Written evidence submitted by Transgender Trend (MISS0046)

Transgender Trend is a UK organisation calling for evidence-based treatment of children with gender dysphoria and the end to teaching the concept of ‘gender identity’ as fact in schools. Our submission focuses on body image problems among teenage girls and the harmful resolution of such problems through cosmetic, medical alteration of the body known as ‘gender reassignment’. We argue that this ‘solution’ is not a real solution at all, but in fact a symptom of the extreme distress girls feel, to the extent that they wish to escape womanhood altogether, and have now been given not only the medical means, but the conceptual framework through which to do so.

Since children have been taught that the criteria for being a ‘boy’ or being a ‘girl’ is their ‘gender identity’ and not their sex, it is predominantly girls who are taking the opportunity to ‘change sex.’ The rise of over 4,000% in referrals to the Tavistock Gender Identity Development Service (GIDS) over the past eight years of girls who develop gender dysphoria at or after puberty, is historically unprecedented, and judging from reports of clusters of girls ‘transitioning’ in schools, these figures represent the tip of the iceberg.  

Becoming a ‘trans man’ or ‘non-binary’ allows an escape from the word ‘girl’ and its associations in today’s highly-sexualised culture, and immediately gives a girl higher status. This completely new phenomenon should be understood within the framework of adolescent female mental health and not within the gender-neutral framework of ‘transgender’. General health and medical research is based overwhelmingly on the male body as default, leading to under-diagnosis or mis-diagnosis for girls and women. In the case of gender dysphoria, the research we have is based largely on boys and men who historically made up over 90% of transsexual adults in the UK as recently as the late Sixties.[1] Today over 70% of referrals of adolescents to the GIDS are girls.[2]

Early childhood referrals to the Tavistock from 1989 reflected this male/female split. In 2011, girls overtook boys for the first time, the sex ratio was reversed and the gap has continued to widen ever since. There is no understanding nor any explanation or hypothesis as to why ‘increased trans visibility’ has influenced predominantly teenage girls, particularly when the trans people who are more visible are largely middle-aged males, often portraying the glamorised version of womanhood young girls are rejecting.

The rise in referrals of teenage girls to the GIDS coincides with several cultural factors: the rise in extreme gendered marketing to children over the past decade (including toys, books and clothes), representing girls as passive pink stereotypes of femininity; the rise of the internet and social media platforms and ‘selfie’ and celebrity culture that disproportionately harms girls; the increased sexualisation of young girls (for example in clothing and toys); and the spread of easily-accessible internet pornography and the assimilation of the porn aesthetic into youth culture through music videos, film and entertainment. These more recent developments have taken place during an era of increased public sexual objectification of women since the Sixties: in newspapers, magazines, film, advertising and tv.

The harmful impact on girls and women of the increasingly hyper-sexualised cultural representation of themselves throughout the decades since the Sixties has been well-documented.

The impact of poor body image

Girls are particularly at risk of poor body image. This may be exacerbated by race, disability (including autism), age and sexual orientation. We focus on girls in general in adolescence.

The Mental Health Foundation Body Image report last year found:

“In our survey, 46% of girls reported that their body image causes them to worry ‘often’ or ‘always’ compared to 25% of boys.”[3]

Surveys such as this consistently find that girls suffer body image problems at a significantly higher rate than boys, although issues such as low body confidence and eating disorders have also increased in boys along with the increasing objectification of the male body over the past decade.

An Ofsted survey in 2011 of 150,000 children found that by the age of 10 a third of girls cited their bodies as their main source of worry:

“16% of fifteen- to seventeen-year-olds have avoided going to school because they felt bad about their appearance and 20% have avoided giving an opinion in public because of it. One in three girls would consider cosmetic surgery.”[4]

What contributes to poor body image?

We have been aware of the contributing factors to poor body image in girls since the report from the American Psychological Association Task Force on the Effects of the Sexualisation of Girls (2007).

“Research also links exposure to sexualized female ideals with lower self-esteem, negative mood and depressive symptoms among adolescent girls and women. In addition to mental health consequences of sexualization, research suggests that girls’ and women’s physical health may also be negatively affected, albeit indirectly.”[5] 

The government-commissioned Sexualisation of Young People Review by Dr Linda Papadopoulos (2010) suggested in the executive summary that this sexualisation starts early:

“Children and young people today are not only exposed to increasing amounts of hyper-sexualised images, they are also sold the idea that they have to look ‘sexy’ and ‘hot’. As such they are facing pressures that children in the past simply did not have to face. As children grow older, exposure to this imagery leads to body surveillance, or the constant monitoring of personal appearance. This monitoring can result in body dissatisfaction, a recognised risk factor for poor self-esteem, depression and eating disorders. Indeed, there is a significant amount of evidence that attests to the negative effects of sexualisation on young people in terms of mental and physical health, attitudes and beliefs.”[6]

In this report Papadopoulos foresaw the mainstreaming of the sex industry and the spread of mainstream pornography through the rise in new technologies and its damaging effects on the health of young girls as well as the rise in assaults against them.

What are the long-term effects?

Poor body image creates self-consciousness and a lack of confidence in the world and your right to take up space in it. Girls know that to be acceptable, the most important thing about them is how they look. This can lead to girls ‘dumbing down’ and focusing their efforts and energy on their appearance rather than their achievements.

Science writer, Matthew Hutson, wrote of the impact of objectification in Aeon magazine (2013):

“Yet it doesn’t make sense to teach people from a young age that they are most highly valued as bodies. Sexualisation — resulting from beauty pageants or the general media landscape — leads girls and women (and sometimes boys and men) to be dehumanised by others, and it also leads to self-objectification, where that dehumanisation is internalised. Focusing on one’s worth to others as a body can lead to eating disorders, reduced self-esteem, and depression. Girls can also fall prey to sexual stereotypes, avoiding other, more intellectual pursuits.”[7]

A study by the Future Foundation think tank (2012) showed that:

“A generation of Britain's best and brightest young women is being held back from fulfilling its potential to produce future leaders, entrepreneurs and trendsetters because of insecurity and relentless societal pressure for girls to strive for physical perfection.”[8]

What is the impact of media consumption on people’s body image, does it impact their mental health?

Media features again and again in reports on the pressures on girls to look perfect. The Girlguiding Girls’ Attitudes survey has provided statistics in this area for years.

The 2016 survey into the views of the UK’s girls and young women, which surveyed over 1,500 young people, revealed that  “36% of seven- to 10-year-old girls say people make them feel like the most important thing about them is the way they look” and that “almost 40% of the same group feel they are not pretty enough, and 25% feel they need to be “perfect”. One in six feel ashamed or embarrassed of how they look.

“The findings suggest that the problem may be getting worse, with the survey reflecting a five-year decline in girls’ body confidence. Almost 40% of girls aged seven to 21 do not feel happy with how they look in 2016, compared with 27% in 2011.”[9]

Laura Bates of Everyday Sexism commented on the survey with some observations from her own work with girls in schools:

“Even at the age of just 12 or 13, girls already know that we live in a world where women are judged, first and foremost, not on their abilities or achievements, but how closely they match up to an unrealistic, media-mandated beauty standard. They feel, deeply, that they must strive to emulate the tall, thin, white, large-breasted, long-legged, glossy-haired, perfect-skinned models they see everywhere in adverts and magazines. They specifically reference the women they have seen online, from the unrealistic body shapes of pornography to “perfect Instagram girls”.[10]

Papadopoulos (2010) makes reference to the fact today’s generation of young people is growing up in an environment saturated with images as never before: 

“The world is saturated by more images today than at any other time in our modern history. Behind each of these images lies a message about expectations, values and ideals. Women are revered – and rewarded – for their physical attributes and both girls and boys are under pressure to emulate polarised gender stereotypes from a younger and younger age. The evidence collected in this report suggests these developments are having a profound impact, particularly on girls and young women.”

Emerging evidence suggests that girls are the highest users of social media and that there is a link between high social media use and depression in girls.[11] The Millenium cohort study (2019) showed that girls’ much-higher rate of depression than boys is closely linked to the greater time they spend on social media and that as many as three-quarters of 14-year-old girls who suffer from depression also have low self-esteem and are unhappy with how they look.

The report from the APA Task Force on the Effects of the Sexualisation of Girls found that:

“Frequent exposure to media images that sexualize girls and women affects how girls conceptualize femininity and sexuality. Girls and young women who more frequently consume or engage with mainstream media content offer stronger endorsement of sexual stereotypes that depict women as sexual objects”.

Papadopoulos (2010) found that:

“Exposure to the sexualised female ideal is linked with lower self-esteem, negative moods and depression in young women and girls.”[12] 

A survey of over 1,000 girls aged 14-21 for the Plan International State of Girls’ Rights in the UK 2020 report found that:

“Girls’ bodies are constantly scrutinized and stigmatised: Cultural pressure to look a certain way remains a key source of anxiety in girls’ lives […] From the images they see in the media to harmful comments at school, girls are feeling pressured to conform to unrealistic beauty and body standards. This is exacerbated by the exponential number of images girls are exposed to today – both online and offline.”[13]

What is the relationship between poor body image and mental health conditions including eating disorders?

The APA Task Force on the Effects of the Sexualisation of Girls found that:

“In the emotional domain, sexualization and objectification undermine confidence in and comfort with one’s own body, leading to a host of negative emotional consequences, such as shame, anxiety, and even self-disgust.”[14]

The Papadopolous report (2010) also linked poor body image caused by idealised notions of beauty with eating disorders:

“The mass media promotes and reinforces an idealised notion of beauty for both men and women, presenting standards – of thinness for women and of muscularity for men – that few can ever hope to achieve. The effects of this are apparent – eating disorders are on the rise. The eating disorder charity BEAT estimates that 1.6 million people in the UK have an eating disorder. The vast majority of these – some 1.4 million – are female. And now we’re starting to see what happens when you tweak the message – young women need to be not only thin, but also sexually desirable. As anorexia increases so now does the number of young women having breast implants at an increasingly younger age.”[15]

Girls develop eating disorders in an attempt to control their bodies to meet impossible standards, or to try to escape the sexualisation that inevitably comes to them once their bodies start developing at puberty. Teachers report to us that the impact of often degrading, humiliating and abusive pornography which is now easily accessible on children’s smart phones, is felt by girls as young as twelve who admit they are terrified of sex. The attempt to prevent the body from developing into that of a woman is a protection against the role that girls see they are expected to play, a role that involves pain and humiliation they are supposed to accept and enjoy.

The full range of the harmful effects on girls of this sexist and sexualised culture, outlined in these reports, is as following:

•                     Lack of confidence in and comfort with own body
•                     Shame, anxiety, self-disgust
•                     Low self-esteem, low self-worth
•                     Depression, negative mood
•                     Eating disorders, anorexia, bulimia
•                     Negative impact on body image and sense of self
•                     Body dissociation and self-objectification
•                     Self-harming behaviours
•                     Increased vulnerability to seek cosmetic surgery

We see a similar list of co-existing mental health issues in an increasing number of teenage girls presenting to gender clinics. The difference between now and 2007 when the APA Taskforce report was published, is that violent porn culture has expanded even further into the lives of young people. A common report from female detransitioners is that they experienced some of these symptoms along with internalised misogyny.

Society has already primed girls to see their own bodies as “wrong;” to view them as objects in need of ‘fixing’ and perfecting. The dissociation with the physical body has already been created, along with the sense of failure and self-blame. It’s not a big step from the self-harming body-modification attempts girls already make to the idea of chemical hormones, breast-binding and mastectomy. As long as society continues to objectify and dehumanise women and value them as commodities above all else, more girls will see themselves as failing to be “real” women and we’ll see more vulnerable girls wanting to opt out of womanhood altogether.

There has been a lack of will from successive governments to tackle the spread of porn culture and the objectification and hyper-sexualisation of girls and young women over the past few decades. The research has existed, the results have been known and the recommendations have been made. For example:

The UN Commission on the Status of Women Report March 15th 2013 Resolution:

“Recognize the important role the media can play in the elimination of gender stereotypes, [...] strengthen self-regulatory mechanisms to promote balanced and non-stereotypical portrayals of women with a view to eliminating discrimination against and the exploitation of women and girls and refraining from presenting them as inferior beings and exploiting them as sexual objects and commodities and instead present women and girls as creative human beings, key actors and contributors to and beneficiaries of the process of development.”

Recommendation from the Expert panel re the media:

“a. Strengthen regulatory frameworks with regard to media, advertising imagery, texts, games and other popular culture mediums which portray women or girls in a discriminatory, degrading or stereotypical way.
b. Engage all media agencies that currently produce, or provide platforms for the distribution of, material/content which objectifies girls and women.”[16]
 

The Shadow report from the UK CEDAW Working Group assessing the UK Government’s progress in implementing the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) April 2013 made this recommendation:

“There is much research into the harms associated with the objectification process in relation to male-female relations and gender roles. This has been shown to impact upon the health and well-being of girls and women, and to play a role in reinforcing discrimination. In the light of such evidence, it is wholly inadequate and inappropriate to regulate sexually objectifying imagery in relation to subjective notions of ‘taste and decency’, which actually serve to trivialise the issue. A more appropriate guide for regulation would be to use and to build upon criteria which addresses objectification and, in particular, sexual objectification.”[17]

The Istanbul Convention Article 17 – Participation of the private sector and the media states:

              “Parties shall encourage the private sector, the information and communication technology sector and the media, with due respect for freedom of expression and their independence, to participate in the elaboration and implementation of policies and to set guidelines and self-regulatory standards to prevent violence against women and to enhance respect for their dignity.

              Parties shall develop and promote, in co-operation with private sector actors, skills among children, parents and educators on how to deal with the information and communications environment that provides access to degrading content of a sexual or violent nature which might be harmful.”[18]

Report on Eliminating Gender Stereotypes in the EU December 2012:

“Negative gender stereotypes can therefore have a significant influence on young women’s confidence and self-esteem, particularly on teenagers, resulting in a restriction of their aspirations, choices and possibilities for future career possibilities. Given the media’s significant influence on people’s perception on gender equality, special orientation courses are needed to raise awareness in Advertising Standard Committees and self-regulatory bodies about the negative influences of gender discrimination and stereotypes in the media; it should not be forgotten that gender equality is a fundamental human right.”[19]

This government must take urgent steps to stop the teaching in schools of ‘gender identity’ which can only be defined by regressive gender stereotypes. Girls’ needs, rights and protections as the female sex must be prioritised. Gender dysphoria is the latest and most extreme expression of body hatred and rejection and it is the causes and the solutions to that problem that this government must urgently address; the solution is not for girls to become boys.

June 2020

References