A structural equation model for age at clinical presentation in nonhomosexual male gender dysphorics

Nonhomosexual male gender dysphorics often make their first requests for clinical assessment when they are in or approaching middle age. This study investigated how well patients' explanations for the timing of these requests fit the objective data. Subjects were 194 outpatients presenting for the first time at a gender identity clinic. Their common explanations for the timing of their requests were incorporated into a formal path model, which was tested using Bentler's structural equations program. The model provided an acceptable fit to the data. The more times a patient has been married and the more children he has fathered, the older he is likely to be when first presenting for clinical attention. This outcome is consistent with the claims of patients that they would have come to a gender clinic sooner if they had not been restrained by commitments to wives and children.