2_v2/"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "bepress:Clinical Psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Gender-related Clinical Presentation of Non-Binary Children and Adolescents",
  "title_text": "Gender-related Clinical Presentation of Non-Binary Children and Adolescents",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:17Z",
  "url": "https://research.draconitic.com/paper/dzv2k30914f5f",
  "venue": "PsyArXiv",
  "versions": []
}