Does Age Matter? Mental Health Implications and Determinants of When Youth Present to a Gender Clinic
Bibliographic record
Abstract
Background: Gender-affirming medical care (GAMC) improves the psychological functioning of transgender adolescents and adults. Purpose: 1) To assess the relationship between age at presentation to GAMC and rates of mental health comorbidities. 2) To identify factors influencing when youth present to GAMC. 3) To determine whether older presenting youth face more barriers to care. Methods: 1) Cross-sectional chart review of new patients to a gender clinic. 2) Sequential exploratory mixed methods study involving semi-structured interviews and subsequent questionnaire design and distribution. Results: Older age at presentation was associated with psychoactive medication use. Late pubertal stage was associated with depressive and anxiety disorders. Younger presenting youth recognized gender incongruence earlier and were more likely to have LGBTQ+ family members. More older presenting youth endorsed familial religious affiliations. Conclusions: Later presentation to GAMC is associated with higher rates of mental health comorbidities and may be driven by later recognition of gender incongruence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".