“Rapid onset gender dysphoria” and unfulfilled predictions of transition regret

Zinnia Jones

A frequent feature of “rapid onset gender dysphoria” (ROGD) advocacy is the claim that increasing numbers of trans youth receiving gender-affirming care such as puberty blockers will surely lead to a massive wave of regret among these youth in the future. As proponents believe these youth are simply misguided cis kids and not “really” gender dysphoric, they consider it inevitable that these children will grow up to realize their supposed transness was false, and that any transition procedures they underwent were unnecessary. Jungian psychoanalyst Lisa Marchiano writes:

I fear that there are young people transitioning – with the ready help of therapists, doctors, and others – who may regret these interventions and need to come to terms with permanent and in some cases drastic changes to their bodies.

ROGD advocates deserve some small measure of praise for at least attaching a vaguely testable prediction to their hypothesis. But where they go astray is in warning of something that may never come to pass, and for which there is currently no evidence at all.

Regret among adult transitioners has been quantified, and one of the largest studies spanning 1960-2010 found an overall rate of regret of only 2.2%, with this number declining over time. Over a more recent time period, another study found zero regrets (0%).

Do studies of trans people who transitioned in adolescence find elevated regrets among this group? No – multiple studies of these trans youth have found no cases of reported regret. There is no indication that an earlier transition is more likely to result in regret. And if someone who transitions at 13 or 14 is actually no more at risk of later regret than someone who transitions at 25 or 35, this argument against affirming care for trans youth falls flat.

Proponents of ROGD may certainly wait for further evidence to roll in, as will the rest of us – scientific theories and models are provisional and subject to change in light of new findings. But at present, they have no grounds to claim that rates of regret will drastically spike as a result of gender-affirming treatment for trans kids.

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About Zinnia Jones

My work focuses on insights to be found across transgender healthcare, public health, psychiatry, and history of medicine, integrating these many perspectives and guided by the lived experiences of trans people. I live in Orlando with my family, and work mainly in technical writing.
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