Being Trans Is Not a Craze Among Youth, Study Finds

No, being transgender is not a craze, a trend, or a contagion -- right-wing rhetoric notwithstanding, say the authors of a new study on the subject.

In the past few years, a variety of sources have contended that somehow, external factors are leading young people to come out as trans. They have ranged from scientists to journalists to supposed comedians like Bill Maher. And this argument has been picked up by anti-LGBTQ+ politicians.

But two scientists who authored study published this month in Pediatrics say they have evidence that social pressure is not producing a phenomenon that a 2018 article characterized as "rapid-onset gender dysphoria," or ROGD.

"There's been a lot of discussion, not so much within pediatric gender medicine or among researchers, but more so among political pundits and in the political arena of this notion that many adolescents are coming to identify as transgender due to social contagion," says the study's lead author, Dr. Jack Turban. "There hasn't been much convincing evidence put forward to suggest that this is true, but the one piece of tangential evidence people have pointed to is the so-called sex ratio."

That's the ratio of youth who were assigned female at birth coming out as trans versus those who were assigned male at birth, Turban explains. "The ROGD hypothesis asserts that young people begin to identify as TGD [transgender] for the first time as adolescents rather than as prepubertal children and that this identification and subsequent gender dysphoria are the result of social contagion," says the new study, "Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents in the United States."

"This hypothesis further asserts that youth assigned female sex at birth (AFAB) are more susceptible to social contagion than those assigned male sex at birth (AMAB), with a resultant expectation of increasing overrepresentation of TGD AFAB youth relative to TGD AMAB youth," the study continues.

But Turban and his fellow researchers found no such overrepresentation. They examined data reported by 91,937 adolescents in 2017 and 105,437 adolescents in 2019 from 16 states that participated in the national Youth Risk Behavior Survey. They found that the total percentage of trans adolescents in the survey decreased from 2.4 percent in 2017 to 1.6 percent in 2019, which would not support the "social contagion" hypothesis.

Also, while 2019 data showed sex ratio shifting slightly toward youth who'd been assigned female at birth than the 2017 data, that was driven by a decrease in the proportion of those assigned male at birth identifying as transgender. The overall percentage of youth who'd been assigned female at birth identifying as trans also decreased.

The ROGD hypothesis additionally posits that young people are identifying as trans rather than as gay, lesbian, or bisexual because they see being trans as more socially acceptable. But the data doesn't demonstrate that trans youth find more acceptance than LGB youth, the researchers say. The information from the Youth Risk Behavior Survey indicated that trans youth are more likely to be bullied than cisgender LGB youth, who themselves experience more bullying than heterosexual youth. And, as has been documented by other studies, trans youth are at great risk of suicide than cis young people.

The researchers conclude that the idea of rapid-onset gender dysphoria "should not be used to restrict the provision of gender-affirming medical care." They note as well that their results "argue against the notions" that trans youth identify as such because of social contagion or fear of stigma associated with being LGB.

But that doesn't keep those ideas from coming up in public debates. In Florida, which this year passed a law restricting classroom instruction on sexual orientation and gender identity, one legislator expressed concern that young people are "trying out" various identities in order to fit in with their peers, and another claimed that "LGBT is not a permanent thing." Florida is now considering a ban on gender-affirming care for youth.

Alabama and Arkansas have adopted laws banning such care, with Alabama's providing for criminal penalties for doctors; both are temporarily blocked due to lawsuits. In Texas, Gov. Greg Abbott and Attorney General Ken Paxton asserted that parents who allow their children to receive gender-affirming care are child abusers, and Abbott ordered child welfare authorities to investigate these parents. This effort is likewise on hold due to a court challenge, but it still represents an attack on gender-affirming care for youth.

Turban notes that some of the rhetoric marginalizing trans youth can be traced to a 2020 book by Abigail Shrier, Irreversible Damage: The Transgender Craze Seducing Our Daughters, which argued that so-called gender ideology was influencing a rise in those assigned female at birth identifying as trans males rather than, for instance, lesbians.

There was also the 2018 article that Turban's new study counters, written by Lisa Littman for the journal PLOS One, drawn entirely from parents' reports of their children's gender dysphoria, without any input from the young people themselves.

And then there are the slurs directed at any adult who supports young people who identify as trans or anywhere under the LGBTQ+ umbrella -- that they're "grooming" children for sexual abuse. It has generally become less acceptable, though, to attack LGB people, so trans people, especially trans youth, have become a target, Turban says.

That's something he says the latest study may change. "We're hopeful this data will make it into some of these conversations," he says.

Turban is incoming assistant professor of child and adolescent psychiatry at the University of California, San Francisco. He collaborated on the study with senior author Dr. Alex S. Keuroghlian, who directs the National LGBTQIA+ Health Education Center at the Fenway Institute and the Massachusetts General Hospital Psychiatry Gender Identity Program.