Recently the NHS was called upon by the Equality and Human Rights Commission to preserve the fertility of young trans people by banking their sperm and eggs. Unreported was the bleak truth: if children take the puberty-blocking drug Lupron then proceed to cross-sex hormones they won’t have any fertility to preserve. Their gametes can’t mature enough to bank. Indeed if your natal puberty is blocked you may never orgasm or feel sexual desire. Imagine the outcry if, say, disabled children were effectively neutered at 11.
But where is the ethical debate and long-term research into how Lupron — a prostate cancer drug used “off label” on children — affects brain development at puberty? Or into the impact of massive, lifelong doses of testosterone on young natal women’s health? Or into where this enormous surge in children diagnosed with gender dysphoria (ie feeling they are in the wrong sex body) is coming from? In particular, why are 1,806 of the 2,509 adolescents (72 per cent) referred in 2017-18 to the Tavistock NHS gender identity service girls?
Such is the power of the trans lobby to damage academic careers with accusations of transphobia that few dare challenge new orthodoxies. Which makes research published this week in the peer-reviewed science journal Plos One by Lisa Littman of Brown University remarkable. As a public health expert, she addressed the rise in teenage girls with gender dysphoria like any other medical outbreak. This condition affects only 0.7 per cent of the population, so why were clinicians reporting clusters of trans cases in many high schools?
She questioned 250 parents whose teenagers (83 per cent girls) had shown no signs of gender dysphoria as children. The vast majority (63 per cent) had pre-existing mental health problems including serious psychiatric disorders; half self-harmed; half had suffered a traumatic event such as death of a parent/sibling, family divorce or sexual abuse. (One previously happy 16-year-old was raped and a few months later declared herself trans.) Such “coming out” invariably occurred after binge-consumption of online trans forums on Reddit or Tumblr. Many girls did so in tandem with peers: one parent reports how her 14-year-old daughter and three friends chose male names and announced they were trans boys.
This, says Dr Littman, has direct parallels with other “peer contagions” in teenage girl cliques such as bullying, drug use and anorexia. In person and on chatrooms, anorexic girls egg each other on to avoid doctors’ efforts to make them eat and compete to be the thinnest. “If similar mechanisms are at work in the context of gender dysphoria,” she notes, “this greatly complicates evaluation and treatment.”
Online trans activists, she notes, encourage young people to interpret their vaguest dissatisfactions as signs they are trans. Do you feel an outsider? Are you awkward in your body? One parent wrote: “I believe my child experienced what many kids feel on the cusp of puberty — uncomfortableness!” But the online world insisted she was in the wrong body. Such forums advised young people to edit their childhoods to persuade clinicians they had always felt trans to gain treatment. One girl who went through early puberty felt fat because she’d grown breasts: when she discovered that hating your breasts is a sign of being transgender she edited the text of her diary.
There are strong comparisons here, says Dr Littman, with “false memory syndrome”, a now-debunked theory among 1990s psychotherapists that ordinary problems, like struggling to form relationships, meant a person was repressing childhood abuse. In the course of therapy these wholly imaginary incidents were “recovered”.
In publishing this report, Dr Littman imperils her reputation. Trans groups will ask what the hell a parent knows about a child’s inner thoughts, or dismiss her respondents as bigots. (In fact more than 80 per cent support gay marriage and trans rights.) They will claim these kids are just realising their true trans identity, although the vast majority were reportedly less happy and stable after they “came out”. They will do anything but admit that what Dr Littman has termed “rapid onset gender dysphoria” among girls is a social contagion, because this undermines their key ideological principle, that gender is not constructed but innate.
The trans movement is mainly led by trans women, who never experienced the maelstrom of female puberty, its intense but fleeting certainties. Some transitioned late after fathering children. What do they care about the fertility of troubled girls? Meanwhile LGBT groups such as Stonewall lobby to expedite hormones and surgery, rather than urge diagnostic caution.
The vast majority of these cases involve lesbians, whose same-sex attractions are seldom clarified until late teens. By then they will be compelled towards blockers, testosterone and double mastectomies, with ovaries, as one endocrinologist put it, like “shrivelled raisins”. In this medicalised iteration of conversion therapy, these young lesbians will be transformed into heterosexual men. It’s time we stopped making it up as we go along.