Sexuality explainers for nineyear-olds?
Teenage girls with no previous doubts suddenly identify as transgender
The Royal College of Paediatricians, one would imagine, should know what is entailed with its authoritative recommendation last week that nine-year-olds at primary school be given “clear information about different types of sexuality” – lesbian, gay, bi- and transsexual (LGBT). But this is scarcely straightforward, not least for the last of these categories. How, for example, to account for the recent massive upswing in the number of adolescents referred to gender identity clinics – a twentyfold increase in just seven years.
Transsexualism is a wellrecognised (if rare) biological phenomenon where, often from early childhood, males identify as females (and vice versa) and evidenced by the high (96per cent) success rates reported by those who subsequently undergo gender reassignment with hormones and surgery.
But this marked rise in prevalence suggests some other factor must at least be partly responsible – as indeed there is: the recently described psychological condition of Rapid Onset Gender Dysphoria (ROGD). This occurs almost exclusively in teenage girls who have not previously expressed doubts about their sexual identity but who suddenly identify as being transgender – not unusually along with others in their friendship group. A survey of nearly 300 parents has revealed several other characteristics – a deterioration in their child’s mental health and the parent-child relationship, withdrawal from family activities and even estrangement.
Prof Lisa Littman, who conducted the survey, proposes this is most likely to be a “maladaptive coping mechanism” to the emotional problems of adolescence “initiated and maintained by social and peer contagion”. So a complicated business. Try explaining that “clearly” to a class of nine-year-olds.
Tragus treatments
The recently featured uncontrollable nocturnal itching of the fleshy eminence in front of the ear canal, the tragus, has elicited several possible explanations. “I have suffered for some time from this intense itching, usually when lying down for the night,” writes one gentleman, who found he could abolish it by turning his head 90 degrees, first to the right for 30 seconds and then to the left. This would suggest it is due to positionrelated pressure on the auricular branch of the vagus nerve that provides the sensory innervation to the tragus and ear canal.
The further possible causes include irritation from cordless headphones (“the circuitry uses a ultra-high frequency that gently cooks the tragus”) or from hearing aids (prevented by applying a dash of olive oil). More generalised itching of the outer ear and canal can be alleviated by applying variously a 50/50 mixture of witch hazel and surgical spirit, the herbal remedy pok root or the proprietary preparation Eargene.
Falling flock
This week’s medical query comes courtesy of Mrs DF from Newcastle, who reports that several of her older fellow parishioners have rather alarmingly collapsed during the Sunday morning service. By the time the ambulance arrived they had all recovered enough to be “fairly compos”. She recalls how, as a teenager at boarding school, her fellow pupils were forever fainting in church. Might this, she wonders, be a distinctive syndrome brought on by haemodynamic changes in blood pressure from constantly changing position (standing, sitting, kneeling) compounded by hymn singing-induced hyperventilation?
Night cramp relief
Finally, my thanks to Prof Neville Rowell, formerly professor of dermatology at Leeds University for passing on his “Rowell manoeuvre” for the prompt relief of excruciating night cramps: cup the hands over the nose and mouth to provide an airtight barrier and re-breathe expired air for a couple of minutes. “The muscles suddenly relax,” he writes, “and there are no side effects.” The mechanism is uncertain but presumably related to the muscle relaxing effects of increased levels of carbon dioxide in the blood.