Transgender-related diagnoses surge among Washington children, with highest teen-girl rate near Oregon border: study

Rates more than doubled among teenage girls and nearly tripled among teenage boys during the study period. Among children ages 8–12, rates increased approximately three-and-a-half-fold for girls and nearly doubled for boys, according to the report published in City Journal by senior fellow Leor Sapir.

The article reported that 1.73 percent of teenage girls represented in the Washington insurance database, approximately one in 58, had a diagnosis in 2022, compared with 0.8 percent of teenage boys.

The combined rate was 1.29 percent. A 2023 review in Diabetes Care cited a youth Type 2 diabetes prevalence of 0.067 percent, describing that condition as “an awakening epidemic.”

The historical contrast was also striking. The DSM-5, published in 2013, estimated adult female gender-dysphoria prevalence at approximately one in 33,000 to one in 50,000.

Sapir calculated that Washington’s teenage-girl rate was nearly 600 times the upper historical estimate.

The highest teenage-girl rate was not in Seattle. It was in Southwest Washington, across the Columbia River from Portland.

In ZIP codes beginning with 986, including Vancouver and Camas, 378 of 15,541 teenage girls in the database had a diagnosis in 2022, 2.43 percent, or approximately one in 41. The Olympia area followed at just under 2 percent, compared with approximately 1.5 percent in Seattle.

An earlier analysis found approximately one in 65 Oregon teenage girls and one in 200 teenage boys received a transgender-related diagnosis between 2017 and 2023. Sapir said the Washington claims also showed patients obtaining services in Portland, home to Oregon Health & Science University.

MultiCare Health System accounted for 11 percent of the Washington minors identified. Its Mary Bridge Children’s Hospital closed its pediatric gender clinic in January 2026, citing federal enforcement risks and threats to Medicare and Medicaid funding.

Sapir argued that the higher rates among girls warrant scrutiny of peer influence and identified K–12 schools as a possible route into clinics.

England’s Department for Education now calls school-supported social transition an “active intervention” in its safeguarding guidance. It urges caution and cites evidence that children who socially transition before puberty are more likely to pursue medical treatment, though that association does not prove causation.

A 2025 article in the Journal of Sex & Marital Therapy, cited by Sapir, similarly argues that early transition can reinforce gender dysphoria.

The findings come as Washington voters decide November 3 whether to restore parental-rights protections lawmakers rolled back and reserve girls’ school sports for female athletes.

IL26-001 would restore the parental-rights law enacted through Initiative 2081 in 2024, reversing changes the Legislature made in 2025. It would require access to school records within 10 business days, restore advance notification when nonemergency medical services are offered, and require notification when schools arrange treatment requiring follow-up beyond school hours. Parents would also regain broader rights to opt their children out of certain surveys and activities involving sexual experiences, family beliefs, and mental-health issues.

IL26-638 would prohibit male students from competing in designated girls’ interscholastic sports, establishing eligibility based on biological sex rather than gender identity. Supporters say the measure would protect girls from losing competitive opportunities and placements to male athletes.

That debate has already sparked protests in Camas. Nearly half the girls’ cross-country team walked off the starting line October 13 rather than compete against a male teammate. Battle Ground runner Elise Bierer staged a similar protest on October 21.