Three observations:

One, people who have paid attention to the science and to other examples of levels of something increasing with social acceptance and then leveling off are unanimously going "DUH!"

Another is do not be surprised if the reactionaries reply to this study by claiming that "It was around 2018 when we started saying we wouldn't put up with this crap and the growth stopped, proving we were right! Social contagion! Trans ideology! SAVE THE CHILDREN!"

The last is that although most of the artificially-created social panic has been over transgender women, the sharpest increases in diagnosis and legal change in the years before 2018 were for transgender men, the difference pointing to the sexist and sex-obsessed nature of the opposition to justice.

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Time will tell us what is going on. I completely understand why conservatives are in a panic (literally and not in any way justified) and I get why we as trans people and our allies want hard sciences to back us when we tell them to fuck off.

Some people can't handle social change and the rest of us just want to be left to be our best most wonderful and beautifully realized selves.

It is an interesting study perhaps showing a glimpse of something but what?

I whole heartedly agree that the social contagion thing is laughable except that underlying it is a very dangerous message, "trans isn't normal and it is unwanted/dangerous!"

Like left handedness, we are and have been suppressed in who feels safe in being out.

I agree that we aren't there yet in the US or anywhere else (except this glorious place I go in my imagination when things get tough). Just think of all the trans kids being raised in these conservative families/communities. For many, it is going to take at least a decade or two (if ever) to get over that kind of hate and oppression - even if the world around them becomes more supportive and accepting.

From the "left handedness"graph, the change was profound and it took at least forty years (I was in elementary school in the US in the 60s/70s and being left handed wasn't something being actively discouraged but teachers weren't yet comfortable with left handed students). The entire graph of the Swedish study covers 40 years. In another 40-80 years we will likely have the same sort of perspective that we have on being left handed. A more direct comparison would be sexuality - being gay is a very different thing now than what it was in 1960 but there are still kids being taught to reject that part of themselves and to reject others. The sexuality curve isn't flat yet. It's getting closer and I really wish we were there but being gay still involves "coming out" and not just being. We'll likely know we're there with sexuality and gender when people no longer know what you mean if you said you were "coming out."

"Sally came out to us last week as left handed. The family is adjusting and generally supportive! We're all thrilled that she has such a great doctor/counselor etc."

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And Erin, I didn't say it in the previous post but I too am a huge fan of all you are doing. I'm in my 60s and my life is demonstrably better for what you (and Zoey) do every day. Thank you!

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Dec 27, 2023·edited Dec 27, 2023

Erin, I'm a huge fan of your work. But there is a clear logical error in this post's analysis. We don't know how much rates of trans identification are being artificially depressed, and we won't know for *at least* 50 years. This study doesn't measure that, and cannot measure it.

Look again at the graph of left-handedness, with particular attention to the time axis. A simplistic way of interpreting it would be that left-handedness was suppressed to some degree for people born up until the 1950s, and then that suppression stopped.

The problem is, left-handedness was definitely *still* being suppressed for some people born well into the 1970s and beyond, at the same time that the graph is "flat". This example is in the UK rather than the US, but my ambidextrous partner was punished for using her left hand to write when she was in school in the 80s. She was born in 1984. Later in school, she was given a "choice" --- as long as that choice was right-handedness. (She later switched to using her left hand, but only as an adult.) I don't know what the prevalence of such experiences is in the US, but I bet it's not zero.

That is, left-handedness rates for people born in the 1970s and 80s were in equilibrium, yes: equilibrium with some level of ongoing oppression. It's not possible to measure the prevalence of that just by measuring how many people end up left-handed, right-handed, or ambidextrous. You could estimate it by asking directly --- but that could only give an estimate, because they may not actually know what their handedness would have been. The same applies to gender or sexuality.

I look at the graphs from the study you're citing and I am angry and sad, because I see oppression and violence in them. Given that, according to what I've heard, Swedish trans people have suffered a substantial increase in gatekeeping recently, the decline at the end is more likely to be due to that than to any "natural" levelling out of the trend for more people to recognise that they are trans. (It should also be noted that 2020 is an atypical year because of the pandemic.)

I get that it may be a useful argument against the bigots that their claim of a "trans explosion" or whatever doesn't fit the facts. But we should be extremely careful to avoid falling into tacitly accepting right-wing framing while trying to debunk their arguments. The "social contagion" argument doesn't even deserve the time of day; it's so obviously an argument from bigotry. Of course trans people are more likely to recognize that they're trans earlier if they see other examples among their social peers; so what? What is there not to *celebrate* in the increase in trans people? I celebrate that, and I do the same for the huge increase in gen-Z people who openly say they aren't straight. Finally, queer and trans people are starting to be able to be themselves after literal centuries of oppression. We're not even close to the end of that process.

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I cover these in my caveats section! Namely, that we may not be at the true "natural prevalence" of transgender people yet.

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Dec 27, 2023·edited Dec 27, 2023

Right; I saw that caveat, and perhaps I should have addressed it explicitly. The thing is, it seems quite likely that increased gatekeeping is a primary explanation for the recent decrease in these measures of transition rate in Sweden.

The Garnet Initiative posted a very comprehensive study on the experiences of Swedish trans people of their healthcare system. They state that "Trans healthcare in Sweden has been deteriorating for years."


The study is worth reading in full, but this in particular jumped out at me:

> Have you felt hurt by an interaction in healthcare but been too scared to bring it up for fear you might be further targeted or refused healthcare?"

> 103 participants overall [out of 118] replied:

> Yes — 67 (65.05%)

> No — 36 (34.95%)

(Note that this is 56.8% of the entire study population, so it wouldn't be adequately explained by a response bias that people who had negative experiences are more likely to respond to this question.)

Here's a more personal account of one trans man's experience of gatekeeping in Sweden [cw dysphoria and failures of medical care]: https://www.reddit.com/r/asktransgender/comments/63zxmu/rantvent_about_gatekeeping_sweden/

More on gatekeeping attitudes in the Swedish trans healthcare system: https://www.diva-portal.org/smash/get/diva2:1432239/FULLTEXT01.pdf

Of course not only medical gatekeeping, but also media portrayals and social attitudes have a huge effect on people's decisions on whether it is safe to come out or transition. Judging by the comments at https://www.reddit.com/r/transnord/comments/wvftml/is_sweden_still_a_leader_in_trans_rights/ , Sweden doesn't seem great on that score. There seem to be a lot of similarities with the UK, famously known as "TERF Island" :-(

The main point I wanted to make is: the Swedish study can't actually tell you what the *cause* of the decline in these measures of transition rate is. It doesn't attempt to answer that.

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In terms of just numbers rather than trend, these findings once again confirm that this is an issue that affects so few people. The extent to which bigotry towards trans folks who just want to live their lives free of interference has been weaponized for political gain is obscene.

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Great SCIENCE on this topic, which is bandied about in the #ksleg all the time. Thanks!

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Thank you! Going into the database . . .

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In the graph, the "rate" axis doesn't list a unit. Is that in thousands of people? Ratio to someone else? We need units on both axes to correctly interpret graphs like that

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Thank you as always Erin.

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