Pediatric referrals to specialist gender clinics increase with media coverage
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Referrals for transgender and gender-diverse children to specialist gender clinics in the United Kingdom and Australia increased with media coverage on transgender topics, according to study data published in JAMA Network Open.
“Various theories and assumptions have been put forward to explain the rising rates of referral to specialist gender clinics. We felt it was important to move beyond such theories and assumptions to look at the empirical evidence,” Ken Pang, FRACP, PhD, associate professor and a clinician scientist fellow at Murdoch Children’s Research Institute, Australia, told Healio. “While these data do not provide any direct evidence of causation, the results are nonetheless consistent with our clinical experience, in which transgender and gender-diverse patients and their families commonly identify the media as a way of empowering them to seek clinical assistance.”
For a cross-sectional study, Pang and colleagues obtained referral information from the Royal Children’s Hospital Gender Service in Melbourne, Australia, and the Gender Identity Development Service in London. The data included the date of referral, age at referral and assigned sex at birth. The study included all referrals from 2009 to 2016.
Researchers used Google News to obtain relevant local media coverage on topics, including transgender, gender dysphoria, gender identity disorder and gender service, along with stories featuring the names of the two clinics and either the word “child” or “adolescent.” Media items were classified as predominantly focused on transgender issues, peripherally related, or directly mentioning one of the clinics. The media search was conducted in the same period of 2009 to 2016 as the referral search.
The study period included 5,242 referrals from Gender Identity Development Service in the U.K. (n = 4,684; 39.4% assigned male at birth; mean age, 15.3 years for those assigned male and 15.4 years for those assigned female) and Royal Children’s Hospital Gender Service in Australia (n = 558; 44.8% assigned male at birth; mean age, 11.9 years for those assigned male and 14.4 years for those assigned female). During that time, there were 2,194 transgender news items published in the U.K. and 420 in Australia. The number of referrals and transgender news items in both countries increased sharply with each year (P < .001), according to the researchers.
In Australia, the association between referrals and total number of media items was the strongest in the second week after the item’s publication (beta = 0.12; 95% CI, 0.04-0.2), whereas in the U.K., the first week of a media item’s publication had the strongest association with an increase in referrals (beta = 0.16; 95% CI, 0.03-0.29).
Transgender-focused stories, excluding those only peripherally associated with transgender issues, were associated with an increase in referrals in Australia in the first week (beta = 0.16; 95% CI, 0.04-0.28) and the second week (beta = 0.23; 95% CI, 0.11-0.35). Referrals in the U.K. increased the first week after a transgender-focused story’s publication (beta = 0.22; 95% CI, 0.01-0.44).
Media items classified as peripherally related to transgender issues were not associated with an increase in referrals at either location. For coverage mentioning Gender Identity Development Service, there was an increase in referrals the first week (beta = 0.5; 95% CI, 0.11-0.88) and the second week (beta = 0.57; 95% CI, 0.18-0.98), but not the third week. Coverage mentioning Royal Children’s Hospital Gender Service resulted in no associations with an increase in referrals.
Researchers wrote that the findings aligned with their clinical experiences, and media coverage may empower transgender and gender-diverse adolescents and their parents to seek clinical care.
“This work highlights the importance of providing information about gender diversity and relevant clinical care within broader society,” Pang said. “While the media obviously plays a critical role in the provision of such information, other institutions — eg, schools, universities, health services — have a critical role to play, too.”
Pang added that future studies should explore whether the sentiment or tone of media stories affects the association between referrals and media coverage.
“In the past few years, there has been a significant amount of negative press coverage of pediatric gender services, and it is possible that this may have dissuaded some young people and their families from seeking care,” Pang said. “Thus, testing whether negative media coverage is associated with reduced rates of help-seeking would be of interest.”
For more information:
Ken Pang, FRACP, PhD, can be reached at Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052, Australia; email: ken.pang@mcri.edu.au.
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