attracted to females) and sel f-identify as lesbian is lower (ranging from 32% to 50%).
In both adolescent and adult natal males, there are t wo broad trajectories for develop-
ment of gender dysphoria: early onset and late onset. Early-onset gender dysphoria  starts in
childhood and continues into adolescence and adulthood; or, there is an intermittent pe-
riod in which the gender dysphoria desists and these individuals self-i dentify as gay or ho-
mosexual, followed by recurren ce of gender dysphoria. Late-onset gender dysphoria  occurs
around puberty or much later in life. Some of these individuals report having had a desire
to be of the other gender in childhood that was not expressed verbally to others. Others do
not recall any signs of childhood gender dysp horia. For adolescent males with late-onset
gender dysphoria, parents often report surpri se because they did not see signs of gender