THE TRANS WAVE WAS CAUSED BY SOCIAL INFLUENCES

The evidence is too strong to ignore

LAURA LÓPEZ – 5 MAY 2024 – ARGUMENTSWITHFRIENDS

The parents writing at Parents with Inconvenient Truths about Trans, like thousands of other parents around the world, believe that their children are being socially influenced towards gender transition. One mother writes:

The first sign that there was something very wrong was when Sinead was 12 and she became unhappy, withdrawn and angry seemingly overnight. She came out as non-binary and then trans when she was thirteen and a half after first self-diagnosing with everything from BPD (borderline personality disorder) to DID (Dissociative Identity Disorder). She was self-harming and had lost all interest in schoolwork or family life. Covid didn’t help and the lockdowns allowed her to spend hours on the internet when she was supposed to be doing online school. I found out later that influencers like Jammie Dodger and Noah Finnce were indoctrinating her into the trans cult and she was also talking to disturbed kids like herself on Discord… I had [also] been witnessing the carry-on of my daughter’s group of friends with all the talk of trans and demi-boys, agender, ace, non-binary and so on… Sinead had been indoctrinated by the internet and to a lesser degree her peers… 

It was unthinkable to me that Sinead was ‘trans’. A parent’s first rule in life is to protect their child and that means that the thought of someone slicing off pieces of her healthy body and destroying her health with hormones sickened me. I would sooner volunteer that I sacrifice bits of myself than that she would do this to herself… 

Sinead did not agree with her mother’s perspective, and their relationship deteriorated. Sinead’s mother writes that when Sinead “did voluntarily talk to me it was to subject me to angry rants about how she had always been a boy”. But Sinead’s mother held fast to her beliefs. She restricted her daughter’s internet access, spent time rebuilding her relationship with her daughter, and showed her daughter videos that exposed her to different ways of understanding her experience. She encouraged her to engage in healthy activities and interests. Over time, Sinead desisted from her trans identity.

Sinead’s mother writes:

I know that I did the right thing because Sinead told me so. She has thanked me many times and although I was only doing my duty and it was a pleasure to do it, it is still nice to know that she is grateful. I know that I did the right thing because she is happy again. Without even intending it I am now very good friends with Sinead (while still being the parent). I really enjoy her company and I am so grateful that I am getting the opportunity to get to know her again.

Did Sinead’s mother do the right thing? Is it possible that Sinead was influenced into identifying as trans by her peers and the internet, as her mother believes (and, it seems, Sinead now agrees)? Did her mother save her from a lifetime of unnecessary medicalisation? Or was Sinead trying to express her true, innate, immutable gender identity, and did her mother prevent her from becoming her authentic self?

In the past decade, the number of young people seeking medical gender transition has risen dramatically, with devastating health consequences. Understanding the reasons for this rise is crucial to understanding teenagers like Sinead, and how parents and professionals can help them.

There are two main hypotheses that seek to explain the trans wave. The innate hypothesis holds that the trans wave was caused by greater acceptance of gender transition. According to this hypothesis, trans identities have not really become more common in recent years – they have merely become more visible. This hypothesis thus implies that in the past, many people suffered from a suppressed longing to transition. As stigma and barriers to transition have fallen away, innately trans youth have had the freedom to express themselves and find fulfilment, happiness, and contentment by altering their appearance with drugs and surgeries.

The innate hypothesis is rooted in gender identity theory – that is, the belief that everyone has an innate ‘gender identity’. This theory holds that when there is a mismatch between the sex you were born and your gender identity (as male, female, or something else), then that makes you transgender. This mismatch is hypothesised to cause suffering that can only be relieved by medical interventions that reshape your physical appearance to align with your gender identity. According to this theory, because your gender identity is (supposedly) innate and immutable, it cannot be altered by social influences. Thus, no amount of social influence can change whether someone is ‘really’ trans – only whether they reveal to others that they are trans.

In contrast, the social influence hypothesis holds that various social forces have encouraged more people to identify as trans – it’s not just that trans people have become more visible. The social influence hypothesis is based on the theory that identifying as transgender, like most other human behaviour, is influenced by a range of biological, psychological, and social factors.

While gender activists sometimes attempt to paint the social influence hypothesis as a fringe idea, this hypothesis has in fact enjoyed considerable mainstream attention. Respected media outlets and academic journals that have published articles favouring the social influence hypothesis include The Economist, The Times, The Australian, The Atlantic, The New York Times, The Guardian, MedScape, Skeptic magazine, PLOS ONE, the Archives of Sexual Behaviour, Sexuologie, The New Bioethics, and the Journal of Open Inquiry in the Behavioral Sciences.

Numerous researchers and clinicians have argued in favour of the social influence hypothesis. A few of the more prominent of these include:

• The National Association of Practicing Psychiatrists (Australia).
• Erica Anderson (former president of the United States Professional Association for Transgender Health and a transwoman).
• Carol Tavris (social psychologist and Association for Psychological Science Champion of Psychological Science).
• David Bell (psychiatrist and former governor of the Tavistock and Portman National Health Service foundation trust).
• David Geary (Curators’ Distinguished Professor in the Department of Psychological Sciences, University of Missouri).
• James Cantor (clinical psychologist, sex researcher, and Associate Professor at the University of Toronto).
• Michael Bailey (professor of psychology at Northwestern University).
• Lisa Littman (president and director of the Institute for Comprehensive Gender Dysphoria Research). 
• Dianna Kenny (former professor of psychology at the University of Sydney).
• Celso Arango (former president of the Spanish Society of Psychiatry).
• Céline Masson and Caroline Eliacheff (a French clinical psychologist and a child psychiatrist who were joint winners of the Marcelle Blum bursary for the study of female psychology).
• Riittakerttu Kaltiala (chief psychiatrist in the department of adolescent psychiatry at Finland’s Tampere University Hospital).
• Jonathan Haidt (social psychologist at New York University’s Stern School of Business).
• Michael Biggs (associate professor of sociology at the University of Oxford).

The most recent, and authoritative, endorsement of the social influence hypothesis comes from the Cass Review of gender-identity services for children and young people in the UK. This independent review concluded that “societal acceptance… is not an adequate explanation for the overall phenomenon” of the explosion in trans identities. The review instead acknowledges that various “peer and socio-cultural influences” have likely contributed to the trans wave. In an interview with The Guardian, Dr Hilary Cass (the paediatrician who led the review) has stated frankly that there has been “some very dangerous influencing going on”.

The fact that so many respected researchers and clinicians have spoken out in favour of the social influence hypothesis, despite often vicious attacks by gender activists, is a testament to its credibility and importance. While several professional organisations have issued statements disagreeing with the social influence hypothesis (or at least certain forms of it), these statements are influenced by activists and do not necessarily reflect the best evidence or imply a consensus among their members.

The social influence hypothesis offers hope. It implies that trans-identified youth have multiple options for finding happiness. The innate hypothesis, in contrast, implies that these children and adolescents face an inevitable future of either permanent medicalisation (which carries serious health risks), lifelong psychological distress, or both (a common outcome of medical transition). Therefore, it’s worth examining the evidence for both hypotheses carefully, rather than being too quick to dismiss one or the other for political reasons.

Of course, the social influence hypothesis does not imply that people who transition genders should be treated with any less respect and dignity. Nor does it imply that medical transition should be prohibited, at least not for mature adults who are fully informed of the risks. It does, however, suggest that a cautious approach to teaching children about gender, and to medical transition, is warranted.

To more fully understand the social influence hypothesis, it’s worth exploring the range of factors that might cause someone to identify as transgender.

Six reasons to be trans

Most researchers do not appear to believe that trans identities are innate or immune to social influences. The aforementioned Cass Review concluded that “There is broad agreement that gender incongruence is a result of a complex interplay between biological, psychological and social factors”. Similarly, the Endocrine Society describes itself as “a community of 18,000-plus endocrine investigators and clinicians…in more than 100 countries”. The Society writes bluntly in its Scientific Statement on Sex as a Biological Variable in Basic and Clinical Studies:

Although gender is strongly influenced by environmental and cultural forces, it is unknown if the choice to function in society in male, female, or other role(s) is also affected by biological factors.

What then are the biological, social, psychological, and cultural factors that lead to a trans identity? Both research and testimony from trans people themselves point to at least six broad factors, different combinations of which may be at play in any individual case. With the exception of sexual motives, all these factors are mentioned by the Cass Review.

Discomfort with fitting into gender roles and stereotypes

Some children are extremely gender nonconforming, meaning that they prefer to dress, play, and behave in ways that are more typical of the opposite sex. Evidence suggests that gender nonconformity has a significant genetic and/or biological component. 

Gender nonconforming children and adolescents are sometimes rejected, bullied, or simply feel that they don’t fit in as well as they should. Unsurprisingly, on average these young people are unhappier than their peers. Some gender nonconforming children wish that they were the other sex, perhaps because they believe this would make others accept them more. Because young children’s understanding of ‘male’ and ‘female’ can sometimes be influenced more by sex stereotypes than by biology, occasionally these children even imagine that they really are the opposite sex. In a few children this combination of factors causes a fixation on becoming the opposite sex which is associated with significant distress (i.e. ‘gender dysphoria’).

Childhood gender nonconformity is often (although not always) associated with being gay or lesbian as an adult, rather than trans. Studies suggest that childhood gender dysphoria typically, but not always, resolves naturally over time (although social transition and puberty blockers appear to disrupt this natural process). However, persistent gender dysphoria, and/or the quest to persuade others to fully accept their gender nonconformity, motivates some people to adopt a trans identity and seek medical transition.

An example of someone who seems to fit the theme of a transition motivated by gender nonconformity is transman Zander Keig, who says:

I transitioned to be a man because I did not fit the stereotype of what it means to be a woman. I was once called a dyke and had a bottle thrown at my head by a passing car. I transitioned because I thought life would be easier for me to live as a man than as a masculine woman—and I was right, because our society’s adherence to rigid gender stereotypes made living my life as I was unbearable.

I wish the message that we should be free to be who we are, had been allowed to win over society. If it had, I might not have felt the need to make the medically risky choice to transition.

Recently, schools, libraries, and other trusted authorities have started to teach children that gender nonconformity is a potential sign of ‘being trans’. This may be one factor contributing to the trans wave.

For individuals suffering distress resulting from gender nonconformity, greater self- and societal acceptance is a potential alternative route to relief.

Sexual motives

Some men acknowledge being sexually aroused by the thought of themselves as women. These men enjoy dressing, acting, and being treated as women during sex or masturbation (and they have documented this interest in copious amounts of porn – links are not safe for work).

Some researchers believe that these sexual interests are related to an underlying sexual orientation, which they call autogynephilia. They also hypothesise that autogynephilic men can, in a sense, fall in love with their image of themselves as female (i.e. their female gender identity). The inability to make this imagined self real causes severe distress (i.e. gender dysphoria). This gender dysphoria can lead to a desire to be treated as female across every aspect of the person’s life, and spur the decision to medically transition.

Just like the love between a romantic couple, autogynephilic desire is not purely sexual, and can persist even after someone’s sex drive fades (e.g. due to the impact of cross-sex hormones). The theory holds that autogynephilia is found in heterosexual and bisexual transwomen (i.e. natal males attracted to women), and that homosexual transwomen (i.e. those attracted to men) have other reasons for transitioning.

While the existence of autogynephilic fantasies is not in serious dispute, various authors have debated whether autogynephilia drives medical transition, and if so how often. In one survey of heterosexual transwomen, 86% reported that they at least sometimes experienced sexual arousal while cross-dressing. However, only 27% reported that their “Concrete sexual fantasies played a role in making the decision to transition”. Interestingly, one study of detransitioners found that 39% of men (and 13% of women) acknowledged that “I had erotic reasons for wanting to transition”.

Possibly, some transwomen may be too ashamed to acknowledge the reasons they transitioned, and self-insight is not always perfect. This makes it hard to verify the proportion of transwomen who transition because of autogynephilia. However, the activist claim that autogynephilia is a “a mere pseudoscientific talking point in anti-transgender propaganda” implies that everyone who says that their transition had a sexual component is mistaken, which seems implausible (and ignores considerable evidence).

While some researchers believe that autogynephilia is probably innate, other writers have suggested that the recent explosion of trans-themed online porn is contributing to the trans wave. To my knowledge, evidence for this connection remains anecdotal.

It’s not uncommon for men to report being aroused by sexual fantasies involving cross-dressing without wanting to medically transition. This suggests that the way that these fantasies are interpreted may be key to whether they trigger a desire for transition. Recent shifts in societal narratives about trans issues may have caused more men to interpret autogynephilic feelings as a sign that they ‘are trans’ and need to medically transition.

An example of someone who appears to have transitioned for at least partly sexual motives is trans author Andrea Long Chu, who famously wrote, “Sissy porn did make me trans”.

For at least some autogynephilic men, finding other ways to channel their sexual desires, without medical intervention, is a potential alternative route to contentment (as is coming to terms with the fact that they can never truly be female).

The belief that transition will alleviate distress 

Recently, a new cohort of adolescents have emerged, who identify as trans after a long period of psychological distress. Some are young women who are uncomfortable with their developing bodies, or who have experienced sexual assault. Often these young people have no history of significant gender nonconformity.

Typically, these young people hold a strong belief that medical transition will alleviate their distress, and this motivates their desire to transition. 

An example of someone who appears to fit this theme is Noah, a young woman who started identifying as trans as a teenager, and had her breasts surgically removed at age 16. Noah is not gender noncoforming – she acknowledges that, “I have feminine interests and I had feminine interests growing up”. Noah was interviewed by Nelly Bowles on the Witch Trials of JK Rowling podcast:

Nelly:  And were you seeing a therapist or a counselor at that time? Like when all of this started.

Noah: I had a lot of mental issues. Maybe that’s not the most delicate way to say that, but I was dealing with a lot of mental struggles once puberty began.

Nelly: You mean aside from your issues with gender? 

Noah: Yeah, and I couldn’t really identify that I had issues with gender. I just had all of these abstract feelings that didn’t coalesce into gender dysphoria until I understood what that term meant fully, which was later on in my life. And so I was dealing with very severe anxiety disorder, a depressive disorder, obsessive compulsive disorder and attention deficit hyperactive disorder. And so my mom got me a therapist who I’ve been with ever since. And when she picked out that therapist, she picked out someone who specialized in anxiety and gender issues and adolescence, which I find interesting to look back on. And I had a psychiatrist as well. And around eighth grade I went into this really severe depressive episode and I ended up telling my psychiatrist that I was debating suicide. 

And so everyone decided that we were gonna have to like keep an eye on me. And so I just kept going to therapy and like I said, the core issue which we couldn’t figure out was never resolved. And I believe within a year I joined a support group for transgender youths and my therapist helped me identify that a lot of what I had been expressing to her for a really long time could be identified as feelings of gender dysphoria. And after at least a year and a half or two years of those issues being present, she referred me to a gender clinician and talking to my parents was the first big step that was taken. 

We identified what I wanted from the gender clinic, which was to go on testosterone and to get top surgery… it had to become very clear that not only was my gender dysphoria spawning all of the other mental issues I was having, but that the solution was medical intervention. And that was seemingly the only thing that could help me because we had tried pretty much every other option at that point. 

As both researchers and clinicians have noticed, stories like Noah’s are eerily reminiscent of the ‘repressed memories’ scandal. In the 1980s and early 90s, numerous patients (often young women) came to falsely believe that they had been sexually abused as children.

These patients, like Noah, often presented to therapy with seemingly intractable psychological distress. The 80s and 90s patients saw therapists who specialised in uncovering ‘repressed memories’ – that is, supposed memories of abuse so horrific that they had been hidden from the conscious mind. Over time, through a process of exploration and suggestion, these patients came to truly believe that they had been sexually abused. Sometimes, parents were imprisoned on the basis of these supposedly recovered memories.

Noah, on the other hand, saw a therapist who specialised in gender issues. As Noah tells it, there were no initial signs that her distress had any connection with gender. However, Noah’s therapist appears to have suggested that gender dysphoria (i.e. a repressed trans identity) could be at the heart of her distress, offering her a potential road to self-understanding and recovery. 

Over time, through a process of exploration and under the influence of her therapist, a trans support group, and online trans influencer content, Noah came to believe that she was definitely, truly, innately trans. Now that she has taken the drastic step of surgically removing her breasts, this belief would take tremendous courage to let go of, because this would require acknowledging and living with a terrible, life-altering mistake. And acknowledging serious mistakes is something that most people find very hard to do.

While Noah’s therapist appears to have encouraged her belief that transition would relieve her distress (alongside other influences), other adolescents are discovering the same idea outside of therapy (e.g. in the media, on social media, and from friends).

Young people who transition to relieve distress might instead benefit from more effective, and less invasive, treatments for conditions like anxiety and depression.

Peer and online influences

People, especially adolescents, have a powerful drive to belong. This makes us highly susceptible to influence from those around us.

The idea that peer and online influences might play a strong role in some gender transitions was first brought to widespread public attention by Lisa Littman, a physician and researcher at Brown University. 

Littman’s curiosity was piqued by the sharp increase in youth seeking treatment at gender clinics. Additionally, both clinicians and parents had reported that many of these youth were showing a previously unusual pattern of symptoms. These adolescents seemed to be developing gender dysphoria without having shown any obvious gender-related distress earlier in their childhoods. Often, however, these adolescents had pre-existing mental health issues.

Littman coined the term ‘Rapid Onset Gender Dysphoria’ (ROGD) to describe this syndrome, because of parental reports of gender distress appearing ‘out of the blue’. However, there is no reason to believe that social influences always operate rapidly as opposed to over a longer period of time. As far back as 2019, Littman herself acknowledged that “The potential pathways of social influence and maladaptive coping mechanisms leading someone to interpret their feelings as gender dysphoria and to seek transition may ultimately be more relevant than the perceived rapidity of the onset” of ROGD.

Littman’s original study of ROGD, which was based on parental reports, found that two thirds of adolescents with perceived ROGD had at least one friend who came out as trans at a similar time. This suggested that peer influences might have played a role in their decision to transition.

While research into ROGD has been helpful in highlighting social influences on transition, unfortunately some people interpret this research as suggesting that gender clinic patients are either purely socially-influenced or ‘truly trans’ (and not socially influenced at all). As may be obvious from what I’ve already written, it seems more likely that social influences play a role in most, perhaps all, decisions to transition – just in different ways, and in combination with different factors. While gender clinic patients are far from homogenous, the social influence hypothesis does not require that these patients fall into completely distinct, easily identifiable ‘types’.

Testimonies from parents of trans-identified children, and from former members of the trans community, cast light on how peers might influence people towards transition. These sources report that within certain social circles, ‘being trans’ earns you respect, approval, and acceptance. This is particularly true in ‘woke’ online communities, as detransitioner Helena Kerschner writes:

On Tumblr, the situation was such that any claim to being “oppressed” would accumulate social credibility, while any unfortunate “privileged” status was justification for verbal abuse… It’s understandable that any young person exposed to this kind of belief system would grow to deeply resent being white, “cis”, straight, or (biologically) male. 

The beauty of gender ideology is it provides a way to game this system, so that you can get some of those targets off your back and enjoy the camaraderie of like-minded youths. You can’t change your race, pretending to have a different sexuality would be very uncomfortable in practice, but you can absolutely change your gender, and it’s as easy as putting a “she/they” in your bio. Instantly you are transformed from an oppressing, entitled, evil, bigoted, selfish, disgusting cishet white scum into a valid trans person who deserves celebration… 

With the new pronouns often comes a wave of positive affirmation from friends and followers, and the subconscious picks up quickly that there’s a way to make the deal of being on Tumblr even sweeter.

This is the incentive I felt to comb through my thoughts and memories for things that might be further evidence that deep down, I wasn’t really a girl.

Peers and online trans influencers may also persuade young people that transition is the key to self-confidence and feeling good about themselves. Here’s how Ellie, a detransitioner who was interviewed by the BBC, explains the impact of online influencers on her decision to transition:

I watched some YouTube videos of trans guys who take testosterone, and they go from this shy lesbian to a handsome guy who is super-popular. I liked thinking of myself having that possibility – it felt like I should have a male body.

An example of someone who appears to fit the theme of a socially-influenced transition is Ollie Davies, a detransitioner who was interviewed by The Australian newspaper:

Ollie Davies was 26 years old and at the lowest ebb of his life when he made a decision to come out as a trans woman.

Suffering depression, anxiety and behavioural problems as well as a crisis of self-identity, he existed in what felt like a dissociative state. He had distanced himself from family. “I felt as if I had no free will,” Mr Davies says. “I was completely nihilistic and lonely and self-­hating and had no self-esteem. I was experiencing a total loss of identity and lack of sense of self.”

Mr Davies, who was openly ­bisexual, had never questioned his gender identity as a child or young adult. But when people within his group of queer activist friends repeatedly suggested to him that he was trans, he began to believe it was true.

“Ultimately it came from suggestions from others, people just started suggesting that I question my gender,” Mr Davies said.

In addition to peer influences, influences from schools, the media, social media, and even some parents may also have fuelled the trans wave. For those whose gender distress is fuelled by these influences, a change of friend group, a long trip, and/or a break from the internet, may ease their distress.

Accepting gender identity theory 

As a hypothesised psychological condition becomes better known, more people tend to start saying that they have it. This happens because people start to interpret their personal experiences through the lens of the condition. In some cases, such as electromagnetic hypersensitivity, believing in the condition can result in genuine symptoms that have no physical cause.

Something similar appears to have happened with trans identities. When people learn about the concepts of gender identity and gender dysphoria, some of them start to interpret their experiences through this lens. Emotional distress, trouble fitting in, and discomfort with the body or with sex stereotypes are all then perceived as signs of ‘being trans’.

This process then tends to build on itself in a self-reinforcing circle. For example, as a young woman immerses herself in gender identity theory, she learns that ‘misgendering’ (i.e. being called by the correct pronouns for her biological sex) is deeply harmful. This causes tremendous anxiety and distress, since inevitably most people around her will continue to (correctly) perceive her as female. In turn, she interprets this distress as a symptom of ‘being trans’, causing her to become more and more certain that she is ‘truly trans’.

An example of someone who seems to fit this theme is detransitioner Helena Kerschner. Helena has directly stated that “It was this weird belief system I found on the internet that made me want to be trans”, and that learning to doubt that belief system was a key part of her recovery.

The popularisation of gender identity theory (also known as gender ideology) in schools, social media, and the media may have contributed to the trans wave. Teaching alternate viewpoints may help resolve it.

Neurodiversity

There is a clear connection between trans identities and autism spectrum disorders (as well as other neurodiverse conditions). There are several plausible causes for this link. People with autism are often more rigid in their thinking, which could lead to the belief that if you don’t fit female stereotypes, then you can’t really be a girl (for example).

People with autism also frequently suffer from feelings of discomfort in their own bodies, which may be mistaken for symptoms of ‘being trans’. Additionally, the social difficulties that accompany autism may make people with autism especially susceptible to manipulative social influences. And the idea of medical transition as a cure-all is especially appealing to people on the spectrum, who often have difficult and socially isolated lives.

An example of someone who appears to fit this theme is a detransitioner called Ash, who when asked why he started identifying as transgender, says:

Well, I think one of the big parts was reading about the treatments and hormones and stuff. The biggest thing that made me attracted to it was… taking estrogen would cause facial hair and body hair to thin, and one of the things I’ve been struggling with… is having body and facial hair because it’s a very unpleasant sensory experience for me and I hate the way it looks. I hate the way it feels and I hate the fact that if I want it to go away I have to shave it… but that’s just life… I saw that at the time as a manifestation of gender, but I realize now that it’s just something I do… that isn’t a gendered thing.

It seems unlikely that neurodiverse conditions, by themselves, cause trans identities. Instead, neurodiverse conditions probably make people more vulnerable to the other causes that we’ve already discussed. Educating people with neurodiverse conditions about this vulnerability, and teaching them coping strategies, may help build their resilience to these influences.

Now that we’ve looked at the innate and social influence hypotheses in more detail, we can weigh the evidence for and against each of them.

Arguments for the innate hypothesis

I’ve searched extensively for arguments for the hypothesis that trans identities are innate and immune to social influences. I address the most common of these in the following sections.

Personal attacks on people with different views

Arguments for the innate hypothesis often consist chiefly of smearing anyone who disagrees with this hypothesis as “anti-trans”. One illustration of this is the essay ‘All the Evidence Against Transgender Social Contagion’, written by influential trans activist Julia Serano.

The very first item that Serano includes in his dot-pointed list of supposed “evidence” against the social influence hypothesis is not ‘evidence’ at all. This is the claim that “The concept of ‘transgender social contagion’ was invented by a trans-skeptical parent on February 2016 on the anti-trans website 4thWaveNow”.

Serano doesn’t really explain why he thinks this claim is evidence against the social influence hypothesis. Presumably, his aim is to discredit this hypothesis by implying that it was inspired by hostility towards transgender people. Possibly, he is suggesting that because social influences on transition were first noticed by a mere parent rather than a researcher or clinician, these observations are not ‘scientific’…