In what is described as the largest study to date to tackle a damaging narrative surrounding transgender health, researchers examined data from more than 90,000 trans or non-binary teens across the United States and found no evidence that “social contagion” drives transition rates in adolescents. .
Researchers found that adolescents designated female at birth (AFAB) were no more likely than adolescents designated male at birth (AMAB) to identify as trans or gender diverse, disproving a fundamental tenet of a an idea that experts say is currently being exploited politically to eliminate health care for trans youth.
In the study published Wednesday in Pediatrics, the official journal of the American Academy of Pediatrics, researchers looked at national data collected in the United States in 2017 and 2019 to challenge the controversial theory of “gender dysphoria rapid onset” (ROGD).
This theory, considered by many experts and critics to be transphobic, suggests that many teens suddenly decide to transition as teenagers just to fit in with friends, equating the transition with a dangerous fad.
A 2021 position statement co-signed by more than 60 international healthcare and scientific organizations, including several Canadian ones, condemned the theory, stating that “there are no solid empirical studies on ROGD”.
But few studies before this one have been able to answer the ROGD claims directly.
ROGD’s main claim is that young people assigned a female at birth are more susceptible to “social contagion”, with proponents citing some smaller studies as evidence of a disproportionate increase in the number of AFAB trans teens.
However, this new US national study found that the percentage of AFAB youth openly identifying as transgender or gender diverse actually decreased slightly, from 1.9% in 2017 to 1.4% in 2019, and that AFAB youth were not overrepresented among trans teens as a whole.
“The assumption that transgender and gender-diverse youth 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 providing gender-affirming medical care to adolescents,” Dr. Alex S. Keuroghlian, director of the Fenway Institute’s National LGBTQIA+ Health Education Center and lead author of the study, said in a press release.
The study also looked at data on the reported levels of bullying that students faced, to address another persistent component of ROGD: the suggestion that cisgender adolescents might change gender only to escape persecution because that they are gay or lesbian, or because the transition provides social benefits.
The study showed that cisgender sexual minority teens, such as gay, lesbian, or bisexual, experienced more bullying than their heterosexual peers.
But transgender students were even more likely to be targets of bullies. In 2019, about 29% of cisgender sexual minority students reported being bullied at school, compared to 45% of transgender students.
Trans and gender-diverse students were also more likely to have attempted suicide than cisgender sexual minorities.
“The idea that attempts to escape the stigma of sexual minorities are driving teenagers to come out as transgender is absurd, especially for those of us who are caring for [trans and gender diverse] young people,” Dr. Jack Turban, new assistant professor of child and adolescent psychiatry at the University of California and lead author of the study, said in the statement.
“The harmful effects of these unsubstantiated assumptions on the further stigmatization of transgender and gender diverse youth cannot be underestimated. We hope that clinicians, policymakers, journalists and anyone else who contributes to the politics of Health will review these results.”
INSIDE THE DATA
To get the big picture, the study used data collected as part of the 2017 and 2019 Youth Risk Behavior Survey, a biennial survey of high school students conducted by the Centers for Disease Control. and Prevention from the United States.
Not all US states collect gender identity information, so only 16 states were included in the study, with over 91,000 respondents in 2017 and over 105,000 respondents in 2019.
The researchers also looked at age, educational level, race/ethnicity and sexual orientation, as well as gender identity.
Looking at the student body as a whole, the study found fewer young people identified as trans or gender diverse in 2019 compared to 2017.
In 2017, 2.4% of the sample identified as transgender, while in 2019 that number had dropped to 1.6%. Of the 2017 cohort, 2.8% of AMAB teens were trans, while 1.9% of AFAB teens were trans. In 2019, 1.7% and 1.4% of AMAB and AFAB teens, respectively, identified as trans or gender diverse.
Because part of ROGD includes the perception that AFAB teens move faster, researchers looked at the number of trans or gender-diverse AMAB students compared to AFAB and found that both years had fewer trans youth AFAB.
In 2017, 40.5% of trans or gender-diverse students were AFAB, while 59.5% were AMAB.
In 2019, the AFAB percentage increased to 47.2% from 52.8% of AMAB students, but this was actually due to a larger drop in the number of AMAB students openly identifying as trans. There were 876 AFAB trans students in 2017 compared to 774 in 2019, while AMAB’s numbers increased from 1,285 in 2017 to 866 in 2019.
When it comes to bullying, trans students reported higher levels of school bullying and electronic bullying compared to their cisgender peers who identified as gay, lesbian, bisexual, or otherwise. sexual minority.
And teens who identified as trans reported significantly more suicide attempts.
Although 94% of cisgender students said in 2017 that they had never attempted suicide, only 67% of transgender students could say the same. Nearly one in ten transgender teens said they had attempted suicide six or more times in 2017, compared to 0.4% of cisgender teens.
These results are consistent with numerous previous studies showing that transgender adolescents face hostility from their peers and have mental health issues, often due to this lack of acceptance.
“These exceptionally high rates of bullying among [trans or gender diverse (TGD)] young people are incompatible with the idea that young people come out as TGDs either to avoid the stigma of sexual minorities or because being TGD will make them more popular among their peers, two explanations that have recently been propagated in the media” , notes the study .
ROGD has not been accepted as a clinical diagnosis by any major psychological or medical organization, but its influence should be disputed, according to the authors.
The concept dates back to a widely discredited 2018 study, which resulted in an apology and a correction published by the journal that published it.
Even though this study was based entirely on interviews with parents of trans teens, many of whom came from ostensibly anti-trans online forums, and drew immediate scholarly condemnation for its bias, the concept of ROGD took hold. in political and social discourse.
As of March 2022, 15 U.S. states had restricted access to gender-affirming care for teens or were considering doing so by the legislature — with many lawmakers citing the so-called threat of social contagion among their reasonings.
“This study comes at a time when there are many political attacks on trans youth in legislative arenas,” Turban said. on Twitter on Wednesday. “The hypotheses of social contagion and flight from LGB stigma have figured prominently in these debates.
“We hope [this] new data will be brought urgently to these legislative discussions.”