Trans20

Trans20 is a longitudinal cohort study comprising 618 children and adolescents. The study, which commenced in 2017, is embedded in standard clinical care at the Royal Children’s Hospital Gender Service (RCHGS). Trans20 aims to evaluate clinical outcomes of trans and gender diverse children and adolescents. Data is collected from patient during their episode of care with the service (~ yearly) and also once discharged (~every 24 months). Data is collected across multiple domains, including gender identity, mental health, physical health, quality of life and family functioning. This rich dataset offers tremendous opportunities to address important questions in the field of transgender health.

Study Summary
Study name Trans20
Study abbreviation Trans20
Current principal investigator/s Ken Pang
Michelle Tollit
Carmen Pace
Pip Buckingham
Rushani Wijesuriya
Ghazaleh Dashti
Cate Rayner
Rachel Skinner
Primary Institution/s The Royal Children’s Hospital - RCH
Murdoch Children’s Research Institute - MCRI
Major funding source/s The Royal Children’s Hospital Foundation - RCHF
National Health and Medical Research Council - NHMRC
Hugh Williamson Foundation
Key reference for study Tollit, M. A., Pace, C. C., Telfer, M., Hoq, M., Bryson, J., Fulkoski, N., ... & Pang, K. C. (2019). What are the health outcomes of trans and gender diverse young people in Australia? Study protocol for the Trans20 longitudinal cohort study. BMJ open, 9(11), e032151.
Study focus

The Trans20 study aims to prospectively document the natural history of gender diversity in trans and gender diverse children and adolescents from Victoria, Australia, and to investigate long-term outcomes (gender, mental health, physical health, schooling, family functioning, quality of life) for those receiving gender affirming interventions.

Sampling frame

Participants include patients (aged 3-17 years old) who attended the Royal Children's Hospital Gender Service in Melbourne, Australia, between February 2017 and February 2020.

Primary study type Longitudinal cohort
Year commenced

2017

Is this study ongoing? Yes - the study is ongoing
Ongoing recruitment? No
Sample size (N)

618

Survey data available? Yes
Imaging data available? No
Linkage to administrative dataset/s? No, no consent to link to administrative dataset(s) obtained
Biosamples available? No
Are data available to others outside study team, with appropriate safeguards and structures in line with the cohort’s ethics and governance processes? Yes
Are there any costs associated with data/sample access for approved requests? There are usually no costs associated with access
Broadest type of participant consent available

Questionnaires are completed as part of routine clinical care at RCH Gender Service and are analysed under a clinical audit framework. Long-term follow-up of patients who leave the Gender Service require specific consent.

2025

McLean A, Hoq M, Pang KC, O'Connell M. (2025). Frequency, Timing, and Management of Erythrocytosis in Adolescents Receiving Gender-Affirming Testosterone Therapy-A Retrospective Study. Transgend Health, 10(4), 401 - 406. DOI: 10.1089/trgh.2024.0233

Moussaoui D, O'Connell MA, Elder CV, Grover SR, Pang KC. (2025). Characteristics of Menstrual Suppression and Its Association With Mental Health in Transgender Adolescents: Correction. Obstet Gynecol, 146(6), 925 - 927. DOI: 10.1097/AOG.0000000000006096

Tollit MA, Maloof T, Hoq M, Haebich K, Pace CC, Rodriguez ZM, Sial M, Payne JM, Pang K. (2025). Corrigendum to "A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study" [The Lancet Regional Health-Western Pacific Volume 47, 2024, 101084]. Lancet Reg Health West Pac, 60, 101631. DOI: 10.1016/j.lanwpc.2025.101631

2024

Kerr JA, Paine J, Thrower E, Hoq M, Mollica C, Sawyer SM, Azzopardi PS, Pang KC. (2024). Prevalence of Eating Disorder Symptoms in Transgender and Gender Diverse Adolescents Presenting for Gender-Affirming Care. J Adolesc Health, 74(4), 850 - 853. DOI: 10.1016/j.jadohealth.2023.11.396

Tollit MA, Maloof T, Hoq M, Haebich K, Pace CC, Rodriguez ZM, Sial M, Payne JM, Pang K. (2024). A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study. Lancet Reg Health West Pac, 47, 101084. DOI: 10.1016/j.lanwpc.2024.101084

2023

Engel L, Majmudar I, Mihalopoulos C, Tollit MA, Pang KC. (2023). Assessment of Quality of Life of Transgender and Gender-Diverse Children and Adolescents in Melbourne, Australia, 2017-2020. JAMA Netw Open, 6(2), e2254292. DOI: 10.1001/jamanetworkopen.2022.54292

Hoq M, Lami F, Tollit MA, Pang KC. (2023). Gender identity questionnaire for children: An alternative scoring approach reflecting a child's affirmed gender identity. Int J Transgend Health, 24(2), 127 - 131. DOI: 10.1080/26895269.2022.2129612

Moussaoui D, O'Connell MA, Elder CV, Grover SR, Pang KC. (2023). Characteristics of Menstrual Suppression and Its Association With Mental Health in Transgender Adolescents. Obstet Gynecol, 142(5), 1096 - 1104. DOI: 10.1097/AOG.0000000000005317

2021

Dahlgren Allen S, Tollit MA, McDougall R, Eade D, Hoq M, Pang KC. (2021). A Waitlist Intervention for Transgender Young People and Psychosocial Outcomes. Pediatrics, 148(2). DOI: 10.1542/peds.2020-042762

2019

Tollit MA, Pace CC, Telfer M, Hoq M, Bryson J, Fulkoski N, Cooper C, Pang KC. (2019). What are the health outcomes of trans and gender diverse young people in Australia? Study protocol for the Trans20 longitudinal cohort study. BMJ Open, 9(11), e032151. DOI: 10.1136/bmjopen-2019-032151

0

Buckingham P, Tollit MA, Wong G, Wijesuriya R, Hoq M, Pace CC, Pang KC. (). Social transition in young trans people accessing gender-affirming care International Journal of Transgender Health, ahead-of-print(ahead-of-print), 1 - 19. DOI: 10.1080/26895269.2025.2516678

Study Contacts
Principal investigator/s Ken Pang
Michelle Tollit
Carmen Pace
Pip Buckingham
Rushani Wijesuriya
Ghazaleh Dashti
Cate Rayner
Rachel Skinner
Study Contact

Email: genderservice@rch.org.au 
Address: Department of Adolescent Medicine, Gender Service
Royal Children’s Hospital
Flemington Road, Parkville
Victoria 3052 Australia