‘Social contagion’ is not making more young people transgender, study finds

“Social contagion” isn’t driving an increasing number of teenagers to come out as transgender, according to a new study published in the journal Pediatrics.

The study also found that the proportion of teens who were assigned female at birth and who came out as transgender did not increase either, which contradicts claims that teens whose birth sex is female are more susceptible to this so-called external influence.

“The hypothesis that transgender and gender-diverse youth who are assigned female at birth identify as transgender due to social contagion does not stand up to scrutiny and should not be used to argue against the provision of gender-affirming medical care for adolescents.” senior study author Dr. Alex S. Keuroghlian, director of the Fenway Institute’s National Center for LGBTQIA+ Health Education and the Psychiatry Gender Identity Program 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 at the time was a professor of behavioral and social sciences at Brown University, coined the term “rapid-onset gender dysphoria,” which she described as teenagers experiencing a conflict between their birth sex and gender identity “suddenly during or after puberty”. These teenagers, she wrote, “would not meet criteria for childhood gender dysphoria” and are experiencing dysphoria due to social influence.

Littman also hypothesized that adolescents assigned female at birth are more likely to be affected by social contagion and, as a result, are overrepresented in groups of adolescents with gender dysphoria when compared to those who were assigned male. at birth.

After intense debate and criticism, PLOS One conducted a post-publication reassessment of the article and issued a correction that included changing the headline to clarify that Littman did not research transgender or gender-diverse youth, but actually researched their parents. The correction also noted that “rapid-onset gender dysphoria (ROGD) is not a formal mental health diagnosis at this time.”

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 aged 12 to 18. . In 2017, 2.4%, or 2,161 of the 91,937 adolescents surveyed, identified as trans or of diverse gender. In 2019, that percentage dropped slightly to 1.6%, or 1,640 of 105,437 teenagers surveyed.

The researchers concluded that the decrease in the overall percentage of teens who identify as trans or gender-diverse “is incongruous with the (rapid-onset gender dysphoria hypothesis) that posits social contagion.”

The study also found that the number of transgender teens who were assigned male at birth surpassed those assigned female at birth in 2017 and 2019, providing additional evidence against a “notion of social contagion with unique susceptibility” among gender designates. female at birth.

The hypothesis of social contagion, by assuming that young people are coming out, for example, because their friends are, affirms that there is some social desirability in being trans. Some proponents of the theory, according to the study, also believe that more young people identify as trans or gender-diverse because those identities are less stigmatized than cisgender sexual minority identities, or those who identify with their sex at birth and gender. are lesbian, bisexual, gay or homosexual. queer, among other sexual identities.

To assess these claims, the researchers examined rates of bullying among teens who identified as trans and gender-diverse, and those who did not.

They found that, according to other research, transgender and gender-diverse youth were significantly more likely to be victims of school bullying (38.7% in 2017 and 45.4% in 2019) compared to lesbian, gay, cisgender youth. and bisexuals (30.5% in 2017 and 28.7% in 2019) and cisgender and heterosexual youth (17.1% in 2017 and 16.6% in 2019).

“The idea that attempts to escape sexual minority stigma lead teenagers to come out as transgender is preposterous, especially for those of us who treat [transgender and gender diverse] youth,” said the study’s lead author, Dr. Jack Turban, assistant professor of child and adolescent psychiatry at the University of California, San Francisco, in a statement. “The harmful effects of these baseless assumptions on further stigmatizing transgender and gender-diverse youth cannot be underestimated. We hope that physicians, policymakers, journalists and anyone else who contributes to health policy will review these findings.”

They wrote that despite methodological flaws in Littman’s study, the concept of rapid-onset gender dysphoria “has been used in recent legislative debates to advocate for and later enact policies that prohibit gender-affirming medical care” for transgender adolescents. and of different gender.

For example, in June, the Florida Health Care Administration Agency issued guidance against gender-affirming care for minors – including social transition, which involves changing a child’s name, pronouns, clothing and/or hairstyle. . The guidance was linked to reports citing Littman’s article.

A growing number of states have also attempted to ban or restrict trans youth’s access to gender-affirming medical care through legislation. The number of bills seeking to restrict gender-affirming healthcare for transgender youth has grown from one in 2018 to 36 this year, according to an analysis by NBC News. Governors of three states – Alabama, Arkansas and Tennessee – successfully signed these restrictions into law, although judges blocked these measures from taking effect in Alabama and Arkansas.

The study lists several limitations, including the fact that the data was collected through a school survey and, as a result, out-of-school youth were not represented. He also noted that young people were asked, “What is your sex?” and that the response options were limited to females and males. It did not ask about respondents’ “assigned sex at birth” and did not include an additional question about their “gender identity”, which is an established survey method for asking about gender identity. But researchers have credited several studies that have found that trans and gender-diverse youth are aware of the differences between sex assigned at birth and gender identity.

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