The aim of this study was to provide preliminary information on the natural history of 25 girls with gender identity disorder (GID). Clinical and standardized assessment data in childhood and at follow-up (M age, 23.24 years; range, 15-36) were used. At follow-up, 3 (12%) participants were judged to have persistent GID or gender dysphoria. Regarding sexual orientation, 8 (32%) participants were classified as bisexual/homosexual in fantasy and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The base rates of GID persistence and bisexuality/homosexuality were higher than base rates in the general female population. About half of the participants had clinical range behavioral and psychiatric problems at follow-up. The low rate of persistent GID suggests that gender identity among girls with GID is relatively malleable, but more research is needed to evaluate the factors associated with variation in outcome.