A clinical psychologist who is transgender is raising red flags about the huge cultural shift among children and teenagers that is fueling an explosion of gender-questioning cases.
Erica Anderson argues that health care providers need to examine all the factors that contribute to a child’s condition, “not to dissuade them from their assertive gender, but to understand how other things may be related,” such as now mental health problems such as anxiety or a history of abuse.
With more than 40 years of professional experience in both pediatric and adult psychology, Anderson has worked in a variety of healthcare settings, most recently at the University of California, San Francisco (UCSF) in behavioral pediatrics. Anderson urges professionals to consider the relationship between pre-existing mental health issues and the affirmation of a child of a different gender.
“I’ve never seen a major mental illness cured by a gender transition,” says Anderson. Contrary to the belief of some colleagues that “the distress that children experience is all due to gender issues”, Anderson considers these cases to be “pretty simple” and “rare”.
“We need to explore the course of this gender journey on the part of the young person,” emphasizes Anderson. The psychologist argues that the exploration of gender among teenagers is not immune to peer pressure, like any other aspect of teenage life.
From her extensive work at UCSF and now in private practice, Anderson notes a shift in patient demographics from young men who identify as women to a more diverse group of mostly young women than before they had not questioned their gender. This challenges current treatment protocols for transgender youth, Anderson explained.
“The major social polls of recent years have confirmed what I’ve been saying, that a large number of children are questioning their gender beyond anything we expected, up to one in five children who are teenagers in the United States express a gender. sexuality other than heterosexual and cisgender. This is a big change,” said the psychologist. “We used to think of transgender kids as a very small proportion, maybe half a percent, 1% or less.”
Most trans activists, Anderson explained, have welcomed this change, but she doesn’t think it’s the only factor.
“It’s obviously common for kids to talk to each other, so we have to ask, well, what’s going on with these kids?” Anderson asked. “Will they all be transgender? Past research has told us that some children who are gender-questioning at a younger age persist and become what we call transgender, but not all.”
The clinical psychologist then explored the “emotional blackmail” that is persuading parents to allow their children to transition.
“I call it emotional blackmail,” Anderson said. “Parents love their children, they don’t wish their children any harm, so if a responsible professional, a doctor tells them that…” Anderson added that this statement is a “misreading of the literature.”
“The more widely cited 40% or 41% rate of suicidal ideation is based on a retrospective study, a self-report of trans adults from five, six years ago, and other reports…fits the ideation rates suicides and other young people with mental health challenges,” said the psychologist. “It’s taken out of context, it’s a scary statistic and it’s used inappropriately, I think.”
“This statistic has been used to bash many parents and manipulate them, in my view, into consenting to treatment that they had reservations about,” Anderson added. “I think this is wrong.”
European countries have already begun to take a “more cautious approach”, recognizing that the population of people seeking gender-related care has evolved. Anderson notes that certain events, such as the pandemic, may have compounded the problem as teens turn to online sources that can offer misleading advice.
Anderson also warns that the medical community is too quick to affirm a child’s chosen gender, often neglecting to perform the necessary individual assessments. “I’ve been concerned that too often children rush into medicalization,” says the psychologist, noting that such hasty decisions could amount to malpractice.
The health professional also pays attention to the long-term effects of medical interventions such as puberty blockers, citing European research and specific cases that have shown a lack of comprehensive understanding of the impact of these treatments.
Anderson criticizes the American Academy of Pediatrics (AAP) for not updating its guidelines, accusing them of “hubris” and emphasizing the need for evidence-based review.
As for the claim that not affirming a child’s gender identity leads to an increased risk of suicide, Anderson calls this “emotional blackmail,” saying the statistic is often taken out of context.
In short, Anderson believes there is a “mental health crisis among American teenagers,” and calls for a comprehensive, individualized approach that takes into account “every aspect of a child’s life.”
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OPINION: This article contains comments that reflect the opinion of the author.