‘Rapid-onset gender dysphoria’ is a popular weapon in the anti-trans arsenal. It is nothing but unscientific bunk
I owe an apology to anyone who knew me between the years of 2016 and 2018, when I somehow found a way to derail every conversation into rambling about how bad it was about to get for queer and trans people across the globe. The fact that – ultimately – I was proven right doesn’t detract from how annoying that had to be! I was fixated on the new websites where people ruminated upon the increasing numbers of youth coming out as transgender, arguing that this couldn’t be normal, that there had to be a nefarious cause, and that young people were being ‘brainwashed’ into thinking they’re trans by medical professionals, social media and peer pressure. Such websites, including Transgender Trend, 4thWaveNow, and Youth Trans Critical Professionals, were known to conservative news outlets, who cited their posts as evidence that young people seeking transition care represented an epidemic caused by the influence of a cult and egged on by a liberal medical establishment. These youth couldn’t really all be trans. Rather, these online circles insisted the new wave of trans kids had a form of gender dysphoria induced by society itself.
The term they gave to this purely speculative diagnosis was ‘rapid-onset gender dysphoria’ (ROGD), so named because parents participating in studies reported the sudden shifts. That conservative groups were promoting the term raised alarm bells for me because infamously homophobic lobbyists were openly planning to target trans rights as an electoral strategy. One such group, Family Research Council, openly stated their intent to use transgender rights as a wedge issue to weaken feminist, progressive and queer coalitions. The idea, they said in 2017, was that: ‘Trans and gender identity are a tough sell, so focus on gender identity to divide and conquer … If we separate the T from the alphabet soup we’ll have more success.’
As an early stage graduate student in psychology, who’d been out as nonbinary and queer for quite some time, I’ll admit that it was probably not the healthiest choice to actively seek out such spaces online and attend to their output. And yet, all these years later, ROGD as a concept has gone viral in conservative circles as the explanation for why trans youth seek support and care, and why those should be prohibited. During the 2022 midterm elections in the United States, escalating attacks on trans youth and those who support them relied on these talking points as common centerpieces of campaigns all across the US.
To be clear, there is a discussion worth having about the number of trans youth who are seeking recognition and care, and why that number is higher now than it has been in the past. I understand why, across English-language news media, stories about them have increased in frequency, and why so many of them report on increasing numbers of adolescents and young adults who self-describe as transgender or who seek transition procedures – ranging from simply changing clothes or using a different name (‘social transition’) to medical procedures such as hormone treatments to surgical interventions, like chest reconstruction or genital surgery. After all, both clinical experts and demographers across the globe have described these referral trends, with one Dutch team in 2020 calling them ‘exponential’. It’s normal and OK for someone to wonder: ‘Why are these numbers so much higher than previous estimates suggested?’ It’s even OK to wonder: ‘What happens if someone changes their mind? How do “detransitioners” fit into this?’
What’s less OK is how news stories fail to contextualize the issues. For example, The Telegraph website in 2018 described a ‘4,000 per cent increase’ in referrals in the UK for young people who were assigned female at birth – not specifying that any per cent increase from essentially zero (or 40 children in the entire population of the UK, which is 67 million) is going to look massive (the actual number of children referred in 2018 was 1,766 more than in 2009) and that such an increase followed the removal of barriers to accessing care. One headline in 2019 read: ‘4-Year-Old Can Begin Transgender Transition, Says UK Court’, neglecting to specify that the case was over whether the child could wear a girl’s uniform – not over anything medical or surgical. Vivid individual accounts of detransitioners often imply that regret is a common risk of transitioning when young, even though the evidence doesn’t support the suggestion, and some detransitioners now feel that their stories were inappropriately exploited.
What’s definitely not OK is when such stories source claims from groups that have built their entire platforms around the concept of ROGD, as if such organizations were equivalent in quality and integrity to the medical consensus. Affiliates of organizations such as the Society for Evidence-Based Gender Medicine (SEGM) and Genspect argue in favour of banning transition for young people under age 25, partly because they endorse the neuromyth that adolescence lasts until 25, and partly because (according to them) the youth presenting for care can’t actually all be trans. A leaked audio recording from 2021 suggests that their leadership seeks to promote ‘desistance’ – meaning that the goal is to stop them from being trans in adulthood. Further, Stella O’Malley – Genspect’s founder, and a member of SEGM – admitted in 2021 in a Twitter Space meeting she co-organized with other anti-trans actors that her explicit goal is to make sure that those she regards as children (including legal adults) desist from seeking medical transition; any who do end up transitioning are viewed a priori as negative outcomes. In her own words (which you can listen to in audio from the meeting available here):
I suppose, uh, where I’m coming from this more than anything is, uh, to, um, make sure that children are, if – if at all possible – are stopped from medical transition. I think that’s the most important thing for me.
Lisa Marchiano, a psychotherapist and Jungian analyst who acts as an advisor and core member to both Genspect and SEGM, argues (on the basis of anecdotal or uncited evidence) that ROGD represents a ‘psychic epidemic’ and that therefore ‘many’ youth who come out as trans are ‘false positives’. Members of both organizations oppose attempts to ban conversion therapy internationally because they believe in the promise of psychotherapies aimed at ‘treating’ gender dysphoria so that the children can become cisgender adults. While such members sometimes claim to oppose conversion therapy, the model of ‘gender exploratory therapy’ that they advocate nevertheless explicitly advocates against youth transition procedures and (functionally) argues that every attempt should be made to prevent youth from undertaking transition through psychological interventions. In their eyes, these youth aren’t ‘really’ trans, they just have ROGD – therefore, treating them is harmful unless attempts to force them into a cisgender identity fail until their late 20s. Genspect specifically hosted a conference on ROGD in 2021 as well as a ‘ROGD Awareness Day’ event.
To such groups, ROGD is the answer to the collective denial that there could be this many trans youth naturally, and that there must be some striking causal explanation that ‘turned’ young people trans. While ROGD is unscientific, it provides an allegedly ‘scientific’ rationale for reactionaries who escalate attacks on trans people, and it has served as pretext for proposing and implementing rollbacks of trans rights. Here, I aim to explain why such denial doesn’t hold water among most experts and informed laypersons.
Bluntly, there is no solid evidence that ROGD exists. The study that birthed the term – circulated on, and designed for, these anti-trans websites – was first published in 2016 as a poster by the physician Lisa Littman, then at the Department of Behavioral and Social Sciences at the Brown University School of Public Health in Rhode Island. A self-described gender dysphoria expert, Littman later published her findings in a (now heavily revised) paper in PLOS One in 2018. At no point was a single trans person studied for these findings. Instead, Littman recruited an anonymous sample of people who claimed to be parents of trans ‘youth’ (ranging in age from 11 to 27) from websites including 4thWaveNow, Transgender Trend, and Youth Trans Critical Professionals. All three sources are infamous for transphobia, with 4thWaveNow in particular spreading unsubstantiated conspiracy theories.
Hate groups such as the Alliance Defending Freedom (ADF) and the American College of Pediatricians (ACPeds) have gotten in on the act as well. For example, ADF defended a professor’s ‘right’ at Shawnee State University to misgender trans students by using pronouns not reflecting their gender identity. In 2016, the presidents of ACPeds and of ADF signed an open letter condemning what was termed ‘gender ideology’. Such documents have successfully been used as ammunition in court to fight transgender rights.
To be fair, samples composed of parents are not inherently disqualifying. The TransYouth Project – a 20-year longitudinal study from Princeton University, which has been responsible for important findings on trans children – studies only children with supportive parents, as do other analyses from the same researchers. However, Littman’s ROGD research could not verify whether her own study’s participants were actually parents of trans youth, or simply trolls fabricating input. Further, Littman’s study violates basic research principles because her participants were not blind to the research hypothesis. Not only did the recruitment materials state that Littman was investigating the phenomenon that these websites themselves had conceptualized, recruitment was active while the concepts it sought to validate – social contagion and ROGD – were being reported on in the media as if already proven real.
Even ignoring these problems, Littman’s study is fatally flawed because it relies exclusively on parental hearsay – if indeed the respondents are actually parents. Her study cannot assess how accurately these parents assessed the timeline of their children’s gender incongruence. It shows only what unsupportive parents recruited from anti-trans web sources think happened. Parents aren’t always reliable sources about their children – particularly because queer and trans folk often come out to their parents last, long after they’ve come out to supportive friends. Littman’s study also suggested that ROGD could represent underlying mental health concerns – all while ignoring existing research suggesting that members of minority populations (including transgender youth) often have significant mental health concerns due to the stresses that being trans in an unsupportive society causes them.
These issues immediately incited a flurry of intense criticism of Littman’s paper, ultimately resulting in an extensive correction. At the time, I was still a graduate student, but read these criticisms with great interest – both because the controversy over Littman’s paper was personally relevant, and because, on the surface, her work resembled similar now-discredited arguments that stigmatized identities could be prevented or changed and were spread through social contagion. I remember reading claims on the Psychology Today website as late as 2010 insinuating that lesbianism or bisexuality among girls was increasing because of trends in pornography consumption, even though basic logic would dictate that it’s because homosexuality had been illegal in 13 states less than a decade prior, so you’d expect ongoing normalization to lead more people to come out, and come out earlier (as polls demonstrate). One study even found that trans youth realized they were trans years before they came out to their parents, who only perceived that their children might be trans a few months before the child came out.
ROGD has proven to be a popular talking point in conservative circles, forming the basis for Abigail Shrier’s influential (and misleading) book Irreversible Damage: The Transgender Craze Seducing Our Daughters (2020), and referenced in US congressional testimony and by lawmakers. But, as far as the mainstream scientific community were concerned, this was the end of it: in August 2021, the Coalition for the Advancement and Application of Psychological Science (CAAPS) – now co-signed by 60 organizations – put out a statement to eliminate use of the term ROGD ‘given the lack of rigorous empirical support for its existence’.
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Quinnehtukqut McLamore is a postdoctoral fellow at the University of Missouri. They received their PhD in social psychology from the Psychology of Peace and Violence Program at the University of Massachusetts Amherst. Their research is strongly multi-method and wide-spanning: in general, they focus on ‘common knowledge’, narratives, extremism, and processes related to group identification.
Courtesy: AEON (Received through email on Jan 23, 2023)