How the WSJ handles the inconvenient facts of “rapid onset gender dysphoria”

Zinnia Jones

I was recently consulted on an op-ed in the Wall Street Journal about the dispute over Lisa Littman’s study of a supposed new “rapid onset gender dysphoria” condition said to be contagiously spreading among youth. Jillian Kay Melchior describes my involvement in this controversy:

Ideologues try to suppress a study on the increasing prevalence of ‘rapid onset gender dysphoria.’ …

Dr. Littman’s detractors also accuse her of bigotry. Her work “negates the experience of many transgender youth,” according to Diane Ehrensaft, of the Child and Adolescent Gender Center Clinic at the University of California San Francisco’s Benioff Children’s Hospital.

Transgender activist Brynn Tannehill calls Dr. Littman’s research “a naked attempt to legitimize anti-transgender animus with a veneer of academic responsibility.” And Zinnia Jones, founder of the website Gender Analysis, called rapid-onset gender dysphoria a “hoax diagnosis” perpetuated by those who would deny transgender children “acceptance and affirmation.” The motto of Ms. Jones’s website: “The personal is empirical.”

The effort at suppression had an effect. …

… As for Dr. Littman’s critics, they equate caution with bias, even hatred, and encourage teens to go through hormone therapy or surgery—drastic interventions whose effects are irreversible.

For background, I spoke with Melchior a week before her op-ed was published. She asked me to confirm that the two sentences about me were accurate, and I agreed they were. However, I informed her that the problems with the study are much more substantial:

Thanks so much for getting in touch with me on this. Those two sentences are indeed accurate, although my issues with the study in question run a bit deeper than that. This is a problem with the paper’s analyses and hypotheses that has not received as much attention as other issues with the study, but it is a serious flaw.

Namely, the study’s author directly quoted one of my articles on symptoms of gender dysphoria, and misleadingly labeled this “vague and nonspecific symptoms called signs of GD” while attributing it to a Tumblr blog. Her description of these symptoms as “vague and nonspecific” is simply incorrect, as I was describing symptoms associated with depersonalization disorder, a known condition that occurs vastly more frequently among trans people and is often successfully treated by transitioning. Numerous published studies confirm this. The author either was not aware of this or chose not to acknowledge it, and as a result, she implicated my own work in supposedly contributing to her proposed mechanism whereby cisgender youth are being led to believe falsely that they are trans via reading lists of “vague and nonspecific symptoms called signs of GD”. Because these are not in fact vague or nonspecific symptoms, and do often occur in untreated gender dysphoria, her hypothesis is badly compromised.

I’ve summarized the relevant evidence here (https://genderanalysis.net/2018/08/rapid-onset-gender-dysphoria-study-misunderstands-trans-depersonalization-ends-up-blaming-zinnia-jones/), as this is a major oversight of both her paper and the peer review process that allowed it to be published. Needless to say, it’s concerning to me that I would be personally implicated in causing the spread of a new “disease” based on her own misreading and misunderstanding of my work.

“The personal is empirical” is an acknowledgment that the life experiences of trans people, and the scientific evidence regarding transness and gender, are not at all in conflict as is often portrayed – rather, these are frequently complementary and consistent. What trans people often observe in their everyday lives, which would otherwise be relegated to mere community folklore, is in reality often supported by scientific findings. One example would be the phenomenon where a trans woman is seen as a woman by one person, but “clocked” as trans by another, even on the same day – this turns out to involve known cognitive and perceptual biases and individual factors influencing a person’s categorization of others’ genders (see more here: https://genderanalysis.net/2016/07/the-social-paradox-of-passing-gender-analysis-23/). Another example would be my own work on depersonalization symptoms in gender dysphoria. Many trans people have reported exactly these symptoms for years, even decades, as well as their amelioration with transitioning, but the community did not always have a framework for understanding the nature of these symptoms or what they meant. As it turns out, there is a name for this condition, and what they were perceiving was indeed real; multiple studies have confirmed the presence of these symptoms in gender dysphoria. “The personal is empirical” means that trans people can draw on the findings of science to help understand their own lives, and that trans people’s experiences can also provide useful hints about where scientific investigation can productively direct its attention and learn more about us.

Additionally, if you are interested, I’ve summarized some of the other issues with the study and its findings, including the significant sampling bias inherent in recruiting respondents from communities that demonstrate overt anti-transgender prejudice (https://genderanalysis.net/2018/08/meet-the-unbiased-reliable-not-at-all-transphobic-parents-from-the-rapid-onset-gender-dysphoria-study/), its inaccurate presentation of certain transgender community strategies for navigating healthcare as being a new development when in fact these have been known and observed for decades (https://genderanalysis.net/2018/08/rapid-onset-gender-dysphoria-study-omits-historical-context-of-transgender-narratives-and-medical-gatekeeping/), and its wide net of supposed “alternative causes” of gender dysphoria that seem designed to enable labeling any given trans youth as having “rapid onset gender dysphoria” (https://genderanalysis.net/2018/08/rapid-onset-gender-dysphoria-study-an-impossibly-wide-net-of-alternative-etiologies/).

Again, thank you so much for the much-needed attention to these issues. If there is any other help I can provide, please let me know :)

So, a WSJ writer covering the controversy was made aware of all of these serious issues with the study a week in advance. I don’t see how I could have made it more clear that this is a matter of deeply flawed research and scientific criticism of that research – criticisms that would stand regardless of what any “ideologues” did or didn’t do at any point in time. Yet this engagement with the study’s substance – the very post-publication community review invited by PLOS One – is still reduced to an “effort at suppression” by “ideologues” against science.

Many people have rightly pointed out how the uselessly overbroad and practically meaningless theory of ROGD is based on egregiously biased sampling that selected for anti-trans respondents, as well as an ignorance of psychiatry and well-known transgender history. This theory is so bad, it implicates my articles on depersonalization in trans people – a condition already known to be real – as a causative factor in a (likely illusory) new “contagion”. I explained the many flaws of ROGD at length last month; my publication of that criticism can hardly be said to be an act of “suppression”.

Exactly how are we supposed to engage in critique of this study? We can do everything right – we can take the time to address the substance of the research, we can offer the relevant scientific review solicited by the journal, we can explain all of this quite succinctly to those who invite our comment – and that still won’t keep the Wall Street Journal from reducing us to mere ideologues fighting to suppress science.

Since the study’s publication, several others have elected to cover this controversy using the same framing of suppressive ideologues versus scientific facts. Writing for Quillette, Jeffrey Flier, a former dean at Harvard Medical School, accuses the study’s critics of making spurious and ideologically motivated criticisms intended to suppress science:

Many papers face questions after they have been published, which is well and proper: the systematic assessment and scrutiny of published work is a core method by which the scientific community corrects errors, and builds upon imperfect preliminary observations. … But that is not what has happened in regard to Dr Littman, whose critics have not performed any systematic analysis of her findings, but seem principally motivated by ideological opposition to her conclusions. …

There is no evidence for claims of misconduct in Dr Littman’s case. Rather, unnamed individuals with strong personal interests in the area under study seem to have approached PLOS One with allegations that her methodology and conclusions were faulty. Facing these assertions, which predictably drew support from social media communities populated by lay activists, the journal responded rapidly and publicly with the announcement that it would undertake additional expert review.

In all my years in academia, I have never once seen a comparable reaction from a journal within days of publishing a paper that the journal already had subjected to peer review, accepted and published. One can only assume that the response was in large measure due to the intense lobbying the journal received, and the threat—whether stated or unstated—that more social-media backlash would rain down upon PLOS One if action were not taken.

To me, what’s most conspicuous in this article is what it leaves out. Flier offers this screenshot of a Twitter exchange between trans woman Hailey Heartless and PLOS One:

He just happened to omit my adjacent tweet that did offer scientific criticism of the study’s misinterpretation of depersonalization in gender dysphoria, and was also acknowledged by PLOS One:

Is this not the very “assessment and scrutiny of published work” that serves as a “core method by which the scientific community correct errors”? Is it not an effort to build upon an imperfect preliminary observation? These contributions were neither spurious nor censorious. But if you choose to ignore the evidence that’s been placed right in front of you, then I’m sure it’s quite easy to say that critics of the theory “have not performed any systematic analysis of her findings” and must therefore be “motivated by ideological opposition to her conclusions”.

When I contacted Flier to let him know about the serious issues with the science of the study, he clarified that he was condemning the actions subsequently taken by PLOS One and Brown University, and was not taking a position on the quality of the study itself. He stated that while we may all have our opinions, this should never be used to influence a study’s publication.

This is an odd assertion. Peer review, corrections, and retractions are all practices that have their places in academic publishing, and these are all instances where certain arguments and opinions do hold influence over the publication status of a given paper. It is the application of human judgment of whether or not the paper in question meets required standards. When I wrote in to PLOS One expressing my concerns with this study’s misuse of my work, I described this as exactly what it should be: a correction. Correcting a scientific article to address its inaccuracies is quite the opposite of censorship – it is a step in the direction of improving the quality of research.

It is curious that someone would take a stance of supporting the study’s publication as well as its promotion by Littman’s university, while consciously withholding judgment of the study’s quality and overall soundness. When you decide to throw your support behind something, wouldn’t you want to be aware of just what it is you’re supporting, and whether that support is deserved? It is not at all outside the realm of possibility that a study can be so deeply flawed, it would in fact be appropriate for a journal to conduct additional review and a university to remove their press release promoting its findings. But when you choose to remain agnostic on the quality of the study, that possibility will not enter into your consideration – you wouldn’t be able to reach such a conclusion even in cases where a study is utterly abysmal and fully deserving of being withdrawn. While Flier accuses others of disregarding the science and acting as mere ideologues, his own choice to disregard the science is somehow above suspicion.

In his 1877 essay “The Ethics of Belief”, mathematician W. K. Clifford highlighted the issue of those who readily adopt a given belief on a subject while wholly dismissing the task of learning about it:

“But,” says one, “I am a busy man; I have no time for the long course of study which would be necessary to make me in any degree a competent judge of certain questions, or even able to understand the nature of the arguments.”

Then he should have no time to believe.

Proponents of the ROGD study have certainly made time to believe it. It is less clear whether they intend to take the time to understand it.


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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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