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Attitudes in the U.S. Toward Hormonal and/or Surgical Interventions for Adolescents Experiencing Gender Dysphoria

Abstract

In order to align with their inner sense of gender identity, adolescents suffering from gender dysphoria are increasingly being treated with cross-sex hormones and irreversible surgeries to alter their bodies. The present study is the first to examine attitudes about these recently emergent medical practices in a national population. We used data from the 2018 Post-Midterm Election Study, a survey representative of adults in the USA ages 20 to 65 years (N = 5285), to examine the social factors associated with approval or disapproval of hormonal and/or surgical interventions for adolescents seeking medical treatment for gender dysphoria. Higher fertility, race/ethnicity (in this case, black), sex (male), and heterosexual self-identity were each robustly associated with disapproval. Nested regression models revealed that a range of religion measures were statistically significant (toward disapproval). However, all but evangelical self-identification were no longer significant after accounting for support for abortion rights, the spectrum of political self-identification, and voting behavior. These findings, prompted by a high percentage of variance explained, led us to consider perspectives on medical transitions for adolescents as fitting the “culture war” framework, largely polarized between a “progressive” worldview of bodily autonomy and an “orthodox” worldview of bodily integrity.

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Notes

  1. Agreement that hormonal or surgical interventions for adolescents should be ok is conceptually the same as approval of said interventions for adolescents. We therefore use the two terms interchangeably throughout this paper. While “approval/disapproval” may sound more value-laden than “agreement/disagreement,” our survey respondents were in effect asked to make a value judgment. Our outcome variable does not indicate approval or disapproval of transgender people themselves as having human dignity, worthy of love and respect, etc.

  2. Knowledge Networks (now Ipsos) recruited the first online research panel that is representative of the US population. Dubbed the KnowledgePanel®, members are randomly recruited by telephone and mail surveys, and households are provided with access to the Internet and computer hardware if needed. Unlike other Internet research panels sampling only individuals with Internet access who volunteer for research, the KnowledgePanel® is based on a sampling frame which includes both listed and unlisted numbers as well as those without a landline telephone, is not limited to current Internet users or computer owners, and does not accept self-selected volunteers. As a result, it is a random, nationally representative sample of the American population. More information about Ipsos and the KnowledgePanel®, including panel recruitment, connection, retention, completion, and total response rates, is available from their Web site.

  3. We also realize the term “abortion rights” itself is contested in American public life. Our use of that term is not intended to signal any normative position, one way or another, on the proper scope of rights concerning abortion.

  4. A real type, as opposed to a Weberian ideal type, following Gorski, is a conceptual abstraction that helps social scientists to understand why particular structures/patterns of human social relations are the kind of structures they are by identifying some set of elements and interrelations without which those social structures would be something else and/or would not have the particular kinds of emergent causal powers we believe they have.

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Funding

The survey was underwritten by the Austin Institute.

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Correspondence to Brad Vermurlen.

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The IRB at the University of Texas at Austin waived approval because the research used a de-identified dataset.

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Regnerus, M., Vermurlen, B. Attitudes in the U.S. Toward Hormonal and/or Surgical Interventions for Adolescents Experiencing Gender Dysphoria. Arch Sex Behav 51, 1891–1902 (2022). https://doi.org/10.1007/s10508-021-02214-2

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  • DOI: https://doi.org/10.1007/s10508-021-02214-2

Keywords

  • Gender dysphoria
  • Gender identity
  • Cross-sex hormones
  • Surgery
  • Adolescents
  • Public opinion