More gender diversity should mean fewer drugs and surgeries

In a highly publicized study recently published in the journal Pediatrics, researchers found that up to 10% of urban American high schoolers could be classified as “gender diverse,” with a higher percentage of ethnic minorities identifying as such compared to white adolescents. The team notes that this figure is up from a 2017 study that found 1.8% of a similar cohort identifying as transgender (though the term “transgender” is hardly the same as “gender-diverse”). They conclude that gender-diverse students of color in particular need more equitable access to gender-affirmative care, stating this is another example of systemic racism.

Let’s unpack all that and analyze whether these conclusions are justified. On the surface, it appears that increasing numbers of young people are identifying as gender diverse. But we don’t truly know why. It could be that teenagers are becoming more comfortable with “coming out,” given the seismic shift in acceptance of sexual minorities and people identifying as different gender identities across the Western world (although this would surely also demand a huge surge in homosexuality in the wake of the legalization of gay marriage). It could be the impact of perpetual coming-out celebrations of famous lesbian, gay, bi, and trans celebrities. It could be the influence of the “gender unicorn” that schools and activists love to tote out, giving children new language to express age-old discomfort with growing up. The study also does not delve into whether these young people feel any distress from their gender diversity.

Although it might be helpful initially for children with non-sex-stereotypical interests to have language to describe why they feel “different,” ultimately it may be problematic and reductive as well as entrench gender stereotypes. It may also risk the depletion of gay people, who historically have been gender-non-confirming from a very young age. Hand-in-hand with the notion of gender identity, there is now a very powerful campaign to medicalize children who say they feel a different sense of “gender” with experimental drugs to stop their puberty (which can happen as early as eight), followed by cross-sex hormones and surgeries (in the US, girls as young as 13 get mastectomies).

The Pediatrics study also fails to explore the new type of gender diversity that has emerged over the last decade: the exponential growth of biological girls identifying as boys or non-binary (when historically gender-questioning kids were predominantly natal boys), frequently in the same friend or social groups as one another, and immersing themselves in social media. It would have been an unprecedented opportunity for the researchers to investigate whether peer influence had a hand in an extraordinary near-sixfold increase of gender-diversity in urban youth over just four years.

As more young people recognize their unique qualities, and as Sweden, Finland, and the UK overhaul treatment of their gender-diverse youth, we as a society must rethink the pathologizing of non-conformity to sexed stereotypes. The diversity of human expression is beautiful and should be celebrated, not attacked with syringes and scalpels. The alternative is scary: 7 million young Americans (ages 8-25) are on track for experimental, highly invasive interventions that will make them infertile and dependent on drugs for life.