When Veronica’s* 15-year-old daughter told her mother and stepfather last year she thought she may be gay, there was no hesitation for this modern, liberal couple in supporting their only child as she adjusted to her sexuality.
After a fledging relationship broke up, however, and Caroline* suddenly announced she wasn’t gay but a boy trapped in a girl’s body, the news this time turned a once happy home into a combat zone.
With an unprecedented increase in young people reporting unhappiness with their biological sex, the experiences Veronica recounted have worrying implications that should concern all parents — not least the approach of the medical profession towards these young people.
A greater than 100% increase in referrals was reported in 2015/16 by the Gender Identity Development Service (GIDS) at London’s Tavistock and Portman NHS Trust, the centre for treating children and young people who may be suffering from gender dysphoria – discomfort with one’s birth sex. Last year saw another 42% rise. And data from clinics in Canada and Holland suggest for the first time gender dysphoria in adolescents now affects more girls than boys.
Questions are now also being raised about whether or not some of those describing themselves as transgender are, in fact, part of a new phenomenon.
Termed ‘rapid onset gender dysphoria’, it has been the subject of a study in America and described by one academic there as an epidemic.
ROGD is also being referred to as a ‘social contagion’ as incidences can appear in clusters or affect young people spending a lot of time accessing online sites and groups where being transgender is considered cool and brave. Identifying as transgender – particularly after the attention given to celebrities such as Caitlyn Jenner – may bring a sense of belonging to children who may be socially awkward, perhaps suffering mental health problems. Critically, it is believed to be temporary.
Veronica believes her daughter fits the bill for ROGD. ‘I split up from her father when she was a toddler which brought its own problems as she was growing up,’ Veronica explains. ‘Then she lost a relative after a long illness, followed by all of her friendship group as she first told them she was gay, causing some to reject her, before her romantic relationship with one of the girls ended badly.’
The transgender announcement came out of the blue shortly after. ‘There was no inkling beforehand,’ Veronica says. ‘She wasn’t tomboyish, wore dresses, had always had waist-length hair. But suddenly she started climbing trees and behaving as if that’s how she believed a boy should.’ Caroline even started wearing a chest binder to hide her developing breasts.
‘She talked about being trapped in the wrong body and had been born with a ‘boy’s brain’, that if we weren’t supportive of her aim to ‘become’ a boy we were guilty of abuse and she’d kill herself,’
Veronica recalls. ‘I recognised the expressions she used because I was monitoring the sites she was accessing. Many advocated children distancing themselves from their parents.’
But what is most shocking about Caroline’s sudden subjugation of her sex was the reaction of state services that, Veronica says, seemed concerned only with propelling Caroline towards ‘transitioning’ fully into a male.
Veronica informed Caroline’s school in their Midlands market town who, without consulting Veronica, began to refer to Caroline by a male name and using male pronouns. She was also referred to an NHS counselling service for young people. ‘At the first session,
I was allowed in only at the end just in time to hear the counsellor reassure Caroline she didn’t have long to wait until she could access hormone blockers
which can’t be prescribed until the age of 16.’
Veronica was horrified. ‘I thought they’d try to get to the root of why she so suddenly felt ‘trapped in the wrong body’ rather than assuming she was,’ Veronica says. Veronica allowed her daughter to attend a couple more sessions while she searched for an independent therapist.
But events took a sinister turn as the counselling service removed Caroline from lessons for a meeting without her mother’s knowledge before calling the family to report that Caroline didn’t want to change therapists – and with the chilling implication that if they weren’t more supportive of her wishes, Caroline may not continue to live at home.
Last month a meeting was called at Caroline’s school with the counselling service at which Veronica was told Caroline was considered to be Gillick competent – a term used in medical law to decide if a child under the age of 16 is capable of consenting to their own medical treatment. The family was also being referred to social services.
Returning home that evening visibly upset and fearful at the speed with which her rights as a parent were being dismantled by strangers, yet another row broke out. But it became clear Caroline herself had not been informed of the meeting that had been called that day. In a rare moment of unity, mother and child lodged a complaint about the divisive and inflammatory approach taken by officials even Caroline recognised was causing harm to her family.
They are awaiting contact from social services.
‘If we hadn’t now found our own therapist who doesn’t seem hellbent in affirming what I think are mental health issues, I’d have keeled over,’ Kristina says.
‘I see a child desperately trying to fit in and she finds people online who accept her but who reinforce how she feels.
‘The trust has gone between us now and it is heartbreaking,’ Veronica adds. ‘We all feel utter despair at the entire process and the people following guidelines which we believe to be morally wrong and damaging to our daughter’s longterm future.’
Contact has been made by several other parents with similar stories, including mothers from America and Canada who are also reporting alarming enthusiasm by health professionals to confirm their children’s beliefs without question and the speed at which they are then propelled towards medical intervention. Some say they have ‘lost’ their children. All were fearful of talking openly in case they were accused of being ‘unsupportive’ and therefore abusive.
‘There’s not enough time for these kids to think and make a good decision,’ says Susan Bradley, a child psychiatrist in Toronto, who has specialised in child and adult gender dysphoria for four decades. ‘They’re being pushed. And
once you start on the path of blockers and sex hormones and surgery, you keep going, not least because some of the effects are irreversible.
Periods stop, breast enlargement and hair growth diminishes, the penis and testes don’t grow. In girls the voice deepens permanently. There is decreased calcification of bones so there may not be the same growth they should have. There is some evidence it interferes with fertility.’
Two young people who believed they were transgender and have now ‘desisted’ also made contact, one of whom believes she may have considered taking her own life had she begun the medical process of transitioning only to have changed her mind. Of course, there are many young people who feel similarly had they not been allowed to transition.
The pattern of young people suddenly deciding they are transgender at the same time as others among their peers in real life or online has been examined in a descriptive study currently awaiting peer review and publication by Dr Lisa Littman, assistant professor of the Department of Behavioral and Social Sciences, Brown University of Public Health, New England.
Although Dr Littman cannot discuss her findings before publication, contact has been made with doctors familiar with her work who say the group studied reflects their own observations: young people suffering mental health problems, personality disorders or who have experienced trauma; report ‘homoerotic’ feelings; and with a disproportionate number on the autism spectrum.
Studies suggest rates of autism in transgender referrals range from 9.9% to a Dutch service to 26% of adolescents in the Finnish service.
‘What we are observing with ROGD is not like cases of child onset gender dysphoria, which are obvious and affect kids who do not learn their behaviour patterns from anybody,’ says Michael Bailey, professor of psychology at Northwestern University, Illinois, Chicago, a specialist in gender identity and dysphoria. ‘It develops independently of how they socialise and usually very early – by age four or five.
ROGD, he says, however, is ‘socially contagious’. He also describes it as a ‘rapidly growing epidemic’. ‘If you are seeing two, three, four transgender people in a year group, the likelihood that that may happen by chance is low,’ Professor Bailey says.
Dr Littman herself adds:
’Theorising the increase is due to decreased stigma doesn’t explain the predominance of girls now presenting. There’s something going on that isn’t explained.’
Dr Polly Carmichael at GIDS says the clinic is aware ‘there is discussion around what is being described as rapid onset gender dysphoria,’ adding: ‘There have always been adolescents who have more recently come to understand their experiences as being cross-gender. Some of those will go forward to physical interventions and some will not.
‘This is a time of huge interest in gender and young people are exploring different ways of expressing theirs,’ Dr Carmichael continues. ‘Young people use social media and the internet as part of their everyday lives, so it will naturally be a venue for their exploration.
She points out there is no research currently about clusters of referrals in the UK and ‘there isn’t yet any published evidence distinguishing ROGD in clinical samples’.
Dr Carmichael concludes: ’We feel it is appropriate to take a considered and paced approach to support every young person on an individual basis and not assume outcomes.’
Names have been changed.