The researchers found that teens assigned female at birth (AFAB) were no more likely than teens assigned male at birth (AMAB) to identify as transgender or intersex, disproving a key tenet of an idea that experts say it is currently being used politically to eliminate health care. for transgender youth. In the study published Wednesday in Pediatrics, the official journal of the American Academy of Pediatrics, researchers examined national data collected in the US in 2017 and 2019 to challenge the controversial theory of “rapid onset of gender dysphoria” (ROGD). This theory, considered by many experts and critics to be transphobic, suggests that many teenagers suddenly decide to transition as teenagers purely to fit in with friends, likening transition to a dangerous fad. A 2021 position statement co-signed by more than 60 international health care and scientific organizations, including several Canadian ones, condemned the theory, stating that “there are no valid empirical studies of ROGD.” But few studies prior to this have been able to directly address ROGD’s claims. ROGD’s main claim is that young people who are assigned female at birth are more susceptible to “social contagion,” with advocates pointing to some smaller studies as showing a disproportionate increase in AFAB transgender teens. However, this new, US national study found that the percentage of AFAB youth openly identifying as transgender or gender nonconforming actually decreased slightly from 1.9 percent in 2017 to 1.4 percent in 2019, and that AFAB youth were not overrepresented among transgender youth as a whole. “The assumption that transgender and diverse youth assigned female at birth identify as transgender due to social transmission does not stand up to scrutiny and should not be used to argue against the provision of gender-affirming adolescent medical care,” said Dr. Alex S. Keuroghlian, director of the National LGBTQIA+ Health Education Center at The Fenway Institute and senior author of the study, said in a press release. The study also looked at data on reported levels of bullying experienced by students in order to address another persistent component of ROGD: the suggestion that cisgender teens may change genders purely to avoid persecution for being gay or lesbian, or because the transition provides social benefits. The study showed that cisgender adolescents of a sexual minority, such as gays, lesbians or bisexuals, experienced more bullying than their peers. But transgender students were even more likely to be targeted by bullies. In 2019, about 29 percent of cisgender sexual minority students reported being bullied at school, compared to 45 percent of transgender students. Transgender and intersex students were also more likely to have attempted suicide than cisgender sexual minorities. “The idea that efforts to escape the stigma of being a sexual minority leads teenagers to come out as transgender is absurd, especially for those of us who provide treatment to [trans and gender diverse] youth,” Dr. Jack Turban, associate assistant professor of Child and Adolescent Psychiatry at the University of California and lead author of the study, said in the release. “The damaging consequences of these unfounded assumptions in further stigmatizing transgender and genderqueer youth cannot be understated. We hope that clinicians, policy makers, journalists and anyone else contributing to health policy will reconsider these findings.”
INTO THE DETAILS
To get a broad picture, the study used data collected in the 2017 and 2019 Youth Risk Survey, a biennial survey of high school students conducted by the US Centers for Disease Control and Prevention. Not all US states collect information on gender identity, so only 16 states were included in the study, with more than 91,000 respondents in 2017 and more than 105,000 respondents in 2019. The researchers also looked at age, grade, race/ethnicity, and sexual orientation, along with gender identity. Looking at the student body as a whole, the study found that fewer young people identified as transgender or genderqueer in 2019 compared to 2017. In 2017, 2.4 percent of the sample identified as transgender, while in 2019, that number had dropped to 1.6 percent. Of the 2017 cohort, 2.8 percent of AMAB teens were transgender, while 1.9 percent of AFAB teens were transgender. In 2019, 1.7 percent and 1.4 percent of AMAB and AFAB teens, respectively, identified as transgender or gender nonconforming. Since part of the ROGD includes the perception that AFAB youth are transitioning at a faster rate, the researchers looked at how many trans or diverse students were AMAB versus AFAB and found that both years featured fewer trans AFAB youth. In 2017, 40.5 percent of trans or diverse students were AFAB, while 59.5 percent were AMAB. In 2019, the AFAB rate jumped to 47.2 percent compared to 52.8 percent of AMAB students, but this is actually due to the larger drop in AMAB students who openly identify as transgender. There were 876 trans AFAB students in 2017 compared to 774 in 2019, while AMAB numbers increased from 1,285 in 2017 to 866 in 2019. In terms of bullying, transgender students reported higher levels of both in-school bullying and cyberbullying compared to their gay, lesbian, bisexual, or other sexual minority peers. And teens who identified as transgender reported significantly more suicide attempts. Although 94 percent of cisgender students said in 2017 that they had never attempted suicide, only 67 percent of transgender students could say the same. Nearly one in ten transgender teens reported in 2017 that they had attempted suicide six or more times, compared to 0.4 percent of cisgender teens. These results align with numerous previous studies showing that transgender teens face hostility from their peers and struggle with their mental health, often because of this lack of acceptance. “These extremely high rates of bullying among [trans or gender diverse (TGD)] Young people are inconsistent with the notion that young people come out as TGD either to avoid sexual minority stigma or because being TGD will make them more popular with their peers, both of which are explanations that have recently been popularized in the media “, the study noted. . ROGD has not been accepted as a clinical diagnosis by any major psychological or medical organization, but its influence should be questioned, the authors say. The idea goes back to a widely discredited 2018 study that resulted in an apology and correction published by the journal that published it. Although this study was based entirely on interviews with parents of trans teens, many of whom had come from apparently anti-trans online forums, and sparked immediate scientific condemnation for its bias, the concept of ROGD took place in political and social discourse. As of March 2022, 15 US states had restricted access to gender-affirming care for teenagers, or lawmakers were considering doing so—with many lawmakers citing the so-called threat of social transmission among their considerations. “This study comes as there are many political attacks against transgender youth in legislative spaces,” Turban said on Twitter Wednesday. “Social contagion and assumptions about the stigma of LGB escapism have featured prominently in these discussions. “We hope [this] new data will be urgently brought forward in these legislative debates.”
