Transsexual Teens In UK Gender Dysphora Treatment

In a spate of recent UK media there was a wild accusation that a “thousand” youths were suing the National Health Service for wrongly pushing them into transsexual medical treatments. But there is a serious problem with this statement. That number, a thousand, is roughly the TOTAL number of transsexual teens that have been treated in the UK from 2008 through 2021. Are ALL of them suing the NHS? No, the story is disinformation generated by a transphobic propagandists under the rubric of the “Big Lie” theory, that the bigger the lie, the more believable it is. In truth, very few teens would be unhappy with receiving treatment and most would be very grateful. (Though they may grumble about aspects of the hoops they had to clear to get it.)

I’m a US citizen living in California, so I have zero direct experience with the UK NHS and their gender dysphoria treatment system. But as I understand it, to get treatment, one must jump through multiple hoops, first convincing a (potentially transphobic) skeptical General Practitioner (GP) to provide a referral to the Gender Identity Service (GIDS). The GIDS does a psych and history evaluation and may or may not provide a referral to the Endocrine Service which may or may not then provide puberty blockers (PB) or cross-sex Hormone Replacement Therapy (HRT).

If you were to believe the propaganda, you would be think that the NHS hands out HRT like candy on Halloween. They do not. Further, the real numbers from these clinics show that the number of teens treated is NOT indicative of an “epidemic” of gender dysphoria. Far from it.

We need to review some stats. The current population of the entire UK is a bit over 67 million people. The long time historical estimate of actual transsexuals, those who experience gender dysphoria, seek medical treatment, and live full time as the opposite sex is known to be less than one in ten thousand (<1:10,000). That includes those that seek treatment as adults. So, the maximum number of people we expect in the NHS system receiving HRT and later Sex Reassignment Surgery for gender dysphoria would be less than 7,000 people TOTAL. So, we expect, that the number of transsexual teens would be some lower number. And that is exactly what we see.

Consider the recent paper published in the British Medical Journals by Butler, et al. In it we learn that the NHS Gender Identity Services referred only 1,151 teens for evaluation between 2008 and 2021 inclusive. Of that only 1089 had known outcomes. Of those, 32 did NOT receive hormonal medical treatment, likely realizing that they weren’t actually gender dysphoric when confronted with the reality of what that really meant. (That is, they were likely falsely claiming to be “trans”, which has become a very popular fad among teens and young people such that there are likely over 500 people falsely claiming to be “trans” or “non-binary” for every actual transsexual.) Of the remaining 1,057 teens, 58 (5.5%) later elected to cease medical treatments leaving 999 that continued into adulthood.

Again, this is NOT indicative of a sudden epidemic of gender dysphoria among teens. In fact, it is perfectly in keeping with the number we expect from decades of clinical experience. Most especially, these numbers put the lie to the assertion that a thousand youths are planning to sue the NHS for medical malpractice. It also gives us an insight into the relative stability of gender dysphoria and of transsexual identities in teenagers, that so called “desistence” occurs before puberty onset.

Further Reading:

More Proof That Transsexual Teens Persist

How Many Transfolk Are There, Really?

Lost In The Crowd – The recent phenomena of young people falsely claiming to be “trans” or “non-binary”

Age Of Innocence – Clinical evidence that “desistence” occurs before puberty onset.

Reference:

Butler G, Adu-Gyamfi K, Clarkson K, et al., “Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021” Archives of Disease in Childhood (2022) doi: 10.1136/archdischild-2022-324302

Falsely Claiming To Be “Trans” Is “Cool” (NOT!)

Yet another paper making the mistake of interpreting teenagers ticking the box that says “I am trans” as actually being trans. When that happens, the rest of the data is nearly worthless, as in found in the just published paper by Turbin, et al. I’ve pointed out that this use of self-ID in online surveys, especially for teenagers is bogus. This shows only how popular it is, how “cool” it is, to say that one is “trans” or “non-binary”, NOT how many are actually gender atypical and gender dysphoric.

First, we know, from much more careful studies using better operational definitions such as getting a diagnoses as gender dysphoric, or from US Census and Social Security Administration records showing how many changed their name/sex so as to actually live as the opposite sex, that the incidence rate of gender dysphoria is on the order of ~6 per 100,000 people. That figure would also include “late onset” transsexuals who would not have shown up in studies of gender dysphoria in teenagers. Thus, if a study had been valid, we would expect that significantly fewer than six out of one hundred thousand surveyed would be clinically gender dysphoric.

But Turbin’s paper relies on surveys conducted in 2017 and 2019 with only ~92K and ~105K teens. Thus, we would only expect less than a single handful of clinically gender dysphoric teens. Such a broad community survey is not a good means to identify gender dysphoric teens in sufficient numbers to provide any useful insights.

But that didn’t deter Turbin. Since the survey has an inadequate (read: useless and silly) self-ID question, far more (false positives) were included as “trans”, etc. How badly off are numbers? They found 2.4% and 1.6% respectively. This is about one hundred times the number we expect to find. This is on the order of the incidence rate of exclusive homosexuality, NOT gender dysphoria. Could it be that these teens are conflating and confusing the two constructs? Superficially, this would make sense, given that homosexuality is highly correlated with mild gender atypicality. Or perhaps other issues are present?

One of the explanations for this large number of teenagers claiming to be trans or non-binary is a putative phenomena, Rapid Onset Gender Dysphoria (ROGD) in which large numbers of teens become gender dysphoric due to “social contagion”. However, there are a number of problems with this explanation. First, it has the poor evidentiary support. Second, for ROGD to exist as such, the teens would have to actually BE gender dysphoric. So far, that doesn’t hold up. While there has been an increase in the number of children and teens being referred to clinics, as those clinics have finally begun offering serviced that gender dysphoric teens actually need and want, those numbers are closer to the tiny handful that we would expect, not from a putative epidemic of ROGD. In other words, there is a disconnect between the number self-proclaiming to be “trans”/”non-binary” and the number seeking medical services for clinical gender dysphoria.

At this point, I would like to share personal experiences and observations that may shed light on this situation. I volunteered as a Court Appointed Special Advocate and had previously been a foster/adoptive mom. Since I am transsexual, I was paired with two “transgender” teens, one FTM, the other MTF. It was instantly obvious that the CASA program, his caseworkers, etc. had no clue and had mistaken a flamboyantly queenie gay boy who occasionally performed in drag as “trans”. He was not in the least bit gender dysphoric, and would actually become angry when misidentified as such. The other teenager was indeed a classic FTM transsexual, a typical transman. At 17, if you met him, you would instantly read him as a typical boy, into skateboarding and deeply in love with his straight girlfriend. In seeking resources for him, I recommended that he attend a drop-in group for LGBT kids. I had heard that it was very trans-friendly. He refused to return, but wouldn’t, or more accurately, couldn’t explain why wouldn’t go back. — Later, I had occasion to understand why from personal observation. Only one of the teens was actually an FTM transsexual. A large majority of the teens attending the meetings were not LGBT, but mostly feminine heterosexual girls who were very obviously falsely claiming to be “trans” or “non-binary”, demanding that everyone use “they/them” or even more odd made-up pronouns. There were a few gay boys also doing this, but they were clearly doing it to fit into the gang, to be cool. They made my CASA youth uncomfortable, uneasy, and feeling unwelcome. He was in truth what they were falsely claiming to be and the obvious contrast was disconcerting for all. Frankly, these teens made ME feel uneasy and unwelcome for the same reason. This was a novel experience after decades of working as an activist and community organizer in the transsexual community.

If the putative ROGD phenomena was actually comprised primarily of these girls, it would go a long ways explain it. This phenomena has existed in very small numbers for decades (I met one such in 1980) but exploded in numbers during the mid ’10s. Turbin in mistakenly according these large numbers of teens self-identifying as “trans” / “non-binary” as being so, tried to argue that these surveys proved that it was not a “social contagion”. I argue just the opposite, that it proves that such false self-identification IS a social contagion in the sense that it reinforced a latent desire by some teens, of both sexes, to do so to be “cool”. And if anything, if the numbers can be trusted, the drop over the two year period from 2017 to 2019 of 50% would indicate that the fad is fading.

Addendum 8/10/2022:

No sooner had I posted this essay up pops another news item talking about yet another study where the authors now claim that “trans” / “non-binary” / “gender diverse” teenagers are under counted. The number quoted? Seven percent! Worse, having found this new study, I learn that the primary author, Kidd, had an earlier study that said the number was ten percent! These numbers hark back to the earlier Wernick (2017) study had found nine percent. As I pointed out in previous essays, these numbers all come from the error of asking teens if they identify as “trans”, etc. without proper operational definitions and certainly never having validated these survey items to see if they mean anything more than the popularity of (falsely) claiming to be a perceived to be “cool” marginalized minority identity.

It’s long past time that researchers stop naively using unvalidated survey items and actually conduct in-depth interviews of these teens (and their friends and families) claiming these identities. I predict that these teens will not show ANY clinical gender dysphoria nor be very gender atypical when compared to control teens who are not claiming these identities, save for a few who will be homosexual. Far from being “gender diverse”, they will prove to be rather ‘gender ordinary’. Further, I predict that while sociologically and psychologically, these teens may be an interesting group, with some risk factors that correlate to their need to identify with a stigmatized and very RARE sexual minority, they are NOT the group that has any etiological or sociological connection to gender dysphoric youth. Also, if tested for implicit self-identification I predict that these teens will very clearly identify with their natal sex and not have a significant alienation from it.

A final thought. If so many youth are “Gender Diverse”, why aren’t there more such adults? Also, as adults looking back at our own high school days, we can recall knowing kids that would later come out as gay or lesbian, maybe a couple straight transvestites, but not 7-10% “gender diverse” kids. Could it be because most adults aren’t into following silly fads that make them feel “cool” or “special” and instead just be who and what they really are, gender typical?

As a transsexual, someone who was actually “gender different”, who began transition in high school in the early 1970s, I can assure you I was the only one at either of the two large suburban schools I attended, and suffered because of it.

Further Reading:

How Many Trans Folk Are There, Really?

Lost In The Crowd

ROGD Redux

Where Are All These “Detransitioners” Coming From?

References:

Turbin, et al., “Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents In The United States”, Pediatrics (2022), https://doi.org/10.1542/peds.2022-056567

Kidd, K. et al., “The Prevalence of Gender-Diverse Youth in a Rural Appalachian Region”, JAMA Pediatrics (2022), DOI:10.1001/jamapediatrics.2022.2768

Wernick, et al., “Gender Identity Disparities in Bathroom Safety and Wellbeing in High School Students”, Journal of Youth and Adolescence (2017), DOI: 10.1007/s10964-017-0652-1