Rapid-onset trans: social media’s contested role
UPDATED | Social media and peer groups have nothing to do with the global spike in troubled teens coming out as trans.
Social media and peer groups have nothing to do with the worldwide spike in troubled teenagers, chiefly girls, declaring they are born in the wrong body, according to Australia’s peak lobby group for 24,000 psychologists.
Speaking for the Australian Psychological Society, gender academic Damien Riggs says “empirical evidence” refutes claims that a young person’s transgender declaration may be driven by “social contagion”. The APS and Dr Riggs have ignored repeated requests for details of this evidence.
Some researchers and parents believe social contagion plays a role in a worrying surge in teenagers suddenly outing themselves as transgender, sometimes in online clusters of friends.
Dr Riggs, a Flinders University professor, says it is “scientifically incorrect” to say social media pressure is creating “a trans-identity crisis”.
“Claims that young people are transgender due to ‘social contagion’ serve to belittle young people by asking them to believe that their sense of self and their gender is nothing more than a by-product of what other people might think or say through the media,” he says.
The internationally dominant “affirmation” narrative is that trans identity is inborn, and the online media parade of trans actors, models and influencers simply feeds in to a more welcoming society and encourages children to reveal their true self and seek treatment for dysphoria.
Let children lead
In recent articles Dr Riggs has argued children are “experts on their gender” and likened sceptical parents to perpetrators of abuse. He has suggested hospitals may have to sidestep such parents by taking court action to authorise treatment of children with puberty-blocker drugs.
Reports indicate a sharp rise since the mid-2000s in teen girls at gender clinics in Australia, New Zealand, Britain, North America, Sweden, the Netherlands and Finland. In some cases, data is patchy or not available because politically correct surveys will not ask participants for their birth sex.
Australia’s biggest clinic for young people, at the Royal Children’s Hospital in Melbourne, refuses to say how many of its dramatically expanded caseload were born girls.
The global teenage trend worries critics of the pro-trans “affirmation” approach because most young patients diagnosed with “gender dysphoria” — distressful conflict between identity and body — used to be boys.
And most children with early-onset dysphoria grow out of it, many emerging as gay or bisexual, although it’s not clear if this research holds true for the new, chiefly female, late-onset group.
Many in this group turn up at gender clinics with a history of mental health issues, awkward same-sex attraction, family trauma or autism spectrum disorder, and some health professionals believe transgender medical treatment is not only risky but probably the wrong therapuetic response.
An unknown number of young dysphoria patients worldwide are given the 1990s “Dutch protocol” of puberty-blocker drugs, cross-sex hormones that threaten fertility, and in some cases surgery.
Social epidemics
In a new paper on the transgender trend, Sydney psychologist Dianna Kenny says the young are “particularly vulnerable to peer contagion if they have experienced peer rejection, hostility and/or social isolation from the peer group.”
She cites the example of anorexia: “If we add social media and online networks (to peer groups) as further sources of influence, affected adolescents can effectively surround themselves exclusively with like minds, thereby normalising cognitive distortions around eating and body image and making recovery very difficult.”
In gender dysphoria, she points to an “open-system network” linking the US, UK, Asia, Europe, Scandinavia and Australia.
“Most countries are reporting sharp increases in the number of people seeking services and treatment for gender dysphoria,” Dr Kenny says.
“Many are ramping up services and setting up new gender clinics to cope with demand.
“This network is highly centralised with only one voice – the transactivist lobby - being heard above the desperate whispers of terrified parents and horrified academics, doctors, psychologists and psychotherapists.
“Opinion leaders operating at the centre of these networks are very influential.”
Critics of the “affirmation model” say it has been entrenched by a small group of gender specialists without the wider health professions or bureaucrats understanding its weak basis in evidence and its worrying implications.
Dr Kenny says young people who do not fit easily into typical gender roles often have multiple problems, including anxiety and depression.
She speculates that in search of peers, these teenagers begin to exaggerate what sets them apart from gender norms, thereby leaving the social outgroup and forming “an ingroup of extreme gender-nonconformers, transcending the gender barrier altogether and declaring themselves transgender.
“Suddenly, the discomfort and fear of not being gender typical becomes a virtue, and rather than fearing the disapprobation of their peers, their open revolt in declaring themselves transgender is valorised by a politically powerful transactivist lobby.”
Check the evidence
Dr Kenny has launched an online petition to Health Minister Greg Hunt, seeking an urgent independent inquiry into the social and medical gender transition of young people.
Following reporting by this newspaper last month, Mr Hunt asked the Royal Australasian College of Physicians — which covers paediatricians — to look into concerns about the ethics and safety of trans medical treatment for young people.
The RACP, which previously helped lobby for easier and faster access to hormone treatment for young trans people, has protested it is chiefly an education body and “does not conduct inquiries.”
Dr Kenny has written to Mr Hunt suggesting the job be handed over to a third party expert in analysis of medical evidence, such as Cochrane in the US or Oxford University’s Centre for Evidence-Based Medicine.
Sudden and different
US-based researcher Lisa Littman enraged the trans lobby last year with a paper suggesting social influence might be driving a new “rapid onset” form of gender dysphoria.
After activists denounced her peer-reviewed paper as hateful transphobia, the journal PLoS put it through an unusual “post-publication review”.
A sceptical reframing of the study, stressing limitations already put on the record by Dr Littman herself, was issued in March as a “correction”, although her results withstood scrutiny. Even so, she conceded the process allowed some improvements.
Writing in the Psychology Today web magazine, social psychologist Lee Jussim says: “In my experience, a ‘correction’ that is not a correction is unprecedented in psychology and most scientific publishing.”
Professor Jussim, chair of psychology at Rutgers University, says it appears to be a case of scientific hypocrisy “when people raise plausible-sounding methodological critiques for research that offends them but give a pass to research that uses identical methods but produces conclusions that they like.”
The trans lobby has been criticised for basing claims on evidence that is weak, short-term, not applicable to young dysphoria patients, or simply not the kind of study that can support a certain claim.
Dr Littman is a physician and researcher at Brown University trained in preventive medicine, public health, obstetrics and gynecology.
In her original 2018 paper, she pitches the study as a descriptive “exploratory study” to generate hypotheses for future research.
She makes clear she recruited parents chiefly from groups where members had documented sudden trans declarations by teenagers. These groups are sceptical or opposed to trans medical treatment for young people, and the sample surveyed may not represent the wider trans community.
Dr Littman offers case studies, such as a 12-year-old girl who “was bullied specifically for going through early puberty and the responding parent wrote ‘as a result she said she felt fat and hated her breasts.’ She learned online that hating your breasts is a sign of being transgender. She edited her diary (by crossing out existing text and writing in new text) to make it appear that she has always felt that she is transgender.”
Another case study is a 14-year-old girl who with “three of her natal female friends (was) part of a larger friend group that spends much of their time talking about gender and sexuality.
“The three natal female friends all announced they were trans boys and chose similar masculine names.
“After spending time with these three friends, the 14-year-old natal female announced that she was also a trans boy.”
According to the parent survey, more than a third of these teenagers “asked for medical and/or surgical transition at the same time that they announced they were transgender-identified.”
Two thirds wanted cross-sex hormones and almost a third “brought up the issue of suicides in transgender teens as a reason that their parent should agree to treatment.”
More than half “had very high expectations that transitioning would solve their problems in social, academic, occupational or mental health areas.”
Retweeting graphs showing a sharp rise in young females presenting to gender clinics across the world, leading US sexuality researcher Michael Bailey added an ironic comment: “What was Lisa Littman thinking, postulating something like ROGD (rapid-onset gender dysphoria?)”
Vulnerable girls
In Victoria’s parliament last month Liberal MLA Louise Staley cited the Littman study when speaking against a proposed law to allow self-identified gender to supplant biological sex on birth certificates would contribute to social contagion.
Ms Staley, a former director of Networking Health Victoria and the Australian Institute of Family Studies, said that when consulting people about this bill, she was often told of “the pressure potentially lesbian girls are placed under to transition.
“Teachers and counsellors in schools are taught students presenting with comments such as, ‘I feel different’, ‘I am androgynous’ or ‘My body is not right’ are encouraged to explore transitioning.
“I doubt it will surprise any woman in this (parliament) that 13-year-old girls, perhaps particularly girls who are lesbian or might be, will fit the criteria of feeling different and not liking their bodies.”
Ms Staley warned the pro-trans birth certificate bill would add to these pressures.
“When social contagion may cause gender dysphoria in teen girls and the remedy for gender dysphoria may cause otherwise healthy girls to become infertile and we as a parliament enable such social contagion by making it merely a matter of self-identification, we are perpetuating an attack on these girls, and that is wrong.”
Late doesn’t mean false
In a statement for the peak APS last month, Dr Riggs dismisses rapid-onset gender dysphoria as “a concept used largely by people who question rather than affirm young people’s gender.”
“The term was developed by parent communities who felt that their children’s disclosure that they were transgender or non-binary was sudden; the claim being that their children had been influenced by peers or by the media,” he says.
“While the (diagnostic manual of psychiatric disorders) does make a distinction between early (in childhood) and late (in adolescence) disclosure, and notes that the latter may be a surprise to parents, it does not suggest that either earlier or later disclosure are more indicative of the ‘veracity’ of being transgender or non-binary.”
Dr Riggs is cited as an authority in the treatment standards for young dysphoria patients issued last year by the RCH gender clinic in Melbourne. The standards, promoted by Victoria’s government as the “world’s most progressive”, make no mention of the Littman paper.
Clinic director, paediatrician Michelle Telfer, did not reply when asked her view of the rapid-onset gender dysphoria hypothesis.
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