ATLANTA ― Social media can be liberating for members of the transgender community, making it easier for them to "come out," but it can also open the door to additional ridicule and bullying, new research shows.
Here at the American Psychiatric Association (APA) 2016 Annual Meeting, Robert J. H. Johnston, MD, a third-year psychiatry resident at the University of Virginia, in Charlottesville, described two cases that captured the "complex" response among gender dysphoria patients to the Caitlyn (formerly Bruce) Jenner story.
A former Olympic athlete and star of the reality television show Keeping Up with the Kardashians, Jenner garnered even more media attention, including being featured in Vanity Fair magazine, when she changed genders. A day after she released her story, Jenner shattered Twitter records and instantly became world famous.
One of Dr Johnston's cases involved a 19-year-old man with obsessive compulsive disorder (OCD) who, after Caitlyn Jenner publicly came out, started to question his own gender identity.
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Dr Robert Johnston |
"Some of that was driven by his OCD, where the mind just kind of latches onto something and takes it and ruminates on it, but it seemed like it was also a doorway for him to actually do some exploration of his own," said Dr Johnston.
The Caitlyn Jenner story served as a kind of "catalyst" for him, he said.
In some ways, social media makes the "coming out process a little easier," said Dr Johnston. "People are able to try on new identities before they actually incorporate [one]."
He added that the media can serve as a "proxy for acceptance."
However, social media can expose members of the transgender community to insensitive attacks, said Dr Johnston.
Although the platforms provided by social media may be liberating for transgendered people, those "on the other side of this are also disinhibited," which may increase the possibility of their making comments that they would not make face to face, he noted.
Sensationalizing "Painful"
In the second case, the patient was a young transgendered woman who was being treated for depression. Here, the Caitlyn Jenner event "sensationalized a process that for her was really painful," said Dr Johnston.
"She felt that there was this voyeurism on the part of the public, which was really disturbing to her. This was an internal process that she wasn't really comfortable with, and she felt [the media attention on Jenner] made it more difficult for her" to come to terms with her sexual identity.
This patient felt that the Caitlyn Jenner story "cheapened the experience in some ways," said Dr Johnston.
Also, just as thin fashion models represent an unattainable standard for teenage girls, the Caitlyn Jenner coverage "kind of continued to perpetuate this unattainable standard for beauty" for the transgendered community, said Dr Johnston.
This community "might be more sensitive to how these images are portrayed in the media," he added.
Early media images of transgendered individuals were, for the most part, derogatory. According to Dr Johnston, transgendered persons were portrayed as criminals or serial killers.
But that is changing, and images are becoming more representative of the population.
An estimated 3% to 6% of the US population identify as lesbian, bisexual, gay, or transgendered (LGBT). But it is difficult to determine how many identify as transgendered, said Dr Johnston. Only recently has census data begun to reflect this information.
Transgendered people, as well as others in the LGBT community, are at higher risk than the general population for depression, anxiety, and substance use disorders.
Clinicians, said Dr Johnston, should make sure that patients who are experiencing negative reactions to their gender identify feel "safe" and "that they have a place where they can talk about it."
Guide and Protect
Gabrielle Shapiro, MD, associate clinical professor of psychiatry specializing in child and adolescent psychiatry at the Mount Sinai Hospital, New York City, agreed that psychiatrists should provide a safe environment for these patients.
She stressed the importance for transgendered people who are struggling with gender identity to get the mental health treatment they may need "to guide them and protect them from things spinning out of control."
But the psychiatric profession should also urge this population "to be very careful about what they reveal" online in chat rooms and the like. "This is public, and anyone can use it, and if you open yourself up to discussion, it can work both for you and against you."
In a workshop on cyber bullying conducted at the APA meeting, Dr Shapiro described a case of a young male Hispanic from East Harlem, New York City, who was grappling with his sexual identify and who killed himself after being relentlessly bullied.
She agreed that social media has pros and cons in terms of its effects on transgendered individuals. It can "enlighten" and help "erase the stigma" of gender identity and be "a positively reinforcing medium for people to feel strengthened and supported in being open about their sexuality identity," she said.
Unfortunately, many transgendered people are lonely, and social media may be an attractive medium to ease the often "life-impacting" coming out process, said Dr Shapiro.
However, she added, "because one can't filter social media, it also leaves people open to criticism, bullying, and being ostracized."
Dr Johnston and Dr Shapiro have disclosed no relevant financial relationships.
American Psychiatric Association (APA) 2016 Annual Meeting: Abstract 79, presented May 14, 2016.
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