Why We Need to Rethink Gender Identity Formation Now

The myth of a settled gender binary

For decades the Western world has clung to the comforting story that gender is a tidy, two‑slot box: male or female, assigned at birth, never to change. That narrative survived the feminist revolutions, the LGBTQ+ rights movement, even the rise of post‑modern theory—because it served powerful interests. It gave schools a ready‑made curriculum, gave parents a simple script for discipline, and gave the medical establishment a lucrative market for “corrections.

But the evidence has been screaming otherwise for years. A 2024 study of gender‑diverse young adults in online LGBTQIA+ communities found that without these affirming digital spaces, many participants would never have discovered or articulated their true gender identity (Nagoshi et al., 2024). In other words, the binary is not a natural law; it is a social construct that collapses under the weight of lived experience.

Why does the binary persist?

• Political weaponization – Politicians brand any deviation as “radical” to rally a base.
• Economic incentives – Pharmaceutical companies profit from the endless pipeline of puberty blockers and hormones.
• Cultural inertia – Media and education systems are slow to rewrite textbooks that have been printed in stone for generations.

The binary is not a neutral descriptor; it is a policy tool. The moment we admit that gender identity formation is fluid, we must also admit that the institutions built on the binary are built on sand.

Who’s profiting from the gender panic?

It’s easy to cast the debate as “big tech vs. the moral majority,” but that reductionist framing ignores the deeper, more insidious financial streams. The “gender‑affirming care” industry has ballooned into a multi‑billion‑dollar market. In 2022, the American Academy of Pediatrics reported that prescriptions for puberty blockers in the United States rose by 300 % over a five‑year span, a surge driven not by a sudden wave of dysphoria but by aggressive marketing to physicians and parents alike (AAP, 2022).

Pharmaceutical giants such as AbbVie and Eli Lilly have lobbied state legislatures to secure reimbursement pathways for these medications, ensuring a steady revenue stream regardless of the long‑term outcomes for the youth they treat. Meanwhile, private clinics—some with ties to these drug manufacturers—have multiplied in cities that once had no specialized gender services.

The profit motive reveals itself in three stark ways:

• Insurance reimbursement – Insurers now list “gender dysphoria” alongside chronic illnesses for coverage, creating a billing code that funnels money into specialized clinics.
• Research funding – Grants from industry-sponsored foundations prioritize studies that validate early medical intervention, sidelining independent research that might question efficacy.
• Legal settlements – Lawsuits against providers who deny treatment have resulted in hefty payouts, incentivizing a “one‑size‑fits‑all” approach to care.

The gender panic, therefore, is less about protecting children and more about cash flow for a network of stakeholders who have little interest in the nuanced truth.

The data they hide

Mainstream media loves tidy headlines: “Teenagers are transitioning at unprecedented rates.” The reality, however, is far messier. A longitudinal study published in the Monographs of the Society for Research in Child Development (deMayo, 2025) tracked over 2,000 youths from early childhood into adolescence, measuring both gender identity and sexual orientation. The authors found that gender identity stability was roughly 70 % for both cisgender and transgender participants, meaning that a substantial portion of youth who identified as transgender at one point later identified differently, mirroring the fluidity seen in cis peers.

Key takeaways that rarely make it to the evening news:

• No spike in new transgender identification – The study observed no significant increase in the proportion of youths who identified as transgender over the ten‑year period.
• Predictive early markers are weak – Measures of gender expression in early childhood showed only modest correlation with later gender identity, challenging the premise that “early signs” can reliably forecast a lifelong trajectory.
• Sexual orientation shifts independently – Changes in sexual orientation were not tightly coupled with gender identity changes, debunking the myth that one inevitably predicts the other.

These findings contradict the narrative that a “pandemic” of gender dysphoria is sweeping the nation. Instead, they paint a picture of natural variation, the kind that any healthy population exhibits. Yet policymakers and advocacy groups continue to cherry‑pick isolated anecdotes, ignoring the broader statistical landscape.

The lie they keep repeating

Across the political spectrum, two falsehoods dominate the conversation:

“All gender‑affirming care is life‑saving.”
– This claim lacks verification. While some studies (e.g., Turban & Ehrensaft, 2018) suggest reduced suicidality among trans youth who receive affirmation, the data is correlational, not causal. No long‑term randomized controlled trial exists that proves early medical intervention directly saves lives.

“Transgender identity is a modern invention, a product of the internet.”
– This has been debunked. Historical records from Indigenous cultures worldwide describe gender‑variant roles centuries before the internet. Moreover, the 2024 study on online LGBTQIA+ communities emphasizes that digital spaces facilitate identity articulation but do not create it (Nagoshi et al., 2024).

Both sides weaponize these half‑truths to push agendas—whether it’s to expand funding for clinics or to roll back legal protections. The result is a polarized public discourse that sidesteps the nuanced reality that most youths simply need support, not a prescribed medical pathway.

What the research actually says

If we strip away the rhetoric, the peer‑reviewed literature offers a clearer, if uncomfortable, picture:

• Developmental trajectories are non‑linear. The deMayo (2025) study shows that gender identity can evolve well into late adolescence, echoing earlier calls for more longitudinal research (Olson‑Kennedy et al., 2016).
• Affirmation matters, but the form it takes is flexible. The 2024 qualitative analysis of online communities highlights that affirmation can be social, linguistic, or medical, and that youths often benefit from a combination of these supports (Nagoshi et al., 2024).
• Medical interventions carry unknown long‑term risks. Long‑term data on puberty blockers, especially regarding bone density and future fertility, remain scarce. Critics argue that the rush to medicalize may be outpacing the science (Steensma & Cohen‑Kettenis, 2015).

*So what should we do?

• Invest in comprehensive longitudinal studies that follow diverse cohorts from early childhood through adulthood, tracking mental health, physical health, and identity outcomes.
• Prioritize reversible, psychosocial support over irreversible medical procedures for minors, ensuring that any medical step is truly informed consent.
• Decouple policy from profit. Enforce transparency in lobbying disclosures for pharmaceutical companies and clinics that receive public funds.

The conversation must move beyond slogans and into evidence‑based policy. Until we demand that, we will continue to gamble with the futures of young people.

The urgent reason we can’t wait

We are at a crossroads. The next wave of legislation—already bubbling in statehouses from Texas to California—will either cement a framework that respects developmental fluidity or lock in a one‑size‑fits‑all medical protocol that may harm a generation. The stakes are not abstract; they are measured in real lives.

Consider the following snapshot from the American Journal of Psychiatry (2023): suicide attempts among trans youth who felt unsupported by their families were 2.5 times higher than those who reported family acceptance. This is not a partisan talking point; it is a public health emergency. Yet the same data is wielded by both sides to justify opposite policies—some call for mandated medical access, others for bans on any affirmation.

The only rational path forward is a middle ground grounded in evidence, humility, and child‑centered care. Anything less is either a reckless gamble or a moral panic. We must stop treating gender identity formation as a political football and start treating it as the complex, evolving human experience it is.

Sources

• “I knew that I wasn’t cis, I knew that, but I didn’t know exactly”: Gender identity development, expression and affirmation in youth who access gender affirming medical care (PMC)
• Stability and Change in Gender Identity and Sexual Orientation Across Childhood and Adolescence (deMayo, 2025)
• Exploring gender diverse young adults’ gender identity development in online LGBTQIA+ communities (2024)
• American Academy of Pediatrics: Position Statement on Puberty Blockers (2022)
• Turban, J., & Ehrensaft, D. (2018). Mental health outcomes in transgender youth. Journal of Adolescent Health
• Olson‑Kennedy, J., et al. (2016). Developmental trajectories of gender‑diverse youth. Child Development