Teens, Dysphoria & Social Contagion

Why are trans youth more visible these days?  Is it due to more widespread acceptance, or more media coverage?  And just how many trans kids are there?  Good questions all, so, let’s begin by defining the term gender dysphoria, which simply stated is the unease a person may have because of a mismatch between their biological sex and their gender identity.  And to be very clear, while gender dysphoria is real, it is also rare.

According to the Diagnostic and Statistical Manual of Mental Disorders, the prevalence rates of gender dysphoria are estimated between 0.005 % to 0.014 % of the population for natal males, and between 0.002 % to 0.003 % for natal females—or roughly 40,000 afflicted people living in the United States.  However, the Washington Post, citing UCLA’s Williams Institute suggests there are 1.2 million transgender people in the U.S. /

So, is it 40,000 or 1.2 million?  That’s quite a disparity, and therein lies the problem when discussing this matter—the dearth of statistics and peer reviewed studies.  And this is particularly evident regarding teenage girls.

According to the National Institute of Health (NIH) there is little research on how gender dysphoria and/or transgender identity are associated with development in adolescents.  And what research there is lacks randomization, is poorly designed, uses inadequate sample sizes, includes recruitment biases, have short study durations, high subject dropout rates, and an over-reliance on “expert opinion.” In essence, the NIH feels there are just too many methodological issues that need to be resolved to be able to claim that gender dysphoria diagnoses can be validated.

But regardless of validation, the relentless chafe of a body that simply “feels wrong” must be excruciating for young people of any age.   Fortunately, there is evidence that without medical intervention or encouragement to ‘socially transition,’ most kids naturally outgrow their dysphoria.   

Meanwhile, there’s also evidence that a young person’s coming out as transgender is often preceded by increased social media use and/or having one or more peers also come out, which suggests that social contagion may be a contributing factor in the increasing number of young people seeking treatment.

Ever-larger numbers of teenage girls now claim to have gender dysphoria.  But prior to 2012 there was no scientific literature on gender dysphoria arising in this demographic since most gender dysphoria is established by age seven.  Dr. Lisa Littman, then a Brown University public health researcher, used the phrase “rapid onset gender dysphoria” to refer to the subsequent sudden spike in transgender identification among teenage girls with no childhood history of the affliction.

Predictably, within days of the paper’s publication, transgender activists claimed the paper was “transphobic” and biased.  Naturally Brown University pulled its press release and disavowed Littman’s conclusions.  But an Online journal that publishes peer-reviewed studies determined that Littman just needed to clarify that hers was a study of parental reports and not clinical diagnoses.  And other than adding a few missing values in one table, the results section was unchanged, and the concept of rapid-onset gender dysphoria was essentially vindicated.

It’s difficult to explain the decade-to-decade increase of over 4,400% in the number of teenage girls seeking treatment at the United Kingdom’s national gender clinic without taking social contagion into account.  But a quick glance at suicide rates also tells us many teen girls are in real pain; and many cope by using drugs, developing eating disorders or engage in cutting and other mental health comorbidities.

Vis-a-vis the foregoing it’s not unreasonable to consider the possibility that depressed teens struggling to be socially accepted and who may hate their bodies or who can gain status in school by declaring trans identity or perhaps just engage in the age-old tactic of “sticking it to mom & dad,” might succumb to social contagion, especially with the added intoxicant of social media.

Being a parent myself, I cannot imagine the anguish both parents and children must feel when dealing with this issue.  Nevertheless, considering that most gender dysphoria is established by age seven, the enormous increase in cases among teen girls combined with the fact that this spike is a Western phenomenon, compels us to at least consider that social contagion may be a factor.

And not to put too fine a point on it, but as a friend suggested the other day, it’s doubtful there are a lot of little boys in Afghanistan who want to be little girls.

Quote of the day: “I love science.  I hate supposition, superstition, exaggeration, and falsified data.   Show me the research, shoe me the results, show me the conclusions and the show me some qualified peer reviews of all that.”—Bill Vaughn. American columnist and author.