A Longitudinal Study of Adolescents’ Pornography Use Frequency, Motivations, and Problematic Use Before and During the COVID-19 Pandemic

A Longitudinal Study of Adolescents’ Pornography Use Frequency, Motivations, and Problematic Use Before and During the COVID-19 Pandemic. Beáta Bőthe, Marie-Pier Vaillancourt-Morel, Jacinthe Dion, Marie-Michèle Paquette, Maude Massé-Pfister, István Tóth-Király & Sophie Bergeron. Archives of Sexual Behavior, Jan 20 2022. https://link.springer.com/article/10.1007/s10508-021-02282-4

Abstract: Since the beginning of the COVID-19 pandemic, an increase in pornography use has been reported based on cross-sectional findings, raising concerns about associated adverse outcomes, such as problematic pornography use (PPU). The aims of the present study were to document potential changes in adolescents’ pornography use frequency, motivations, and PPU before and during the COVID-19 pandemic. As part of an ongoing study on adolescents’ sexual health, we used a large sample (NTime 1 = 1771; 47.6% girls, Mage = 15.42 years, SD = 0.59) to examine changes from baseline (before the COVID-19 pandemic) to one year later (during the COVID-19 pandemic) in adolescents’ self-reported pornography use frequency, motivations, and PPU, using latent change models and examining potential gender differences. No significant changes were observed in adolescents’ pornography use frequency and pornography use motivations, and no gender differences were present in these trends. Although statistically significant, slight decrease was observed in boys’ PPU levels, and a statistically significant, slight increase was observed in girls’ PPU levels, these changes were very small, providing no practical or clinical relevance. In sum, despite previous propositions, concerns, and cross-sectional findings, longitudinal results suggest that adolescents’ pornography use characteristics were rather stable between November 2019 and June 2021, and the COVID-19 pandemic and related lockdowns might not have led to general increases in adolescents’ pornography use as it was expected.

Discussion

Similar trends were observed in boys and girls’ pornography use characteristics when examining potential changes before and during the COVID-19 pandemic. Despite prior studies reporting a self-perceived increase in adolescents and young adults’ pornography use since the beginning of the COVID-19 pandemic (Li et al., 2020a, b; Nebot-Garcia et al., 2020; Nelson et al., 2020), our results suggest that adolescents during the COVID-19 pandemic did not report using pornography more frequently and they did not engage more frequently in pornography use due to different motivations (e.g., using pornography to decrease boredom or suppress negative emotions). Moreover, in line with the findings of the only longitudinal study reporting temporal trends in PPU in adults (Grubbs et al., 2021), our results suggest that PPU slightly decreased during the COVID-19 pandemic in boys, compared to pre-COVID-19 times. Although girls’ PPU levels were low before and during the COVID-19 pandemic as well, a statistically significant increase was observed in girls’ PPU levels. Yet, these changes were negligible and the overall score of girls is still considered low, providing no real practical relevance.

No Significant Changes in Adolescents’ Pre-COVID-19 and During COVID-19 Pornography Use Frequency and Motivations

Despite previously documented differences between adolescent boys and girls’ pornography use characteristics (Bőthe et al., 2019; 2021d; Bőthe et al., 2020b; Peter & Valkenburg, 2016), no gender differences were observed in the trends of changes in pornography use frequency and pornography use motivations. In contrast with our hypothesis and findings of prior studies among adolescents and young adults (Li et al., 2020a, b; Nelson et al., 2020), adolescents during the COVID-19 pandemic and related lockdowns did not show significant changes in their frequency of pornography use compared to the pre-COVID-19. On average, boys used pornography many times per week, while girls used it less than once a month both before and during the COVID-19 pandemic.

One main difference between the present study and previous ones is that we used a longitudinal study design to compare adolescents’ pornography use characteristics before and during the COVID-19 pandemic, whereas past studies used samples recruited during the pandemic and asked about participants’ perception concerning changes in their pornography use (e.g., whether they watched less, more, or the same amount of pornography since the pandemic; Li et al., 2020a, b; Nelson et al., 2020). Given potential recall biases in retrospective studies of online activities (Kahn et al., 2014), adolescents’ reports about their pornography use before the pandemic or changes in their pornography use during the pandemic may not be as accurate as comparing actual reports on pornography use characteristics before and during the pandemic.

Another difference between previous studies (Li et al., 2020a, b; Nelson et al., 2020) and the present one is related to samples’ characteristics. Our study included a diverse sample of adolescents aged between 14 and 18 years (with a mean age of 15.4 years at baseline), including all genders and sexual orientations. However, two of the prior studies included both adolescents and young adults (i.e., 967 participants were aged between 15 and 35 with a mean age of 26.6 years in Li et al., 2020a, b; and 134 participants were aged between 16 and 20 with a mean age of 19.2 in Nebort-Garcia et al., 2020), while the other study focused on a more specific population of 151 adolescents, namely sexual minority boys aged between 15 and 17 years (Nelson et al., 2020). These differences in sample characteristics might have yielded different results. For example, as our sample only included adolescents, most lived with their parents. As many parents also followed COVID-19-related regulations (e.g., social distancing, closure of workplaces) and experienced shutdowns, adolescents were more likely at home with their parents, and thus, might not have more opportunities to view pornography than before, while young adults might have lived alone and worked from home during the pandemic, providing more opportunities for pornography use.

Moreover, adolescents aged between 13 and 18 years also vary in their level of engagement in social distancing, with only 30.5% of them engaging in pure social distancing (no in-person contact with those outside their household; Oosterhoff & Palmer, 2020; Oosterhoff et al., 2020). Therefore, it is possible that adolescents spent more time with their friends in offline settings, leaving less time for engaging in online activities, including pornography use, resulting in no changes in their pornography use frequency.

Lastly, adolescents returned to a hybrid model of education (i.e., half in-class and half online) in the province of Quebec (Canada) between the fall of 2020 and summer of 2021 (i.e., when the follow-up survey was administered), which might have provided them with the opportunity to return to part of their pre-COVID-19 academic routine, resulting in the no significant changes in their long-term pornography use frequency. Still, temporary increases in pornography use might have been present among adolescents in the first months of the COVID-19 pandemic (i.e., spring and summer of 2020). One of the largest pornography websites reported higher traffic on their website in Canada between March and July 2020 compared to pre-COVID-19 rates, with a peak of a 21.5% increase in pornography use on March 25, 2020 (Pornhub.com, 2020a, 2020b). These reports of increases in pornography use were also supported by a global analysis of Google search trends (Zattoni et al., 2020). Yet, in line with our findings, when a longer-term trend in pornography use frequency was examined before and during the COVID-19 pandemic among adults, individuals’ use had returned to similar or even lower levels of use as reported before the pandemic by August to October 2020 (Grubbs et al., 2021). In sum, findings suggest that although a temporary increase might have been present in individuals’ pornography use frequency in the first months of the COVID-19 pandemic, these changes were likely transient.

Although it was proposed in the literature that pornography may be used as a potential distraction from negative emotions and stress that accompany the COVID-19 pandemic (Mestre-Bach et al., 2020), adolescents did not report significantly higher levels of emotional distraction and suppression, boredom avoidance, and stress reduction pornography use motivations during the COVID-19 pandemic, compared to the pre-COVID-19 levels. Still, it is important to note that adolescents during COVID-19 may have experienced varying levels of stress and negative emotions due to the pandemic and related restrictions (Duan et al., 2020; Ellis et al., 2020; Fegert et al., 2020; Racine et al., 2020) and may choose other activities to cope with these difficulties. Studies conducted during the COVID-19 pandemic documented that adolescents engaged in more online activities, including schoolwork, monitoring the latest news about the pandemic and used social media to stay in touch with friends and peers (Ellis et al., 2020; Munasinghe et al., 2020). This suggests that adolescents may engage in these activities instead of pornography use, and that these may help them cope with COVID-19-related stress. Concerning other pornography use motivations that were assessed in the present study (i.e., sexual pleasure, sexual curiosity, fantasy, lack of sexual satisfaction, and self-exploration), adolescents did not report significantly different levels of these motivations pre- vs. during COVID-19.

In sum, these results suggest that adolescents’ pornography use characteristics, in general, might not have changed as significantly as it was suggested by previous findings (Li et al., 2020a, b; Nelson et al., 2020) or predicted in popular media outlets (Döring, 2020). Prior studies also suggest that adolescents may use pornography out of curiosity or as an aid for masturbation, rather than a means to cope with negative emotions and stress (Arrington-Sanders et al., 2015; Bőthe et al., 2019; Romito & Beltramini, 2011; Ševčíková & Daneback, 2014), and these motivations may not be impacted as profoundly by the pandemic as the coping-related motivations. Yet, substantial inter-individual variability was observed in both the initial levels and changes of pornography use frequency and motivations in boys and girls as well, suggesting that some adolescents might have had higher, whereas others might have had lower, initial pornography use frequency and motivations levels than the average, and individual changes were likely to be heterogeneous (i.e., different levels of increase, decrease, or stability might have been present for some adolescents), reinforcing the need to better understand the factors involved in adolescents’ pornography use.

Negligible Changes in Adolescents’ Pre-COVID-19 and During COVID-19 Problematic Pornography Use

Corroborating the findings of the only longitudinal study reporting temporal trends in PPU in adults (Grubbs et al., 2021), our results also suggested that PPU slightly decreased during the COVID-19 pandemic in boys, compared to pre-COVID-19 times. Although the latent changes models suggested that this general decrease in boys’ PPU levels were significant, this change was very small on a descriptive level (i.e., when observing boys’ pre-COVID-19 and during COVID-19 mean scores, the change was -0.03 on a scale from one to seven). Concerning girls, the latent changes models suggested that their PPU levels significantly increased over the one-year period of the study. However, again, it needs to be noted that this change was very small on the descriptive level (i.e., when observing girls’ pre-COVID-19 and during COVID-19 mean scores, the change was + 0.03 on a scale from one to seven). These significant changes might derive from the large sample size (i.e., with large sample sizes, even small differences turn out to be significant differences), and thus, we do not consider them as meaningful changes.

Yet, it needs to be noted that as in the case of pornography use frequency and pornography use motivations, substantial inter-individual variability was observed in both the initial levels and changes of PPU in boys and girls as well. These findings suggest that some adolescents might have had higher or lower initial PPU levels than the average. Also, individual changes were likely to be heterogeneous, suggesting that some adolescents might have experienced steeper increases or decreases in their PPU than the mean PPU changes. Thus, it may be plausible that some adolescents who might already have had problems with their pornography use before the COVID-19 pandemic might experience an increase in their PPU under such an unprecedented situation as a pandemic (Király et al., 2020; Mestre-Bach et al., 2020).

Limitations and Future Directions

The results of the present study provide preliminary answers to current concerns about whether adolescents’ pornography use characteristics, including pornography use frequency, motivations, and PPU, might have changed due to the COVID-19 pandemic and related restrictions (e.g., social distancing). Nevertheless, some limitations of this study need to be noted. We used data from a self-selected sample of adolescents, who completed self-report measures. Thus, the findings may include some biases (e.g., recall bias, under- or over-reporting, or selective loss of participants; Štulhofer et al., 2021). Although moral incongruence toward pornography use may be associated with self-perceived PPU (Grubbs & Perry, 2019; Grubbs et al., 2019a, b, c), it was not assessed in this study. The present study only assessed intentional pornography use; unwanted exposure was not examined. We used a diverse sample in terms of gender and sexual orientation, but it was not representative of all adolescents in the country, limiting the findings’ generalizability. The fact that our sample included adolescents from a Western, educated, industrialized, rich, and democratic (WEIRD) country also limits the generalizability of the findings. Future studies are needed to replicate and extend the present study’s findings, preferably in pre-registered study designs, including non-WEIRD samples (Klein et al., 2021).

As is usually the case in large-scale and longitudinal studies among adolescents (Kohut et al., 2021; Vandenbosch & Peter, 2016; Vandenbosch et al., 2015), we had to reduce the number of items per construct. Therefore, although we assessed a diverse set of pornography use characteristics, each motivation (Bőthe et al., 2021a) and pornography use frequency were measured by one item that may bias findings. Moreover, the use of self-report measures to assess motivations may introduce biases (e.g., it is not possible to differentiate between reports of actual motivations and posterior attributions concerning the reasons of given behaviors). Thus, study designs focusing on real-time data collection when a behavior occurs (e.g., ecological momentary assessment, EMA) might provide a more accurate and nuanced understanding of motivations underlying pornography use. Given the presence of substantial inter-individual variability in the latent change models, future studies would do well in relying on an analytic approach that is able to identify subpopulations of adolescents characterized by different change scores. Lastly, while no differences were observed in the results concerning boys’ pornography use with and without the included control variables, most of the minimal increases in girls’ pornography use disappeared when control variables were added. These results highlight the importance of considering potential confounding variables when examining pornography use, though the selection of these potential control variables requires careful consideration and justification (Wright, 2021), and results should be preferably reported with and without the control variables for full transparency.

Given that many major religions prescribe parent-benefitting norms restricting sexual promiscuity and socially disruptive behavior, we hypothesized that both parenthood and parental care motivation would predict higher levels of religiosity

The Holy Father (and Mother)? Multiple Tests of the Hypothesis that Parenthood and Parental Care Motivation Lead to Greater Religiosity. Nicholas Kerry, Marjorie L Prokosch, Damian R Murray. January 2022. https://www.researchgate.net/publication/357888322

Description: Parenting is a universal element of human life. However, the motivational and attitudinal implications of parenthood remain poorly understood. Given that many major religions prescribe parent-benefitting norms restricting sexual promiscuity and socially disruptive behavior, we hypothesized that both parenthood and parental care motivation would predict higher levels of religiosity. Studies 1-3 (N >2,100 US MTurkers; two pre-registered) revealed that parental status and motivation were robustly associated with religiosity in Americans, and that age-related increases in religiosity were mediated by parenthood. Study 4a (376 students) found a moderated experimental effect, such that emotionally engaged participants showed increases in religiosity in response to a childcare manipulation. Study 4b then replicated this effect in recoded data from studies 1-2. Study 5 used data from the World Values Survey (N=89,565) and found further evidence for a relationship between parenthood and religiosity. These findings support functional accounts of the relationship between parenthood and mainstream religiosity.

 

We need to have a partner in order to show high levels of sex frequency; but once we got one, committing and living together reduces sex frequency significantly: Married people have relatively less sex, close to those without a partner

Which People Have the Most Sex? The sex frequency “billboard,” according to new research. Elyakim Kislev. Psychology Today, January 19, 2022. https://www.psychologytoday.com/intl/blog/happy-singlehood/202201/which-people-have-the-most-sex

[Excerpts, full text and references/links at the article]

In recent years, many studies have documented a decline in sexual activity.2, 7 For example, Twenge finds that Generation Y is on track to have fewer sex partners than members of the two preceding generations. In fact, her numbers show that those who identify as members of Generation Y are two-and-a-half times as likely to be abstinent as Gen Xers in their early 20s.8

According to an analysis of the General Social Survey, the percentage of 18-29-year-olds reporting no sex in the year preceding the survey increased from around 15% in 1990 to 23% in 2018. In addition, the average American adult went from having sex over 60 times a year 20 years ago, to around 50 times in 2018.9

The Implications for Sexual Satisfaction

These results also address a secondary-level question that was raised previously regarding the effect of sex frequency. The results clearly show that sex frequency significantly correlates with sexual satisfaction for men and women alike. The variance accounted for by sex frequency is 22.9% for men and 21.5% for women. This means that couples who are higher on sex frequency (those living apart) are likely to be higher on sexual satisfaction. Indeed, this was also found to be the case.

Married people, in any event, have relatively less sex, close to those without a partner. This makes one think about the reasons for the decline of marriage as an institution and why people choose to forgo wedlock.

Check also Does Marriage Really Improve Sexual Satisfaction? Evidence From the Pairfam Data Set. Elyakim Kislev. The Journal of Sex Research, May 3 2019. https://www.bipartisanalliance.com/2019/05/marriage-is-not-determinant-for-sexual.html

Bank opacity: How much do investors know about the composition of banks' portfolios? It seems that investors were not fully informed about lending portfolios

Bank opacity - patterns and implications. Stefan Avdjiev and Maximilian Jager. BIS Working Papers  No 992, January 19 2022. https://www.bis.org/publ/work992.htm

Summary

Focus: How much do investors know about the composition of banks' portfolios? What parts of banks' balance sheets are least known to investors? What is the impact of public data releases on bank equity prices and CDS spreads? Do banks whose credit risk is underestimated by markets get cheaper funding and make riskier loans? We examine these questions by combining a novel event study methodology with a rich data set on the exposures of European banks.

Contribution: We calculate a new measure of bank risk using a rich data set on banks' exposures to individual countries and sectors. We employ a novel methodology, which allows us to evaluate the impact of public data releases on bank equity prices and CDS spreads. Our empirical framework allows us to identify two effects of new information: the reduction of overall uncertainty and the update of investors' estimates of bank risk. We also investigate the impact of bank opacity on bank funding, lending and profitability.

Findings: We find that investors were not fully informed about bank lending portfolios. Bank equity prices and CDS spreads reacted strongly to public releases of data on banks' exposures. The impact of new data was highest for European periphery banks' sovereign exposures and European core banks' private sector exposures. Banks with underestimated credit risk had lower funding costs and borrowed more. If they were from the European periphery, such banks also made riskier loans and had higher profits.

Abstract: We investigate the patterns and implications of bank opacity in Europe using a rich bank-level data set. Employing a novel event study methodology, we document that public data releases by the European Banking Authority (EBA) on banks' exposures to individual countries and sectors contained information that was not previously priced by equity and CDS markets. We demonstrate that the degree of bank opacity varied considerably across bank nationalities and counterparty sectors – it was highest for European periphery banks' sovereign exposures and European core banks' private sector exposures. Furthermore, we document that underestimations of banks' credit risk by markets were associated with lower funding costs and higher wholesale borrowing (for all banks) as well as with greater risk taking and higher profitability (for European periphery banks).

JEL classification: F34, G21, G28.

Keywords: bank opacity, asymmetric information, event study, credit risk, asset markets.

Check also Despite a more authoritarian personality, Republican CEOs, known to favor the avoidance of threats and ambiguity, tend to prefer a less asymmetric information environment; hence they make more frequent, timelier, and more accurate disclosures:

CEO Political Ideology and Voluntary Forward-Looking Disclosure. Md Noman Hossain et al. American Economic Ass'n Conference 'CEOs and Politics,' Jan 7 2022. https://www.bipartisanalliance.com/2022/01/despite-more-authoritarian-personality.html

Systematic country differences in the extent to which people believe that selfishness is a source of inequality, which sheds light on international differences in public morality, civic virtues, & redistributive policies

Global evidence on the selfish rich inequality hypothesis. Ingvild Almås et al. Proceedings of the National Academy of Sciences, January 18, 2022 119 (3) e2109690119; https://doi.org/10.1073/pnas.2109690119

Significance: People’s beliefs about why the rich are richer than the poor have the potential to affect both policy attitudes and economic development. We provide global evidence showing that where the fortunes of the rich are perceived to be the result of selfish behavior, inequality is viewed as unfair, and there is stronger support for income redistribution. However, we also observe that belief in selfish rich inequality is highly polarized in many countries and thus a source of political disagreement that might be detrimental to economic development. We find systematic country differences in the extent to which people believe that selfishness is a source of inequality, which sheds light on international differences in public morality, civic virtues, and redistributive policies.

Abstract: We report on a study of whether people believe that the rich are richer than the poor because they have been more selfish in life, using data from more than 26,000 individuals in 60 countries. The findings show a strong belief in the selfish rich inequality hypothesis at the global level; in the majority of countries, the mode is to strongly agree with it. However, we also identify important between- and within-country variation. We find that the belief in selfish rich inequality is much stronger in countries with extensive corruption and weak institutions and less strong among people who are higher in the income distribution in their society. Finally, we show that the belief in selfish rich inequality is predictive of people’s policy views on inequality and redistribution: It is significantly positively associated with agreeing that inequality in their country is unfair, and it is significantly positively associated with agreeing that the government should aim to reduce inequality. These relationships are highly significant both across and within countries and robust to including country-level or individual-level controls and using Lasso-selected regressors. Thus, the data provide compelling evidence of people believing that the rich are richer because they have been more selfish in life and perceiving selfish behavior as creating unfair inequality and justifying equalizing policies.

Discussion

The present study reports from a global dataset on people’s beliefs about the extent to which selfishness among the rich has caused inequality. It shows substantial support among people for the hypothesis that the rich are richer than the poor because they have been more selfish in life. We find that people’s belief in the selfish rich inequality hypothesis is related both to societal circumstances—in particular, the corruption level in their country—and to their income rank in the country. Finally, we show that the belief in the selfish rich inequality hypothesis is predictive of people’s views on whether inequality in society is unfair and whether the government should aim to reduce inequality.

These findings contribute to a number of literatures. They highlight how people’s perception of the rich may affect the political economy of redistribution and economic development (30⇓⇓⇓⇓⇓⇓–37). If the fortunes of the rich are perceived to be the result of selfish behavior, then our evidence suggests that there will be substantial support for redistribution. However, we observe that the belief in the selfish rich inequality hypothesis is highly polarized in many countries and thus likely to be a source of political disagreements. In this respect, it is interesting to observe that the United States is one of the most polarized countries in our study and the country in which the belief in the selfish rich inequality hypothesis is most predictive of people’s attitudes toward inequality. Disagreement on the selfish rich inequality hypothesis among Americans may thus be a contributing factor to the present challenging political situation in the United States. More broadly, these beliefs may affect economic development by shaping the trust people have in the rich and in companies and other institutions often headed by people perceived to be among the rich.

This study further contributes to the important literature in psychology and economics on motivated beliefs, which has shown that people engage in self-enhancing attributions (27, 38⇓⇓⇓⇓⇓–44). There is considerable evidence suggesting that people are predictably biased in how they gather and process information to preserve a self-image of being moral and not self-interested (43, 45⇓⇓⇓⇓⇓⇓–52). The present study provides evidence consistent with such a self-serving bias in beliefs, even though we cannot rule out that the observed association between income rank and the belief in selfish rich inequality may be driven by the rich and the poor having access to different information. Finally, the paper speaks to the large literature in moral psychology and behavioral economics studying the role of nonselfish motivation in explaining human behavior (23, 45, 53⇓–55). We provide large-scale evidence showing that people across the world believe there to be heterogeneity in the extent to which individuals behave nonselfishly.

An interesting question is how the belief in selfish rich inequality relates to the actual selfishness of the rich. To shed some light on this relationship, we use self-reported data from the 2018 Gallup World Poll on whether people last month donated money to a charity. In most countries, we find that the rich are more likely to have donated money than the poor, which is not surprising, given that the rich have more money than the poor. However, in SI Appendix, Fig. S8, we show that there is a negative relationship between the belief in selfish rich inequality and the extent to which donating money correlates with the income rank in society (β=−0.055, t57=−2.52$\beta =-0.055,\hspace{0.17em}{t}_{57}=-2.52$, P = 0.014). Hence, the data suggest that the rich are less willing to donate money in countries where people believe there to be selection of selfish people into becoming rich.

People’s beliefs in the selfish rich inequality hypothesis shed light on how we think society works and may shape the kind of life we want to live. These beliefs may also play a fundamental role in determining public morality and civic virtues (56) and therefore represent an essential ingredient in our understanding of human behavior and the organization of society.

Extent to which young people remove their pubic hair, by what means, how often, and reasons for such behavior; pubic hair removal by friends and sexual partners, as well as expectations of sexual partners was also explored

To Shave or Not to Shave: Exploring Pubic Hair Removal among College Students. Sandra L. Caron. American Journal of Sexuality Education, Jan 18 2022. https://doi.org/10.1080/15546128.2021.2025182

Abstract: This exploratory study investigated pubic hair removal behavior among 295 college men and women. Survey questions explored the extent to which young people remove their pubic hair, by what means, how often, and reasons for such behavior. Pubic hair removal by friends and sexual partners, as well as expectations of sexual partners was also explored. Commonalities and differences in responses between college men and women were examined. Results revealed that pubic hair removal is extremely common in both men and women and typically begins in early adolescence. Reasons for pubic hair removal most frequently cited include cleanliness, comfort and appearance. Implications for sexuality education and future research are discussed.

Are Sibship Characteristics Predictive of Same Sex Marriage? An Examination of Fraternal Birth Order and Female Fecundity Effects in Population-level Administrative Data from the Netherlands

Are Sibship Characteristics Predictive of Same Sex Marriage? An Examination of Fraternal Birth Order and Female Fecundity Effects in Population-level Administrative Data from the Netherlands. Christine Ablaza, Jan Kabátek & Francisco Perales. The Journal of Sex Research, Jan 18 2022. https://doi.org/10.1080/00224499.2021.1974330

Abstract: Despite historical increases in the number of individuals engaging in same-sex relations and entering same-sex unions, the causes of sexual orientation remain an open question. Two biological processes that have received some degree of empirical validation are the fraternal birth-order effect (FBOE) and the female-fecundity effect (FFE). Respectively, these processes posit that having a greater number of older brothers and being part of larger sibships independently increase the odds of male homosexuality. Nevertheless, previous studies have relied on suboptimal data and methods, including underpowered and selected samples, and models that fail to fully disentangle the two processes. In addition, they have rarely analyzed samples of women. We address these limitations using high-quality, population-level linked register data from the Netherlands (n = 9,073,496). Applying a novel multivariable approach, we jointly examine the FBOE and FFE by comparing the sibship characteristics of men (n = 26,542) and women (n = 33,534) who entered a same-sex union against those who did not (n = 4,607,785 men and 4,405,635 women). Our analyses yield robust evidence of an FBOE on both male and female homosexuality, but no support for the FFE. Additionally, we find that individuals’ birth order affects the probability of entering a same-sex union, regardless of the sex of older siblings.

The Guardian reported Stonewall’s statistic that “almost half” of young transgenders “have attempted to kill themselves”; real suicidality is 0.03pct (too high, 5.5 times greater than the suicide rate of all adolescents)

Suicide by Clinic-Referred Transgender Adolescents in the United Kingdom. Michael Biggs. Archives of Sexual Behavior, Jan 18 2022. https://link.springer.com/article/10.1007/s10508-022-02287-7

Introduction: Surveys show that adolescents who identify as transgender are vulnerable to suicidal thoughts and self-harming behaviors (dickey & Budge, 2020; Hatchel et al., 2021; Mann et al., 2019). Little is known about death by suicide. This Letter presents data from the Gender Identity Development Service (GIDS), the publicly funded clinic for children and adolescents aged under 18 from England, Wales, and Northern Ireland. From 2010 to 2020, four patients were known or suspected to have died by suicide, out of about 15,000 patients (including those on the waiting list). To calculate the annual suicide rate, the total number of years spent by patients under the clinic’s care is estimated at about 30,000. This yields an annual suicide rate of 13 per 100,000 (95% confidence interval: 4–34). Compared to the United Kingdom population of similar age and sexual composition, the suicide rate for patients at the GIDS was 5.5 times higher. The proportion of patients dying by suicide was far lower than in the only pediatric gender clinic which has published data, in Belgium (Van Cauwenberg et al., 2021).

Suicidality in Transgender Adolescents

“About half of young trans people…attempt suicide,” declared the United Kingdom Parliament’s Women and Equalities Committee (2015). Similar figures are cited by news media and campaigning organizations. The Guardian reported Stonewall’s statistic that “almost half” of transgender young people “have attempted to kill themselves” (Weale, 2017). “Fifty percent of transgender youth attempt suicide before they are at age 21” stated the mother of the most famous transgender youth in the English-speaking world (Jennings & Jennings, 2016). As a transgender theologian has observed, “the statistic about suicide attempts has, in essence, developed a life of its own” (Tanis, 2016).

Representative surveys of students in high schools provide one source of evidence for this statistic. In New Zealand, 20% of transgender students reported attempting suicide in the past 12 months, compared to 4% of all students (Clark et al., 2014). In the United States, 15% of transgender students reported a suicide attempt requiring medical treatment in the last 12 months, compared to 3% of all students (Centers for Disease Control & Prevention, 2018; Jackman et al., 2021; Johns et al., 2019). In another American survey, 41% of transgender students reported having attempted suicide during their lifetime, compared to 14% of all students (Toomey et al., 2018).

To what extent are self-reported suicide attempts reflected in fatalities? The connection is not straightforward. Respondents who report suicide attempts are not necessarily indicating an intent to die. One survey of the American population found that almost half the respondents who reported attempting suicide subsequently stated that their action was a cry for help and not intended to be fatal (Nock & Kessler, 2006). In two small samples of non-heterosexual youth, half the respondents who initially reported attempting suicide subsequently clarified that they went no further than imagining or planning it; for the remainder who did actually attempt suicide, their actions were usually not life-threatening. To an extent, then, “the reports were attempts to communicate the hardships of lives or to identify with a gay community” (Savin-Williams, 2001). Although such elaborate survey methods have not been used to study transgender populations, there is anecdotal evidence for a similar disjuncture. The pediatric endocrinologist who established the first clinic for transgender children in the United States stated that “the majority of self-harmful actions that I see in my clinic are not real suicide attempts and are not usually life threatening” (Spack, 2009).

[...]

Discussion

How reliable are these estimates? The chief uncertainty about the numerator is whether the fourth death will be ruled as suicide when the inquest is eventually held. It could be speculated that there were further suicides unknown to the Tavistock and to the National Confidential Inquiry into Suicide and Safety in Mental Health. All that can be said is that the single suicide by a GIDS patient from 2014 to 2016 is not out of line with comprehensive mortality data on suicides by transgender adolescents in the United Kingdom which counted five suicides in a longer age range and wider geographical area. The denominator for the annual suicide rate, however, is pieced together from various series and so is inevitably approximate. Statistics from the early 2010s are less reliable, though they make only a small contribution to the grand total; the last three years contribute more than half of the total number of patient-years. The most significant limitation is the lack of information on the age and sex of all the patients who committed suicide.

Direct comparison can be made with the Belgian pediatric gender clinic (Van Cauwenberg et al., 2021). Its annual suicide rate was about 70 times greater than the rate at the GIDS. This is especially puzzling because patients at the Belgian clinic scored better, on average, than those at the GIDS on tests of psychological functioning (de Graaf et al., 2018). The explanation for the huge disparity in suicide is not clear. The Amsterdam’s clinic annual suicide rate was four times greater than the rate at the GIDS. The higher rate is not surprising, however, because the Dutch clinical population was dominated by older adults: the median age at first visit was 25 (Wiepjes et al., 2020). Suicide rates peak in middle age, and so a population of older adults would be at higher risk than a population of adolescents.

The suicide rate of the GIDS patients is not necessarily indicative of the rate among all adolescents who identify as transgender. On the one hand, individuals with more serious problems (and their families) would be particularly motivated to seek referral and more likely to obtain it, and so the clinical subset would be more prone to suicide. One study suggests that a child who frequently attempted suicide was more readily referred to the GIDS (Carlile et al., 2021). On the other hand, young people facing hostility from their families would be less able to seek referral, and this hostility could make them especially vulnerable to suicide.

Taking into account these limitations, the estimated suicide rate at the GIDS provides the strongest evidence yet published that transgender adolescents are more likely to commit suicide than the overall adolescent population. The higher risk could have various causes: gender dysphoria, accompanying psychological conditions, and ensuing social disadvantages such as bullying. Studies of young people referred to the GIDS in 2012 and 2015 found a high prevalence of eating disorders, depression, and autism spectrum conditions (ASC) (Holt et al., 2016; Morandini et al., 2021)—all known to increase the probability of suicide (Simon & VonKorff, 1998; Smith et al., 2018). Eating disorders and depression could be consequences of transgender identity and its ensuing social repercussions, but this is implausible for ASC insofar as it originates in genes or the prenatal environment. From a sample of over 700 referrals to the GIDS in 2012 and 2015, 14–15% were diagnosed with ASC (Morandini et al., 2021). This compared to 0.8–1.1% of students in England (Department for Education, 2012, 2015). The association between autism and gender dysphoria is found in many populations (Socialstyrelsen, 2020; Warrier et al., 2020). Autism is known to increase the risk of suicide mortality, especially in females (Hirvikoski et al., 2016; Kirby et al., 2019; Socialstyrelsen, 2020). To some extent, therefore, the elevated suicide rate for transgender youth compared to their peers reflects the higher incidence of ASC. The same holds for other psychiatric disorders associated with gender dysphoria (Dhejne et al., 2016). Ideally, the suicide rate for patients of the GIDS would be compared to the suicide rate for patients in contact with other NHS mental health services, but the latter rate is not available.

One final caveat is that these data shed no light on the question of whether counseling or endocrinological interventions—gonadotropin-releasing hormone agonist or cross-sex hormones—affect the risk of suicide (Biggs, 2020; Turban et al., 2020). Although two out of the four suicides were of patients on the waiting list, and thus would not have obtained treatment, this is not disproportionate: the waiting list contributed nearly half of the total patient-years.