How have gender dysphoria rates by age and sex changed in the U.S. over the past decade?

1. Rising clinical diagnoses and referrals: scope and limits

Multiple clinic‑ and health‑record based studies document substantial increases in diagnoses and referrals for gender dysphoria in the 2010s and early 2020s, with large absolute rises among children and adolescents in some healthcare systems; meta‑analyses and reviews note rising numbers seeking hormonal therapy and specialist care ^{[1] [5]}. These clinical counts reflect both more young people presenting for care and changes in access, diagnostic coding and treatment availability — factors that make it hard to interpret a direct change in underlying population prevalence from clinical data alone ^{[1] [5]}.

2. Age trends: diagnosis getting younger

Research that analyzed large electronic medical record datasets found the mean and median age at diagnosis have been decreasing in recent years, and authors highlight that the fall in age is particularly marked among those assigned female at birth (AFAB), producing a younger cohort seeking care than in earlier decades ^{[6] [2]}. That trend appears consistently in multiple healthcare‑system analyses but the studies caution that differences in data coverage and coding practices across systems affect comparisons ^{[6] [7]}.

3. Sex ratio shift: more AFAB youth in recent cohorts

Clinical samples and reviews report an altered sex‑ratio over time: historically more assigned‑male‑at‑birth (AMAB) than AFAB presented in clinics, but recent years show rising AFAB representation — in some datasets even a reversal of the traditional ratio — especially among adolescents ^{[1] [2]}. Authors and reviewers point to social, diagnostic, and referral‑pattern explanations as plausible contributors, and they note uncertainty about how much of the shift is a true change in incidence versus changes in who seeks and receives diagnoses ^{[1] [2]}.

4. Survey estimates vs. clinic counts: big methodological variation

Population surveys that ask about transgender identity produce much higher prevalence estimates than clinic‑based numbers, and these survey estimates increased among younger cohorts in the 2010s–2020s (examples include estimates spanning roughly 0.3% to over 1% in various waves and studies) ^{[3] [5]}. Reviews emphasize heterogeneity across survey questions, age groups, sampling frames and years — meaning headline percentage increases depend heavily on measurement choices ^{[3] [5]}.

5. Explanations debated: awareness, cohort effects, diagnosis and access

Researchers and commentators offer competing explanations: increased social awareness and reduced stigma likely raise self‑identification and care seeking; expanded clinical services, insurance coverage and guidelines may increase diagnoses and treatment rates; and developmental/cohort effects could change incidence patterns. At the same time, some clinicians and European authorities urge caution about rapid treatment expansion and call for stronger long‑term evidence, indicating a professional disagreement over interpretation and policy implications ^{[1] [8]}.

6. What the largest recent government and review efforts say

The U.S. Department of Health and Human Services compiled a large evidence review in 2025 on pediatric gender dysphoria and treatment practices; the release and peer responses show the topic is now a major federal policy and evidence‑review focus, with advocacy and professional groups offering competing commentaries on the findings and recommendations ^{[9] [10] [11]}. The HHS work underscores both the scale of recent clinical activity and continuing controversies about benefits, harms and best practices ^{[9] [10]}.

7. Key limitations and what’s not answered by current reporting

Available sources document rising diagnoses, younger ages at diagnosis, and a sex‑ratio shift in clinic populations, but they do not establish how much underlying incidence of gender dysphoria in the entire U.S. population has changed versus how much changes reflect awareness, measurement, access or coding ^{[1] [5]}. Longitudinal, population‑representative incidence studies that separate social‑identification change from clinical incidence remain limited in the provided reporting ^{[3] [4]}.

8. Takeaway for readers and policymakers

Data across surveys and healthcare records consistently point to more young people — especially AFAB adolescents — being identified with gender dysphoria and seeking care, and the average age of diagnosis has decreased ^{[6] [2]}. Interpreting those trends for policy requires acknowledging measurement differences, the role of access and social change, and ongoing professional debate about evidence for long‑term outcomes, which the HHS review and international commentaries make plain ^{[9] [8]}.

If you want, I can extract specific numeric trends from one or two of these datasets (for example, the healthcare‑record study with 66,078 diagnoses or the meta‑analytic survey ranges) and lay them out year‑by‑year with their methodological caveats (which dataset would you prefer?) ^{[7] [5]}.