Category Archives: Technological addiction
About a year ago, my colleagues and I published what we believe is the very first study of the helping role that video gaming can play in the lives of transgender individuals. Before I get to that, it’s probably worth noting that there have been studies of how gamers and fans play with sexuality, gender, and the video game Minecraft on YouTube as well as papers discussing whether the gaming industry should cater for marginalized groups and develop games for groups where there is little representation within games (e.g., gay and transgendered characters). For instance, there is now a short autobiographical game by Auntie Pixellante called Dys4ia. This is a WarioWare-style game, played only with the arrow keys, chronicling the experiences of a trans woman rectifying her own gender dysphoria. Such videogames raise interesting questions about how those individuals with gender dysphoria utilize gaming as part of their identity.
In a previous blog I briefly looked at gender swapping in online video games including some of my own research. For instance, in 2003 I published a paper in the journal CyberPsychology and Behavior using secondary poll data from online gaming forums. The paper reported that of 10,350 players at the Everlore fan site, 15% had swapped the gender of their main in-game playing character. We also reported a similar finding among 8,694 players at the Allakhazam fan site with 15.5% reporting that they had gender swapped their main in-game character (and more specifically, 14.5% males and 1% were females who had changed the gender of their lead character). In a 2004 follow-up survey among 540 Everquest gamers (again in the journal CyberPsychology and Behavior) my colleagues and I reported that 60% had swapped their online in-game characters. The prevalence of gender swapping was probably much higher in this study because the question related to the gender swapping of any online game character not just their main playing character.
In a small exploratory study I published in 2008 with Dr. Zaheer Hussain in the International Journal of Mental Health and Addiction, we examined why people engaged in gender swapping in a self-selecting sample of 119 online gamers (mean age of 28.5 years). We reported that 57% of gamers had engaged in gender swapping (any character not just their main character), and that males adopting an online female persona believed there were a number of positive social attributes to becoming female characters in male-oriented gaming environments. The study also reported that significantly more females than males had gender swapped their character – mainly to prevent unsolicited male approaches on their female characters. Some females appeared to gender swap purely out of interest to see what would happen in the game (as a personal experiment), while others claimed that they were treated more favourably by male gamers when they played as a male character. Others reported that gender swapping enabled them to play around with aspects of their identity that would not be possible to explore in real life. Other reasons for gender swapping were that (i) female characters had better in-game statistics, (ii) some specific tools were only available with female characters, (iii) the class of character was sometimes only available in one gender, (iv) they played for fun, and/or (v) they did it to so something that they would not normally do in the game (i.e., they did it for a change in their usual playing behaviour).
Outside of online gaming, a 2002 paper by Hegland and Nelson in the International Journal of Sexuality and Gender Studies noted that the Internet more generally can be used as a tool for expressing gender identity because it allows identities to cross cultural boundaries instantly and without regard for real physical space. They examined 30 cross-dressing websites and argued that for most cross-dressers that visited such websites, the online forum was their primary medium of expression. The users of the website used the Internet to nurture the ability to create a feminine identity, and helped them to pass as a woman in the offline public world. More generally, cross-dressers used the Internet to participate in the larger cultural dialogue of gender.
For an adult to meet current criteria for a diagnosis of transsexualism, the World Health Organisation’s International Classification of Diseases (ICD) reports they must express the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the desired sex through surgery and cross-sex hormones. This transsexual identity must have been present persistently for a minimum of two years and not be a symptom of another mental disorder or a chromosomal abnormality. The latest (fifth) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association uses the term gender dysphoria to describe people who are uncomfortable and/or distressed regarding their assigned gender, their physical sex characteristics and/or their associated social roles. Depending upon the intensity of this distress, some individuals may wish to transition from one point on a notional gender scale to another. The most common direction is from a man to a woman (individuals known as trans women), or from a woman to a man (individuals known as trans men). The distress intrinsic to gender dysphoria may be focused around anatomy, physiology, and/or being perceived and treated as someone of a gender with which the person does not identify. However, these diagnostic labels do not apply to all trans individuals for a multitude of reasons because some people will not identify themselves as a man or as a woman
The World Health Organisation working group has recommended that the latest ICD replace the term Transsexualism with Gender Incongruence) and remove it from the mental and behavioural disorders chapter. Gender incongruence denotes the incongruence between a person’s gender identity and their assigned sex and/or congenital primary and secondary sex characteristics. The terminology in this field has changed over the years and the terms ‘transgender’ and ‘trans’ have been used in the literature as umbrella terms to cover a wide variety of atypical gender experiences and expressions which may lead to permanent change of social gender role but does not necessarily involve treatment with cross-sex hormones or surgical intervention. A recent study has reported an prevalence for transsexualism of 4.6 in 100,000 individuals; 6.8 for trans women and 2.6 for trans men, which is primarily based on studies looking at individuals attending clinical services. (However, it should be noted that recent population studies have reported a significantly higher prevalence rate of atypical gender experiences and expressions).
The study we published in the journal Aloma originated from initial observations made by Dr. Jon Arcelus that a number of gender dysphoric clients presenting at the national (UK) gender dysphoria clinic admitted that they gender-swapped while playing online games. After I met with Dr. Arcelus I suggested he revisit his case files and and to write them up as case studies (as no study in the gaming field has ever examined online gaming among those with gender dysphoria). The main objectives of our study were to use exemplar case studies to highlight that gaming – in some circumstances – appears to be a functional way of dealing with gender identity issues, and that gender swapping in gaming may help such individuals to come to terms with their gender dysphoria.
Our paper featured four case studies who attended an assessment at the National Centre for Gender Dysphoria in Nottingham. All four individuals described in our paper were given pseudonyms and the content of their histories were anonymised (and included ‘Mary’ a 26-year old natal male who fully transitioned to the female social role six months prior to our study; ‘Mark’ a 20-year old natal female who first attended for an assessment in the female role; ‘Paul’ a 31-year old natal male who would like to be female, but still living full-time as a male; and ‘Harry’ a 23-year old natal male who presented for an assessment as a male). If you want to read about each case in detail, the paper can be downloaded for free from here).
The four case studies outlined in our paper are only a selected sample of the number of cases attending a national clinic for people with gender dysphoria. However, they were in no way unusual to the other clients that have sought help at the Centre. However, these individual accounts were specifically selected to demonstrate the different ways that video gaming may help people with gender dysphoria come to terms with their gender identity. For example, gaming can be used among trans people as a psychological tool to increase one’s awareness of gender identity and/or as part of the self. Gaming may therefore be a useful way to express one’s experienced gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment. This appears to mirror other the findings of other studies outside of the online gaming environment.
Articles published in the mass media have reported that online games such as World of Warcraft provide a creative space that allows gamers that might be questioning aspects of their identity to explore their lives as different individuals. Some have even gone as far as to argue that this could help gamers transform their ‘offline’ identity, as is the case with some trans gamers. This was also demonstrated in the case studies described in our study. Other authors have asserted that the online medium offers an infinite space for development and resistance to traditional gender roles, and that online interaction enables a transgression of the dichotomous categories of male and female, constructing trans (or even genderless) social identities and relationships. However, although such anonymous online communities may provide trans individuals with the power to subvert their physical sex.
Our case studies also demonstrated the different functions of gaming in trans people (e.g., the function of “testing out” their gender feelings). For instance, using gaming to ‘come out’ to other people, by initially coming out in the online community, which is perceived as a safe environment, and then gradually coming out in real life. Gaming, as for many non-trans individuals, can derive psychological benefits and a sense of escapism. This is even more relevant among trans people as it may be the only time that they feel they can be themselves, allowing them to feel happy, relaxed, and achieving a sense of completeness. This could develop into a powerful coping skill substituting unhealthy behaviours, such as self-harming behaviour. This is particularly important in this population as research shows a strong association between being trans and mental health problems, particularly depression and self-harm as a way to manage one’s trans feelings. This is not surprising as the discomfort and distress about assigned gender and body dissatisfaction may lead to a sense of hopelessness, which can bring low mood, self-injury and even suicide.
Although gaming appears (at least initially) to be a positive and beneficial activity for many trans people, there is also the risk that staying in the game becomes too much of a secure and safe environment. This can create a vicious circle where the trans person does not wish to move out of the secure online world, and back into reality. Spending an increasing amount of time in online gaming carries the risk of developing a gaming dependence or addiction. This may not only affect one’s personal relationships, work and/or study, but may also impair real life social gender role transition, as in many cases, the individual is expected to socially transition before they can be considered for treatment.
Obviously our paper only included four participants and may be perceived by some researchers as ‘anecdotal’ because the data were not collected for this specific study but were retrospectively collated. However, our findings showed that for a trans individual, the online gaming environment was perceived as “safe” but further research is needed to establish what the distinctive elements of online gaming are that help to raise gender awareness (or not as the case may be). With the rates of gender dysphoria attending clinical services increasing significantly, future research should investigate (i) the rates and severity of gaming among this population as well as its function, and (ii) the rates of gender dysphoria among game addiction as coming out may help their addiction. The game industry may also want to consider how they can use games as a way of helping trans people being more accepted within society by developing game industry may want to co-observe how their games can prepare and assist individuals to socially transition. Online games also provide a safe environment that provides people access to a platform where individuals can discuss and experiment with gender identity.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Arcelus, J., Bouman, W. P., Witcomb, G. L., Van den Noortgate, W., Claes, L., & Fernandez-Aranda, F. (2015). Systematic review and meta-analysis of prevalence studies in transsexualism. European Psychiatry, 30, 807-815.
Arcelus, J., Jones, B., Richards, C., Jimenez-Murcia, S., Bouman, W.P. & Griffiths, M.D. (2017). Video gaming and gaming addiction in transgender people: An exploratory study. Journal of Behavioral Addictions, 6, 21–29.
Dale, L. K. (2014, January 23). How World of Warcraft helped me come out as transgender. The Guardian. Retrieved from http://www.theguardian.com/technology/gamesblog/2014/jan/23/how-world-of-warcraft-game-helped-me-come-out-transgender
Griffiths, M.D., Arcelus, J. & Bouman, W.P. (2016). Video gaming and gender dysphoria: Some case study evidence. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 34(2), 59-66.
Griffiths, M. D., Davies, M.N.O. & Chappell, D. (2003). Breaking the stereotype: The case of online gaming. CyberPsychology and Behavior, 6, 81-91.
Griffiths, M.D., Davies, M.N.O. & Chappell, D. (2004). Demographic factors and playing variables in online computer gaming. CyberPsychology and Behavior, 7, 479-487.
Griffiths, M. D., Kiraly, O., M. Pontes, H. M. & and Demetrovics, Z. (2015). An overview of problematic gaming. In Starcevic, V. & Aboujaoude, E. (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp.27-55). Oxford: Oxford University Press.
Fahs, B., & Gohr, M. (2012). Superpatriarchy meets cyberfeminism: Facebook, online gaming, and the new social genocide. MP: An Online Feminist Journal, 3(6), 1-40.
Hegland, J. E., & Nelson, N. J. (2002). Cross-dressers in cyber-space: Exploring the Internet as a tool for expressing gendered identity. International Journal of Sexuality and Gender Studies, 7(2-3), 139-161.
Huh, S., & Williams, D. (2010). Dude looks like a lady: Gender swapping in an online game. In Online worlds: Convergence of the real and the virtual (pp. 161-174). London: Springer.
Hussain, Z., & Griffiths, M. D. (2008). Gender swapping and socialising in cyberspace: An exploratory study. CyberPsychology and Behavior, 11, 47-53.
Lewis, A., & Griffiths, M. D. (2011). Confronting gender representation: A qualitative study of the experiences and motivations of female casual-gamers. Aloma: Revista de Psicologia, Ciencies de l’Educacio i de l’Esport, 28, 245-272.
McLean, L., & Griffiths, M. D. (2013). Female gamers: A thematic analysis of their gaming experience. International Journal of Games-Based Learning, 3(3), 54-71.
Osborne, H. (2012). Performing self, performing character: Exploring gender performativity in online role-playing games. Transformative Works and Cultures, 11. doi:10.3983/twc.2012.0411.
Potts, A. (2015). ‘LOVE YOU GUYS (NO HOMO)’ How gamers and fans play with sexuality, gender, and Minecraft on YouTube. Critical Discourse Studies, 12(2), 163-186.
Shaw, A. (2012). Do you identify as a gamer? Gender, race, sexuality, and gamer identity. New Media and Society, 14(1), 28-44
Taylor, T. L. (2003). Multiple pleasures women and online gaming. Convergence: The International Journal of Research into New Media Technologies, 9(1), 21-46.
Todd, C. (2012). ‘Troubling’ gender in virtual gaming spaces. New Zealand Geographer, 68(2), 101-110.
Over the past year I have been carrying out research with my Spanish colleague – Dr. Hibai Lopez-Gonzalez – into problematic sports betting and sports betting advertising which has already produced a number of papers (see ‘Further reading’ below) and with many more to come. One of the issues we have faced in contextualising our work is that there is no such concept as sport-related problem gambling in prevalence surveys because problem gambling is assessed on the totality of gambling experiences rather than a single activity. For instance, in the three British Gambling Prevalence Surveys (BGPSs) conducted since 1999, sport-related gambling is subsumed within a number of different gambling forms: ‘football pools and fixed odds coupons’, ‘private betting’, and ‘other events with a bookmaker’. The 2010 BGPS (which I co-authored) included ‘sports betting’ as a category, along with ‘football pools’ (no coupons), ‘private betting’, ‘spread betting’ (which can include both sports or financial trading). In addition, the 2010 BGPS added a new category under online gambling activities to include ‘any online betting’. More recently, the Health Survey for England also introduced a new category: ‘gambling on sports events (not online)’.
Despite these limitations, some evidence can be inferred from gambling activity by gambling type. In 2014, Heather Wardle and her colleagues combined the gambling data from the Health Survey for England and the Scottish Health Survey. They reported that among adult males aged 16 years and over during a 12-month period, 5% participated in offline football pools, 8% engaged in online betting (although no indication was made about whether this only involved sport), and 8% engaged in sports events (not online). The categories were not mutually exclusive so an overlapping of respondents across categories was very likely. A similar rate was found in South Australia in a 2013 report the Social Research Centre with those betting on sports over the past year accounting for 6.1% of the adult population, an increase from the 4.2% reported in 2005.
In Spain, the Spanish Gambling Commission (Direccion General de Ordenacion del Juego [DGOJ] reported that 1.5% of the adult (male and female) population had gambled online on sports in 2015. This is a significantly lower proportion compared with the British data, although the methodological variations cannot be underestimated. Spanish data also shows that, among those who have gambled online on a single gambling type only, betting on sports is the more prevalent form with up to 66% of those adults.
In France, the data on the topic only focuses on those who gamble rather than examining the general population of gamblers and non-gamblers. Among online gamblers, Dr. Jean-Michel Costes and colleagues reported in a 2011 issue of the journal Tendances that 35.1% had bet on sports during the last 12 months. In another French study by Costes and colleagues published in a 2016 issue of the Journal of Gambling Studies, sports betting represented 16.4% of the gambling cohort, although again, the representativeness of sports betting behaviour among the general gambling and non-gambling population could not be determined.
Due to the aforementioned shortcomings in the definition of sport-related gambling, there is only fragmented empirical evidence concerning the impact of sports-related problem gambling behaviour. For instance, in 2014, Dr. Nerilee Hing noted that clinical reports indicate that treatment seeking for sports-related problem gambling had grown in Australia. In British Columbia (Canada), a 2014 survey by Malatests & Associates for the Ministry of Finance reported that 23.6% of at-risk or problem gamblers had gambled on sports either offline or online. A smaller proportion (16.2%) was found in the Spanish population screened in the national gambling DGOJ survey, except this subgroup was entirely composed of online bettors.
In a 2011 study published in International Gambling Studies with patients from a pathological gambling unit within a community hospital in Barcelona, Dr. Susana Jiménez-Murcia and her colleagues found that among those who had developed the disorder gambling online only (as opposed to those who gamble both online/offline or offline only), just over half (50.8%) were sport bettors. Those who gambled online only (on any activity) and those that only gambled online on sports events represented a small minority of the total number of problem gamblers. Overall, there is relatively little research on this sub-group of gamblers therefore I and others will be monitoring the evolution of this trend as the online gambling population grows.
(Note: This blog was co-written with input from Dr. Hibai Lopez-Gonzalez).
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Costes, J-M, Kairouz, S., Eroukmanoff, V., et al. (2016) Gambling patterns and problems of gamblers on licensed and unlicensed sites in France. Journal of Gambling Studies 32(1), 79–91.
Costes, J., Pousset, M., Eroukmanoff, V., et al. (2010). Gambling prevalence and practices in France in 2010. Tendances, 77, 1–8.
DGOJ (2016a) Análisis del perfil del jugador online. Madrid: Ministerio de Hacienda y Administraciones Públicas.
DGOJ (2016b) Estudio sobre prevalencia, comportamiento y características de los usuarios de juegos de azar en España 2015. Madrid: Ministerio de Hacienda y Administraciones Públicas.
Hing, N. (2014) Sports betting and advertising (AGRC Discussion Paper No. 4). Melbourne: Australian Gambling Research Centre.
Jiménez-Murcia S, Stinchfield R, Fernández-Aranda F, et al. (2011) Are online pathological gamblers different from non-online pathological gamblers on demographics, gambling problem severity, psychopathology and personality characteristics? International Gambling Studies 11(3), 325–337.
Lopez-Gonzalez, H., Estevez, A. & Griffiths, M.D. (2017). Marketing and advertising online sports betting: A problem gambling perspective. Journal of Sport and Social Issues, in press.
Lopez-Gonzalez, H. & Griffiths, M.D. (2016). Is European online gambling regulation adequately addressing in-play betting advertising? Gaming Law Review and Economics, 20, 495-503.
Lopez-Gonzalez, H. & Griffiths, M.D. (2017). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport, in press.
Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review and Economics, in press.
Malatests & Associates Ltd (2014). 2014 British Columbia Problem Gambling Prevalence Study. Victoria, Canada: Gaming policy and enforcement branch, Ministry of Finance.
The Social Research Centre (2013) Gambling prevalence in South Australia. Adelaide, Australia: Office for problem gambling. Available from: http://phys.org/news/2012-03-lung-doctors-respiratory-diseases-worsen.html.
Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.
Wardle H, Seabury C, Ahmed H, et al. (2014) Gambling behaviour in England & Scotland. Findings from the health survey for England 2012 and Scottish health survey 2012. London: NatCen Social Research.
Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M.D., Constantine, R. & Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: The Stationery Office.