What Can an Actual Social Contagion Tell Us About Trans Youth?

The New York Times reported on teens who developed severe tics during the pandemic, after videos of teens with severe tics became popular on TikTok. Most teens recovered on their own.

by Evan Urquhart

In the New York Times this morning there’s a fascinating look at a cohort of teens who developed severe tics during the pandemic, causing them to make wild gestures and/or repeat silly or offensive phrases out of the blue. This sudden development of tics in adolescence was very different from the usual progression of Tourette's syndrome, which typically begins showing up in early childhood. A large number of cases occurred at the same time as videos of young people with very similar tics became popular on TikTok, and seemed to happen for kids who had experienced great trauma or stress.

The breakdown of gender was different from Tourette’s as well; Tourette’s is more common in boys, but the majority of teens who developed tics were girls. There was also a relatively high percentage of trans youth among patients with tics. The Times focused on Aidan, a nonbinary youth who recovered from their constant, disruptive, and very extreme tics after six months of intensive treatment. The New York Times also reported that most of the youth stopped displaying tics after about a year, without special treatment. According to neurologists, these tics faded on their own over time.

Doctors refer to disruptive symptoms which suddenly appear with no clear medical cause as functional disorders. When they affect a group of people that’s called mass psychogenic illness. This is what experts believe happened with the onset of tics among teens who viewed TikTok videos of teens with big, disruptive tics.

The Times piece doesn’t go quite so far as to say that the teens’ transgender identities developed in a similar way, but the possibility hangs over the article throughout. The closest the piece comes to addressing it head on is in a section where one named expert, Dr. Z Paige L’Erario, speculates that trans youth may have higher rates of functional disorders due to stress caused by “higher rates of discrimination, stigma, and bias.” This is contrasted with the opinion of other unnamed doctors who are said to “suspect that a small subset of adolescents with serious mental health issues may be more susceptible to social influences.”

screenshot from the New York Times

Is transgender identity similar to developing tics after seeing videos of peers who have tics? There are some superficial similarities, and many significant differences.

Let’s start with the similarities. Teens who developed tics often did so after seeing social media posts about teens who had tics, and teens who come out as trans often describe seeing posts by other trans teens as having been part of their self-discovery process. The tics caused the teens distress, and untreated gender dysphoria also causes distress. That’s about it.

There’s one more thing that may seem like a similarity, particularly to those who already believe that gender dysphoria is a social contagion, but it’s a bit more complicated in reality. It has to do with the gender of people who developed tics, and beliefs about the inauthenticity of trans men. The New York Times story mentions a gender disparity in the teens who have developed tics, with more girls developing tics than boys. It then lays out some slightly sexist hypotheses for why this might be so.

screenshot from the New York Times

However, the article later mentions, albeit briefly, that in Germany many more boys developed this symptom than anywhere else. Curious!

screenshot from the New York Times

If the existence of a single popular male influencer with Tourette’s in Germany was enough to have completely changed the gender balance of teens who displayed these symptoms, then how could higher empathy or desire for belonging among girls be the main factor at play? The article doesn’t answer, or even seem to recognize that there’s something off here.

Gender differences are important because many people use the same sexist rationale to support the belief that trans male identities are inauthentic. They reason that that girls are susceptible to falsely beliefs and social contagions. There’s no particular basis for this belief, except the fact that people are more likely to use the language of social influence to describe maladaptive or anti-social behavior in girls, but not for boys. While article after article bemoans the problems of boys, no one uses the word social contagion to describe them. No one says social contagion effects are causing boys to binge drink, use drugs, set fires, or commit rapes, even though if you look at these behaviors you often find unhealthy peer groups surround them.

Ultimately, there are also clear differences between teens who have developed tics and teens who are trans. Tics are disruptive and interfere with functioning, while being transgender is not. Teens who experience tics don’t enjoy having tics, and want their tics to go away. Trans youth, on the other hand, don’t want to stop being trans or experience their transness as an illness that needs to be cured. Perhaps most importantly, teens who developed tics in this socially mediated way mostly lost those tics over time, even without any particular treatment. None of the trans teens whose tics disappeared were reported to have stopped being trans during the same time, and the nonbinary youth profiled in the Times piece was nonbinary before their tics started and was still nonbinary by the end of the piece.

Being transgender isn’t a mass psychogenic illness because it isn’t an illness. It doesn’t cause people distress, and it doesn’t naturally fade over time. While gender dysphoria can cause distress, sometimes intense distress, it’s also highly responsive to treatment, unlike these tics, which were not responsive to treatment but did disappear naturally over time. Comparing these two things is disingenous, but the desire to do so is likely to be appealing to bigots who consider being transgender just as disruptive and intrusive as waving your arms around or yelling out curse words. While the New York Times is careful not to draw any conclusions, we predict we’ll see the right wing media jumping at the chance to do so in the wake of this piece.