Something really does seem to have changed recently. Major media outlets are publishing pieces that are critical of some elements of transgender orthodoxy. Yesterday it was the Washington Post with an opinion piece from a trans woman who wrote about wishing she’d waiter longer before having sex reassignment surgery at age 19.

Today the LA Times published a story about transgender clinical psychologist Erica Anderson. Anderson is not only trans herself, she’s helped hundreds of teens who wanted to transition but now she’s publicly questioned whether or not some of the surge of teens announcing they are trans is in fact the result of influence by other teens.

She has helped hundreds of teens transition. But she has also come to believe that some children identifying as trans are falling under the influence of their peers and social media and that some clinicians are failing to subject minors to rigorous mental health evaluations before recommending hormones or surgeries.

“I think it’s gone too far,” said Anderson, who until recently led the U.S. professional society at the forefront of transgender care. “For a while, we were all happy that society was becoming more accepting and more families than ever were embracing children that were gender variant. Now it’s got to the point where there are kids presenting at clinics whose parents say, ‘This just doesn’t make sense.’ ”

Anderson’s own willingness to talk about her concerns has developed over time. But in 2020 she began to see a change in the families and kids coming to her for help.

As millions of teenagers across the U.S. went into quarantine in 2020, Anderson found herself meeting more and more parents who were startled when their children came out as trans. The UC San Francisco adolescent gender center where she worked saw a total of 373 new patients last year — up from 162 in 2019.

The teens tended to tell similar stories: They were in online school, had a lot of time on their hands and were spending more time on social media. TikTok, Instagram and YouTube, and even video games, allowed teens to craft virtual identities that they could then try out in the real world.

Online, a stream of transgender influencers and activists told teens that if they felt uncomfortable with their bodies, or didn’t fit in, maybe they were trans. Some coached kids on how to bind their breasts, how to change their name and pronouns at school, how to push their parents for testosterone.

“To flatly say there couldn’t be any social influence in formation of gender identity flies in the face of reality,” Anderson said. “Teenagers influence each other.”

Anderson is specifically concerned that some of those teens, influenced by peers and given affirming care by professionals who believe it’s offensive to question a teen’s views about their own gender, will later come to have regrets.

She said clinicians should not dismiss cases like that of Keira Bell, who sued Britain’s only youth gender clinic, claiming that after “a series of superficial conversations” with social workers she was prescribed puberty blockers at 16 and underwent a mastectomy at 20 — only to regret the decision and later resume life as a woman.

“Giving over to hormones on demand will result in many more cases of poor outcomes and many more disappointed kids and parents who somehow came to believe that giving kids hormones would cure their other psychological problems,” Anderson said. “It won’t.”

Last month Anderson wrote a piece for the San Francisco examiner which specifically pointed to Planned Parenthood as a place where teens could get hormones without even basic screening requirements.

It is widely known that the executive function of the brain — specifically in terms of planning and anticipation of consequences — is not fully mature until approximately age 25. That is why so many parents, and often progressive parents who strongly support LGBTQIA+ rights, express concern when their child announces they are trans and have started hormones without undergoing gender exploratory psychotherapy.

As mentioned, the student health centers and Planned Parenthoods operate under the informed consent model, which casts aside mental health screening requirements. Yet parents frequently tell me aghast that their young adult withheld from the medical provider a history of mental health challenges, including in some cases self harm or suicidal thoughts. Other college-age students gloss over details of their mental health history, dismissing further inquiry or accusing providers of “gatekeeping,” which in gender affirming circles is akin to being called out for racism by a person of color…

Gender dysphoria presenting abruptly in late adolescence/young adulthood may not be a simple or straightforward recognition of gender identity. It is also sometimes complicated by other factors, such as depression, anxiety, autism spectrum disorder, social inadequacy, competency fears, delayed impact of trauma and/or misplaced adolescent rebellion against parents and family. I also believe that the pandemic, social isolation and, in too many cases, excess consumption of social media with its bizarre and prescriptive dynamics are unhealthy for gender questioning young adults.

This sort of discussion is becoming more widespread and that’s ultimately going to be good news for kids and their parents, though you may not get that sense from Twitter.