Adolescent mental health

Further to yesterday’s post, the Guardian reports that Gus O’Donnell (Britain’s most senior civil servant under Tony Blair, Gordon Brown and David Cameron) has spoken out about the declining mental health of teenagers in the UK. Figures published recently by the NHS show that 20% of girls aged 17-19 and 10% of boys the same age had self-harmed or tried to kill themselves. Non-heterosexual youths were 2.5 times more likely to suffer from a mental health disorder than heterosexuals of the same age. The Guardian notes that “experts described the figures as deeply worrying and raised questions about the damage that social media, pressure to look good and sexual violence were doing to the mental welfare of young women in England.”

Adolescence has always been a time of emotional turmoil, but new pressures (particularly because of the pervasive influence of social media and the impact of the widespread availability of hardcore pornography) are intensifying these challenges. For example, doctors have begin to report a new condition called “Snapchat dysmorphia“, in which some people are seeking surgical interventions to make their appearance match better the greatly enhanced representations of themselves that are produced so quickly and effectively by algorithms on their phones.

The objectification and denigration of women is not new, but modern media create intense pressures on adolescent women at a time of great vulnerability. In the context of the debate about how to respond to gender non-conformity in children, it is significant that recent years have seen an explosion in the number of young women coming forward to seek help from gender identity services. Many of these young women first present after the onset of puberty, raising the possibility of what has com to be referred to as “rapid onset gender dysphoria”. There was a storm of protest recently when Brown University academic Lisa Littman published a study of this phenomenon. Littman was interested in the possibility that

“the belief that non-specific symptoms (including the symptoms associated with trauma, symptoms of psychiatric problems, and symptoms that are part of normal puberty) should be perceived as gender dysphoria and their presence as proof of being transgender; 2) the belief that the only path to happiness is transition; and 3) the belief that anyone who disagrees with the self-assessment of being transgender or the plan for transition is transphobic, abusive, and should be cut out of one’s life.”1

Littman’s conclusion is that making an accurate diagnosis can be extraordinarily complex – self reported cases of gender dysphoria post puberty may, she argues, have complex causes. It is possible that they are an expression of latent gender dysphoria, but perhaps they are also a modern expression of the much older challenge for young women of coming to terms with the sexualisation and objectification of their bodies. Glosswitch has argued powerfully that the latter is the case.

A team from the UK’s national Gender Identity Development Service (GIDS) has examined the rapid recent rise in the number of referrals of birth-assigned females.2 They explored a variety of possible explanations, including the possibility that “‘coming out’ …may be easier for birth-assigned females than it is for birth- assigned males”, and the impact of the digitisation of adolescents’ social interactions, in particular the way “that influences of socially constructed views of ‘femininity’ and ‘masculinity’ and the way these are being displayed on social media may have an impact on the increase of birth-assigned female referrals, especially for those who do not feel they fit this stereotype”.

This is a complex matter and I am not competent to weigh the arguments. Certainly there is an epidemic of mental ill-health among young people, and whether this is the cause or the consequence of expressions on gender dysphoria in some cases, it is an enormous problem that urgently needs attention.


1. L. Littman, PLoSONE 2018, 13(8), e0202330.

2. N. M. de Graaf, G. Giovanardi, C. Zitz and P. Carmichael, Archives of Sexual Behavior, 2018, 47, 1301–1304.

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