The fall, and fall, and fall of “rapid-onset gender dysphoria”: New study does not find evidence of a distinct “ROGD” population of gender-diverse youth

Zinnia JonesIn proposing a new condition of “rapid-onset gender dysphoria” (ROGD), Littman (2018) describes an allegedly distinct new cohort of youth presenting to gender clinics for assessment and transition treatment. According to Littman’s telling, these youth, mostly assigned female, have begun to experience what they believe to be gender dysphoria relatively recently – a few weeks or months before seeking treatment. However, these apparent symptoms are instead a misidentification of other conditions experienced by these actually-cis youth, such as depression, eating disorders, autism, social difficulties, or nearly anything else, and this misidentification is likely the result of influence by peer groups or online resources.

Littman’s study, claiming to be about trans or gender-questioning youth, surveyed only anonymous parents from three specifically anti-trans websites, rather than youth themselves or parents and children confirmed to be engaged with gender clinics. From these unconvincing beginnings, the “ROGD” claim has only continued to fall apart: though mental and behavioral health conditions and social and emotional difficulties may be very common among youth in the general population, it is still very uncommon for youth overall to report symptoms of gender dysphoria. One of the supposedly influential online resources cited in the study as misleading cis youth into believing they’re trans was actually a post from this website about a dissociative condition experienced unusually frequently by trans people. Most pertinent to the central ROGD claim, trans people, including trans kids, are typically aware of their gender for many years before making this known to others, meaning that only surveying their parents on the timeline of their gender identity development will systematically bias the results.

When actual gender clinics survey trans kids and their parents together, we see the other half of this information that Littman left out – these youth have known they were trans for a significant portion of their lives, while their parents believed these gender-dysphoric symptoms had only emerged very recently. (I’ve set up a convenient link to resources on that study at rapidonsetgenderdysphoria.com.) Now, another study has examined a group of trans and gender-diverse kids attending a gender clinic to determine whether this includes a distinct cluster resembling the “ROGD” profile of a very recent self-realization of gender dysphoria accompanied by other serious mental health conditions or peer and online influences.

Bauer et al. (2021) reported data on 173 trans youth under 16 receiving care at 10 gender clinics across Canada from 2017 through 2019 – Littman and other proponents of the “ROGD” phenomenon have asserted that it reached its fullest flourishing during this time. These subjects were grouped by the length of time between their realization of their gender dysphoria and first seeking gender-related care, and those for whom this gap was less than two years were compared to those with a gap of two years or more. The “recent” group was not any more likely to exhibit traits that have been proposed as characteristic of ROGD:

Controlling for age and sex assigned at birth, recent gender knowledge was not significantly associated with depressive symptoms, psychological distress, past diagnoses with mental health issues or neurodevelopmental disorders, gender dysphoria symptoms, self-harm, past-year suicide attempt, having gender-supportive online friends, general support from online friends or transgender friends, or gender support from parents.

However, the “recent” group did have a significantly lower severity of anxiety and was less likely to have used cannabis. The authors ran these tests again with three years rather than two years as the threshold for the recency group, with no change in the results other than cannabis use no longer being significantly different between groups.

These findings do not reflect ROGD-related predictions that there is a discrete population attending gender clinics without genuine gender dysphoria, that this group has a higher frequency of other mental health conditions and social difficulties, or that this group has been disproportionately influenced by support and encouragement from peers and online communities. They do confirm the results of Arnoldussen et al. (2019), in which youth aged 10-18 seeking treatment at Amsterdam’s VUmc gender clinic from 2000-2016 did not tend toward having less intense gender dysphoria or greater psychological difficulties over time. The current study suggests that ROGD phenomena continue not to be observed in youth seeking this care from 2016 to present.

To be clear, I consider the ROGD debacle to be an unfortunate and unnecessary waste of everyone’s time, sparked entirely by an illusory result that emerged from a clearly unsuitable study design for the topic at hand and an apparent ignorance of much existing literature on the timelines of trans people’s gender identity development and disclosure to others. But now that it has been put out there, and others with clinical and research experience in this field have done the detailed examination of these claims that should have been performed by Littman and others in the first place, ROGD’s proponents cannot honestly assert that these questions have been given insufficient attention by mainstream gender clinics. They’ve done the work, and detection of these signals has been attempted – it is the signals that are missing. 

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About 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.
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