Teenagers and the Trans Contagion

The NHS Gender Identity Development Service has become mired in controversy. There is the internal report claiming that children are being rushed through “gender-transition”, and the poor evidence base for puberty-blocking drugs.

There is the legal challenge from a distressed parent, the spate of resignations, accusations of being misled from ex-transgender people, questions over its relationship with radical trans activist organisations, “hidden” study results showing poor mental health in “treated” teenagers. The list goes on.

At the heart of it all, however, lies a medical mystery: in only a decade, the clinic has seen a more than 3,000% increase in young people referred for gender dysphoria, from 77 in 2009/10 to 2,590 last year. Most are teenagers, three-quarters of whom are girls.

Honest Answer

Each year the service prescribes hundreds of them with puberty-blocking drugs, and thousands more are on the waiting list. While there have always been cases of gender confusion, particularly among young males, this burgeoning new cohort signals something radically peculiar – but what?

This very question was put to Elizabeth van Horn, a psychiatrist at the clinic, in a recent appearance on BBC Radio 4. She responded:

“I suppose the honest answer to that is that actually nobody knows yet, but actually my own personal view… is that… there have been significant cultural changes that perhaps make it more acceptable for people to tell their families and their friends that they’re transgender.”

Like many others, van Horn believes that “social acceptance” has merely brought trans people into the open. While there may be some truth to this, it is a superficial explanation that reveals an unwillingness to inquire further among those who should know better.

It seems highly improbable that “acceptance” alone could ever account for such a unique and rapid phenomenon. Equally superficial, however, is the tendency to dismiss transgenderism as a passing fad.

The term “Transtrender” is a nickname for those who identify as trans only because it is trendy. While there’s no doubt such people exist, the “fad” idea underestimates the intensity of distress experienced by these adolescents over their biological sex. It takes more than trendiness to make a person inject themselves with hormones.

So, we return to our question: if not just “social acceptance” or a “passing fad”, what is the cause of this apparent explosion in teenage gender confusion?

what is the cause of this apparent explosion in teenage gender confusion?

Feminists, LGB activists and others have offered their own theories. They blame misogyny, gender stereotypes, and “internalised homophobia” for leading teenagers into thinking they are the wrong sex. Christians should think critically about these ideas, and listen especially closely to the testimonies of ex-transgender people.

We don’t have to adopt their ideas wholesale to see that much of their thinking has merit. However, such theories often serve other ideological commitments, and as believers we should start with a frank acknowledgement of the complexity of the situation before us. It is likely there is no single cause for all this.

Social contagion

That said, there is one phenomenon that deserves a large portion of blame but rarely features in the discussion: “social contagion”. Broadly, this term refers to the spread of feelings or behaviour throughout populations. In recent years it has been applied to the social ills of self-harm and eating disorders, and the subcultures that promote them.

These behaviours are often “maladaptive coping mechanisms” (behaviours that try – but fail – to address underlying problems). Notably, they seem to concern a particular demographic: young people with poor mental health and little direction, engaging in self-abusive behaviour.

The contagious quality of such behaviours is uncontroversial. Since the 1980s anorexia contagions, for example, have been repeatedly observed.

Friendship groups have regarded eating disorders as an adolescent identity and social distinction, and research has looked at the transmission of this identity through things like body-size comparisons, bullying and manipulation. Deanne Jade, of the British National Centre for Eating Disorders, put it bluntly:

“…I ask myself if an eating disorder unit is the best place for an impressionable young girl to be… As any inpatient will tell you, a specialist unit is the best place to learn how to be really, really good at anorexia… Some patients have reported bullying and intimidation by the hard-core cases…”

Social media

Research has shown that social media makes the problem worse, leading some clinics to adopt a policy of “no online talk”. In fact, back in 2012 social media platform Tumblr seemed to twig that their own website may not have been helping matters. They issued a policy change, saying: “Don’t post content that… urges or encourages readers to cut or mutilate themselves; embrace anorexia, bulimia, or other eating disorders; or commit suicide…”.

Until then, Tumblr had been a hotbed for this content. Directionless teens were able to stew amongst a myriad of pictures, memes, and in-jokes celebrating anorexia and self-harm – and facilitating contagion.

The online groups promoting self-harm or anorexia bear a striking resemblance to the transgender community. Paediatrician Dr Lisa Littman points out examples of young people being encouraged to deliberately deceive clinicians into issuing hormones more speedily. In the words of one trans person: “It’s about getting treatment, not about being true to those around you.”

a very troubling trans subculture

The “transition-or-suicide” narrative is routinely employed to blackmail parents and generate a sense of urgency in the community. Some hold positions of seniority over others; benevolent, more experienced mentors, affectionately known as “trans-elders”, who take it upon themselves to “validate” the younger ones, assisting them throughout transition.

But, just as in 2012, today’s Tumblr is home to a very troubling trans subculture. A cursory search reveals a constant stream of posts and videos glorifying the transition process, graphic self-loathing, memes, comics, and in-jokes. Much makes light of irreversible intervention.

A lot of it represents very genuine, agonised cries for help. But it all contributes to a dangerous ecosystem which normalises the claims of gender ideology, and demonises anyone who disagrees. On this evidence, the notion of a “trans social contagion” looks like a highly plausible explanation.


It is also worth noting the role of “suggestibility” in social contagion. This is the way that a suggestion, when believed, can have significant impact on the senses. This vulnerability of the mind, often spectacularly exploited by mentalist performers, is perhaps best known in the role of the placebo: you take the pill, under the suggestion you may get better, and so you do feel better.

Perhaps more startling is the nocebo effect. This is where the belief you will suffer leads to negative symptoms themselves. History is full of examples. There are cases of groups experiencing fainting and headaches, all because they wrongly believed a gas attack had taken place.

There are maladies like “electro-sensitivity”, apparently causing groups to suffer sickness or insomnia – yet dozens of experiments show that such people are just as likely to report the same symptoms when exposed to transmitters that, unbeknown to them, are fake. All this demonstrates the power of suggestibility.

the power of suggestibility.

Naturally, the suggestion must be believable, but it only takes a dull ache, or some small abnormality not normally noticed, for you to then attribute it to the suggested cause. This can have a contagious quality: the more people exhibit symptoms, the more others become open to the false suggestions.

It doesn’t take much for the snowball effect to take hold. This was seen in 1962, when factory staff experienced dizziness and vomiting, believing a bug was spreading in their department. Investigation by the US Public Health Service, however, concluded that the symptoms were caused by social contagion. More than sixty workers were affected.

It is no stretch to suspect a similar process is taking place in the trans community. When a person is suffering vague angst or discontent, negative suggestions find fertile soil. All it takes is for those feelings to be diagnosed as symptoms of something much bigger for the nocebo effect to take hold.

It doesn’t take much for the snowball effect to take hold.

And social media platforms, like Reddit, are full of people open to an authoritative diagnosis of their vague afflictions. “Do I have dysphoria?”, says one; “Trying to figure out if I am trans or not” says another. The cries go on and on: “I honestly don’t know if I’m trans or not, any advice?”; “Is it gender dysphoria? Can you help me?… I am so confused.” One person says: “I think I’ve gone through just about every online article and quiz, looking for something that makes it click one way or the other, but nothing has…”

And predictably, the response is unequivocally affirmative: “This is like. Textbook. I had more or less these exact thoughts and I don’t know if I’ve ever met a trans girl who didn’t.” Another asks: “Am I really thinking about this right?… Ok, so I am not 100% sure that I am a girl on the inside…[but] I generally feel more connected to women”.

And the response: “You didn’t specifically ask the question but I will answer it anyway. Yes, you are probably trans. I and most others who have started [hormone replacement therapy], went through the same doubts that others have gone through…Then make an appointment with your… endocrinologist to start [hormone replacement therapy].”

Many are doubtful: “Is there some other reason I’ve hated my body since puberty? Some other reason that I hated having short hair? Some other reason that I kept cross dressing?” But they are soon re-educated: “You don’t want to be a girl because you hate yourself. You are a girl, and you want to love yourself.” Material like this is constant and abundant.


To demonstrate how easily a vulnerable teenager can be swept into the belief they are transgender, consider the “transgender survival guide” found on Tumblr. It offers “signs” of gender dysphoria:

“Continual difficulty with simply getting through the day… A feeling of just going through the motions of everyday life… A seeming pointlessness to your life, and no sense of any real meaning or ultimate purpose; Knowing you’re somehow different from everyone else, and wishing you could be normal like them.”

Such broad “signs” describe just about any teenager – and many of all ages – yet they are flagged up as evidence of dysphoria. The suggestion is made, the nocebo is swallowed, and for some, genuine feelings of confusion and gender-related distress take root. As one ex-transgender girl puts it:

“I saw all these young awkward girls who were obviously super uncomfortable with themselves, getting to become new glitzy attractive men… and I wanted that… if the ball got rolling… that meant a lot of depression and that meant a lot of… I think real gender dysphoria.”

Biblical worldview

It remains true that the transgender explosion probably has no single cause. Social contagion is part of the answer but we should not seek to oversimplify the problem. We live in a society that has undergone immense cultural upheaval over the last century, and all of us have been affected in complex ways. Young people have been left particularly vulnerable, many struggling with poor mental health, feeling directionless and without meaning.

Often it seems the secular worldview dominates the public square. Recently, powerful transgender ideology has seeded in the morass. It has sprouted its own subculture, offering community, identity, and meaning to the vulnerable. It celebrates gender-transition, promotes self-loathing, and employs manipulative messaging. In some quarters it encourages young people, with evangelical fervour, to view their struggles through the lens of dysphoria.

All this exploits their predispositions and vulnerabilities, having a profound effect on suggestible minds, and leading some to real gender confusion. It is a social contagion of unknown proportions and durability.


Although it is not the purpose of this article, we should remember that the biblical worldview is more robust and beautiful than anything offered by transgenderism. The hope Jesus Christ extends to the weak and weary surpasses the “new birth” promised by gender-transition.

Christians must think it, speak it, and live it, at all times and all places. And they must think carefully about how to reach the victims, and would-be victims, of the contagious transgender culture.

(This article was originally published in the Affinity Social Issues Bulletin for February 2020. The whole edition can be found at www.affinity.org.uk)

Michael Taylor is a Research Assistant for The Christian Institute.