How many Dutch youth call themselves trans or gender-diverse

Peter Vasterman analyses the figures from Seks onder je 25e. The result: 92,500 young people, a growth of 45 percent in five years, and a sex ratio that blows up the biological explanation.

The big numbers

The four-yearly survey Seks onder je 25e — carried out by Soa Aids Nederland and Rutgers commissioned by the ministry of VWS and RIVM — asked young people aged twelve to twenty-five in its fourth edition how they identify themselves. Three point three percent of that group call themselves transgender or gender-diverse. In absolute numbers: about 92,500 young people. Five years earlier that percentage was 2.3 percent. The rise in absolute numbers is 29,000 young people — a growth of forty-five percent in five years. Vasterman puts the figures side by side and asks the logical question: which innate biological condition changes by forty-five percent in prevalence in five years?

Girls dominate — and how

The sex ratio is the most shocking figure. Among girls the percentage trans or gender-diverse is 4.3 percent. Among boys 2.4 percent. Female young people make up 63 percent of the whole group — 58,563 women against 33,936 men. The growth is also skewed: among girls the percentage rose by 1.4 percentage points in five years, among boys by 0.7 percentage points. Vasterman points out that an innate condition cannot carry such sex-skewed growth. What it can carry: a socially spread identity label that is dominant in female peer groups on TikTok, Tumblr and Instagram.

The inside of the figure: non-binary grows, transgender falls

The detailed figures make the picture even more interesting. Among girls, the specific "transgender" identification has actually decreased between 2017 and the current measurement, from 0.9 to 0.6 percent. Among boys it rose slightly, from 0.4 to 0.7 percent. The growth lies elsewhere. Among girls, the "non-binary" category has exploded, from 0.2 to 0.8 percent — a quadrupling. The "don't know yet" category went among girls from 0.3 to 1.3 percent — more than a quadrupling. What we see is therefore not an increase in classical trans identity, but an explosion of non-binary and doubting self-identification, especially among girls. That is sociologically a totally different phenomenon than medical gender dysphoria.

Waiting lists and treatments

The figures on treatment make clear that this identity effect leaks through into medical care. Thirteen percent of transgender young people have had "gender-affirming treatment" — about 2,548 young people. One percent of the gender-diverse group have had treatment — about 694 young people. Nine percent are on the waiting list — about 1,764. The average age at which these young people say they came to their identity: 16.6 years, with a standard deviation of four years. That means: a comfortable majority only come to this self-image in or after puberty. These are not the children for whom the Dutch Protocol was originally designed — children with since-toddler-age persistent dysphoria.

Comparison with the UMCG figure

Vasterman explicitly links these figures with other Dutch research. The UMCG-TRAILS study found in a Northern Dutch cohort that persistent, clinically significant gender unease among adult young people lies at the per-mille level — less than one percent in a strict definition. Seks onder je 25e measures 3.3 percent self-identification. The difference between the two figures is not a measurement error. It is the difference between clinical condition and social identity. That we conflate these two in public and political debate is what Vasterman has been writing about for years.

What the figures do and don't tell us

The figures do not tell us how many of the 92,500 young people will still think of themselves this way in five years. They do not tell us whether the self-chosen label leads to persistent dysphoria or to letting go. They do not tell us what role comorbidities — autism spectrum, eating disorders, depression — play in the choice for this label. They do not tell us what percentage ultimately undergoes irreversible medical procedures and how many of these later detransition. For all these questions Dutch research is lacking. What we do know: in five years, self-identification has grown by 29,000 young people, especially among girls, especially in the non-binary and doubting category. Whoever calls that a natural biological phenomenon is not reading the figures.