title: Prevalence of Adolescent Gender Experiences and Gender Expression in Germany.
abstract: OBJECTIVE
  Adolescence marks a transition period in the development of gender experience and expression. Although there is growing awareness about various gender identities in health research, only limited data on the prevalence of adolescent gender variance in the general population exist.
  
  
  METHODS
  German female and male adolescents (n = 940) aged 10-16 years participating in the nationally representative "Health Behaviour in School-aged Children" Hamburg survey were asked to report their current gender experience (identification as both feminine and masculine) and gender expression (gender role as a girl or boy). Two overall categories and five subcategories on gender experience and expression were established based on previous research.
  
  
  RESULTS
  In total, 4.1% of the adolescents' responses were rated as variant in gender experience and 3.0% as nonconforming in expression. Both variant experiences and nonconforming expression together were present in only .9% of adolescents. Gender variance was more strongly present in girls and in younger age groups. In detail, 1.6% reported an incongruent, 1.1% an ambivalent, and 1.5% no gender identification. Another 8.0% of the responses could be rated as only somewhat congruent.
  
  
  CONCLUSIONS
  Fluidity between clearly congruent or incongruent pathways is present in adolescence, including variant as well as possibly still developing (only somewhat clear) gender experiences, whereas clearly incongruent identification and nonconforming expression were less frequent. Understanding adolescent gender development as multidimensional is important to identify the needs of those who do not fit into the current understanding of either female or male.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Sex Research and Forensic Psychiatry (second affiliation), University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: i.becker@uke.de.
authors.forename: Inga
authors.initials: I
authors.lastname: Becker
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ravens-Sieberer
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Ottová-Jordan
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schulte-Markwort
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005783:Gender Identity; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D015995:Prevalence; D014189:Transsexualism / Q000453:epidemiology
keywords: Adolescence; Gender dysphoria; Gender identity development; Gender nonconformity; Gender variance