Culture-Bound Disease Syndromes


One of the best things about my life is I get to read a LOT. And even reading in social sciences adjacent to my own is helpful. Today I got to read an article about "culture-bound disease syndromes."

I actually first encountered this concept decades ago in an anthropology class. I believe we were talking about Indonesia. I remember being fascinated at the idea that pathology can manifest itself in a very culture-bound way. In a sense, the pathology cannot be recognized unless it manifests itself in a way that can be "read as legible" by the culture in which it is found. Furthermore, what is "legible" can change over time, still within a cultural context that constrains the narrative of the pathology.

The article I read today spoke about "amok" in Malaysia, and "dhat" in India as examples of these culture-bound syndromes. But then, very interestingly, it talks about culture-bound syndromes in the US. I had never thought about that possibility before, but the examples given were cultural narratives I remember from my own lifetime. Are you old enough to remember when Multiple Personality Disorder was a big thing? That was the 1980s, and I remember how common that was, and how talk show hosts had people with MPD on. As that syndrome kind of faded, my culture then started talking about Satanic ritual abuse of children. I remember the scandal at various day care centers where tiny children would accuse their caretakers of such abuse. And also the "recovered memories" of child abuse that many had. I am convinced some truth existed in the narratives of some of those who claimed these conditions. But it also seemed as if there were a bit of social contagion going on: all of a sudden the condition seemed to be everywhere, and then it faded and often was even pooh-poohed as a real phenomenon. And at some point it would even be made the butt of jokes by comedians. The fever peaked and then abated. The narratives changed.

So I pricked up my ears (or eyes, rather!) when the author suggested that the very latest culture-bound disease condition in the US was Rapid-Onset Gender Dysphoria (ROGD):

"ROGD is a gender identity disorder first described by Lisa Littman, an assistant professor at Brown University School of Public Health, in a paper published in 2018. As part of her research, Littman surveyed the parents of young trans people and asked about the circumstances in which their children had come out as trans. She found that a large proportion of these young people had announced their intention to transition suddenly, out of the blue, having previously shown no signs of cross-sex identification. Littman also notes that:

    "The expected prevalence of transgender young adult individuals is 0.7%. Yet, more than a third of the friendship groups described in this study had 50% or more of the AYAs [adolescents and young adults] in the group becoming transgender-identified in a similar time frame, a localized increase to more than 70 times the expected prevalence rate.

"The young people who were the subjects of Littman’s research had also often suffered from serious mental health problems, which in many cases worsened following transition. She tentatively concluded that these findings suggested that social contagion might have a part to play in the recent huge rise in the diagnosis of Gender Identity Disorder in young people, particularly natal females. Littman’s research suggested that ROGD might be an example of a culture–bound syndrome, in which young people were drawn to identify as trans as a way of expressing deep unhappiness with and alienation from their bodies. The claim by proponents of ROGD is that the symptom pool available to people in distress now includes cross-sex identification."

I had never of ROGD in that way before, but it makes sense. There is a type of distress experienced by young women in this grossly pornified era that would be inchoate if there was not some means to make it legible in our culture. Cross-sex identification is that means. And social contagion is a large part of this phenomenon.

I know God hears the cries of His daughters, and I know the blame for this distress will rightfully be laid at the feet of His sons. God is a God of justice, not only a God of mercy. Some days I find myself praying for God's justice for His daughters.