The research team, led by sociologist Mark Regnerus of the University of Texas at Austin together with Anne Morse of the Austin Institute, drew on the 2025 Relationships in America Survey, which interviewed 5,460 English-speaking Americans aged 20 to 70. The survey was conducted by Ipsos using its KnowledgePanel, a probability-based pool designed to produce estimates representative of the national adult population. Crucially, the 2025 instrument repeated, word for word, the statement posed to respondents in the 2018 Post-Midterm Election Study: that it should be acceptable for adolescents to transition with hormones or surgery if they identify with another gender. Respondents answered on a five-point scale ranging from strongly agree to strongly disagree, and both datasets were weighted to correct for differential nonresponse, making the two waves directly comparable.

The headline finding is stark. In 2018, 26 percent of American adults agreed that adolescent medical transition should be permissible; by 2025, that figure had fallen to 21 percent, a statistically significant five-point decline. Disagreement surged even more dramatically, rising from 43 percent to 55 percent, an increase of more than twelve percentage points. Meanwhile, the share of respondents who said they neither agreed nor disagree shrank, a pattern the authors attribute to the intense media and political coverage of the issue over the intervening years, which pushed previously ambivalent citizens to form an opinion one way or the other.

The internal composition of the shift is as revealing as its magnitude. The decline in agreement came almost entirely from respondents who had previously said they simply agreed, while the share who strongly agreed showed no statistically significant change. On the other side of the ledger, the proportion who strongly disagree grew substantially and significantly, among both men and women alike. In other words, the population did not become uniformly more hostile; rather, moderate support eroded while firm opposition deepened, a signature of one-sided polarization on an issue that has become a cultural flashpoint.

Perhaps the most striking result concerns age cohorts. Because the two surveys used the same sampling frame and question wording, the researchers could track how specific birth cohorts moved between 2018 and 2025 by comparing, for example, the attitudes of people aged 30 to 34 in 2018 with those of people aged 37 to 41 in 2025. Every cohort born in 1988 or earlier showed a significant increase in disagreement. The cohort aged 35 to 39 in 2018 displayed the largest swing, with disagreement jumping from 40 percent to over 60 percent, a twenty-one-point rise. In 2018, no age cohort had a majority that disagreed with adolescent medical transition; by 2025, every cohort except those aged 32 to 36 did.

These within-cohort shifts challenge a common intuition that the attitudes of older people are fixed while younger generations gradually liberalize the national mood. Demographic churn should, if anything, have pushed support upward: older, less supportive cohorts aged out of the sample while younger, more supportive ones aged in, and the 2025 sample indeed contained more college graduates, more political liberals, and more transgender-identified respondents than the 2018 sample. Yet aggregate support still fell. The authors conclude that a period effect, a cultural shift affecting people of all ages simultaneously, accounts for a substantial portion of the change, echoing sociological research showing that aggregate attitudes often morph through intracohort change rather than generational turnover. Unusually, however, the direction here is conservative rather than liberalizing.

One cohort stands apart. Adults who were aged 25 to 29 in 2018, born between 1989 and 1993, remained the most supportive and least opposed group at both time points, even as their elders shifted beneath them. The sex dynamics within younger cohorts are also notable. Among Americans aged 20 to 24 in 2018, only 21 percent of men agreed with adolescent medical transition, compared with 42 percent of women, a wide gap. Seven years later, the men in that cohort had become somewhat more likely to agree while the women had become less so, narrowing the difference to 25 percent versus 29 percent. Across the full sample, men and women both showed significant increases in disagreement, and the most common pattern was no statistically significant difference between the sexes at all.

To probe what drives these attitudes, the team replicated the nested regression models from the original 2018 study, building from baseline demographics through sexuality and relationship variables, then religion, and finally political identity. The predictors themselves proved remarkably stable: no significant variable changed direction between the two surveys. But some effects shifted in revealing ways. In 2018, being female was significantly associated with greater support in every model; in 2025, that effect vanished once political self-identification was added, suggesting that the apparent sex difference operates indirectly through the growing alignment of women with liberal politics. Religious affiliation effects from evangelical Protestant and LDS identities, significant in 2018 even after political controls, were drowned out by political variables in 2025. Meanwhile, the coefficient for having voted for Donald Trump grew larger than any other significant coefficient, and identifying as transgender, now measured in a sample more than twice the size of 2018, emerged as a significant positive predictor of support, even though roughly a quarter of transgender-identified respondents themselves disagreed with adolescent medical transition.

The findings arrive against a backdrop of rapid legal and political change. The study period encompassed the surge of state legislation restricting gender-affirming care for minors, the Tennessee law banning puberty blockers and hormone therapy that the Supreme Court upheld in June 2025, and a 2025 executive order withholding federal funding from medical transitions for minors. Pew Research Center data cited in the paper show that support for banning such care rose ten percentage points between 2022 and 2025, with declines among Democrats as well as Republicans. The new analysis adds nuance to that picture: the liberal-to-conservative gap widened, but the widening was driven by movement among conservatives and moderates, while liberals held steady.

The authors are careful about limitations. The single survey item compresses a multifaceted issue into one agree-disagree continuum, combines hormonal and surgical interventions without distinguishing them, and says nothing about social transitions or adult care. The comparisons are cross-sectional rather than a true panel, and cannot adjust for cohort attrition through mortality or migration, though a sensitivity check on the 401 respondents who participated in both surveys found no evidence of differential attrition distorting the results. Robustness checks using ordered logistic regression and multiple imputation confirmed the substantive findings. Whether the documented decline proves durable or temporary remains an open question, but the study makes clear that public opinion on adolescent medical transition is not static, that it has moved within cohorts of both sexes, and that political identity now overshadows nearly every other predictor of where Americans stand.

Subject of Research: Cohort changes in American public attitudes toward adolescent medical gender transition between 2018 and 2025

Article Title: Cohort Change in Attitudes About Adolescent Gender Transitions Between 2018 and 2025

Article References: Regnerus, M., & Morse, A. (2026). Cohort Change in Attitudes About Adolescent Gender Transitions Between 2018 and 2025. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-026-03659-z

Image Credits: AI Generated

DOI: 10.1007/s10508-026-03659-z

Keywords: public opinion, gender dysphoria, adolescent gender transition, cohort analysis, transgender health, hormone therapy, puberty blockers, gender-affirming surgery, survey research, political polarization, Archives of Sexual Behavior, period effects