Social media is fueling a movement that is seeing the number of children seeking to change gender growing, announced the director of England’s only specialist NHS Clinics for young people yesterday. Dr Polly Carmichael said that the number of children seeking referrals for gender change treatment had risen from just 97 in 2009 to 2,519 in 2018, with children now having to wait up to 20 months for their first appointment.

Reports published in the medical journal Pediatrics supports this trend, attributing the growth in ‘gender identity disorder’ to a psychiatric condition that makes some children aware their brain functions more similarly to those of the opposite sex than to their own gender. By some estimates, 1 in 10,000 children are affected by the condition, and in some cases children as young at four years of age are in the process of ‘transitioning’ to another gender as the result according to Mermaids – a UK-based charity which provides support to the families of children with gender identity issues.

Dr Margaret Moon, a member of the American Academy of Pediatrics’ bioethics committee, argues that providing irreversible sex-changing treatment to children younger than 18 years old raises serious ethical concerns – and she is not alone. The ethics of gender change surgery have long been debated, with some arguing a child should not be able to make such an impactful decision while they are still a minor, and with others arguing that regardless of age a person should have the personal right to be able to choose which gender they belong to.

Long standing guidelines issued by the Endocrine Society are worthy of contemplation – they endorse hormone treatment but argue it should not be given to a child before puberty begins. Even then, the guidelines dictate that only puberty-blocking drugs should be delivered at the age 16, and that mental health professionals should be involved in the entire process.

Currently, specialized gender change facilities offer young people and their families psychological counseling and monitoring until puberty, which usually occurs around age 11 or 12. Then, children are given the aforementioned puberty-blocking drugs in the form of monthly injections or implants inserted into the arm. Gender change surgery is actually only done by a handful of highly specialized doctors in the United States and can only be done on patients who are at least 18 years old. That being said, more minor surgeries including breast removal are often done under the guise of something else, for example the child’s discomfort.

So, how is social media to blame for the rise is transgenderism, and the increasing number of young people seeking gender change surgery?

With the ever-growing number of support communities, forums and services one can easily find on platforms including Facebook and Twitter that cater specifically to those with gender identity issues, it only makes sense that greater awareness and understanding of transgender issues is growing. Ten years ago, social media did not exist, let alone the countless groups and pages dedicated to the dissemination and discussion of transgender material, or the virtual communities set up to accommodate discussion and concerns surrounding the phenomenon. Operational research courses that focus on statistical analysis now even use this subject as a basis for research projects, given the strong and ever-rising correlation between children using social media and those applying for transgender surgery.

Dr Polly Carmichael also told the Daily Mail, “I think that social media has a big influence in that young people can get information, talk to each other… Social media can be a source of support and information for young people.”

Social media’s newfound ability to hyper-target specific communities has only increased the likelihood of online users to stumble across this type of information and support, increasing the likelihood of young people in feeling comfortable and safe enough to take steps to achieve gender change. The issue lies in whether or not those young people are truly responding to personal identity issues, or a greater desire to attract attention, experience excitement and fit in to a rare and unique community.

As with all forms of media, messages perpetrated through social media can have both positive and negative influences on society – and young people in particular. Would these children have recognized an identity problem, or an issue, were it not for the communities and information being shared online? Many question whether social media’s ability to skew or misleadingly present reality is leading young people to make monumentally life changing decisions on a whim, supported by a virtual community of people who are essentially supporting decisions that will not affect them in any way.

Specialist health services in the UK are worried. They are now facing pressure from lobby groups to ‘speed up’ the process of supporting children with the transition to a new gender, which only heightens the ethical concerns felt by specialists and experts operating in the industry. Offering a ‘quick fix’ or a quick solution is, according to experts, the entirely wrong tact to take, especially if it results in the irreversible and life changing decision by a minor to change gender. More care and consideration certainly needs to be given to each young patient than currently is being given – and perhaps also to the ideas being perpetuated and driven by social media platforms today.