UCLA Pauses 'Unethical' Study Designed to Mentally Distress Trans People

Researchers at the University of California, Los Angeles have “paused” a study on transgender identities that advocacy groups say is unethical and designed to cause mental distress to subjects.

Since 2017, the National Institutes of Health (NIH) has awarded the research team more than $2.3 million to study the neurobiology of gender dysphoria, the discomfort people may experience when their socially-assigned gender doesn’t match their gender identity.

Jamie Feusner, a professor of psychiatry and biobehavioral sciences at UCLA and his colleagues have used the funds in part to study what they describe as “a novel body-morph visual processing task.” The research involves dressing each transgender research participant—and any cisgender “control” they might be compared against—in “a skin colored, skin-tight, full body unitard” and then using software to morph their image with "male" and "female"-coded body traits. 

The researchers then record participants’ responses to these images with the intent of understanding how “brain structure/function, body phenotype, and hormones pre-treatment may predict who will benefit in terms of improvement of dysphoria and quality of life,” according to an NIH project description.

In December, the scientists reached out to organizations like Gender Justice LA for help with recruitment for a study that aims to evaluate how participants reacted to “body-morph” images, as well as scan their brains using an fMRI machine. 

“A lot of red flags started to come about,” said Ezak Perez, executive director of the grassroots organization, in an interview. 

The research seemed to lump together gender dysphoria to unrelated diagnoses like body dysmorphic disorder and anorexia nervosa, Perez said. It also treated trans people as deviating from a cis norm. Most urgently, the research method of taking subjects’ photos in skin-tight clothing and “morphing” their bodies seemed like it was designed to create distress in trans people. 

On Jan. 27, Perez and Dannie Cesena of the non-profit California LGBTQ Health and Human Services Network published a letter to the transgender, gender variant, and intersex community warning them against participating in the study, due to their “grave concerns about the unethical research design.” 

“It needs to be shut down and those resources need to be redistributed and an apology given to anyone who’s participated, if not some type of grant or compensation,” Cydney Brown of the Black Emotional and Mental Health Coalition, or BEAM, and a graduate student in public health at Claremont Graduate University, told Motherboard. 

A solidarity letter, co-signed by Perez, Brown, and more than 150 academics, researchers, and clinicians, many of them also at UCLA, soon followed. 

Feusner’s “deeply pathologizing approach to studying transgender identities has been used to rationalize corrective and conversion therapies, a set of practices that are widely rejected by transgender people and the medical and psychological establishment,” they wrote. “By locating the stress that transgender people experience solely in human biology, rather than emergent from social systems that have been arranged to police and maintain gender conformity, we weaken efforts to change institutionalized relations of power.”

In the past, trans advocates and researchers have worried that such studies can serve as justification for medical gatekeeping, which is already a common barrier for many trans people seeking treatment such as hormone replacement therapy. The U.K.'s high court recently ruled that trans kids under 16 can be denied puberty blockers, basing its arguments on those commonly made by anti-trans groups.

On Feb. 4, UCLA announced in a statement that the researchers had “voluntarily paused” the study to “receive additional input from the transgender, non-binary and gender-nonconforming communities, understand their concerns more deeply and have a dialogue about the study’s objectives and design.” 

In a statement to Motherboard, Feusner and his collaborator Ivanka Savic-Berglund, an adjunct professor of neurology at UCLA, stressed that “from the beginning, the aim was to help increase acceptance of transgender individuals.”

“Since the study’s methods were developed several years ago—informed by input from members of the LGBTQ community—the expectations for research in this area and our understanding of experiences have naturally evolved,” the researchers wrote. “It is clear that additional and deeper dialogue is now essential.”

The researchers say that the study was approved by the school’s Institutional Review Board and that the team has asked the board to re-review the study’s entire protocol “to ensure that it meets all ethics and safety standards.”

Any research involving human participants must undergo an ethical review before it begins, to protect their rights and welfare. In some cases, a review board may decide that causing participants distress is acceptable, said Maura Priest, a bioethicist and assistant professor in philosophy at Arizona State University. But participants must be able to provide informed consent, and any discomfort must be weighed against the potential value of the study’s results. 

“Are the results [of Feusner’s study] going to be good enough to justify putting people in this situation? From what I know now, I’d be a bit skeptical,” Priest said.  

These considerations are especially important when the research subjects are members of marginalized communities, according to Jack Turban, a fellow in child and adolescent psychiatry at Stanford University School of Medicine, where he researchers the mental health of transgender youth.

“Psychiatry has a long history of conducting research that pathologizes gender diversity,” Turban said in an email. “Many correctly highlight that research has been used to harm transgender and gender diverse people. Researchers must be held to a high standard to ensure that their research will improve the lives of the people they are studying and to not cause harm.”