A new study of social contagion raises important clinical and ethical questions.
Posted Nov 28, 2018
Transgender identity* is characterized by experiencing distress with, or an inability to identify with one’s biological sex, usually prompting a desire to live one’s life as the opposite sex.
In the DSM-5, the standard classification of mental disorders used by mental health professionals, this condition is known as “gender dysphoria.” Note that classifying gender dysphoria as a disorder does not—indeed, should not—imply a moral judgment of transgender individuals. Depending on the degree of social stigma associated with it, transgender identity can be accompanied by very significant distress. The point of the mental-health outlook is to help reduce stigma and assist transgender individuals in leading good lives. The role of social norms in this picture, however, remains unclear and hotly debated.
As attested by current controversies, rates of transgender identity appear to be on the rise, particularly among young people. Increased social acceptance of a previously stigmatized condition likely plays a role in this process, but other findings are clearly puzzling: Transgender identity is now reported among young natal females at rates that clearly exceed all known statistics to date.
In a recent survey of 250 families whose children developed symptoms of gender dysphoria during or right after puberty, Lisa Littman, a physician and professor of behavioral science at Brown University, found that over 80 percent of the youth in her sample were female at birth. Littman’s study reported many other surprising findings. To meet the diagnostic criteria for gender dysphoria, a child typically needs to have shown observable characteristics of the condition prior to puberty, such as “a strong rejection of typically feminine or masculine toys,” or “a strong resistance to wearing typically feminine or masculine clothes.” Again, 80 percent of the parents in the study reported observing none of these early signs in their children.
The plot thickens again: First, many of the youth in the survey had been directly exposed to one or more peers who had recently “come out” as trans. Next, 63.5 percent of the parents reported that in the time just before announcing they were trans, their child had exhibited a marked increase in Internet and social media consumption. Following popular YouTubers who discussed their transition thus emerged as a common factor in many of the cases. After the youth came out, an increase in distress, conflict with parents, and voiced antagonism toward heterosexual people and non-transgender people (known as “cis” or “cisgender”) was also frequently reported. This animosity was also described as extending to “males, white people, gay and lesbian (non-transgender) people.” The view adopted by trans youth, as summed up by one parent, seemed to be that:
“In general, cis-gendered people are considered evil and unsupportive, regardless of their actual views on the topic. To be heterosexual, comfortable with the gender you were assigned at birth, and non-minority places you in the ‘most evil’ of categories with this group of friends. Statement of opinions by the evil cis-gendered population are consider phobic and discriminatory and are generally discounted as unenlightened.”