From hydra to rotifers: A new hypothesis explores pathways to delay aging in humans

“Hydra vulgaris (“Hydra”) exhibits negligible senescence due to continuous self-renewal and stem cell cycling, contrasting sharply with short-lived, eutelic rotifers that exhibit rapid aging and fixed somatic cell numbers post-development.”

Impact Journals LLC

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Figure 1. Detailed flowchart of the iterative experimental strategy to delay senescence by introducing Hydra-like gene expression in rotifers (Brachionus manjavacas). Key manipulations target rotifer orthologs (primarily FoxO and stemness markers) via CRISPR. Evaluation endpoints include lifespan/mortality hazard (survival curves), fertility (fecundity curves), locomotion (swimming assays), stress resistance, and transcriptomics (pre/post similarity to Hydra stem/progenitor states; ≥0.7 correlation threshold). Neoplasia monitoring uses proliferation markers (BrdU/phospho-histone H3) and deviation from Hydra tumor profiles. Iteration decisions are guided by predefined criteria (healthspan extension, transcriptomic shift, fitness constraints). Controls: wild-type and mock-treated rotifers. The framework also tests intercellular competition and multicellular aging through integrated measurements of cellular degradation, vigor-cooperation correlation, cheater emergence (neoplasia proxies), and negative senescence potential (mortality hazard). “Hydra-like” is defined in the text.

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Credit: Copyright: © 2026 Bordonaro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

BUFFALO, NY — April 27, 2026 — A new hypothesis paper was published in Volume 18 of Aging-US on April 8, 2026, titled “From Hydra to rotifer and beyond: implications for human aging and delayed senescence.”

The study was led by first and corresponding author Michael Bordonaro from the Geisinger College of Health Sciences. In this work, the author explores a bold and testable hypothesis centered on two very different invertebrate models of aging: the freshwater cnidarian Hydra and the rotifer Brachionus manjavacas. Hydra are well known for their remarkable ability to maintain tissue integrity over time through continuous stem cell renewal, effectively avoiding many of the hallmarks of aging under laboratory conditions. In contrast, rotifers represent the opposite end of the biological spectrum, with short lifespans, fixed somatic cell numbers, and a predictable pattern of age-related decline.

Building on these contrasts, the paper proposes that introducing Hydra-like gene expression patterns into rotifers could delay senescence and extend healthspan. The hypothesis focuses in particular on conserved molecular pathways, including the transcription factor FoxO, which plays a central role in maintaining stem cell function and cellular resilience. Rather than attempting to recreate full stem cell renewal in rotifers—an organism with a fixed adult cell number—the proposed strategy emphasizes improving cellular maintenance, stress resistance, and proteostasis within existing cells.

The paper outlines an iterative experimental framework, beginning with targeted genetic manipulation in rotifers and extending to more complex organisms such as Daphnia and mouse models. This stepwise approach is designed to identify which elements of the Hydra genetic program are truly responsible for its resistance to aging, while also allowing researchers to monitor potential trade-offs, including increased risk of uncontrolled cell growth.

“We hypothesize that delayed senescence at the organismal level is possible through recapitulation of Hydra-like patterns of gene expression in rotifers, and that data obtained may help generate hypotheses for somatic interventions and prioritize pathways for mammalian validation in future studies.”

Importantly, the author emphasizes that complete elimination of aging is unlikely in complex organisms due to evolutionary and biological constraints. Instead, the goal is more realistic: extending healthspan and delaying the onset of age-related decline. The paper also highlights the importance of balancing potential benefits with risks, particularly the possibility that enhancing cellular renewal pathways could increase susceptibility to neoplasia.

Overall, this study presents a conceptual and experimental roadmap for translating insights from simple organisms into strategies that may eventually inform human aging research. By bridging the gap between negligible senescence and rapid aging models, the work provides a fresh perspective on how conserved biological mechanisms might be harnessed to improve health across the lifespan.

Paper DOI: https://doi.org/10.18632/aging.206370        

Corresponding author: Michael Bordonaro – mbordonaro1@geisinger.edu

Keywords: aging, FoxO, Hydra, rotifer, senescence

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Journal

Aging-US

DOI

10.18632/aging.206370 

Method of Research

News article

Subject of Research

Not applicable

Article Title

From Hydra to rotifer and beyond: implications for human aging and delayed senescence

Phage therapy at a turning point: Valencia 2026 to define the next era of antibacterial medicine

Mitochondria-Microbiota Task Force

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Join clinicians, scientists, regulators, and industry leaders for two days focused on turning phage therapy into clinical reality — from GMP production and regulatory harmonization to precision medicine and global applications in health, veterinary, food, and industry.

The post-antibiotic era is here. Be part of shaping the response.

Valencia, Spain | June 9–10, 2026

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Credit: @ISM

Targeting Phage Therapy 2026 will convene international leaders to accelerate clinical deployment, highlight innovation, and recognize excellence through the Targeting Phage Therapy Awards.

As antimicrobial resistance continues to challenge modern medicine, bacteriophage therapy is entering a decisive phase. The question is no longer whether phages can kill bacteria. The strategic question is whether the field can now build the clinical, regulatory, industrial, and hospital infrastructure required to make phage therapy a mainstream therapeutic option.

The Targeting Phage Therapy 2026 Congress, taking place in Valencia, Spain, on June 9–10, 2026, will bring together leading scientists, clinicians, microbiologists, engineers, biotech leaders, regulators, hospital teams, start-ups, and innovators to address one central challenge:

How can phage therapy move from promising science to accessible, validated, and deployable medicine?

The 2026 agenda is structured around a clear translational trajectory: from mechanisms and clinical evidence to production, regulation, innovation, implementation, and access.

A Strategic Program: From Science to Clinical and Applied Impact

The first day of the congress will focus on “From Science to Clinical and Applied Impact” It will explore how phage biology, therapeutic design, chronic infection models, engineered phages, and One Health applications can shape the next generation of antibacterial strategies.

The congress will open with Benjamin K. Chan, Yale University, USA, who will deliver the opening keynote lecture: Turning Evolution into Therapy: A New Strategy to Fight Antibiotic-Resistant Infections. His lecture will highlight one of the most powerful shifts in the field: using bacterial evolution not as an obstacle, but as a therapeutic lever. This strategy can potentially drive bacteria toward evolutionary trade-offs, weaken pathogenicity, and restore antibiotic sensitivity.

Other confirmed speakers for Day 1 include:

Opening Keynote Lecture: Turning Evolution into Therapy: A New Strategy to Fight Antibiotic-Resistant Infections
Benjamin K. Chan, Yale University, USA

Advancing Phage Therapy for Chronic Infections: From Experimental Evidence to Clinical Use
Joana Azeredo, University of Minho, Portugal

Bacteriophages Redesigned: Engineering of Next-Generation Phage Therapeutics and Diagnostics
Martin J. Loessner, ETH Zürich, Switzerland

The Human Virome in Chronic Infection: What Patient Phages Teach Us About Therapeutic Phage Design
Katrine Whiteson, UC Irvine, USA

Phage for Sustainable and Scalable Infection Control in Aquaculture
Adelaide Almeida, Universidade de Aveiro, Portugal

Phage Therapy in Livestock Disease Models: Lessons for Animal and Human Health
Robert Atterbury, University of Nottingham, United Kingdom

Nasopharyngeal Phages: The Silent Players in Piglet Health
Oscar Mencía-Ares, Universidad de León, Spain

Day 2: Enablers for Scale, Access, and Impact

The second day will focus on the decisive enablers of phage therapy deployment: production, regulation, quality standards, personalized treatment pathways, manufacturing, hospital integration, and innovation. 

Confirmed speakers for Day 2 include:

Personalized Bacteriophage Therapy in Germany and Beyond – A Consensus-Based Guideline
Annika Y. Classen, Cologne University Hospital, Germany

France launches its first public GMP platform to produce large batches of therapeutic phages at affordable scale
Frédéric Laurent, Hospices Civils de Lyon, France

The Qualified Presumption of Safety (QPS) Qualification of Lytic Bacteriophages: Scientific Criteria and Regulatory Perspectives
Juan Evaristo Suárez, Universidad de Oviedo, Spain

From Bioreactor to Patient: Scalable Manufacturing and Delivery of Therapeutic Phages
Danish J. Malik, Loughborough University, United Kingdom

Chronic Respiratory Infections in the Inflamed Lung: Host–Pathogen Interactions and Opportunities for Phage Therapeutics
Paula Zamora, University of Kansas Medical Center, USA

Personalized Phage Therapy at the Hannover Medical School: barriers, challenges, and next steps
Evgenii Rubalskii, Medizinische Hochschule Hannover, Germany

From Promise to Practice: What Will Make Phage Therapy Mainstream?

This final discussion will address the key barriers that still separate phage therapy from routine medical use: clinical validation, regulatory alignment, GMP production, reimbursement, hospital adoption, and international coordination. 

Submit Your Innovation: From Concept to Clinical Impact

The congress invites start-ups, biotech companies, academic teams, hospitals, diagnostic developers, manufacturing platforms, AI-based phage-matching initiatives, translational consortia, and One Health innovators to submit their innovations.

Selected innovations may be presented during the congress and highlighted to an international audience of experts, clinicians, investors, industry representatives, and institutional partners.

The Targeting Phage Therapy Awards 2026 will be a central highlight of the congress. These awards will recognize outstanding contributions that are helping transform phage therapy from scientific promise into clinical, technological, and societal impact.

The awards will spotlight excellence in five major areas:

• Scientific Excellence Award
  Recognizing outstanding research in phage biology, phage-bacteria interactions, resistance evolution, host range, genomics, therapeutic design, and mechanistic understanding.
• Clinical Translation Award
  Honoring work that brings phage therapy closer to patient care, including clinical case studies, compassionate use programs, hospital implementation, treatment protocols, and multidisciplinary clinical workflows.
• Innovation and Technology Award
  Recognizing novel platforms and technologies that can accelerate phage therapy deployment, including diagnostics, manufacturing, AI, engineering, formulation, delivery systems, and quality control.
• Young Investigator Award
  Supporting the next generation of phage therapy researchers through recognition of outstanding short oral presentations, posters, and early-career contributions.
• One Health Impact Award
  Highlighting work that extends phage applications beyond human medicine, including food safety, aquaculture, livestock, environmental microbiology, and antimicrobial resistance control.

- Short Oral Abstract Submission Deadline: May 9, 2026
- Poster Abstract Submission Deadline: May 13, 2026
- Innovation Submissions: Open

Submit your abstract here: https://phagetherapy-site.com/

Awards and Recognitions: Open for selected scientific, clinical, technological, young investigator, and One Health contributions

The ambition is clear: to move phage therapy from fragmented success stories toward a structured therapeutic ecosystem.

About Targeting Phage Therapy 2026

Targeting Phage Therapy 2026 will take place in Valencia, Spain, on June 9–10, 2026. The congress is dedicated to accelerating the translation of bacteriophage science into clinical, industrial, regulatory, and One Health applications.

Congress: Targeting Phage Therapy 2026
Dates: June 9–10, 2026
Location: Valencia, Spain
Abstracts, innovation submissions and awards: Open
Website: Targeting Phage Therapy 2026 / Agenda at a Glance: www.phagetherapy-site.com

 

Construction industry urged to shift from zero-tolerance to embrace action errors for learning

Higher Education Press

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A new perspective paper published in Engineering calls on construction organizations to move beyond a zero-tolerance mindset toward errors and adopt an error management approach that treats unintentional action errors as inevitable and valuable for organizational learning and innovation. The paper emphasizes that action errors, defined as unintended deviations from plans, goals, or adequate feedback processing as well as incorrect actions resulting from lack of knowledge, are unavoidable in construction work, yet the sector widely holds the belief that all errors can and should be eliminated. This zero-tolerance orientation, centered on strict error prevention and punitive responses, risks stifling organizational learning, innovation, and profitability, while discouraging transparent error reporting and hiding systemic problems that enable mistakes.

 

The authors clarify that action errors differ from intentional violations and judgment-related errors, arising at individual, team, and organizational levels with distinct causes and implications. Individual errors often stem from slips, lapses, or skill-related mistakes; team errors emerge from communication breakdowns and coordination flaws; and organizational errors are rooted in flawed structures, policies, and cultures that increase failure risks across lower levels. A single individual error can escalate into costly project failures when unaddressed by weak team processes and unsupported organizational systems, with consequences amplified by fear of blame and underreporting. In contrast, organizations outside construction have long embraced errors as learning opportunities, a practice the paper argues can be adapted to improve resilience and performance in construction.

 

Error management, as outlined in the paper, acknowledges errors as inevitable and focuses on open communication, timely detection, shared knowledge, collaborative analysis, and effective resolution rather than blame, with the ultimate aims of learning from mistakes to reduce their future occurrence and mitigating their negative impacts. This approach requires psychological safety, where workers can report mistakes without punishment, and collective responsibility for anticipating and addressing risks. The paper notes that some large construction projects, such as Australia’s Level Crossing Removal Project, have implemented integrated error management systems with no-blame cultures and digital platforms for real-time error data sharing, showing potential to reduce rework compared with traditional delivery models.

 

The paper identifies gaps in empirical research on action errors in construction, including limited data on their nature, frequency, causes, and full costs, as well as a lack of systematic studies on how to build and sustain error management cultures in the sector. It highlights the need for future inquiry into cultivating such cultures, integrating error prevention and management practices, and identifying effective leadership styles to support positive error-oriented outcomes. The paper concludes that shifting to a constructive error orientation can enhance adaptive capacity and long-term performance in construction organizations, though further empirical evidence is needed to validate these benefits.

 

The paper “Moving Beyond a Zero Tolerance Mindset: Embracing Action Errors in Construction,” is authored by Peter E.D. Love, Jane Matthews, Weili Fang. Full text of the open access paper: https://doi.org/10.1016/j.eng.2025.10.018. For more information about Engineering, visit the website at https://www.sciencedirect.com/journal/engineering.

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Journal

Engineering

DOI

10.1016/j.eng.2025.10.018 

Article Title

Moving Beyond a Zero Tolerance Mindset: Embracing Action Errors in Construction

 

Illinois scientists sound the alarm on field inundation, work with farmers to find solutions

University of Illinois College of Agricultural, Consumer and Environmental Sciences

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Catastrophic flooding in Central Illinois field in 2008.

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Credit: University of Illinois Urbana-Champaign

URBANA, Ill. — Larry Dallas’ farm in Central Illinois’ Douglas County is as flat as it gets. That’s a good thing for planting straight rows and maneuvering farm equipment in the field, but there’s a major downside, too.

“Heavier rain is hard for us to deal with because of the poorly drained soils and the lack of any roll to the ground. It's hard for the water to get away when the rain starts,” Dallas said. “We have installed a lot of drainage tile trying to mitigate that.”

But tile drains are no match for increasingly intense precipitation events. In the spring of 2019, for example, widespread flooding drenched the Midwest to devastating effect, causing record losses across the entire agricultural industry.

“2019 was a nightmare. We did everything in the mud and had a lot of crops drowning out,” Dallas recalled. “And on top of that, we didn't get a lot of sunlight that year and the corn was wet. The elevators got really behind, drying it.”

Field inundation is a real problem even in less catastrophic years, says Christy Gibson, an Illinois Distinguished Postdoctoral Scholar in the Department of Crop Sciences, part of the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois Urbana-Champaign. 

Inundation impacts field workability, planting dates, erosion, and nutrient loss, but Gibson says inundation also causes widespread, systemic problems across the food system. These include economic issues, including more crop insurance claims, prevented planting, reduced profitability, sunk costs for suppliers, and lost sales for damaged or diseased grains, fruits, and vegetables. There are also biological changes, with inundation creating favorable conditions for pathogens and pests and altering soil microbial communities. Finally, Gibson points to human health impacts, such as heightened depression and anxiety in agricultural practitioners and potential disease transmission via contaminated water. 

Given these impacts, Gibson and a team of her U. of I. colleagues are sounding the alarm on field inundation and encouraging fellow researchers to dig into the issue.

“Everyone seems to be interested in drought and investing resources in breeding for drought tolerance. That’s important, of course. But fewer people in the research community seem to notice that intermittent flooding is a problem throughout the Midwest, and that it impacts everything from crop profitability to soil health to farmer mental health,” Gibson said. “We have to look at this.”

The team recently published an article in Global Change Biology discussing the issue and drawing up a research agenda. The paper points out that although certain best management practices, such as cover cropping and conservation tillage, are thought to help with field inundation, few farm-scale studies have proven their effectiveness. 

That’s why Gibson and her colleagues are looking to include working farms in their studies. They’re collaborating with farmers like Dallas, where they’ve already installed instruments to establish baseline and long-term measurements of soil parameters and other factors. Then, following a heavy precipitation event, their rapid response team will deploy to learn how conditions change and over what timeframe. 

Gibson’s co-author Esther Ngumbi, assistant professor in the Department of Entomology at Illinois, says this rapid response approach in collaboration with working farms fits right in with new USDA funding priorities for emerging issues in agriculture, including weather events.  

“The funding agencies are realizing that it will take funding specifically tailored at these more unpredictable problems in real time,” Ngumbi said. “We need that support to get out, get the data sets, and report back what we have found.”

The project leaders hope to recruit researcher-farmer teams across the Midwest to study how well best management practices mitigate field inundation. Ultimately, they want to learn enough to create a customizable toolbox of solutions suited to specific contexts.

“No two landscapes are identical. What works for a farmer in Gifford won't work for a farmer 30 miles away in Tuscola,” Gibson said. “In order to create and deliver tailored toolboxes to stakeholders, we have to monitor what’s going on now and try new solutions to see what else might work.”

She adds that although researchers might be the ones crunching the numbers, they can’t build meaningful tools without the full participation of farmers and other agricultural practitioners. 

“I'm very much a believer in the co-production of knowledge and solutions. We're a land-grant institution with a strong Extension program. We have to constantly collaborate with our stakeholders and those who invest in what we do — that’s every taxpayer,” Gibson said. “We have to make sure that whatever we're putting out actually works for our stakeholders, whether that’s commodity groups, seed producers, fertilizer companies; really, everyone who contributes to our food system.”

Frank Rademacher, who farms in Gifford, Illinois, and has opened up his farm to Gibson and the team, says collaborating with researchers benefits both parties.

“Partnering with researchers is a two-way street. It’s incredibly important for them to conduct research in real-world conditions, across a spectrum of management practices, climates, soils, etc.,” he said. “And we get exposed to the latest research and get to share practical experiences with the team. It’s a win-win.” 

The research team is always looking to network with farmers and other stakeholders who are experiencing the impacts of flooding and other severe weather. They’d like to hear what farmers have done to mitigate adverse effects, and if these practices are keeping pace with intensifying severe weather. To learn more about partnering with the research team, contact Christy Gibson at deltac13@illinois.edu. 

The study, “Keeping Pace With Intensifying Agricultural Field Inundation Events: A Framework for Testing the Mitigative Capacity of Current Best Management Practices,” is published in Global Change Biology [DOI: 10.1111/gcb.70842]. 

Research in the College of ACES is made possible in part by Hatch funding from USDA’s National Institute of Food and Agriculture. 

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Journal

Global Change Biology

DOI

10.1111/gcb.70842 

 

Common claim that most transgender youth renounce that identity is not supported by statistics, VCU research finds

The argument that studies show transgender youth desist from that identity on average has been used to support anti-gender-affirming care legislation nationwide.

Virginia Commonwealth University

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RICHMOND, Va. (April 27, 2026) – The frequently cited claim that 60% to 90% of transgender and gender-diverse children and young adults ultimately identify as cisgender – or their gender assigned at birth – is not supported by statistical analyses of published scientific research, according to a new study from Virginia Commonwealth University. The study, which analyzed 11 studies compiled in a commonly referenced 2016 blog post as well as five more recent publications, instead found that almost any stance on gender-affirming care for minors could be supported by different statistical analyses of the same data.

“We should rely on accuracy with our science, and we should rely on accurate science to guide legislation,” said Catherine Wall, Ph.D., an assistant professor of psychology in the College of Humanities and Sciences and the study’s lead author. Wall and her coauthors published their study in the journal APA PsycNet.

The quantitative meta-analysis found that “desistance” – or renouncement – of transgender identity by youth could be estimated to be as low as zero percent to as high as 100%, depending on how the studies’ data were interpreted. Meanwhile, rates of persistence of transgender identity could also range from zero percent to 100%, depending on how the studies – many of which were conducted pre-1990 on small sample sizes – were analyzed.

Opponents to gender-affirming care for transgender minors referenced the original 11 studies in arguments leading to the 2025 United States v. Skrmetti decision, which ruled that state-level bans on gender-affirming care for minors were not unconstitutional. But the results of this study, Wall said, disprove the statistical foundation for the narrative that the majority of transgender youth desist from that identity.

“We were particularly interested in examining this idea of the concept of trans identity desistance because it’s a number that has been bandied about for years as if it’s 100% accurate,” Wall said. “And we wanted to take a deeper look, especially because it’s currently being used for things like legislation and bans of best-practice gender-affirming care in 26 states.”

Evolving science influences data

Many of the studies listed in the 2016 blog post were conducted before 1990, when popular and scientific opinions on transgender identities were radically different. In that time, transgender identities were seen by the medical community as a pathological mental illness, and not as an inherent identity.

That outlook influenced how the studies were conducted. Of the seven pre-1990 studies, three examined effeminate behavior in young boys, and never directly focused on gender identity. Youth in the remaining four studies did not explicitly identify as transgender – instead, they were children that exhibited gender nonconforming or gender-atypical behaviors.

“Right away, we’ve got some significant potential issues here, where people are being referred to psychiatric care for not being a typical boy or not being a typical girl,” Wall said. “They’re being referred to care because of how their actions are perceived within a societal context, rather than an explicit cross-gender identification.”

Additionally, in several early studies, the aim of the studies’ psychologists was to counsel youth to conform to the social behaviors of the genders they were assigned at birth, now often referred to as conversion therapy. In one 1987 study, researchers separated transgender youth from their families for up to six months in order to encourage them to adapt to their assigned gender.

“A lot of those early frameworks were explicitly intending to stop people from expressing their gender identity,” Wall said. “It’s this idea of transgender identity as a state of disordered being.”

Most of the studies also had small sample sizes, counted participants’ nonresponse or discontinuation of the study as desistance from transgender identity, or primarily focused on the subjects’ psychiatric concerns – such as anxiety and depression – over concerns related to their gender identity.

The researchers also noted that transgender desistance and persistence are still not well-defined, and youth may ultimately settle on a related identity, such as genderqueer or nonbinary, which could be classified as desistance in some studies.

Deeper data analysis

In this research, Wall and her coauthors performed qualitative analyses, statistical meta-analyses and simulation methods to analyze the data from the 11 studies. The researchers additionally reviewed scientific literature published since 2016 and found five related studies, which are also included in their analyses.

The researchers closely examined the limitations of the past studies, such as small sample sets. Notably, all but two studies included participants who did not respond to study follow-up assessments, and were often counted as desisting from a transgender identity.

“People can drop out of studies for any reason. Making an automatic assumption that they dropped out because they desisted in their identity isn’t a fair assumption to make,” Wall said.

To overcome that limitation, the researchers examined transgender persistence and desistance as separate outcomes, and ran analyses under three separate assumptions: participants left treatment for reasons unrelated to the treatment, such as moving to a new city; participants left treatment because it had a positive outcome and was no longer necessary; and participants left treatment because it had a negative outcome.

Under those assumptions, the researchers then ran analyses that either assumed that nonrespondents persisted with their transgender identities, or that nonrespondents desisted from their transgender identities. They also ran sensitivity analyses to determine how likely those outcomes were, as well as simulations to find out how volunteer bias might impact study samples.

A ‘far from stable’ dataset

Wall and her coauthors found that plausible rates of both desistance and persistence could range from zero percent to 100%, depending on how the 16 studies were statistically interpreted.

“We are ultimately finding that the real rate of desistance spans almost the entire range of percentages based off of different sets of assumptions,” she said.

Rates of persistence also increased by nearly 5% with the addition of each study since 2016, which were generally conducted under modern scientific assumptions about transgender identities and with more precise methodologies than earlier studies, such as by only including individuals who explicitly expressed a transgender identity.

The authors assert that while some children and young adults likely do desist from their transgender identities, both the pre- and post-2016 datasets should not be used to create gender-affirming care legislation for minors.

“Understanding the context in which research is done is incredibly important to understanding the results,” Wall said. “Just because a number exists does not mean it’s correct, and does not mean it’s 100% accurate. We should not be making legislation based off a number that might range from zero percent to 100%.”

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Journal

Psychology of Sexual Orientation and Gender Diversity

DOI

10.1037/sgd0000912 

Article Title

“Desistance”: A multimethod review of the literature on gender identity variability in transgender and gender diverse youth.

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