A History of Transgender Ideology & Gender Dysphoria

The truth about the social contagion killing our youth: historical analysis, data, and context everyone needs to know

“Individuals with gender dysphoria have a marked incongruence between the gender they have been assigned to (usually at birth, referred to as natal gender) and their experienced/expressed gender. This discrepancy is the core component of the diagnosis.”

– DSM-5, p. 453. American Psychiatric Publishing.

Over the last decade, gender dysphoria and its accompanying ideology has taken the public by storm. To some, the rise seemed to come out of nowhere – but it has, in fact, been brewing for quite some time. The object of the following study is to demonstrate how the culture slipped down the slope of gender theory, distinguish between two kinds of gender dysphoria, and briefly respond to the claim that the soul can be sexually distinct from the body. In this way, the goal is to inform Orthodox Christians about the transgender movement and equip them with the dogmatic truth of the Church. 

THE DATA: GENDER DYSPHORIA

We have about 100 years of data on gender dysphoria (DSM-IV, 1998: gender identity disorder); the data reveals that up until recently (2000s) gender dysphoria was extraordinarily rare. According to the DSM-5, which was only published a decade ago (2013), the primary demographic affected is adult males at .005–.014% (1:10000) while natal females reported a prevalence of .002–.003% (1:33000).

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The classification of “rare disease” is a quantifiable term in American medical practice that refers to an affliction affecting 86 or less out of 100,000 people. To put it in perspective, .01% is 10 out of 100,000; .003% is 3 of 100,000. By these metrics, gender dysphoria is not only rare but rarer than rare. To put it another way, it is three hundred times more likely to have a child with cerebral palsy (3%, 3:1000) than a child with clinically diagnosable gender dysphoria; it is one hundred times more likely to have a child with down syndrome (1% chance or 1:1000), a heart defect (1%, 1:1000), or a cleft lip (1%, 1:1000). 

In spite of its historical rarity, the government in Great Britain reported that the number of young people referred for gender treatment increased by 4000% percent between 2009 and 2017 (75% of whom were female), with a 4500% increase in biological female presentation specifically.

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In June of 2022, Pew research released a study detailing the upsurge of trans-identifying individuals among different demographics, with 5.1% of the US population under the age of 30 identifying as trans or nonbinary. That’s an increase of 5000% in a single age demographic, making the final probability that 1 in 20 (1:20) young people in America today identify as trans or nonbinary.

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Perhaps the most striking aspect of the pew study is that, while the historical data accounts for people of any age in any geographic location, pew restricted age range and geographic location. Echoing Great Britain’s findings years earlier, pew found that the primary demographic of individuals presenting with gender dysphoria flipped: from adult men to teenage girls. 

This raises a peculiar question: why the sudden explosion in trans-identifying kids? 

Trans-activists (TRAs) frequently answer that the increase in trans-awareness and decrease in stigma surrounding the trans community has resulted in normally closeted trans-folk feeling safe enough to vocalize their “authentic selves.” The glaring issue with this explanation, though, is that it does not account for the isolation of a single age demographic or the male-female demographic reversal. In the world of statistical analysis, dramatic shifts of this kind raise red flags. The first to notice was Dr. Lisa Littman of Brown University. With young girls of her own, she decided to get to the bottom of it.

RED FLAGS IN THE DATA

Littman conducted a study surveying 256 parents of self-identifying trans kids. What she found was startling. Contrary to the previous data, where adults would present with persistent gender dysphoria from early childhood on into adulthood decades later, nearly all of those surveyed noted that the feelings of dysphoria showed up out of the blue, without any prior signs of it in childhood. Nearly 86.7% reported an increase in social media or internet usage prior to self-identifying as trans;

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62.5% reported comorbid neurodivergence (autism spectrum disorder, ASD) or mental health diagnoses. She published her findings in the academic journal Plos One after several peer-reviews, designating the cause of the demographic shift as rapid-onset gender dysphoria (ROGD) to distinguish it from persistent gender dysphoria, which manifests in early age (2–4) and continues into adulthood: 

Rapid-onset gender dysphoria (ROGD) describes a phenomenon where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood. ROGD appears to represent an entity that is distinct from the gender dysphoria observed in individuals who have previously been described as transgender.

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Trans rights advocates did not appreciate her work; as a result of publishing, Littman endured grave social abuse. Eventually, the complaints of transphobia and biased research reached Brown University, who retracted the study for further inspection. A year later, the study was published with small adjustments in phraseology but no changes in data or findings. The findings were likewise unchanged: the “cluster outbreaks of gender dysphoria…raise the possibility of social and peer contagion.”

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PSYCHOGENIC DISEASE AND SOCIAL CONTAGION

Social contagion and psychogenic diseases are not a new phenomenon. It must be stated, though, that while some psychogenic diseases seem to exist only as social contagion, others exist in reality as a condition of a rare diagnosis that, given widespread attention, can be the catalyst or social contagion. In such cases, the publicity given to an often over-generalized diagnostic criteria winds up suddenly manifesting the symptoms for positive diagnosis – something Canadian philosopher Dr. Ian Hacking termed the looping effect, where the classification of a disorder can come to shape the disorder itself. 

One example of a disease that exists solely as social contagion would be the dancing plague of 1518. It started with an unaccompanied woman, known today as Frau Trauffea, who started dancing in the streets of Strasbourg, France. After a week, thirty people were dancing nonstop, “long past the point of injury.”

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It did not take long for the citizens that were not affected to raise concerns. The civic authorities responded by providing hall space and musicians to facilitate the dancing, with the hopes of taming the symptoms and those afflicted. The plan backfired, with the number of those afflicted reaching 400 people. During the two-month period several people danced themselves to death. And then one day the entire affair ended just as suddenly as it had begun.

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Henri Ellenberger details the 19th-century social contagions of spiritism, hysteria, and hypnotism in his tome The History of the Unconscious

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In 2010, Ethan Watters published Crazy Like Us, assessing the rise of psychogenic diseases in specific cultures of the 20th century: anorexia nervosa (in Hong Kong), PTSD (in Sri Lanka), schizophrenia (in Zanzibar), and depression (in Japan). For his part, Fr. Seraphim Rose suggested something similar with regards to obsession over UFOs and the outburst of “holy laughter” in pentecostal circles – and other pentecostal-isms generally.

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Although Rose would place the locus of this delusion within demonic activity in the world, neither Ellenberger nor Watters probed to that end. But they do both demonstrate that such social contagions tend to begin and find momentum in one specific demographic: young women. 

In September of 2022, Ethan Watters wrote an article for the New York Times entitled, “The forgotten lessons of the recovered memory movement,” wherein he describes how therapists would make general comments about daydreaming or nausea or something similar and if the client had recently experienced these, it would be suggested that they were suffering from repressed memories. The psychological journey that they would then embark upon would include techniques that we now know manifested the exact condition it purported to be treating. One can’t help but wonder if Watters’s most recent work is a cautionary tale for where we find ourselves today with gender self-identification. Although the recovered memory movement has been undeniably debunked in recent decades, countless lives and families were destroyed in the process. 

The point here, of course, is that children identifying as trans or nonbinary may indeed be experiencing significant distress, pain, and confusion. But such things are a normal part of growing up that tend to resolve naturally. Instead of allowing children to experience the natural discomfort in their changing bodies, however, they are now told that the cause of their distress is gender dysphoria. As they begin to read more about this online and participate in friend groups where it is in vogue, they begin to manifest even more symptoms that point to the diagnosis. They are then told that living out “their truth” through social transition, cross-sex hormones, and medical transition will solve all these problems. When such affirmation becomes the primary model of care for youth, social contagion explodes. 

TREATING GENDER DYSPHORIA: THEN AND NOW

But this was not always the primary model of care for gender dysphoria. In fact, it is recent (c. 2016).

The leading expert in treating gender dysphoria, Dr. Kenneth Zucker, had been advocating what he called “watchful waiting” for years, wherein no immediate intervention is taken for the self-identifying trans-individual. Instead, the therapist and client would venture on a period of time (typically a few years) where they would observe, together, the psychological movements of the dysphoria. Although this method was radically successful in demonstrating that many children with gender dysphoria grow out of it shortly after puberty – a fact that would later be bolstered by eleven separate studies around the world, wherein it was observed that this was consonant with roughly 80% of children who present with gender dysphoria

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– Zucker was booted out of his position at Toronto’s Center for Addiction and Mental Health (CAMH) in 2016 when his “watchful waiting” technique fell out of favor with the progressive society’s new version of treatment: gender affirming care.  

Gender affirming care took a different approach entirely. Based on the idea that quality of life (at present and in the future) for gender non-conforming, prepubescent children would increase dramatically if they had access to medication that would stop puberty to facilitate an easier medical transition later on. And the data was revealing: Every single child treated with the gender affirming care model – who were accepted as the other sex, socially transitioned, and was subsequently put on puberty blockers – continued to cross-sex hormones and were likely to continue on to surgical transition. And it is this model that is considered the gold standard for treating gender dysphoria in American youth.

Here, it must be pointed out that as recent as this month (May 2023), the country of Sweden – one of the first trailblazers in gender affirming medical intervention – reversed its stance on gender affirming care.

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What the aforementioned studies do not tell us, though, is how many of these kids regret it. The dichotomous results of the wait-and-see approach and the gender affirming approach can be illustrated by two separate encounters I’ve had with former trans kids. 

EMELIE AND CHLOE: THE TWO TREATMENT MODELS

I met Emelie on a Wednesday afternoon. We had arranged our meeting through Twitter a few weeks prior, where I happened upon one of her tweets detailing her experience as a formerly gender confused teen girl. At 23-years-old, she’s been to hell and back again. Her story begins, as many do, in her early teens, navigating the inane intricacies of tween social life. But she didn’t like traditionally girly things – she was a tom-boy. And she was frequently bullied for this exact reason. The onset of puberty exacerbated her problems. 

She was uncomfortable with the changes in her body. The development from a girlish physical frame to that of a woman brought with it jokes made at her expense – and attention from men that she did not want. Not only did she not want it, she hated it. And she came to hate herself too. At first, she expressed this self-hatred in acts of self-harm…until she found the trans community the summer of her freshman year in High School. 

Emelie spent most of her summer online consuming the content of ultra-“accepting” LGBTQ+ communities. It did not take long for her to internalize this community's slogan:  “If you think you’re trans, you probably are.” In her mind it made complete sense: she had never been a girly-girl and she hated her developing female form. “Maybe I’m actually a boy.” The thought hit with enormous impact. So she spent the rest of the summer gathering what information she could, adjusting her physical appearance as able, and entered the new school year proclaiming her new pronouns (he/him) and new name: Jacob. 

As a gender non-conforming girl in the throes of post-pubescent neuroticism, coming out as trans seemed to have innumerable benefits. The bullying stopped immediately, she gained instant popularity, countless “friends,” and, for the first time, a vibrant social life. All of this curtailed the statistically normal influx of negative emotions that accompanies female puberty. And so her social transition seemed to be a smashing success, instantaneously solving all of her problems in one fell swoop – except for her parents. 

Emelie was 16-years-old. She had life figured out. But her parents hated her – or so she thought. See, they would not sign off on hormone replacement therapy. At the time, blue states had not yet passed laws greenlighting hormones for self-identifying trans minors without parental consent. So Emelie was stuck. She was ready to move forward in the world as Jacob. The next step was hormone replacement therapy followed by surgical interventions. But her parents would not budge. She spent two years in this no man’s land, trying to pass as Jacob without the help of hormones. But when her medical care was finally placed in her own hands at 18, she started to hesitate. Her friends in the trans community encouraged her to pursue medical transition: “It’s what you want! If you don’t do this you will always hate yourself. You might end up killing yourself!” In time, her continued hesitation was met by vitriol which, in turn, increased her uncertainty. Recalling her two year LGBTQ trajectory, she began to deconstruct her trans-identity: even though I like traditionally masculine activities it does not mean I am, or should be, a man. 

Emelie’s trans-community was not supportive of this introspection. Her friends continued to cajole her but when the gaslighting did not work, they turned to hostility: “you were never really trans in the first place” and “I can’t believe you want us all to die.” Eventually, they shunned her. And eventually, Emelie would discover that her awkward social gaffes were due to autism spectrum disorder, not being born in the wrong body; her self-hatred was due to underlying, untreated mental health conditions. 

Today, Emelie is a 23-years-old desister (that is, a former self-identifying trans kid that never underwent hormone or surgical treatment), newly married, and forever grateful to her parents on account of whom she retains her bodily form and function as a natal female. 

Emelie was fortunate. She got out before what Abigail Shrier has appropriately titled, Irreversible Damage. But Chloe didn’t. 

Today, Chloe is 18-years-old. At 13, she was put on puberty blockers and testosterone. Her parents had been told that if they did not sign off on this intervention, Chloe would likely kill herself. At 15, Chloe underwent a double mastectomy; at 16, she realized it was all a mistake – and she began her detransition by halting all cross-sex hormones and socially identifying and presenting as her God-given sex. 

13-years-old sounds pretty young to be making life-altering choices. But by today’s standards, it’s pretty old to be starting puberty blockers: gender affirming care advocates are starting kids as young as 8 on puberty blockers and cross-sex hormones. 

HOW DID WE GET HERE? 

The mainstream acceptance of transgender ideology is traceable to a series of cultural shifts over the last few hundred years according Dr. Carl Trueman in his excellent work, The Rise and Triumph of the Modern Self. Reflecting on American sociologist Philip Rieff’s three world assessment model of culture, Trueman explains that throughout history there have been three primary paradigms. The first was belief in fate and the gods like the Greeks of antiquity, which Reif calls a first world culture. A second paradigm bloomed with the rise – and widespread acceptance of – Christianity. Fate was replaced by faith and the divine will; polytheism was replaced with monotheism. With the advent of modern science followed by the technological advancements of the industrial revolutions, however, the broader cultural paradigm replaced the supernatural with the natural. This movement from what Rieff calls the second world culture of Christianity to the third world culture now prevalent in society was an open rebellion against the transcendent: which is something both the first and second world cultures shared in common. In third world cultures, there is no objective meaning or truth – there is not fate or divine will. There is no plan. That which is right is said to be so because people feel it to be right; two individuals can disagree on truth and both be correct, according to this model, because truth is inherently internal, based on feelings, subjective, and individually personal. Truth is relative: what is right for someone does not mean it’s right for everyone. Charles Taylor called this the immanent frame as opposed to a transcendent frame (for the first and second world cultures).

This makes interacting with the socio-political culture difficult for Christians, who have what Taylor called a mimetic view of the world – where the world has “a given order and a given meaning” – as opposed to a view he called poiesis, which views the universe and time as raw material out of which human beings must create their own meaning.

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Furthermore, Christians have always accepted the second world culture model but are now living in a society that has largely abandoned this model in favor of the self-referential third world culture model. While all three cultures are distinct they can exist in a society simultaneously: a fact pointed to by the existence of neo-paganism, Christianity, and atheism in the world today.

Although Rieff does not extrapolate past the third world culture, I would argue that we are now living in a fourth world culture – or at least a space between the third and an emerging fourth. Allow me to explain. While third world cultures dispense with the transcendent they do not historically dispense with observable reality. Today, even observable reality is denied; it is said that women can have penises and men can have vaginas; that one’s internal understanding of self can be at odds with one’s biological state, be it sex or age or species. Indeed, just as the third world culture replaced the supernatural with the natural, the fourth has replaced the natural with the unnatural – objective scientific fact for science fiction. I would argue that the fourth world culture is in fact one that has replaced fact with fantasy; one that has cultivated a social imaginary, in Taylor’s words, that allows for the expression of general, societal truths rooted in its own fantastical first principles. Trueman explains: 

Why does the sentence “I am a woman trapped in a man’s body” make sense not simply to those who have sat in poststructuralist and queer-theory seminars but to my neighbors, to people I pass on the street, to coworkers who have no particular political ax to grind and who are blissfully unaware of the rebarbative jargon and arcane concepts of Michel Foucault and his myriad epigones and incomprehensible imitators? The statement is, after all, emblematic of a view of personhood that has almost completely dispensed with the idea of any authority beyond that of personal, psychological conviction, an oddly Cartesian notion: I think I am a woman, therefore I am a woman. How did such a strange idea become the common orthodox currency of our culture?

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So how did we arrive at a place where the observable fact of the biological binary, existent in every mammalian species and reflected even in the naturalism of evolution, is laughed away as infantile or lacking sufficient sophistication? To answer this question, Trueman points to the 18th century genevan philosopher Jean-Jacquis Rousseau (1712–1778). 

Rousseau believed that the purity of the individual is corrupted by outside influences. In other words, the authentic self of an individual is internally defined; society obtrudes this purity with false narratives. Trueman writes: “for Rousseau, the social order is a source of falsehood or to use the modern term, inauthenticity.”

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  As this idea trickled down over the course of the last three hundred years, it paved the way for what Rieff calls, psychological man; what Charles taylor calls expressive individualism. Both Rieff’s and Taylor’s concept refers to the modern dilemma created when people do not look beyond themselves for meaning but within themselves for what Trueman calls “personal psychological happiness.” 

To illustrate this turn, Trueman contrasts what he remembers of his grandfather’s sense of meaning and satisfaction being able to provide for his family through his job as a metal worker (an external sense of meaning) with the understanding of job satisfaction today, which relies on a psychological fulfillment of meaning. This change, from external to internal, can be seen marching ever forward from Rousseau, who claimed the true self is self-directed in living it’s authentic truth, to poets like Wordsworth, and on still through the rise of existentialism with Nietzsche’s emphasis on self-creation. 

By the time of the industrial revolution, Marx would frame history as a long stream of oppression; by the time of Freud, ultimate fulfillment was considered to be satisfying suppressed desires through sexual expression. Between Marx and Freud, “society now intuitively associates sexual freedom with political freedom,” according to Trueman, “because the notion that…we are defined by our sexual desires is something that has penetrated all levels of our culture.”

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This is precisely why, over the last one hundred years, sexual preference (or sexual orientation to use the modern terminology) is considered directly connected to personhood. Magnus Hirschfield (1868–1935) advocated the acceptance of sexual minorities because he implicitly understood this connection in the early 20th century; Harry Benjamin (1885-1986) likewise undertook the surgical manipulation of the male human body into the approximation of the female form; Alfred Kinsey (1894–1956) sex research was an outgrowth of this developing idea. The sexual revolution of the 1960s came about as a result.

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From 1960 to the 1990s sexuality and identity were explored on every level. Slowly, everything became permissible; to each his own – and to each his own moral code. To impose any external standard became antiquated or bigoted. Probing the boundaries of biological sex and socialization, John Hopkins psychologist, John Money, would sever the term gender from sex. Money believed that male and female stereotypes placed on children under five would facilitate the manifestation of these behaviors in adulthood. In other words, Money believed that gender (or one’s identity as a man or woman, together with their social preferences) was formed by nurture not nature. 

THE CASE OF DAVID REIMAR:

John Money’s theories were based on – and to a certain extent validated – by his treatment of David Reimar. Born Bruce in 1965 with an identical twin brother named Brian, he was the victim of a botched circumcision which destroyed his male genitalia. His parents were distraught; they did not know what to do. And then they heard John Money speaking about his hypothesis: if you simply raise a biological male and a female, then he would be one. After getting in contact with Money, they began to raise Bruce as Brenda. First, they had him undergo a number of surgeries as a toddler to approximate the change. As an adolescent, he was put on hormones so he would develop breasts. But he was never told about the botched circumcision – or that he was born male. It was not until a fateful day in 1980, after a severe depressive episode, that his parents told him the truth. 

David always knew he did not like the dolls or dresses he was given and now he knew why. From then on he ceased living as Brenda, he eventually changed his name to David, and he lived the rest of his life as a man. Unfortunately, his life tragically ended in 2004 at his own hand. But Money’s philosophy, which had been sold as a total success, even after David reverted to identifying as a male, had already taken root in the culture. All of this paved a golden path for gender to make its debut in the late 1990s. 

THE 1990s GENDER THEORY

Gender theory can be generally reduced to two distinct phases: the first began in academia. Spearheaded by Judith Butler, who emphasized gender performance over cosmetic modifications, academic gender theory (as I’ve come to call it) posits that the repetitive actions of men and women performing specific gender roles over a long period of time manifests both the social and physiological gender distinctions. In other words, gender is entirely arbitrary. Rather, it is a result of sustained, performative action. In Butler’s philosophy, one need only be true to themselves in action, in order to manifest their self-created gender.

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Over time, gender theory trickled down to the public consciousness, transforming on its way into what I call pop gender theoria – the formative ideology of today.

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Pop gender theory takes elements from Butler’s system to build the general framework only to bastardize the system itself. Instead of external sex or performative action, pop gender theory emphasizes internal gender identity: a perceived feeling of the authentic self within. The goal is to conform the external self to the internal to produce the “authentic product” of self to present society. This often draws upon the binary itself and stereotypes of men and women, both of which Butler eschews.

Today, internal gender identity might be considered “more real” than the external sex and thus takes precedence.The perfect example of pop gender theory is the story of former super athlete Bruce Jenner. In 2015, the world watched Jenner espouse, in that now famous interview with Diane Sawyer, that in his soul, he feels like a woman– That he is, in truth, a woman!

This raises a peculiar question for theology: are souls sexually differentiated? 

THE QUESTION OF SEXUAL DIFFERENTIATION AND CHRISTIAN ANTHROPOLOGY

The confusion around this topic, even in Orthodox circles, was made manifest to me as I sat in a seminary classroom in 2017 where this question was asked by a fellow seminarian: “are souls gendered?” The conversation that ensued was concerning. If our future priests were confused about this subject, how are they going to teach the people? After being asked by several classmates to write about the topic, I did in what became my Masters Thesis and later my first book: On Gender and the Soul. If you happen to be interested in theological anthropology or what the first 1000 years of Christian writers have to say about gender and its relationship to the soul, you may find it of interest.

If you’re not sure, you can read the first chapter or two for free, here. (If you’re a paying member of this substack publication – first of all, thank you! and secondly – you can read the entire book for free at the same link – and download a PDF copy of it for free:)

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OTHER RESOURCES:

Great resources on transgender ideology: in no particular order: The Rise and Triumph of the Modern Self by Carl Trueman. Trans by Helen Joyce; The End of Gender by Debra Soh; Material Girls by Kathleen Stock; What is a Woman? by Matt Walsh; When Harry Became Sally by Ryan T. Anderson; Irreversible Damage by Abigail Shrier.

1. DSM-5, p. 454.

2.  Great Britain began gathering and retaining these statistics earlier than America. See UK Investigating Why Gender Dysphoria Children Increased over 4000 percent in 10 years (Christian Post).

3. See Pew Research (June 7, 2022). About 5 of Young Adults in the US Say Their Gender is Different From Sex Assigned at Birth.

4. Lisa Littman. “Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria” in Plos One (August 16, 2018; March 19, 2019).

5. Ibid.

6. Ibid.

7. Britannica, The Dancing Plague of 1518.

8. See Brittanica, The Dancing Plague of 1518: “The 1518 event was the most thoroughly documented and probably the last of several such outbreaks in Europe, which took place largely between the 10th and 16th centuries. The otherwise best known of these took place in 1374; that eruption spread to several towns along the Rhine River.” American Medical historian John Waller convincingly explained why he believes this was a case of psychogenic disease.

9.  History of the Unconscious, pp. 84, 98.

10. See Fr. Seraphim Rose, Orthodoxy and the Religion of the Future.

11.   See Jesse Singal, What’s Missing From the Conversation About Transgender Kids.

12. See Sweden’s Karolinksa Ends All Use of Puberty Blockers

13. Carl Trueman. The Rise and Triumph of the Modern Self, p. 39. 

14. Ibid,  p. 35. 

15. Ibid, p. 111.

16. Ibid, p. 263. 

17. Although many see the sexual revolution as the cause of sexual promiscuity it is really the natural result of the burgeoning third world culture. 

18. Of course, this has overtones of Nietszche and Sartre.

19. This is what I call academic morphology in my book, On Gender and the Soul.