Adolescents assigned female at birth are no more likely than those assigned male to identify as transgender, which researchers say helps debunk a theory of social contagion.
This theory, sometimes known as rapid-onset gender dysphoria, stigmatizes youths and “should not be used to argue against the provision of gender-affirming medical care,” authors wrote in “Sex Assigned at Birth Ratio among Transgender and Gender Diverse Adolescents in the United States,” (Turban JL, et al. Pediatrics. Aug. 3, 2022).
The theory stems from a study of parent surveys and reports from some pediatric gender clinics that more patients were assigned female sex at birth than male. Researchers, whose disclosures include expert witness payments from The American Civil Liberties Union and Lambda Legal, tested the theory by analyzing data from the 2017 and 2019 Centers for Disease Control and Prevention’s Youth Risk Behavior Survey. The survey included about 100,000 adolescents from 16 states each year. Among other questions, youths were asked their sex, which authors said they believed respondents would understand to mean sex assigned at birth.
In 2017, 2.4% of adolescents identified as transgender/gender diverse with the ratio of male to female assigned at birth of 1.5 to 1. In 2019, 1.6% identified as transgender/gender diverse and the ratio was 1.2 to 1. The difference in the ratios from year to year were due to a decrease in those assigned male at birth identifying as transgender, according to the study.
Authors said the combination of no prevalence in those assigned female sex at birth plus the drop in adolescents identifying as transgender in 2019 help disprove the social contagion theory.
To test it further, they also looked at rates of bullying victimization. The surveys showed about 39% of transgender/gender diverse youths reported school bullying in 2017 compared to 17% of cisgender heterosexual youths. Likewise, about 45% and 17%, respectively, reported school bullying in 2019.
“These exceptionally high rates of bullying among TGD (transgender/gender diverse) youth 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 among their peers, both of which are explanations that have recently been propagated in the media,” authors wrote.
The AAP and other medical organizations support gender-affirming care for transgender youths (see resources). Authors of the study said youths should continue to have access to this care as their findings did not show social contagion is a factor in identifying as transgender.
“Multiple studies have revealed that prohibiting TGD adolescents from accessing gender-affirming medical care would be expected to have detrimental impacts on TGD youth wellbeing,” they wrote.
- AAP policy Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents
- AAP News story “AAP, medical community speak out to protect transgender youths
- AAP News story “AAP continues to support care of transgender youths as more states push restrictions”
- AAP News story “Study: Few transgender children retransition to cisgender”
- Information for parents from HealthyChildren.org on gender-diverse and transgender youths