In recent years, the controversial "Rapid Onset Gender Dysphoria" (ROGD) theory has ignited considerable debate among academics, clinicians, and policymakers. The term "ROGD" was coined by Lisa Littman, a doctor, and researcher at the Icahn School of Medicine at Mount Sinai, to describe a phenomenon whereby people, especially adolescents, seem to experience an abrupt and profound identification with a gender other than the one that was assigned to them at birth. This essay will focus on the original paper that led to the formulation of this hypothesis and critique its shortcomings.
Gender dysphoria refers to the condition in which a person’s gender identity does not match their biological sex. While scientists are yet to discover the precise causes of gender dysphoria, research indicates that both genetic and environmental factors may be involved. Some researchers distinguish between early and late-onset gender dysphoria, i.e. gender dysphoria that persists from early childhood and that which emerges in later adolescence.
Littman proposes a third classification to describe the phenomenon of adolescents suddenly identifying with a different gender after a brief period of exploration and without a history of gender-related distress in childhood. In her study, titled "Rapid Onset Gender Dysphoria in Adolescents and Young Adults: A Study of Parental Reports", Littman attributes social media and peer pressure as potential causes for rapid onset gender dysphoria.
What is true about Littman’s observations is that in recent years there has been a sharp increase in adolescents (particularly girls) identifying as transgender. Until 2015, the vast majority of people opting for gender-affirming care were transwomen (i.e. biological males who wanted to transition to female). That being said, it is quite difficult to ascertain whether this is indicative of social contagion or improved societal attitudes towards gender non-conforming individuals. Regardless, Littman’s study faced criticism from the academic community for its faulty methodology and its potential to be misused.
Sampling Bias
The study's participants were not adolescents, but parents recruited through online forums and social media groups that were already skeptical towards gender-affirming care for children.
Parental Testimony
Psychological research does not rely on anecdotal evidence to arrive at objective, empirical conclusions. Moreover, parental testimony in itself may not reflect the opinions and perspectives of the adolescents themselves. The lack of direct input from the individuals experiencing gender dysphoria themselves raises questions about the overall findings.
Lack of Peer Review
The study was initially published in a journal but was later retracted and subjected to post-publication peer review by the university owing to concerns about methodology and framing. This raises questions about the rigor of the original peer-review process.
Ethical problems
Finally, critics argue that the study's approach of surveying parents without obtaining informed consent from the adolescents involved raised ethical concerns, as it potentially violated their privacy.
It’s not surprising to see how quickly Littman’s findings were adopted by conspiracy theorists and conservative lawmakers. The study validated their belief that young people are being influenced or pressured into identifying as transgender, despite its methodological inconsistencies. Nevertheless, Littman’s study has ignited dialogue between the academic community and LGBTQ groups. It serves as an important reminder of the need to conduct research sensitively and rigorously.
The World Professional Association for Transgender Health (WPATH) and the American Psychological Association (APA) do not recognize ROPD as a valid diagnostic category. Nor is the term listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). A recent study published in the Journal of Adolescent Health appears to refute the findings of Littman’s study.
References:
Diamond, Milton. "Transsexuality among twins: identity concordance, transition, rearing, and orientation." International Journal of Transgenderism 14.1 (2013): 24-38.
Hare, L., Bernard, P., Sánchez, F. J., Baird, P. N., Vilain, E., Kennedy, T., & Harley, V. R. (2009). Androgen receptor repeat length polymorphism associated with male-to-female transsexualism. Biological psychiatry, 65(1), 93–96. https://doi.org/10.1016/j.biopsych.2008.08.033
Littman, L. (2019). Correction: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PloS one, 14(3), e0214157.
Littman, L. (2018). Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLoS One, 13(8), e0202330.
Turban, J. L., Dolotina, B., Freitag, T. M., King, D., & Keuroghlian, A. S. (2023). Age of Realization and Disclosure of Gender Identity Among Transgender Adults. Journal of Adolescent Health, 72(6), 852-859.
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