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Is Transgender The New Anorexia?


Brown University Professor Lisa Littman recently published a blockbuster study on the “transgender” phenomenon, presenting evidence that parts of it might be a “social contagion”—a maladaptive coping technique for troubled teens, spread by peer groups and the Internet. Brown issued a press release about the study, then promptly retracted it and replaced it with a weasely non-statement that just drew more attention to Littman’s research. This was in response to a furious outcry from transgender activists, and I can see why they find this study such a threat.

The study itself is not actually about “gender dysphoria” as it has previously been defined in the scientific literature. Rather, it is about the newer phenomenon of “rapid-onset gender dysphoria” (ROGD). Prior to about ten years ago, cases of gender dysphoria typically involved a long history of a child rejecting identification with his or her biological sex, going back before puberty.

By contrast, “rapid-onset gender dysphoria” involves a post-pubescent child, usually a girl, with no history of dysphoria suddenly claiming within a period of weeks or months not to identify with her biological sex. Not only is rapid-onset gender dysphoria sudden, but it tends to occur in clusters.

Parents have described clusters of gender dysphoria outbreaks occurring in pre-existing friend groups with multiple or even all members of a friend group becoming gender dysphoric and transgender-identified in a pattern that seems statistically unlikely based on previous research. Parents describe a process of immersion in social media, such as ‘binge-watching’ Youtube transition videos and excessive use of Tumblr, immediately preceding their child becoming gender dysphoric. These descriptions are atypical for the presentation of gender dysphoria described in the research literature and raise the question of whether social influences may be contributing to or even driving these occurrences of gender dysphoria in some populations of adolescents and young adults.

Let’s be clear on what the statistical background is. “The expected prevalence of transgender young adult individuals is 0.7%. Yet more than a third of the friendship groups described in this study had 50% or more of the AYAs in the group becoming transgender-identified in a similar time frame, a localized increase to more than 70 times the expected prevalence rate.” AYA is an acronym for “adolescents and young adults.” Remember it, because it’s going to come up a lot.

An open letter from a group of parents in support of Littman’s study provides a graph showing a suspiciously rapid increase in the past decade of reported cases of gender dysphoria, particularly among girls. That leads us to the most suggestive part: the study’s running comparison to the role of “social contagion” in anorexia and other eating disorders. My sense is that this study began because researchers were familiar with this phenomenon in the one area and began to notice eerie parallels in the other.

There are many insights from our understanding of peer contagion in eating disorders and anorexia that may apply to the potential peer contagion of rapid-onset gender dysphoria. Just as friendship cliques can set the level of preoccupation with one’s body, body image, weight, and techniques for weight loss, so too may friendship cliques set a level of preoccupation with one’s body, body image, gender, and the techniques to transition.

Notice the deeper parallel. In the years following puberty, young women are naturally susceptible to insecurities about their bodies and sexuality. In the case of eating disorders, extreme insecurity can lead them to want to negate their bodies through starvation. In the case of rapid-onset gender dysphoria, they make war on their bodies with hormones and surgery. In fact, Littman considers “the possibility that this type of gender dysphoria, with the subsequent drive to transition, may represent a form of intentional self-harm.”

Unlike with anorexia, though, rapid-onset gender dysphoria receives encouragement, not just from a small peer group, but from the wider culture, which has taken up the transgender cause as a political crusade.

The following are quotes from parents about the perceived benefits of transgender-identification afforded to their child. One respondent said, ‘Great increase in popularity among the student body at large. Being trans is a gold star in the eyes of other teens.’ Another respondent explained, ‘not so much ‘popularity’ increasing as ‘status’…also she became untouchable in terms of bullying in school as teachers who ignored homophobic bullying…are now all at pains to be hot on the heels of any trans bullying.’

There’s also a scandal here for the medical profession, in which ideologically motivated gender dysphoria specialists have engaged in massive malpractice in their zeal to “affirm” their young patients’ self-diagnosis. “Respondent accounts of clinicians who ignored or disregarded information (such as mental health symptoms and diagnoses, medical and trauma histories) that did not support the conclusion that the patient was transgender, suggests the possibility of motivated reasoning and confirmatory biases on the part of clinicians.”

I have been wondering for a while if this is not best described as a society-wide form of Munchausen Syndrome by Proxy, in which attention-seeking adults help induce a mental disorder in children to bolster their own self-image as “progressive” heroes.

I have been skeptical of a lot of the contemporary claims about gender, including the term “gender dysphoria.” I use it here because it is used in the sources I’m quoting, but I should note that it replaced the previous term, “gender identity disorder.”

What’s the difference between a “dysphoria” and a “disorder”? “Dysphoria” implies that the problem is the patient’s unhappiness with the mismatch, in his or her mind, between self-image and physiological reality—an unhappiness that can be cured by altering the body to match the self-image. “Disorder” implies that the fundamental problem is the mismatch itself, and that in a conflict between ideas and reality, reality takes precedence.

That said, I advocate tolerance for those who genuinely suffer from this disorder, because the science of psychology does not yet have any effective means to treat it, nor do we even know if it can be treated. (Unfortunately, this includes the treatment currently used, which is to rebuild the body to match the patient’s self-image. It is not clear that this is reliably effective in improving patients’ mental health.)

By contrast, Littman offers evidence that rapid-onset gender dysphoria, unlike the traditional kind, might respond to relatively simple treatment.

There were two unrelated cases with similar trajectories where the , us spent some significant time in a different setting, away from their usual friend group, without access to the Internet. Parents described that these AYAs made new friendships, became romantically involved with another person, and during their time away concluded that they were not transgender. In both cases, the adolescents, rather than face their school friends, asked to move and transfer to different high schools…. In [one] case, the parent relayed that their child thought none of the original friends would understand and expressed a strong desire to ‘…get out of the culture that ‘if you are cis, then you are bad or oppressive or clueless.” Both families were able to relocate and both respondents reported that their teens have thrived in their new environments and new schools.

This sort of case strongly supports the hypothesis of “social contagion,” but let’s be clear that this is an initial study with a lot of limitations. The information it gathers is self-reported by self-selected respondents, which prevents us from assessing whether the results are representative of a broader sample. The evidence is anecdotal rather than statistical, so it does not scientifically support any clear conclusion.

What it does support is a plausible hypothesis that demands further study. Given the potential for irreversible damage to a generation of young women, this hypothesis must be taken seriously and investigated dispassionately.

We all know that won’t be allowed to happen. Given the reaction, it is clear that further study will be strongly discouraged and even persecuted, and there is a good chance that universities and scientific journals will cave in to the pressure.

The wider question, then, is not about gender dysphoria. It is about whether this issue can even be studied and discussed. It is about whether science is to be brought to heel by a political agenda.