Social transition for trans young people an evolving process
· Medical Xpressby Murdoch Children's Research Institute
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Social transition for trans young people is an evolving process involving changes in names, pronouns and appearance, according to new research. The research, led by Murdoch Children's Research Institute (MCRI), reinforces the need for families, schools and health care providers to support young people in finding the form of gender expression that feels right for them, rather than expecting a single gender affirmation journey.
Published in The Lancet Regional Health—Western Pacific, the study followed 234 trans young people, ages 8 to 17, for up to two years, making it the first prospective longitudinal study to examine how social transition changes over time. It explored how social transition goals changed across home, school, online spaces, friendships and extended family relationships.
MCRI researcher Will Conabere said the findings have implications for how young people were supported through social transition.
"Our study showed social transition is often an evolving process, with young people's goals changing as they develop and better understand themselves," he said. "Families, schools and health care providers should respond to each young person's individual needs, rather than expecting everyone will follow the same path."
Support and gaps in meeting transition goals
The research found that younger children were more likely to add to their social transition goals over time, while trans boys were more likely than trans girls to meet their aspirations, highlighting the need for tailored support.
Young people from families with strong communication, support and problem-solving were also more likely to make the changes they wanted. Overall, more than half of participants consistently met their social transition goals.
MCRI researcher Dr. Pip Buckingham said, "With trans girls less likely to achieve all the changes they desire, greater attention should be paid to understanding the reasons behind this gap. We need to create environments where trans girls and trans women are supported and safe to live as their true selves."
Nonbinary young people seek varied affirmation
Additional MCRI-led research published in JAMA Pediatrics found the proportion of nonbinary young people attending a specialist gender service increased from 14.2% in 2017 to 39% in 2023.
Despite differences in their gender affirmation goals, almost all nonbinary participants reported high levels of gender dysphoria compared to their binary trans peers.
It found that while nonbinary young people generally had higher levels of body satisfaction and a lower desire for some forms of medical affirmation, almost all wanted to change at least one body part or feature, with breasts, chest and voice the most common. Most nonbinary young people wanted social affirmation through changes to their presentation, name or pronouns.
Gender euphoria varies with identity and care
A separate study by MCRI, University of Melbourne and Swinburne University of Technology examined gender euphoria—the positive feelings associated with living in a way that aligns with a person's gender identity—in more than 700 trans and gender-diverse Australians, ages 16 to 79.
Published in eClinical Medicine, it found most participants reported experiencing gender euphoria at least once a week. But those experiences varied depending on gender identity, age and access to gender-affirming care.
Nonbinary people reported higher levels of euphoria associated with community connection, but less self-affirmation euphoria compared with their binary trans peers. Those who had accessed gender-affirming hormones or undergone gender-affirming surgery reported more self-affirmation euphoria.
MCRI Dr. Michelle Tollit said the three studies gave a broad picture of the different ways people could experience gender affirmation.
"Taken together, these new findings show gender affirmation is not one-size-fits-all when looking at social transition, the experiences of nonbinary young people and gender euphoria," she said.
"As a society we need to listen to young people and create environments where they can safely express what they want and revisit those goals as they grow. We also need health services and policymakers to ensure care, guidance and policies are flexible enough to respond to this diversity, rather than assuming everyone will have the same experience of gender affirmation."
Publication details
Will Conabere et al., Trajectories of social transition among trans children and adolescents in Victoria, Australia: a longitudinal descriptive study, The Lancet Regional Health—Western Pacific (2026). DOI: 10.1016/j.lanwpc.2026.101933
Pip Buckingham et al., Gender-Related Clinical Presentation of Nonbinary Children and Adolescents, JAMA Pediatrics (2026). DOI: 10.1001/jamapediatrics.2026.4252
Charlotte Blacklock et al., Sociodemographic and gender affirmation factors associated with gender euphoria: a cohort study, eClinicalMedicine (2026). DOI: 10.1016/j.eclinm.2026.104039
Journal information: JAMA Pediatrics , EClinicalMedicine
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PediatricsPsychology & Mental healthPsychiatryChildren's health Provided by Murdoch Children's Research Institute Who's behind this story?
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