[quote=article 1]METHODS: Data gathered on 97 consecutive patients <21 years, with initial visits between January 1998 and February 2010, who fulfilled the following criteria: long-standing cross-gender behaviors, provided letters from current mental health professional, and parental support. Main descriptive measures included gender, age, Tanner stage, history of gender identity development, and psychiatric comorbidity. CONCLUSION: After establishment of a multidisciplinary gender clinic, the gender identity disorder population increased fourfold. [/quote] that's, I mean...... that would seem to indicate that incidence correlates pretty strongly with attention. BUT, that's not an assertion made by the abstract and I'm doing like FIVE of these so I'll leave it at "historical data analysis with inconclusive methodology." This article tells me that people were treated. It does not investigate (in fact it makes a totally valid effort to NOT investigate) whether or not it's "real" in the sense of the debate. MY POINT BEING: this tells us that suddenly this is happening for way more people; it says nothing else. [quote=article 2]Method The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (<12 years of age) and followed up in adolescence. We examined childhood differences among persisters and desisters in demographics, psychological functioning, quality of peer relations and childhood GD, and adolescent reports of GD, body image, and sexual orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. Conclusion Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD.[/quote] Better methodology than 1, with more insight. GD intensity is pretty hard to quantify in any scientific way (you've taken a personality test before, they're not super precise).... but charting that against persistence is interesting. Anyway the fact that it can come and go is a strong argument for environmental factors. THAT SAID, once again the scope is limited and we shouldn't draw too many conclusions from a sample size of 127. Still though, this one is the most scientific thus far. [quote=article 3](report by the Gay and Lesbian Task Force and the National Center for Transgender Equality)[/quote] Not peer-reviewed, not scientific, not a journal. Not saying ignore the hardships or the mistreatment -- just saying. [quote=article 4 and 5] "BUT MEDICAL INTERVENTIONS DO LEAD TO BETTER PSYCHOLOGICAL OUTCOMES" bullet -- summarized together[/quote] [url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178031/]Yeah but.....[/url] It doesn't sound like the scope of these two articles can be considered reasonable, because the long-term outcomes are [i]really bad[/i]. [quote=article 6]paywall[/quote] But the summary says that it's "still a mystery," and discusses the many inconsistencies among research. It's not settled science. VERDICT: I'm not a complete and total idiot, the articles linked here are not directly addressing the issue (incidentally I'm still not positive what the issue is, exactly), and they're certainly not conclusive.