[content warning: brief discussion of suicide statistics]
Like anyone with a hobby of arguing about transness, I am used to debunking people’s dumb interpretations of studies. For instance, there’s the famous Swedish study which shows that post-transition transgender people have a higher suicide rate than cisgender controls, which is used to argue that transition increases suicide rate. There is also the National Transgender Discrimination Survey’s finding that people who have more transition-related health care are more likely to have had suicidal ideation, whch is interpreted as transition increasing one’s chance of committing suicide, even though people who are suicidal about dysphoria are probably more likely to seek transition-related health care.
But rapid onset gender dysphoria is unique. The Swedish study and the National Transgender Discrimination Survey are both good studies, and their actual findings are important: it’s useful to know that trans people are more likely to be suicidal than cis people and that people who have had transition-related health care are more likely to have a history of suicide attempts. They just don’t show the thing that people desperately want it to show. The study that allegedly shows the existence of a condition called rapid-onset gender dysphoria, however, was not even a good study in the first place.
The argument of the article is that sometimes people weren’t feeling gender dysphoric until they start hanging around with a lot of transgender people, at which point they suddenly experience gender dysphoria. How did they find evidence for this, you ask? Did they do a retrospective survey of transgender people asking how they became transgender? Did they identify transgender people, give gender dysphoria questionnaires to their friends on a regular basis, and discover that gender dysphoria increases over time if you have a transgender friend but not if you have, say, a lesbian friend?
No, they asked adolescents and young adults’ parents.
I do not think there is a transgender person in the world who disagrees with the claim that transness often comes as a surprise to one’s parents. Nor is it particularly surprising to transgender people that coming out typically worsens your relationship with your parents, that transgender people typically trust other trans people more than cis people as sources of information about being trans, and that transition often leads one to spend less time with your family and cisgender friends, particularly if they don’t accept your gender.
But here’s the question. If you’re a teenager or young adult, or you remember having been a teenager or young adult, think back to that time in your life. (My apologies for excluding any precocious eight-year-olds who read this blog; I hope this post will help you anticipate what you have to look forward to.)
For most people– even people who had pretty good relationships with their parents– it’s something like this. You carefully filtered the information about your life you gave to your parents. Band practice, favorite movies, and interesting college classes, yes; inner turmoil and struggle, not so much. You felt that your parents were probably as likely to attack or lecture you if you were vulnerable with them as they were to actually be helpful. The deceptions of ordinary teenagers are many: that some of their friends drink; that they sometimes finish their homework in homeroom; that sometimes when they’re going to the mall they’re actually getting felt up by their boyfriend.
A lot of teenagers and young adults who are facing hard times face them on their own or with the help of their friends. There are a lot of parents out there who believe they have a happy, carefree, well-adjusted teenager who happens to be unusually prone to not overheating, while the lives of three of that teenagers’ friends are oriented around helping them not to cut. Teenagers who are depressed, anxious, and suicidal are often afraid that if they told their parents they would be punished rather than supported; these beliefs are often correct. Fortunately, by the time you’re a young adult, you have medical confidentiality, so you may be able to seek therapy and psychiatric medication without your parents’ consent; unfortunately, that means that parents are likely to be even more oblivious about mental illness, since a major reason to tell them has been removed. In short, the parents of many mentally ill teenagers and young adults simply have no idea that their children are mentally ill.
Teenagers who are questioning their gender identity or sexual orientation, in general, don’t share that with their parents. You are unlikely to share with your parents your discovery of how hot gay porn is or your sneaking suspicion that your girl crushes were actually real crushes. Transness is even more unlikely to go unnoticed, because even today many transgender people experience gender dysphoria for years before they know they’re gender dysphoric; how do you explain to your mom “Mom, I keep having fantasies about having breast cancer so I don’t have to have breasts anymore and I don’t know why”? Even once a teenager has come to a stable identity, many teenagers are acutely aware that forty percent of homeless youth are LGBT; even if their parents almost certainly wouldn’t disown them, that “almost” makes the closet a very attractive proposition. A teenager often knows they’re LGBTQQA+ for years before they gather the courage to tell their parents.
You may have or have had a good relationship with your parents where you felt like you could share literally everything with them, as if they were more like a best friend than like a parent; many people do. But even if you did, probably many of your friends had the more ordinary sort of parent-teenager/young adult relationship. Most parents have inaccurate ideas of what their teenagers’ life is like, in at least some aspects; for mentally ill and queer teenagers, parents’ views are even more inaccurate. It’s no wonder that gender dysphoria– which is both a mental illness and a form of queerness– seems to come out of nowhere for many parents. And that doesn’t mean that the child hasn’t been gender dysphoric for years or even a lifetime.
Consider the finding that teenagers and young adults often have friend groups full of out transgender people before they come out as transgender. There are several perfectly reasonable, non-contagion-related explanations for this. The most obvious one is that trans people want to befriend other trans people. If a person starts questioning their gender months or years before they come out to their parents, they may have trans friends for months or years before their parents know anything about it.
Similarly, the exact same things that attract one self-closeted trans person to a group of friends may attract other self-closeted trans people. Trans people are disproportionately likely to be lesbian, gay, bisexual or asexual, and many straight trans people identify as lesbian or gay before they come out to themselves; the school’s Gay-Straight Alliance will probably have a lot of self-closeted trans people in it. Trans people have a lot of traits in common, often ones you wouldn’t really expect: it’s not very surprising if the school’s anime club has a couple of trans people. Self-closeted trans people often find out trans people strangely magnetic.
I don’t want to say that there’s never been a case of a person who believes they experience gender dysphoria when they don’t; I’ve personally known several cases. Having transgender friends may very well lead someone to believe they experience gender dysphoria when they actually experience depression, dissociation, feelings of insecurity about their gender non-conformity, or something else. But, first of all, that is clearly not “rapid-onset gender dysphoria”; it is a person being mistaken about whether they are gender dysphoric, which is a different thing. It’s a case of “I have chronic fatigue syndrome and a lot of depressed friends, so now I think I’m depressed too”, not a case of “being around depressed people is really depressing.”
Second, in my experience, people usually figure it out. Six months or a year later they sheepishly go around saying “yeah, I’m on antidepressants now and I feel a lot better and I really don’t think I’m actually a guy, go figure.” There is not an epidemic of people mistakenly transitioning for two decades because they got confused about what depression is. Of course, hormones and surgery can have long-term consequences. In my experience, while some pressure comes from overenthusiastic trans people convinced what worked for them is the universal solution for everyone, the pressure is most likely to come from people who don’t really accept trans people. If you’ve ever found yourself saying “I don’t see why I should respect his pronouns if he’s not even making the slightest effort to be a woman,” then the difficulties people who are mistaken about being trans face are on you. If we respect people’s gender identities regardless of whether they physically transition, mistaken people are far less likely to physically transition.
Thing of Things 
“If we respect people’s gender identities regardless of whether they physically transition, mistaken people are far less likely to physically transition”.
I don’t see how that follows.
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I imagine it’s something like this- a person who is mistaken may feel pressure to transition in order to get to a point where others will use their desired pronouns. If, however, they were allowed to ‘dip their toe in further’ as it were, they could determine their mistake sooner.
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If physical transition is a precondition for having one’s gender identity respected, people who want their gender identity respected are incentivized to physically transition ASAP even if they don’t care about physical transition per se. This leaves less room for experimentation and backing out later if one decides one was mistaken.
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If physical transition is a precondition for having a transgender identity respected, dysphoric people also incentivized to try really hard to be cis (like looking into other explanations and trying other possible solutions for their issues, like taking anti-depressants). You’d thus expect the incentivizes to go both ways.
I have no idea which effect is stronger and I think it is wrong to claim with high confidence that you know (unless there is some research that answers this that I’m unaware of).
It is plausible that experimentation leads to people figuring out their true gender identity sooner, but it’s also plausible that the experimenting is not very effective at figuring out whether a person has gender dysphoria. If they have body dysphoria rather than social dysphoria, is a social transition going to necessarily be elucidating? The offending breasts/penis will still be there beneath the clothes of the other gender. If they have social dysphoria and have great difficulty at acting like the other gender after a decade plus of being socialized for their birth gender, will the social transition give a clear reduction in feelings of social dysphoria or will they experience social dysphoria that is independent of their gender identity?
Again, not arguing that this alternative view is correct, but I’ve seen no solid evidence that either view is obviously true.
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@Aapje
I don’t think we actually disagree; there’s a bunch of different incentives at play here of course.
Of course there’s an incentive for people not to be trans as long as transphobia exists. I of course think this is a bad thing, because being closeted is terrible and a lot of utility is burned by people not doing things that will make them happier.
But in the specific situation where someone has realized they have social dysphoria but not much body dysphoria and they definitely want to socially transition, there is an incentive to physically transition also. I think this is a bad thing for the same reason I think incentives not to be trans are bad – I think it’s bad when social pressure creates incentives to do something other than what one would otherwise want to do (assuming what one wants to do is not significantly harmful to others).
(Sometimes it works out well – sometimes someone’s dysphoria is initially primarily social, but they try some physical transition steps anyway and it turns out to be great. But I still don’t really want there to be social pressure that accidentally causes good effects at the same time that it causes other harmful effects.)
I think experimentation at least gives you better evidence about what will make you happier than not experimenting. Of course the evidence can be muddled for the reasons you list and other reasons, but it still is evidence.
Honestly I just want to reduce (eliminate, as a stretch goal) all the social pressure and friction around transness so people can have less angst and fear about doing things that will make them happy without worrying about whether they’re Really Trans or What If It Doesn’t Work Out or What If People Don’t Take Me Seriously or you know etc. It should be as close to socially costless as possible to take steps to change one’s gender presentation or pronouns or physical form, including to change it back if one doesn’t like it. I don’t care about pushing more people to be cis or pushing more people to be trans, I just want more freedom so people can figure out what they want and do that.
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@tcheasdfjkl
I agree that it’s in principle best if people are allowed to find their own optimum, rather than just two extreme positions. I’m not sure whether it’s true that experimenting is automatically good though. Humans are pretty good at pattern matching in the wrong way.
For example, imagine an environment that is somewhat hostile to (some forms of) masculinity, more hostile to half-transitioned m->f’s and fairly supportive to fully transitioned transwomen. One could imagine that this environment would cause social dysphoria in some men, more social dysphoria in half-transitioned m->f’s and then less social dysphoria again in fully transitioned transwomen.
Since this environment is fairly supportive of transgender people, the narrative that people would use to explain gender-related dysphoria is likely to be that they are transgender, not that the cause is that environment itself is hostile to (some forms of) masculinity. So then some of the socially dysphoric, cis by default men in this environment might suspect that they are trans, try to socially transition whereupon their gender-related social dysphoria would increase and then decrease again once mostly transitioned. This could then be taken as evidence that they are trans, while they would actually have been completely happy as men, in an environment that would have accepted their type of masculinity.
This pattern would fully explain the anecdotal examples that you see below.
IMO, there is pretty solid evidence that we now have various environments in our society that have the traits of my imaginary environment. Would you have an idea of how we could figure out which percentage of the people who transition in such environments do so because of my theory and which percentage are ‘proper’ transgender people? Is that 0%-100%? 25%-75%? 50%-50%? And how could we distinguish between the groups, if they exist?
PS. One of the things that I worry about with the culture wars is that both sides declare some explanations to be immoral, so progressives are unwilling to seriously consider possibilities like this, while conservatives are unwilling to consider any explanations but these. The truth may then be that both groups are half-right and we then never discover this.
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Currently, physically transitioning has two sets of benefits: 1) the person’s gender identity is respected more, and 2) everything else.
If everyone got respect without needing to physically transition, then there is less of a (relative) benefit to transitioning.
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I agree that parent-completed surveys alone are an extremely limiting methodology (although not without some value—sometimes others can see things about us that are omitted from the stories we tell about ourselves), but the phenomenon of social contagion seems obviously real and worth understanding in detail. (As the Littman abstract says, echoing the eternal refrain of scholars everywhere, “More research is needed.”)
In particular, the difference between “otherwise basically ordinary young people become trans via social contagion” and “self-closeted trans people come out after their peers show it’s possible” may mostly be a matter of perspective.
So, your ideological opponents’ concerns just happen to imply the policy choices that you also support? How amazingly convenient! (The probability of trans self-identification—leaving aside how to adjudicate when this is “mistaken”—is not going to be independent of cultural attitudes about what identities to respect.)
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I’m not sure I agree with the second part of your comment, but your point about social contagion vs self-closeted trans people coming out being a perspective difference is important.
It doesn’t at all seem clear that there’s a fundamental difference between an eggmode trans person and the average cis person who would choose to be the opposite sex, and the second group doesn’t actually seem all that small. Narratives where gender dysphoria seems to increase as a person realizes that they’re trans and starts transitioning are quite common. (Things like “before transitioning, I had no problem male pronouns, but now being called ‘he’ feels like getting stabbed.”) I see little reason why we shouldn’t at least wonder whether a significant fraction of Magic Button Trans people would “become trans” in sufficiently enbyqueer social environments.
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I’m pretty sure that “before transitioning I didn’t mind male pronouns but now I really do” is just hedonic treadmill stuff. Which does present interesting philosophical issues in general, I grant, but few specific to transness.
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I’ve seen things like the pronoun thing with other kinds of dysphoria than dysphoria about pronouns. While this may also be some kind of hedonic treadmill stuff, the important point is that it seems like there could be a large fraction of Magic Button Trans people who could be affected by this, but only if they are in groups that in some sense socially encourage this.
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Wait, I fail at paying attention. It can’t be hedonic treadmill stuff in the cases where body dysphoria appears this way.
That doesn’t change my point about “why shouldn’t this effect also happen for Magic Button Trans people in the right circumstances?”, though.
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I should probably post this thread, since it has lots of examples of what I’m talking about:
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Speaking from personal experience, referring to a rapid increases in dysphoria after coming out as ‘hedonic treadmill’ looses something important. It’s closer to ‘previously used methods to cope with dysphoria suddenly failing’. Denial is a powerful psychological mechanism, and I wouldn’t be surprised if suddenly loosing that was the culprit. I’ve also noticed that if pressed, I can engage in something like a mental seesaw between dysphoria and anhedonia.
Are these experiences typical? I have no idea. It’s frustrating to engage with current trans research because so much of it is speculation and personal experience.
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I did suggest several possible study methodologies in my post and I’d be fascinated by the results. (I am puzzled about how the proposed existence of social contagion goes along with your belief in the two-type model, which really doesn’t seem to have any role for social contagion in its proposed causal model at all.)
I resent the implication that I am not concerned about people who mistakenly believe they’re transgender, and that this wasn’t one of my considerations when I decided that respecting socially transitioning but not physically transitioning people is really important. God, even if it’s a kid who’s trying to feel cool or whatever, let them feel cool without making difficult-to-reverse body modifications!
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> I am puzzled about how the proposed existence of social contagion goes along with your belief in the two-type model, which really doesn’t seem to have any role for social contagion in its proposed causal model at all.
I don’t know if this is M.’s actual thinking, but both the two-type model and social contagion could be part of a more general view that trans desires could be explained in terms of other desires that aren’t specifically about being a particular gender (desires for sex on the one hand, desire to fit in/whatever else motivates people to follow trends on the other), as contrasted with the view that desire to have a particular body and be seen as a particular gender is a more fundamental desire (which is my current understanding/belief). The idea that one should respond to being gay or autogynephilic by transitioning could also be socially contagious, but then again that also applies to the idea that one should respond to dysphoria by transitioning.
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It feels like a good analogy for this is ‘hanging around psychiatrists makes people depressed’.
Before they started hanging around psychiatrists they were just moody! Now they have ~mental issues~ clearly mental health professionals are the cause of this
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Another thing I would note: it is fairly common IME for closeted kids to talk with their parents about a friend (or even “”friend””) with the same identity, to see how their parents will react. (e.g. “so uh I met this really cool person and it turns out they’re gay! what do you think about that? I am very curious how accepting you are of them for reasons that are of course completely irrelevant to me?”) If the parents are accepting, it may seem from their perspective to go pretty quick from “kid tells me all about a transgender friend they have -> kid suddenly comes out as transgender.” Even if the closeted kid doesn’t intentionally use them that way, though, talking about their friend with their parents and seeing their parents interested and accepting–or, at the least, not completely rejecting and hateful–might give them courage to come out.
I don’t think this has as much of an effect as “queer people tend to be friends with each other” or “meeting a trans person can help someone realize and come to terms with their own identity” etc., but it’s something I’ve seen enough that I thought it deserved a mention.
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“You may have or have had a good relationship with your parents where you felt like you could share literally everything with them, as if they were more like a best friend than like a parent; many people do. But even if you did, probably many of your friends had the more ordinary sort of parent-teenager/young adult relationship.”
That presupposes that I actually had friends at that age.
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