Ongoing media misrepresentation of early-onset and late-onset gender dysphoria

Alongside the common misconception that children lack the capacity to understand or recognize that their gender doesn’t align with their assigned sex, there now proliferates the notion that only those trans people who were aware of their gender identity as young children are the ones who are “truly” trans. I’ve previously noted this error in my dissection of Debra Soh’s credulous and incompetent reporting for Quillette on the “rapid onset gender dysphoria” hoax condition. While Soh claimed that the youth in the ROGD study “don’t meet any of the diagnostic criteria for gender dysphoria” (as observed only via secondhand parental reports submitted anonymously online), the study in fact stated that none of these youth “would have met diagnostic criteria for gender dysphoria in childhood”, but that more than 80% of them did meet the diagnostic criteria for adolescent and adult gender dysphoria.

This month, Federalist writer Abigail Shrier repeated the same error in an uncritical regurgitation of ROGD myths for the Wall Street Journal’s opinion page. (This is not the WSJ’s first fumble in covering the “rapid onset gender dysphoria” hoax.) Shrier writes:

This is the phenomenon Brown University public-health researcher Lisa Littman has identified as “rapid onset gender dysphoria.” ROGD differs from traditional gender dysphoria, a psychological affliction that begins in early childhood and is characterized by a severe and persistent feeling that one was born the wrong sex. ROGD is a social contagion that comes on suddenly in adolescence, afflicting teens who’d never exhibited any confusion about their sex.

It is straightforwardly false that “traditional gender dysphoria” invariably or even predominantly “begins in early childhood”, and that gender dysphoria which “comes on suddenly in adolescence” is a recent development or a false presentation of apparent gender dysphoria. The DSM-IV-TR (2000) observes that the course of gender dysphoria across the lifetime can be highly variable, and may first appear in childhood or during adolescence and adulthood (sometimes as a continuation of childhood gender dysphoria). The latter group is not deemed any less authentic in their gender dysphoria than the former.

The DSM-5 (2013) also separates its criteria for gender dysphoria into those for children and those for adolescents and adults, as was made explicit in the ROGD study. The diagnosis makes clear the difference between “early-onset gender dysphoria” beginning in childhood and “late-onset gender dysphoria” appearing in adolescence or adulthood, and specifically notes that gender dysphoria “manifests itself differently in different age groups” and “expression of gender dysphoria varies with age”. Not only does gender dysphoria appearing in adolescence fall well within the most mainstream definitions of “traditional gender dysphoria”, but this has already been known and reported in authoritative literature for decades.

It’s entirely incorrect to claim that “ROGD” “differs” from this in any meaningful way – and this pseudodiagnosis remains insufficiently distinguished from gender dysphoria. Its existence as a new, real, and separate clinical entity continues to be wholly unsupported by evidence. If anything is for certain, it’s this: you’ll be on shaky ground claiming that there’s a new kind of gender dysphoria when you’re unclear on the nature or existence of the already recognized kinds.

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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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