“Social contagion” isn’t driving more and more teens to come out as transgender, according to a new study published Wednesday in the journal Pediatrics.
The study also found that the proportion of adolescents who were identified as female at birth and came out as transgender also did not increase, contradicting claims that adolescents whose gender at birth is female are more vulnerable to this so-called outside influence .
“The hypothesis that transgender people and gender-biased adolescents who were assigned a female at birth identify as transgender because of social contagion does not stand up to scrutiny and should not be used to argue against the provision of gender-affirming medical care to adolescents Leads study leader Alex S. Keuroghlian, MD, director of the National LGBTQIA+ Health Education Center at Fenway Institute and the Gender Identity Program for Psychiatry at Massachusetts General Hospital, in a statement.
The “social contagion” theory can be traced back to a 2018 paper published in the journal PLOS One. dr Lisa Littman, who was a professor of behavioral and social sciences at Brown University at the time, coined the term “rapid onset gender dysphoria,” which she described as adolescents who “suddenly during or during their lifetime” experience a conflict between their birth sex and of their gender identity experienced after puberty.” These adolescents, she wrote, “would not have met the criteria for childhood gender dysphoria” and suffer from dysphoria due to social influences.
Littman also hypothesized that adolescents assigned a female at birth are more likely to be affected by social contagion and are therefore overrepresented in groups of adolescents with gender dysphoria than those assigned a male at birth.
After intense debate and criticism, PLOS One re-evaluated the article after publication and issued a correction that included changing the headline to clarify that Littman was not interviewing transgender or gender-biased youth themselves, but was actually interviewing their parents. The correction also noted that “rapid-onset gender dysphoria (ROGD) is not currently a formal mental health diagnosis.”
To test the social contagion theory, the researchers used data from the 2017 and 2019 biennial Youth Risk Behavior Survey conducted by the Centers for Disease Control and Prevention, which collected gender identity data in 16 states for ages 12 to 18 . In 2017, 2.4% or 2,161 of the 91,937 youth surveyed identified as trans or gendered. In 2019, that percentage fell slightly to 1.6%, or 1,640 out of 105,437 young people surveyed.
The researchers concluded that the decline in the overall percentage of youth identifying as trans or gender-specific is “incongruent with the (rapid onset gender dysphoria hypothesis) postulating social contagion.”
The study also found that in both 2017 and 2019, the number of transgender youth classified as male at birth exceeded the number classified as female at birth, providing additional evidence against a “notion of social contagion with a unique Vulnerability” among those assigned female at birth.
The social contagion hypothesis, by assuming that adolescents come out because, for example, it is their friends, claims that there is a certain social desirability of being trans. Some proponents of the theory also believe, according to the study, that more youth are identifying as trans or gendered because those identities are less stigmatized than the identities of cisgender sexual minorities or those who identify with their birth gender and are lesbian, bisexual, or gay queer, among other sexual identities.
To assess these claims, the researchers looked at rates of bullying among youth who identified as transgender and gendered and those who didn’t.
They found that consistent with other surveys, transgender and gender-matched youth were significantly more likely to be victims of school bullying (38.7% in 2017 and 45.4% in 2019) than cis lesbian, gay, and bisexual youth (30.5%, respectively). %). in 2017 and 28.7% in 2019) and cisgender, straight youth (at 17.1% in 2017 and 16.6% in 2019).
“The idea that attempts to escape the stigma of sexual minorities are leading teenagers to come out as transgender is preposterous, especially for those of us who provide treatment [transgender and gender diverse] youth,” said the study’s lead author, Dr. Jack Turban, an incoming assistant professor of child and adolescent psychiatry at the University of California, San Francisco, in a statement. “The damaging impact of these unfounded hypotheses in further stigmatizing transgender and gender diverse youth cannot be underestimated. We hope that clinicians, policymakers, journalists and everyone else who contributes to health policy will review these results.”
They wrote that despite the methodological flaws in Littman’s study, the concept of rapidly onset gender dysphoria “has been used in recent legislative debates to argue and subsequently enact policies for transgender and gender-biased youth that prohibit gender-affirming medical care.”
For example, in June, Florida’s Agency for Health Care Administration issued guidance against gender-affirming child care — including social transition that involves changing a child’s name, pronouns, clothing and/or hairstyle. The guidance was linked to reports citing Littman’s article.
An increasing number of states have also attempted to legislate to ban or restrict transgender youth’s access to gender-affirming medical care. The number of bills aimed at restricting gender-affirming healthcare for transgender youth has risen from one in 2018 to 36 this year, according to an analysis by NBC News. Governors in three states — Alabama, Arkansas and Tennessee — have successfully signed off on such restrictions, although judges have prevented those measures in Alabama and Arkansas from going into effect.
The study lists several limitations, including that the data was collected through a school-based survey and therefore out-of-school youth were not represented. It also found that adolescents were asked, “What is your gender?” and that response options were restricted to female and male. Respondents were not asked about their “gender assigned at birth” and were not asked an additional question about their “gender identity,” which is a well-established research method for gender identity questions. However, the researchers credited several studies that found that transgender and gender-biased youth are aware of the differences between their birth-assigned gender and their gender identity.
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