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“Rapid onset gender dysphoria” is not one thing: Mapping the claims of ROGD proponents

“Rapid onset gender dysphoria” (ROGD) is a pseudoscientific hoax diagnosis developed and promoted since mid-2016 by a constellation of transphobic advocacy groups and affiliated individuals, primarily serving as a deliberately constructed excuse to invalidate the genders of trans adolescents, and more broadly used to delegitimize all trans people. The hypothesized condition is purported to be characterized by a “sudden” appearance of cross-gender identity among adolescents and young adults (usually trans boys), who allegedly did not exhibit prior signs of gender dysphoria, and are believed to have acquired their cross-gender identity due to “influence” from peers, media, and the internet, often due to a preexisting psychological vulnerability such as depression, anxiety, or PTSD. The website “Parents of ROGD Kids” describes this as follows:

We are a group of parents whose children have suddenly—seemingly out of the blue—decided they identify strongly with the opposite sex and are at various stages in transitioning.  This is a new phenomenon that has only recently been identified.  Researchers are calling it Rapid-Onset Gender Dysphoria (ROGD), and it is epidemic among our most vulnerable youth.

Our children are young, naïve and impressionable, many of them are experiencing emotional or social difficulties.  They are strongly influenced by their peers and by the media, who are promoting the transgender lifestyle as popular, desirable and the solution to all of their problems.  And they are being misled by authority figures, such as teachers, doctors and counselors, who rush to “affirm” their chosen gender without ever questioning why.

We are skeptical of the current Standard of Care, the “Affirmative Approach,”  which only seems to confirm and solidify our children’s misguided, externally-influenced sense of self.

And we are horrified at the growing number of young people whose bodies have been disfigured, their physical and mental health destroyed by transitioning, only to discover—too late—that it did little to relieve their dysphoria.

This is the story told by proponents of ROGD. Unfortunately for its proponents, there’s little more to ROGD than just that: a story, propped up by misinterpretations and outright falsehoods.

“Rapid onset gender dysphoria” is not an actual condition. It is a narrative. From an outside perspective, the described cases of rapid onset gender dysphoria look quite a bit like… gender dysphoria. Parents who promote this “condition” typically report that their child was evaluated for gender dysphoria, diagnosed with gender dysphoria, and given appropriate treatment for gender dysphoria. That diagnosis and treatment is, itself, typically the very subject of their complaints: the problem is that the parent is unhappy about this. By all appearances, what we’re seeing here is simply gender dysphoria – as told from the perspective of unaccepting parents who refuse to believe their child is trans.

That parental perspective is central to the very existence of ROGD as a distinct entity, and it is key to understanding the purposes served by ROGD as a concept. It is a crystallization of parental rejection of transgender youth, tying together a vast array of baseless speculation, motivated reasoning, and general folklore already commonly used as excuses to dismiss a child’s transness. ROGD is not about trans youth, or something that these trans youth have – it is about their parents and relatives, and their discomfort with a trans child.

Around this new narrative, several post-hoc rationalizations have accreted. Understandably, there is rather sparse evidence of ROGD as a distinct clinical syndrome – an absence that is generally papered over with remarkably wide-ranging and farfetched theories about this “condition”, its nature, and its implications. The story of ROGD has come to encompass a number of extraordinary claims that collectively fuel this narrative – while offering little in the way of factual accuracy. These include:

  • ROGD and demographic trends: Evidence of increasing numbers of assigned-female youth seeking evaluation and treatment for gender dysphoria is treated as indicative of a “new kind of gender dysphoria”.
  • The social contagion hypothesis: References to transgender identity as a “social contagion” are ubiquitous among ROGD proponents, with the “belief” that one is trans being attributed to influence from peer groups, social media, Tumblr, YouTube, and online trans support communities. “Transgender ideology” is universally presented as a threat.
  • ROGD as secondary to other conditions: Proponents will often assert that a child’s apparent gender dysphoria is not genuine and is instead caused by depression, anxiety, autism, PTSD, body image issues, ADHD, borderline personality disorder, and any number of other conditions.
  • The clinical picture of ROGD: Few references to “rapid onset gender dysphoria” exist in published literature, with little in the way of clinical features that would distingush this condition from gender dysphoria. Currently, the highest-quality data available on this comes from a still-unpublished study based on an anonymous online survey of parents who visited the three websites which created the concept of “rapid onset gender dysphoria”.
  • The clinical implications of ROGD: The lack of high-quality studies of this supposedly distinct population has led to a similar lack of clarity regarding how this “condition” should be treated any differently compared to gender dysphoria. This, however, has not stopped proponents of ROGD from recommending approaches that happen to align entirely with parental rejection: complaints about “affirmation” feature prominently, as do fears of the “disfigurement” of transitioning. ROGD proponent and Jungian psychoanalyst Lisa Marchiano, who claims to have “been in contact with hundreds of families with ROGD teens”, describes being sought out by parents who “ask if I can direct them to any therapist who won’t just affirm and greenlight their child for medical transition”. Ray Blanchard and J. Michael Bailey, two sexologists who do not have clinical experience with the supposed ROGD population but do have “strong intuitions and hunches”, recommend that parents should “do what you can to delay any consideration of gender transition”, and should instead “identify your child’s problems that existed before ROGD and that may have contributed to it”.

In an upcoming series of articles, I’ll be covering many of the sprawling claims spawned from the overarching ROGD narrative. Addressing this hoax at all can feel like giving it more credence than it deserves, but the promotion of this disinformation is definitely something that trans people and the general public do not deserve. Understanding the misrepresentations and lies behind ROGD is essential to seeing this for what it is: a myth intentionally and heartlessly crafted by transphobic groups to attack trans kids and prevent them from receiving the care and affirmation they need. 

Zinnia Jones: My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.