Internationally, gender clinics, therapists, and parents have noted the rise in the number of teens and young adults coming to identify as transgender without any significant prior history of gender dysphoria. This appears to be a novel presentation of gender dysphoria, and warrants further study. Both according to anecdotal report, and as per newer research findings, many of these young people appear to be suffering from other mental health disorders in addition to gender dysphoria. There is some evidence that these teens and young adults are arriving at a belief that they are transgender after spending time on transgender sites online, and/or in conjunction with one or more peers coming out in the same time frame. This raises the concern that there may be elements of social contagion at work.