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In my last post I mentioned that there was another trend I wanted to cover, and that trend is the increase in the number of people with a transgender or gender non-conforming identity (TGNC). Part of the reason why I didn’t cover it in the last post is that it’s something of a minefield, and if I’m going to get blown up (which I suspect I am) I want it to be after a full and complete explanation of my position, rather than a paragraph tossed in together with a discussion of CPUs and heroin. Also I, probably naively, assume that if I really explain things in a calm, dispassionate fashion that I won’t get blown up, period. Recent events have left me less sure of that, but I persist in believing it nonetheless.
I’ve actually been thinking I needed to write a post on this subject for a long time, but earlier this month I read something that really struck me. It was a report by The Associated Press, on a recent study published in the journal Pediatrics. (Being syndicated, I came across it in US News and World Report.) The study they were reporting on claimed that nearly 3% of high school students identify as TGNC. Specifically from a group of 9th and 11th graders in Minnesota.
The study is an analysis of a 2016 statewide survey of almost 81,000 Minnesota teens. Nearly 2,200 identified as transgender or gender nonconforming.
I thought it’d be nice to know the exact numbers rather than “almost 81,000” and “nearly 2,200” and after some digging I found the original study. It was 2,168 out of 80,929 meaning it was closer to 2.7%. Accordingly I’ll be using that number. But regardless of whether it’s 3% or 2.7% that would appear to represent a gigantic increase in just the last few years. The AP article mentions another study out of UCLA which claims that 0.7% of teens aged 13 to 17 identify as TGNC. Which I would argue, even if it’s closer to the mark is still a large increase. Also it should be noted that the 0.7% was an extrapolation of teen rates from adult answers, meaning that if the trend has recently spiked it might explain the discrepancy.
It has been many, many, many years since I was in high school, but in spite of that fact, and the fact that it’s only a single data point and all the other reasons which make it not a very good comparison for Minnesotan high school students in 2016, I’m going to bring it into the discussion anyway.
My high school was a three year high school that had, conservatively, 1700 students attending. If we apply the 2.7% number to that student body we get 46 TGNC students. Now as you might imagine we didn’t have even a single openly transgender student back then. An experience I imagine most people from my generation share. And any attempts on my part at guessing how many closeted TGNC students there were is going to be wild speculation, but having come this far down the road I might as well continue and guess that maybe there was a couple? Certainly I haven’t heard of anyone coming out later, even in these more tolerate times. If, for the sake of argument we take my number and extrapolate from that we get a compound annual growth rate of nearly 11.5%. Which as I pointed out in the last post does not have to go on for very long before it’s 100% of people. Also I don’t think the rate of growth has been constant since the late 80s, I’ve talked to people 10 and even 20 years younger than me and they report the same basic impression of their high school that I had of mine. Which would mean that it could be a lot higher than even 11% which is already pretty high.
One of the reasons I used my high school experience as a baseline, is that I didn’t find a lot of good numbers on growth in TGNC individuals. And the one thing I did find was in Swedish, that said it’s dramatic enough that I’m going to reference it anyway. It’s a chart of referrals to a clinic specializing in gender dysphoria among children. From 2000 to 2006 the number of yearly referrals is in the single digits. After that it starts to gradually increase, but stays below 20 until 2011. 2012 and 2013 both look to be around 25, but then in 2014 it starts skyrocketing and by 2016 it’s gone all the way up to 197 referrals. Basically an eight-fold increase in the space of three years. I understand this is a report from a single clinic in Sweden, but I think it matches my assumption that the growth rate has largely spiked only very recently.
This aside, for my purposes it’s sufficient to know that it’s a trend and that it’s growing very quickly, which everything seems to indicate. From this, hopefully, safe assumption, I want to spend this post examining the various theories for why this might be happening:
The transgender and gender non conforming have always been with us they’ve just been hiding. Accordingly it’s not the number of TGNC individuals who are increasing, but only our awareness of them
Under this theory the number of high schoolers who are TGNC has always been around 2.7%, and it is only now in this more tolerate and enlightened time that they finally are free to express their true selves.
My sense is that this is the current conventional wisdom. Though that may be putting it too strongly. But you can see evidence of it in the AP article:
Dr. Daniel Shumer, a specialist in transgender medicine at the University of Michigan, wrote in an accompanying opinion article in Pediatrics that the study supports other research suggesting that earlier counts of the trans population "have been underestimated by orders of magnitude." He said that the higher numbers should serve as a lesson to schools and physicians to abandon limited views of gender.
Notice that he doesn’t say that the numbers are increasing but that earlier counts were “underestimated by orders of magnitude.” Leading one to assume that the numbers and percentages are static, we’re just getting better at counting.
For my part, I tend to be skeptical that this is the case. For all the issues I have with full normalization of homosexuality, they can at least point to a fairly deep historical precedent. With gay communities in times and places even when persecution and repression were at their most severe. While there is some evidence for historical TGNC you get the sense that it mostly was present when it was required by culture, rather than existing in spite of culture, like homosexuality.
That said I’m not ruling it out. In this post I’m not ruling anything out. It’s entirely possible that this is exactly how things are.
TGNC numbers are increasing, but that’s a good thing, and it goes hand in hand with progress elsewhere
Last year I attended the Mormon Transhumanist Conference (and I intend to be there again this year). One of the talks was about the gender spectrum and the speaker gave, as her opinion, that when the Proclamation on the Family talks about gender being part of our “eternal identity” that in this case eternal means ever-changing. That one of the abilities we’ll have as our power grows and as we draw closer to Godhood will be the ability to change our gender as we desire. While I continue to argue that this bears no resemblance to any LDS doctrine I’m aware of, it does fit right in with transhumanism.
To put it another way, this theory holds that the number of TGNC people is increasing because technology in general is increasing, and with it an ability to throw off shackles and restrictions which previously would have been unthinkable. An idea that’s at the core of Transhumanism. And, If we consider just what we can now do in this area, then this is obviously true. If we consider what we should do, then the situation becomes a lot murkier.
There is certainly a way in which this works together with the first theory. Previously people who felt that their gender was different than the body they were born in had very little recourse. Now through the marvels of technology we can offer them hormone treatment and gender-reassignment surgery. But beyond that, I get the sense that there’s also a way in which people feel there’s a moral or even spiritual arc to the whole thing, that the freedom to choose your gender goes along with all the other freedoms progress has brought us. That certainly seemed to be the sense in which the MTA speaker meant it.
Under the first theory, the 2.7% of people who have always been TGNC are driving the development of this technology, but under this theory if technology enables transition might it also be encouraging transition?
As I already alluded to, I freely grant that increased availability may lead to an increase in identification, what I’m not sure about is whether it’s a good thing. And you’ll have to wait until part 2 before I tackle that question.
TGNC numbers are increasing because of hormones and other chemicals being introduced into the environment
You don’t have to look very far to find people speculating that there has been a definite decrease in masculinity over the last several decades. Some of this is ascribed to the softening of the culture in general, which we will cover in a moment, but some of this has been tied to hormones in the environment or endocrine disruptors like BPA. If it’s the chemicals that are responsible for depressing masculinity, then it’s not too much of a stretch to imagine that it might get so low that it flips things over to femininity, or just mixes things up entirely, giving us the genderqueer designation. This explanation would be more plausible if the transitioning were all in one direction, but it’s not. That said, there are more male to female transgendered individuals than female to male. With most people estimating the ratio at around 3:1. Also it’s not like we have a smoking gun of causation, so hormones in the environment could be causing all manner of changes in both directions.
It is widely recognized that pharmaceuticals end up in the water supply, included in this are things like birth control pills and testosterone replacement pills. The presence in the environment of chemicals has been a concern for the environmental movement since at least the time of Rachel Carson if not before, one which hasn’t gone away. The question is, is anyone concerned that hormones or other chemicals in the water supply might be contributing to the increase in the number of people who identify as TGNC?
If you search the internet for any support for this theory you immediately find an article titled Fish becoming transgender from contraceptive pill chemicals being flushed down household drains. Dig a little deeper and you’ll find a Smithsonian article which explains that the word “transgender” was never used in the original article, the article was about fish becoming intersex, which is not the same, and that it’s not clear that it was contraceptive pills causing the problems it could easily have been caused by other chemicals in the water. In other words still likely something humans are doing, but not something you can blame entirely on birth control pills.
My own sense of things, is that while something along these lines might be a factor in the increase, if it is, it’s a small one. If you could draw a clear link between some chemical or hormone and an increasing number of people identifying as TGNC, then I think people would have done it already. There would be a larger pattern in how and where it happened. Also most of the candidates under discussion have existed in the water supply for a lot longer than just the last few years, which is when, according to the numbers from our Swedish clinic, most of the increase has happened. At least as I read things. But maybe I’m being naive. The same kind of people who worry about chemicals in the water are the same kind of people who are proponents of theory one, that the underlying rate has not increased at all. Accordingly it might not be in their ideological interest to point out any possible connection.
TGNC numbers are increasing because of mutational load
I talked about this in a previous post. The idea of mutational load is that every generation a certain number of negative mutations are introduced. In the past these mutations didn’t accumulate because individuals with negative mutations were more likely to die without reproducing. As such the mutation load was kept in check because most of these negative mutations did not get passed on. With the advent of modern medicine, the number of people who die before getting the chance to reproduce is very low, regardless of any negative mutations they may be carrying. As such more get passed on, and the overall level across the entire population begins to rise.
As I mentioned in the previous post this idea provides a potential explanation for many troubling modern trends. The increase in autism, low sperm counts, allergies and possibly even suicide risk. If, and I grant that this is a big if, we decide that these things can be explained by increased mutation load then it’s hard to imagine that we wouldn’t consider adding the increase in people who identify as TGNC to the list as well. Also it should be noted, while we’re discussing this that evidence is growing for a link between gender dysphoria and autism.
I suspect that saying that TGNC individuals have a negative mutation is going to upset some people. (I suspect that everyone will be upset by at least one thing in this post.) But it’s important to clarify, again, I’m just trying to make a comprehensive list of explanations that are at least somewhat plausible. I don’t have a horse in this race. (Which is not to say that some horses don’t look better than others.) Also as you may have noticed the theories have moved from least upsetting to more upsetting, so at least I’m trying to ease you into some of the more controversial theories.
As I said, saying that TGNC individuals have a negative mutation may be upsetting, but in a sense everyone who argues that TGNC individuals were born that way, are also arguing for a genetic explanation of the condition they’re just not arguing for a recent genetic explanation. Which is what separates that theory from this theory. Also they may object to the application of the “negative” label. But this is something else I’ll be covering in part 2.
As to my own probability assessment. It’s hard to say. It makes a certain amount of sense, but it’s also a terrifying possibility. Also it’s hard to square it with a dramatic spike in the last couple of years.
TGNC numbers are increasing because of cultural changes
As I mentioned above, my sense is that historically homosexuality was present regardless of how oppressive the surrounding culture was, but that TGNC traits seemed to mostly be present when it was integrated with the culture. In more modern eras, we have the example of drag shows. In ancient Assyria, there were parades. And then there was a cult in ancient Greece who worshipped Cybele, and as part of that worship men castrated themselves, and thereafter dressed and identified as females. If you toss in examples of TGNC among the Native Americans, you have mostly covered the historical examples, at least those listed in Wikipedia. And I’m confident if there were any other large historical examples that they would have found their way into the article, but I’m not any kind of expert.
Based on these limited examples, as I said, it’s my sense that culture may have pushed TGNC rather than the other way around. If that’s the case, and given past trends that have run through society and in particular taken hold among teens, it’s not inconceivable that the increase in TGNC teens could be because of a subconscious sense that it’s now cool.
While TGNC advocates may take issue with the “coolness” theory, they appear to acknowledge that culture is playing a big part in things, such as allowing previously closeted TGNC individuals to out themselves. The question is, if the changing culture is having such a massive effect (once again refer to Swedish Clinic chart) is there any way in which culture may be driving the increase?
All of this is to say that culture is definitely changing, but how much culture is following and how much it’s leading is a very complicated issue. But one thing is clear, culture is definitely contributing to the increase, if for no other reason that people feel far more comfortable identifying as TGNC.
A desire to identify as a different gender than the one you were born with is a sin, and it’s increasing because sins of all kinds are increasing.
As you might imagine, I’m not going to shy away from an explicitly religious theory. Which is not to say that I believe it’s a doctrinally correct theory. (For Christians in any case.) Also before we can do anything else, it’s important to identify whether sin in general is increasing. If it’s not, the theory is considerably weakened. My guess is that most people belonging to any of the Abrahamic religions have no doubt that it’s increasing. And many of the irreligious, though perhaps unwilling to use the term “sin”, would say that the world is getting worse as well. (Pinker would disagree of course.) Given that this is a religious theory, the attitude of the believers is probably sufficient for our purposes.
With the other theories, certain consequences and actions naturally follow, but with this theory they’re a little bit more opaque. If unhappiness with “the gender you were assigned at birth” is a sin, than what should be done about it? It is true that many activities identified as sinful take the form of giving into what have historically been identified as “baser” urges. From this you could imagine classifying the urge to be transgender as no different than the urge to have sex before you’re married, with a similar exhortation to resist it, and for some people (not me) that’s as far as you need to go. For others, the idea of repressing the urge to have sex before you’re married is one they don’t even consider. (They may resist the urge to have sex, but their marital status has nothing to do with it.) And in fact outside of dieting, and exercise, the idea of suppressing urges has to be at some sort of historical nadir.
And this gets more into what I feel the LDS position is on TGNC, that it’s more akin to homosexuality, being gay isn’t a sin, it’s acting on it that’s a sin. Though with TGNC acting on it is a little less clear. Gender-reassignment surgery certainly counts (and is explicitly mentioned in the LDS handbooks) but what about wearing women’s clothing if you’ve previously identified as male all your life? What about binding your breasts if your a woman who feels like man?
I am sympathetic to those who find this theory horribly offensive, or those who aren’t offended but still think it comes across as both bizarre and unlikely. Beyond that even if you could get on the same page, I think many people would point out that being TGNC is tied to people’s identity in a way that being horny (regardless of orientation) really isn’t.
In other words this theory, even on it’s on terms, is kind of messy. And I’m not a big fan, particularly since it so easily slides into mistreatment of the TGNC, when people confuse the sin for the sinner. (Particularly, since, as I pointed out, the sin is actually somewhat unclear.) This sort of mistreatment is something I feel there is far too much of, even now.
That’s where we’ll end for this week. I had intended to cover everything in a single post, but I haven’t even covered all of the different theories yet, so you’ll have to come back next week for part 2.
There are also many theories for why people blog. One theory is that they are motivated by the money they can earn. If that theory seems at all likely to you, consider donating. (My own sense is that this theory is not very likely.)
"My high school was a three year high school that had, conservatively, 1700 students attending. If we apply the 2.7% number to that student body we get 46 TGNC students"
ReplyDeleteThe problem here is I'm all but 100% positive you have not kept in touch with all 1700 students who attended HS with you years ago. Given that you don't really have a measure where you can say 0 out of 1700 were transgender back in the day whereas 2.7% or so now are. We do know 'sex change operations' were being done in the 50's and attempts were made even before so while transgender people are not a large portion of the population, there seems to be no evidence they were ever 0%. (Cross dressing, not exactly the same thing, goes back ages (see Shakespeare's female roles being played by male actors) and seems to show up a lot as either a gag or plot device in literature and plays)
I think the most simple theory would be that gender is primarily set up in the brain's structures with even the genitals being essentially secondary sex characteristics. Since gender and anatomy line up *almost* all of the time, it is really easy to assume it must line up *all* of the time. So which world do we live in? One where gender really always aligns with anatomy or one where it almost always does? The observations we would make would almost always be the same in both worlds unless we started collecting a lot of data.
"And this gets more into what I feel the LDS position is on TGNC, that it’s more akin to homosexuality, being gay isn’t a sin, it’s acting on it that’s a sin. Though with TGNC acting on it is a little less clear. ..."
Hate to say it but to me this smells like the LDS's position is they haven't thought it through, their system of knowledge has provided no guidance to cover it, despite pretensions of supernatural and transcendent origin, and they would rather close their eyes and hope that this whole thing is just some type of illusion that could resolve the issue for them (maybe not some but all transgender people are just somehow confused and once they really think about it they will fall into line and be normal like everyone else and stop stressing the dogma).
This is a problem for religions that claim to be revealed (Mormon, Islam, Christianity in general etc.) but less so for those that are more about process than revelation (Buddhism, possibly Judaism)
I would never argue that TGNC never occurred historically. The question I'm trying to get at is why is suddenly increasing so dramatically. And is the increase all just in the visibility, or is there an increase in the "base rate". I'm interested in your opinion on this. You talk about gender and anatomy lining up *almost* all the time. Is the rate at which they line up dropping? Or are we just becoming more tolerant?
DeletePerhaps that's what you're getting at with your "collecting a lot of data" comment, but refer back to the Swedish Clinic, and the Minnesota numbers, was there some kind of data collection revolution in the last couple of years?
Well you seem to be on the right track here. If the number is some constant, then there should have been about 42 or so in your HS. But you don't remember 42, but then you haven't kept track of 1700+ people you went to HS with so you really don't know...and this would require a lot of 'keeping track', as we know maybe only a handful of people who were extremely close to Bruce Jenner would have had any idea.
DeleteAn even bigger problem is you'd want to know how many of your HS class identify as transgender. Many trans people never get operations or even present in public outside their assigned gender. Many live out their lives privately with little or no clue to outsiders. For you to find out if the number in your HS class was 42 (indicating a constant %), lower (indicating an increasing incidence) or higher (indicating decrease), would require you to conduct a rather intimate census of everyone you went to HS with that would be a bit more deep than Kinsey's sexual research. I will, for what its worth, support your request for a research grant from this administration :)
There's also a lot of incoherence I see in criticism of TG. If gender is purely biological, then you are saying it is simply a matter of anatomy and anatomy can be changed. In other words, if blonde is just a hair color, then a person can become a blonde by just coloring their hair. But TG critics don't like this, no matter how good the anatomy might be, they insist there's some special non-changing essence to gender. Even if Caitlyn Jenner gets the best 'bottom surgery' possible, they are right to refuse to say she's a woman....
ReplyDeleteBUT then if gender is something more fundamental than genital anatomy, then how do you know Caitlyn Jenner wasn't really born female and her anatomy was but a birth defect? If you say some woman is not a 'true blonde' because she colors her hair, then you're saying blonde is about something else than hair color. But if it is about 'something else', then the woman who doesn't appear to be a blonde could say "I'm truly blonde and I use hair color as an aide to achieve who I really am".
TG critics here are losing the culture question very fast because they don't have any ground in the logical argument. They have to pick a position and follow it through.
Okay, I've offered up a bunch of theories. And I'll be honest I'm not sure what's happening. But once again I'm interested in what you think is happening. Which theory do you back? Is it one of the one's I listed or one I didn't?
DeleteFrom a sex perspectivep there is a difference is one of fundamental biology in every cell of a person's body - male vs female. This comes down to the definitional difference of sex versus gender. If you can't agree that Jenner's sex is fundamentally male, there's nowhere to go from there. If we can agree on that, then it all boils down to the nebulous question, "what is gender?"
DeleteThe general definition of gender is that it is socially, or potentially neurologically, constructed. If it's a social conduct, it's unclear what causes certain individuals to interpret their gender to be different from their biological sex based on cumulative social interactions. If it's neurologically determined, we really have no understanding of the fundamental mechanisms involved.
Since we really don't know what causes individuals to identify as a different gender, it's a little premature to claim victory for one side of the argument that claims it is a natural phenomenon to be respected and accepted, over the side the claims it's a condition to be treated. Both sides are arguing from the same degree of ignorance until we know what causes TG. Since we don't even know whether it's increasing our even increasingly identified, I try to be be a little less certain in my proclamations.
I suspect what is happening is probably akin to autism. On the one hand we know more about what to look for hence we see it more than we used too. On the other hand, the definition has been expanded so more are covered by it than they used to. However since we can't measure past populations with today's tests it's hard to rule out if autism has remained constant, decreased or increased. I think we might get to a point where we could rule some things out. For example, I think we could rule out 0% from your days in HS. Might, though, the rate have been 1.5% and now it's 2.5%?
DeleteThere might be something else afoot too...autism, like gender, is about how the individual relates to society and vice versa. Since society isn't constant, this isn't as simple as asking what the 'rate' is.
Well 'social construct' doesn't mean something isn't real. Money, after all, is a social construct yet it really matters and makes a difference. On the other hand, society is a collection of neurological beings so there almost certainly has to be some interplay between the two.
DeleteHere I revert to my 'tenth man' idea. Perhaps evolution wise humans are wired to 'dissent' should any consensus reach 100%. What this would mean is things that are generally true and helpful to survival would be generally accepted by almost everyone but absent some mechanism like that evolution would seek to pair back on our brains (which consume a lot of energy) and hard wire more behavior as instinct...yet keeping our hungry brains leaves us more flexible.
So perhaps no matter how we socially construct gender, there will always be a small portion who will not fall into it. Recall the 2nd Matrix movie where the designer of the Matrix notes that some small percentage of humans just cannot accept the optimal Matrix hence the endless cycle of rebellion and rebirth.
I think the autism comparison is a good one, and one I largely agree with. The key question is whether we should be working to encourage it, or "treat" it.
DeleteAlso to clarify, if you'll re-read the post I never claimed the rate at my high school was 0%. I claimed that 0% were openly transgender, but that if I had to guess there were probably a couple who were closeted transgender, which would be a rate of around a tenth of a percent. Also as I said repeatedly I was more offering it up as a story of how I'm experiencing the phenomenon than as actual hard data.
Perception wise, though, would you have noticed a difference if I told you the number was actually 42 rather than 2?
DeleteA while ago Tyler Cowen at Marginal Revolution wondered why the Ancient Greeks never thought of doing actual controlled experiments and observations to do science. I think part of the reason is to do that right you need to keep good records, which requires paper and paper was expensive. Another part, though, is that it's really hard to tease these things unless you're keeping good records. A drug might extend survival by 6 months but what that means is out of 100 people some will live years more, others will die right away and the signal is so weak it's hard to even notice that it works (or the opposite, a few good cases fools one into thinking the drug is amazing).
I really don't think we have good cause to reject the null hypothesis here. Namely that transgenderism has been roughly constant while it's detection, recognition and acceptance has changed. I also think this should be the null hypothesis, meaning the burden is on the side that wants to argue it has increased to actually demonstrate that.
The Minnesota article breaks out the TGNC population, and asks their perception of their femininity/masculinity. Interestingly, only about 30% of TGNC males perceived themselves as feminine or somewhat feminine, and only about 25% of TGNC females viewed themselves as masculine or somewhat masculine (male/female is the individual's biological sex).
ReplyDeleteI should go back and review it. But maybe you can just answer this question. The problem I run into with stuff like this is that I honestly get easily confused, because the terminology is sometimes reversed and sometimes not. For example, when someone says "transgender male" they generally mean someone who was born female, but now identifies as male.
DeleteSo with these statistics are they saying only 30% of the people who were born male but who now experience gender dysphoria experience their dysphoria as being they are really female? Or is it saying that 30% of the people who were born female but who now identify as male feel that they experience any "residual femaleness"?
When I first read this post, I assumed the first explanation couldn't possibly explain the 4x increase over time. I assumed the definitional difference between "TG" and "TGNC" to be minor, with the TG-NC split to be at most 90%-10%. However, looking at these survey results, it's hard to imagine a trans-man responding as anything other than masculine or somewhat masculine, and certainly not as feminine! Therefore, it appears the survey represents a split closer to 25%-75%, TG-NC. Multiplying out these numbers, we get a population percentage of somewhere between 0.7%-0.9% for transgendered individuals (after taking out the gender non-conforming but not transgendered group). Which is in line with traditional expectations. In other words, this could easily be explained by changing definitions. I know other studies have sought to measure the TG community over time, however many of them are equally subject to changing definitions. It's easier to get published when you're representing 3% of the population than when you're representing less than 1%.
DeleteMeanwhile, the survey asked teenagers whether they conform to the gender they were assigned at birth. Asking teenagers whether they conform to anything is more likely to garner a dissenting response. I'd like to see a longitudinal cohort study that actually follows those NC students over time.
It's not asking for "residual" feeling. Survey participants choose one or the other, or neither. It's asking the person to identify whether they feel feminine or masculine (with "somewhat" for either side, and a neutral option being added in for a 5-point scale). The study first splits out the TGNC population from the survey data. Then they report, from TGNC people who were born male, what people reported on the 5-point scale. Same with the female data.
DeleteSo if you take someone who has been put in the TGNC pool, and you ask questions about how that person identifies themselves, this scale seems instructive. For example, among people who were born male and were identified as TGNC in the survey, perceived gender expression was 15.7% very feminine, 15.1% somewhat feminine, 29.3% equally feminine/masculine, 20% somewhat masculine, and 19.8% masculine (table 4). I have a hard time seeing 40% transgendered people, who were born male and now identify as female, answering "I perceive myself as at least somewhat masculine" when there is clearly a feminine option available. Thus, it seems clear the NC portion of the population is a larger part of this survey group than the TG portion.
I'm 99% sure 'transgender male' means the person was born female but identifies as male.
Delete"So with these statistics are they saying only 30% of the people who were born male but who now experience gender dysphoria experience their dysphoria as being they are really female?"
I'm not sure what this means? It sounds like you have 100 people born male who are transgendered but only 30 of them feel they are 'really female'. But then what are the other 70 saying they feel like? A mix of male and female but not fully either, or 'fluid' ?
On interesting podcast I heard once described a guy who had states of 'feeling female'. Sometimes they would just hit him randomly, others they seemed to be linked to stress. But after an hour or two they would just pass. He felt he had an novel mental condition that has yet to be diagnosed and documented in the literature *but* several therapists said he was in fact 'simply transgendered' and didn't realize it yet. Interesting they came back to him after some time and he reported that the states became more frequent and eventually he identified as being female almost all the time.
Clearly what makes this difficult to study is we can only measure what individuals report about their internal mental state but this relies on them to be perfect at being able to self-diagnose. Imagine we were unable to measure blood sugar and instead had to rely upon diabetics to report what they felt their blood sugar was. This is not the same, though, as saying people are 'just choosing' a gender. It is simply the case that some conditions have no external diagnostic measures yet other than asking the patient.
This is an interesting topic for the philosophy of science in general. There are many things that are only subjectively experienced, but are nonetheless real. Since the scientific method is founded mainly on objective observations, this makes these kind of subjective experiences very difficult to measure accurately. As someone who at one time worked in clinical pain research, and who currently works in oncology (where, among other things, we measure cancer pain) this is something of a challenge at times. There's simply no objective measure for pain. Or love, hate, etc. It is all subjectively experienced, but then nobody is going to argue it isn't real.
DeleteLikewise with TG. It is subjectively experienced, but when we separate out the group of people who subjectively report they feel TG, we find there is a real difference (suicide rate) for this group.
As to the numbers from the survey, they combined TG with NC. I argued that since this is different from a straight TG definition, we should not directly compare TG and TGNC unless we know the difference to be small. Since a large percentage of the people whom they have identified at TGNC respond to basic survey questions in a way that is opposite what we would expect TG to respond as, we cannot assume these two measures are similar. More likely, they are measuring about 25%-30% TG, with the rest being a group that is otherwise poorly defined (in the study directly and in the literature in general).
I absolutely agree that something being a social construct doesn't mean it isn't real. In fact, I think if this phenomenon were just an expression of the principle that "a small percent of people will always reject something" there wouldn't be the same degree of controversy. I think the concern comes due to the suicide rate in the TG community. In the scientific literature, I've seen anywhere from a 40%-50% rate. Compared to the rate of the general population (a quick Google search turns up 30 per 100,000, or 0.03%. If we can identify a trait (even if 'socially constructed') that is associated with such a dramatic risk of negative outcome, we should clearly seek to understand the cause.
ReplyDeleteThe popular explanation I've heard for the cause of this high suicide rate in the TG community is that it is a result of bullying. TG kids are exposed to increased levels of bullying than the general population, and this is causing many of them to take their own lives. If you look up articles in the scientific literature about the link between suicide and bullying, you find that everyone appears to agree there is a small but real link between the two; with some studies finding a link for males but not females, and some disagreeing and finding a link with females but not males. The effect appears to be real, but it also appears to be small. For example, I recently saw a study with an OR of 0.9 for the male relationship between bullying and suicide (interestingly, perpetrator and persecuted are equally likely to commit suicide) and a female OR of 2.9. Compare that to the OR for TG and suicide at over 2000! So clearly bullying alone doesn't come close to explaining why being TG is so closely related to suicide.
Therefore, we must conclude that we don't really know why there is such a high rate of suicide in the TG community. What causes so many of these people to want to take their own lives? For that matter, what causes people to identify as TG in the first place? Is there something inherent in the link between the two, or can we separate them, such that people can live TG lives while not wanting to kill themselves at such an astronomical rate? This, I think, is the best explanation for why we should care about getting answers on this subject.
Quick google search says there's maybe 1.4M transgendered adults in the US. If the suicide rate is 30 per 100K, then that means we are talking about 420 suicides. There's 44,193 suicides in the US or about 13.26 per 100K.
DeleteOne problem you may be having is if you think of bullying as like being exposed to a chemical or drug, then clearly it would be 'dose sensitive'. In other words, someone bullied every day by multiple people is not the same as someone who gets bullied once a week by one particular problematic person. Yet if you're just asking "have you been bullied in the last 30 days?" and comparing suicide rates, you'll likely find a weaker relationship because you're including many people who are getting a relatively low 'dose' of bullying.
I can say from experience that dealing with gender dysphoria is very stressful. I've frequently felt suicidal, and I haven't even had to deal with bullying or any of the other stuff that people who are living an 'out' TG lifestyle have to put up with. There's definitely more to the high suicide rate than just bullying.
DeleteAnonymous, I hope you won't mind if ask whether you would take the opportunity to eliminate your dysphoria if that were an option? Say there was a drug you could take with minimal side effects. Or is it so much part of your identity, that despite it being "very stressful" you wouldn't want to eliminate it?
DeleteAsk away, any other questions too. I would have it removed in an instant. I would give up anything else too, as long as I was assured that I would be happier afterward.
DeleteAs someone who experiences it do you have any opinion on whether it's increasing? And if so any preferred theories for why it is? Either of those I mentioned or anything I've overlooked?
Delete1. Rereading MArk, his suicide rate has to be wrong. If we are talking 1.4M transgender people with a suicide rate of 40-50%, that would be half a million suicides plus every year. There's only 44K suicides pe r year.
Delete2. Say we think 1% of the population is trans and we happen to know how many suicides are transpeople. From that we can calculate a good suicide rate? Well not really. How precise is our estimate of 1%? If it is really 2%, then the suicide rate is only half of what we calculate.
If you recall from your stats, sampling typically will give you an error rate expressed as a few points (i.e. 3% plus or minus 2). That means unless we are talking about an ultra-precise sampling method, we know nothing about suicide rates or the rates of change over time.
I would be curious to hear from Anonymous what is the nature of the dysphoria he or she feels? What would 'removing it in an instant' entail? Would it be changing anatomy to perfectly align with gender perception? If not how would a hypothetical anatomy modification compare as a solution to the stress felt? What does he or she feel a 'not out lifestyle' means and is that any portion of the stress felt?
I agree. It is suspicious that the estimated transgender rate does not match well the rate of actual suicides in the US. You're right that, given we can easily calculate that if we assumed 100% of all suicides in the US were from the TG community (clearly there are other suicide etiologies) the suicide rate of the general population should be higher (based on a 40% suicide rate of even 1% of the population, it should be higher than 0.03%). I cited those statistics knowing this discrepancy exists, but with no good explanation for why. If the calculation is wrong, the source must be from one of the variables in the calculation - US suicide rate, TG suicide rate, and TG rate. Since you brought it up, I can think of a few possiblilities:
Delete1. The suicide rate is wrong. Maybe Google was wrong and I should delve more deeply into it. However, it's unlikely this has been MEASURED incorrectly, since of all the elements in the comparison this is the only one we can directly measure.
2. The population-wide TG rate is wrong. This seems to be the topic of the article, and clearly up for debate since it is estimated from surveys and extrapolated to the rest of the population. Either way, if you're going to argue for a higher TG rate, you have to argue the other two numbers are lower than reported.
3. The TG suicide rate is wrong. This could be wrong in the same ways the TG rate is wrong. I'm suspicious that it would be wrong enough that it could correct the math suggested by the other two numbers. When I made my calculations, I specifically used the lowest estimate of suicide rate in the TG community that I had seen. Saying this number should be a lot lower doesn't make much sense to me.
Look, I think bullying is horrible. My brother was bullied mercilessly, and although to my knowledge he has never struggled with feelings of suicide, the bullying has had other long-lasting negative impacts on his life. Bullying of TG people is horrible and wrong, as much so as bullying of anyone. But my argument was that bullying is not sufficient to explain the suicide rate in the TG community. Not by a long shot. If you are suggesting it is, due to a dose effect, or something like that, I'd like to see the evidence in favor of this hypothesis. The initial hypothesis (that bullying and TG are correlated, and TG and suicide are correlated, so perhaps bullying of TG leads to suicide) sounded plausible. But the problem is that suicide and bullying are only weakly correlated. So by rights we should reject the hypothesis given the state of the evidence. Holding on to it seems more likely to distract us from discovering actual causes and solutions, than it is to lead us to some nuanced way that bullying of TG is different and therefore has an impact that's orders of magnitude greater than for the general population. After all, the initial reason for the base hypothesis no longer has merit, so why are we iterating it to salvage it as opposed to simply rejecting it?
Well let's see if we can get better.
Deletehttp://www.businessinsider.com/sex-transition-plastic-surgery-statistics-2017-5 says there's 3250 'gender confirming' operations in 2016, up 19%.
https://www.advocate.com/politics/transgender/2014/03/13/watch-debunking-surgery-top-priority-trans-people-myth says only 33% of transgender people report getting surgery. So let's say when someone turns 18 they have surgery. That implies two other people who turned 18 are also trans but don't get surgery. 9,848 'new' transpeople are added each year.
https://splinternews.com/transgender-census-who-transitions-when-and-where-1793847327 indicates that about 80% of transpeople fall into the age bucket of 18-44. Just eyeballing it that seems to match the overall population of the US (https://en.wikipedia.org/wiki/Demography_of_the_United_States#/media/File:USpop2010.svg).
Crude birth rate per 1000 people in the US is 12.4 and crude death rate is 8.2 (https://data.worldbank.org/indicator/SP.DYN.CDRT.IN?view=map). That's a difference of 4.2 per 1000 people.
So very crudely if transpeople are 'added' to the tune of 9848 per year to the US, I'm getting that works out to a base population of at least 794,000 people. Given US population of 323M that would be 0.25%. Other estimates of 1.5M may not be crazy since I could see many people failing to report themselves as transgender so the % of transgender people who get surgery might be much lower which means the total population of transgender people would be higher.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178031/ seems to align with the '30-50%' suicide rate however it includes suicide attempts. https://afsp.org/about-suicide/suicide-statistics/ indicates that about 0.5% of all adults have at least one suicide attempt under their belts. Interestingly, for every successful suicide there's 25 attempts. So if 794,000 people made 397,000 attempts (50% rate) that would result in 15,880 actual suicides.
15K suicides per year out of 44K total would mean something like 1/3 of suicides would be transgendered people. I think that would be clearly noticed. It would also exhaust the transgendered population (assuming 9848 'new' transpeople per year 15K leaving by suicide wouldn't work). I also think a demographic that had a huge suicide rate would start to alter their age demographics. I'm assuming trans suicides would happen more with younger than older people. I suspect if there is a high youth suicide rate among transpeople then they couldn't have an age breakdown that roughly mirrors the entire US.
Hopefully someone better at statistics can churn thru my numbers and give them some triple checking.
This got long, so I broke it in two. (sorry)
ReplyDeleteJeremiah, thoughts on whether it's increasing. That's hard. I think, and this may be insensitive, at least some of the rapid increase in teenagers identifying as TGNC is, like Mark said, just teenagers being teenagers. It's non conformist enough to upset their parents and make them feel like they are part of a new age of social change. Like how lots of teenagers are vegans or communists or whatever. Plus, if you're transgender then you aren't one of the cis white males everyone hates these days. What I will be really interested in is to see if the rates continue to rise, and to see how many are still identifying as as TGNC in ten or fifteen years.
One thought I've had is what if there are some traits that we typically associate with females that can show up in either gender, they are just more often in females. So for example, I'm not exactly what you would call a 'manly man', so what if subconsciously it's easier for my mind to want to be a woman than to express those traits as a man? It sounds unlikely now that I'm typing it out, and I really would have trouble saying that most TG people are doing something like this.
Another thought that crossed my mind is that my earliest memories of these feelings are from when I was around 5 years old. I wouldn't call it dysphoria necessarily, but when I would play pretend with the other kids, I wanted to play female characters. Maybe I thought the female characters in the cartoons I was watching were really neat, and my brain decided that's what I was supposed to be? But a lot of the other TG stories I've read have described very closely feelings I've felt without ever mentioning 80's cartoons.
The thing that really gets me is just how familiar the feelings that TG people describe sound. It seems more similar than just a random collection of psychological hangups from childhood could explain. The biological explanation is currently my favorite. Partially because it means I wouldn't have to worry about having brought this on myself, but also because it seems like that could help explain how similar the experiences are. Plus some of the correlations Scott over on Slate Star Codex has pointed out between TG and other things, like Autism. I'm not officially on the autism scale, but I think I'm pretty close.
So my money is on it being heavily biological and we are seeing more of it due to it being more socially acceptable, and some environmental change like what you talked about, chemicals, or mutational load.
Boonton, here's my best attempt to express what it feels like. It's possible I'm describing things that are pretty common for everyone to feel. It feels so 'normal' to me that I find it hard to believe that most other people don't feel this way and they are just handling it better than me. So let me know if this sounds familiar. However, I have visited some TG forums and swapped stories, and apparently my experiences are fairly common for people who identify as TG. I don't really identify as TG, I see it as just a collection of weird things going on in my head that happen to be very similar to what people who do identify as TG describe.
ReplyDeleteThe biggest thing is just an intermittent longing to be female. The best way I can think to describe it is this: imagine that you're a kid at an amusement park, and there's this ride that looks really great and you see lots of other kids going on it, and you know you'll never get to go on the ride, and you're heart kind of aches.
It's being at the supermarket and seeing a fashion magazine at the checkout line and the thought pops into your head: "I wish I could look like that, or even half that good, or a quarter. Heck, I'd just like to be a semi-attractive woman."
It's wishing that you could take the submissive role in a romantic and physical relationship.
It's using a female avatar in a game, or presenting as female in an online community and having it just feel right. Like you've just let out a breath you didn't even know you were holding.
It's just a lot of little moments where a part of you yearns for things to be different. It feels like you're never quite at home. Like there's a hunger that can never be satisfied.
Removing the dysphoria in an instant, for me would mean getting rid of all those small moments of yearning. With or without an anatomy change. Realistically I would prefer it without the anatomy change, it would mean no disruption to my life as it currently is. Plus, with current technology, I would never be able to look in the mirror and see anything but a really ugly man trying to be something he's not. If we had miracle level tech that would basically make me a natural born female, I might go for that instead.
For me 'not out lifestyle' means that no one knows about it. There are only four people that know I deal with this, and three of those are therapists. If you're living it in a way that it's apparent to the average stranger on the street, then that's an 'out lifestyle' for me. I'm not real active in the TG community, so I'm not sure if that's a common definition.
Being closeted certainly does contribute its own stress. Like I'm dealing with something that no one would understand, and that I absolutely can't ever let anyone find out about. There's a loneliness to it. A lot of it too is just my own inability to come to terms with it. I can't accept it, and I haven't been able to get rid of it. It just persists and I don't know what to do with it.
Thanks for taking the time to respond. You've definitely contributed enormously to the discussion.
DeleteI agree with Jeremiah, I think we all appreciate you being here enormously.
DeleteI also think, since we don't know the cause of TG, there's no justification in feeling like you should be to 'blame' for causing it. Imagine you were hiking in remote Montana and you happened upon an undiscovered tribe. This tribe has a rule that anyone they see eating trail mix will be knocked out and have their arm chopped off. You are absently munching some trail mix, and they come upon you so quickly, you don't have any memory of meeting the tribe or the Swift punishment they inflict. You wake up and put your now-absent hand to your head, wondering what happened. You think perhaps that hiking while wearing your favorite t-shirt causes random arm loss, so you chuck the T-shirt and make plans to return to Montana. The point is that even if there is some behavioral component to TG, nobody who is TG today made a conscious decision about it, nor would it be reasonable to say, "well, if you would just do X, you'd be just like everyone else".
As to your lived experience, I'm curious with one additional question: to what extent do your thoughts about being female include a yearning to 1. physically bear a child through pregnancy, breastfeeding, etc. 2. Be a primary caregiver to children?
I'm glad you're finding this interesting. I'm finding it nice to be able to talk about.
DeleteAnd thanks for the analogy. It's an interesting way of thinking about it.
On the subject of children. I have always thought I would really like to have children. I'm doubting it will happen, I don't feel stable enough to be a parent.
On the physical aspects of being a mother, they doesn't come up so often in day to day life, so I don't feel a yearning for that as much. Delivering a child sounds very painful, I would be willing to accept it as part of the rest of the package, but it doesn't particularly call to me. Even though it's not something that comes up frequently when I think about the other physical aspects like carrying a child through pregnancy, nursing, etc. I do feel some longing for that too.
The question of being a primary care giver is an interesting one, it carries several implicit questions. In parenting style I've always thought that I would be very nurturing, more stereotypically female than male. I would want to be very involved in the care giving, I don't have a good feel for how much/little time that would mean. Would I feel that it was enough to provide for the family during the day and take care of the children in the evenings? Or would I want to be there for them all day? It's hard to say.
It also carries the question of providing for the family. I would enjoy being provided for, but I'm the provider for my wife and I, and I very much enjoy my work. It's something I would want to do, but I don't think I would feel the need to do it full time, doing it as a hobby would probably be enough.
Along with the question of provider/child raiser is the typical familial gender roles. The man is strong, more dominant, protects and cares for his wife. The woman is delicate, submissive and supports her husband. I know there are lots of efforts to change this, but the female role is something that appeals very strongly, and I do regularly feel a longing for.
Reading Anonymous's very open account and listening to the podcast (just doing it now), I'm struck by what I think is a disconnect here between TG advocates and critics:
Delete"But beyond that, I get the sense that there’s also a way in which people feel there’s a moral or even spiritual arc to the whole thing, that the freedom to choose your gender goes along with all the other freedoms progress has brought us. That certainly seemed to be the sense in which the MTA speaker meant it."
I notice the 'choose' word gets used a lot and I wonder if it is operating as a signal or dog whistle for some. Ian Banks' Culture Series has a galaxy filled with very advanced technology that allows individuals to live almost as long as they please. Given unlimited long life and unlimited technological ability, characters take a pretty dismissive view to their identity. They may decide to change their gender and have a child for a few decades....or become a walrus and after boredom sets in try something else. While death is technically defeated, many opt to end their existence after no more than a few thousand years at most.
I feel many critics of TG seem to approach it as if this was the 'spirit' of the idea. Yet actually listening to what TG people say, I think we see the opposite. While one may choose to what degree they will go through with gender reassignment operations, so far no one has presented any evidence that people are casually 'trying on genders' the way they might different hair colors. I think its possible if we had Banks' level of technology, we might indeed see some people approach changing their bodies with that consumerist approach, but it is unfair to take that approach to real life TG people as they exist today.
Recall that the sentence you quote is just one theory, and one (if you were to go through and read past posts) you would find I'm not even a particularly big fan of. Also interestingly enough proponents of that theory feel like they're not critics of TGNC identity, but proponents of it.
DeletePerhaps but are you talking about 'transhumanists' pushing their sci-fi view of future history? We might file that under "speculation interesting if it turns out to be true". I recall as the Internet started to rise up, there was a lot of discussion about roleplaying, especially people who assume an online identity different from their own. I can see how transhumanists would speculate about taking that to the next level. If we had perfect ability to alter anatomy, what would be the LDS argument against it since such it seems like it would be just as easy for someone to undo anything they did?
DeleteThe TG argument, though, seems to strike at a deeper argument that few people want to actually make. The TG argument seems to actually mix some elements of left and right. TG seems to assert that gender is part of the individual's nature (not simply a 'social construct') BUT it is possible for outward anatomy to simply be wrong. In other words, a person whose anatomy appears to be that of a healthy male or female actually are not male or female. The brain may, in fact, be a different gender despite healthy appearing genitals. Ultimately the brain is part of our anatomy too but unlike the genitals it is not so easy to examine it.
Exhibit 1 here is the case of the boy who was raised as a girl. A botched circumcision as a baby cost him his penis, doctors working with the social construct theory had his parents raise him as a girl. Despite operations and serious effort on everyone's part, he never brought into it and eventually got his parents to reveal the truth and he started living as a male when he was an adult.
Traditionalists seem to like the idea that gender is set in our nature as individuals and cannot be altered by surgeries (purposeful or accidental) or elaborate cultural conditioning (raising the boy as a girl) but balk at the idea that perhaps the ultimate anatomical decider of gender is the brain itself rather than genitals.
Did you consider in relation to the Minn. study that we are just dealing with a survey and more likely than not the survey left it up to the respondents to define what 'gender non-conforming' means? I suspect that at least some of those that responded that way were thinking they were 'non-conforming' in a sense that we probably would consider very mundane (i.e. guys who don't like sports, girls who like video games etc.).
ReplyDeleteI had not considered it before writing it, but through the comments it does seem like a reasonable hypothesis at this point. But I think the Swedish chart is a better illustration of the increase in any case.
DeleteTrue but that just tells us one treatment center in Sweden is enjoying a huge increase in referrals. That could be a good marketing campaign, a very skilled surgeon whose reputation is generating lots of referrals, coverage expanded, etc.
DeleteIt's not just Sweden "clinics that treat gender dysphoria report a soaring caseload"
Deletehttps://www.economist.com/news/international/21731398-more-people-change-gender-they-are-sparking-debate-enrages-some-and-confuses