Matt Walsh’s 2014 Iran Study Says Most Trans People Have Personality Disorders. Do We?
You’ll be shocked to learn Matt Walsh is cherry picking his research papers.
by Mira Lazine
Recently, conservative idol Matt Walsh tweeted out a link to a study claiming that trans people have a higher rate of personality disorders. While saying that trans people are “narcissistic, sado-masochistic, paranoid and anti-social,” he appears especially interested in an obscure, cherry-picked study from Iran dating back to nearly a decade ago. This is in spite of his historic opposition to Iran (and his general racism towards Muslims)* and to psychiatry as a field. He also ignores a more recent review by the very author of this study, which admits that the findings within this field are extremely mixed.
Really, we’re seeing the pinnacle of facts and logic here. I know that transphobes aren’t known for good research, but you’d think they’d have the ability to scroll down two more links on Google.
Walsh isn’t the only one who parroted this claim. Chris Brunet, contributing editor to the American Conservative, appeared in his replies agreeing with this claim and going so far as to call all trans people murderous. Walsh’s claim has even been made previously by gender critical sites like ‘Parents of ROGD Kids.’ Just one look at the replies to his tweet shows the crowd who adores him - not exactly the peak of what you’d call ‘human decency.’
This rhetoric prompted a few reactions from advocates for trans rights. Journalist Ari Drennen responded by asking if Walsh is projecting, while others criticized Walsh’s hypocrisy. Most have dismissed his blatant bias, but none have taken a detailed look at the study itself.
The 2014 study makes grand claims that are only slightly less strong than those of Walsh. It suggests that around 80% of trans people have a personality disorder of some kind. However, this is using a sample size of only 73 people, selected from a single gender clinic in Iran. This means the results may or may not be generalizable to other trans people in Iran. Given the huge differences in how trans medicine works in Iran, along with Iranian culture’s intense stigma against all LGBTQ+ people and legal ban on homosexuality, the results aren’t generalizable to other countries at all.
But who cares about scientific accuracy when you can be transphobic and ableist all at once!
Another big issue with the study is that the tool used to evaluate personality disorders isn’t exactly reliable. The Millon Clinical Multiaxial Inventory II (MCMI-II) is a self-report tool that doesn’t map well onto diagnoses following the DSM, and is specifically believed to overdiagnose people. The authors of this study suggest using multiple tools in conjunction with the MCMI-II to make an accurate diagnosis, as opposed to relying squarely on the measure.
Finally, this study offers no comparison sample of cisgender people, making it extremely difficult to know if the results were due to some bias of the clinic or sampling measures. It’s standard practice to use a comparison sample for a study such as this, as they help to ensure that it’s showing a notable result as opposed to some quirk of the sample or methods used.
You’d think that the crowd constantly calling for placebo, randomized, quadruple blind studies done by Albert Einstein himself before accepting gender-affirming care is evidence based would actually take a second to think about what they’re citing. You’d really think, but they don’t.
More recent research, using more reliable methods, found a low rate of personality disorders in trans people using a self-report method but a higher rate (albeit substantially less than the 2014 study) using a clinician reported method. This further suggests that the data here are extremely divergent from one another, making authoritative claims impossible based on the current data.
In a later review of the research, the author of the Iranian study found data ranging from 15 percent of trans people to their own study’s estimate of around 80 percent of trans people with a personality disorder of some kind. However, it should be noted that this review too has flaws, best seen in this brief response article. It details problems like a lack of construct validity in how these personality disorders are assessed in the literature, issues with clinician bias and misdiagnosis in the literature, difficulty applying these concepts to transgender populations, and - perhaps most important - the huge stigma associated with getting diagnosed with a personality disorder.
Considering all of this, it’s very likely that the research methods used, characteristics of the samples themselves, and what country the data is gathered from are all contributing factors that suggest a great big nothing: Researchers can’t come to any reliable conclusions about the rate of personality disorders among trans people at all.
I know, I know - it’s shocking that Matt Walsh, a guy who makes a living talking about pop singers’ “bodily orifices” and how moon landing denialism is a conspiracy to undermine the “western man” got this one wrong. Surprise, surprise, it’s true!
Leveraging stigma against personality disorders is the main thrust of this rhetoric from Walsh. Nowhere in his tweets are concern for those who have personality disorders, or a regard for avoiding stigma in a heavily marginalized group. Rather, he treats personality disorders as inherently negative traits, something that intrinsically makes a person ‘bad.’ This is tied to the heavy ableism that people who receive these diagnoses face. It can often be life changing to receive such a diagnosis as people with one are more likely to face discrimination in relationships, employment, and education.
Trans people and people with personality disorders alike deserve compassion, care, and respect. Neither group is bad, and neither group should face scorn for simply existing. However, there is no firm basis to conclude that trans people have a higher rate of personality disorders than others do. We just don’t know.
*An earlier version of this article incorrectly referred to Iranians as Arabic, we have updated it to reflect that Iranians are Persian, not Arab.
Mira Lazine is a freelance journalist covering transgender issues, politics, and science. She can be found on Twitter, Mastodon, and BlueSky, @MiraLazine