Rapid Onset Of Gender Dysphoria Research Articles

Detransition and Desistance Among Previously Trans-Identified Young Adults

Persons who have renounced a prior transgender identification, often after some degree of social and medical transition, are increasingly visible. We recruited 78 US individuals ages 18–33 years who previously identified as transgender and had stopped identifying as transgender at least six months prior. On average, participants first identified as transgender at 17.1 years of age and had done so for 5.4 years at the time of their participation. Most (83%) participants had taken several steps toward social transition and 68% had taken at least one medical step. By retrospective reports, fewer than 17% of participants met DSM-5 diagnostic criteria for Gender Dysphoria in Childhood. In contrast, 53% of participants believed that “rapid-onset gender dysphoria” applied to them. Participants reported a high rate of psychiatric diagnoses, with many of these prior to trans-identification. Most participants (N = 71, 91%) were natal females. Females (43%) were more likely than males (0%) to be exclusively homosexual. Participants reported that their psychological health had improved dramatically since detransition/desistance, with marked decreases in self-harm and gender dysphoria and marked increases in flourishing. The most common reason given for initial trans-identification was confusing mental health issues or reactions to trauma for gender dysphoria. Reasons for detransition were more likely to reflect internal changes (e.g., the participants’ own thought processes) than external pressures (e.g., pressure from family). Results suggest that, for some transgender individuals, detransition is both possible and beneficial.

Rapid-Onset Gender Dysphoria: Parent Reports on 1,655 Possible Cases

During the past decade, there has been a dramatic increase in adolescents and young adults (AYAs) complaining of gender dysphoria. One influential if controversial explanation is that the increase reflects a socially contagious syndrome among emotionally vulnerable youth: rapid-onset gender dysphoria (ROGD). We report results from a survey of parents who contacted the website ParentsofROGDKids.com because they believed their AYA children had ROGD. Results focused on parent reports on 1,655 AYA children whose gender dysphoria began between ages 11 and 21 years, inclusive. These youths were disproportionately (75%) natal female. Natal males had later onset (by 1.9 years) than females, and they were much less likely to have taken steps towards social gender transition (65.7% for females versus 28.6% for males). Pre-existing mental health issues were common, and youths with these issues were more likely than those without them to have socially and medically transitioned. Parents reported that they had often felt pressured by clinicians to affirm their AYA child’s new gender and support their transition. According to the parents, AYA children’s mental health deteriorated considerably after social transition. We discuss potential biases of survey responses from this sample and conclude that there is presently no reason to believe that reports of parents who support gender transition are more accurate than those who oppose transition. To resolve controversies regarding ROGD, it is desirable that future research include data provided by both pro-transition and anti-transition parents, as well as their gender dysphoric AYA children.

RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases

During the past decade there has been a dramatic increase in adolescents and young adults (AYA) complaining of gender dysphoria. One influential if controversial explanation is that the increase reflects a socially contagious syndrome: Rapid Onset Gender Dysphoria (ROGD). We report results from a survey of parents who contacted the website ParentsofROGDKids.com because they believed their AYA children had ROGD. Results focused on 1655 AYA children whose gender dysphoria reportedly began between ages 11 and 21 years, inclusive. These youths were disproportionately (75%) natal female. Natal males had later onset (by 1.9 years) than females, and they were much less likely to have taken steps toward social gender transition (65.7% for females versus 28.6% for males). Pre-existing mental health issues were common, and youths with these issues were more likely than those without them to have socially and medically transitioned. Parents reported that they had often felt pressured by clinicians to affirm their AYA child’s new gender and support their transition. According to the parents, AYA children’s mental health deteriorated considerably after social transition. We discuss potential biases of survey responses from this sample and conclude that there is presently no reason to believe that reports of parents who support gender transition are more accurate than those who oppose transition. To resolve controversies regarding ROGD, it is desirable that future research includes data provided by both pro- and anti-transition parents, as well as their gender dysphoric AYA children.

Age of Realization and Disclosure of Gender Identity Among Transgender Adults

PurposeThe “rapid-onset gender dysphoria” (ROGD) hypothesis theorized, based on a parent-report survey, a distinct and more transient form of gender dysphoria in which individuals purportedly come to understand themselves as transgender and/or gender diverse (TGD) suddenly during adolescence. This study evaluated components of ROGD by (1) estimating the prevalence among TGD adults of first realizing one's TGD identity after childhood (i.e., after the onset of puberty), and (2) assessing the median time between realizing one's gender identity and disclosing this to someone else. MethodsWe conducted a secondary analysis of the 2015 US Transgender Survey, a survey of 27,715 TGD adults in the United States. Participants were asked the age at which they first realized their gender identity was different than societal expectations based on their sex assigned at birth and grouped by “childhood realization” (ages ≤ 10 years) and “later realization” (ages > 10). They were also asked the age at which they first shared their gender identity with another person. ResultsOf 27,497 participants, 40.8% reported “later realization” of TGD identities. Within the “childhood realization” group, the median age of sharing one's gender identity with another person was 20. In this group, the median time between realization of one's gender identity and sharing this with another person was 14 years. DiscussionA substantial proportion of TGD adults reported realizing their gender identity was different from societal expectations based on their sex assigned at birth during adolescence or later. Several years typically elapsed between participants' TGD identity realization and sharing this with another person. The results of this study do not support the ROGD hypothesis.

3.112 Age of Realization of Gender Identity and Mental Health Outcomes Among Transgender and Gender-Diverse Adults: Evaluating The “Rapid-Onset Gender Dysphoria” Hypothesis

The rapid-onset gender dysphoria (ROGD) hypothesis theorizes a distinct form of gender dysphoria in which individuals with no history of childhood gender dysphoria come to understand themselves as transgender and/or gender-diverse (TGD) in adolescence as a result of underlying mental illness, or as a “maladaptive coping mechanism.” This study evaluated the key components of the ROGD hypothesis by: 1) estimating the prevalence of realizing one’s TGD identity after childhood; and 2) determining whether this later realization is associated with poor mental health in adulthood.

Choosing Threat, Embodying the Viral

Choosing Threat, Embodying the Viral

Irreducible Damage: The Affective Drift of Race, Gender, and Disability in Anti-Trans Rhetorics

ABSTRACT This essay examines social panic surrounding trans youth, arguing that rhetorics supporting “rapid onset gender dysphoria” (ROGD) emerge from and reinforce hegemonic scripts about race, gender, sexuality, and dis/ability. Building from Jay Dolmage’s concept of “disability drift,” I demonstrate how anti-trans activists channel other social anxieties into transphobia. Arguments about ROGD frame trans people as infinitesimally rare and as threats to all other communities, but these claims rely on the same narratives used to stigmatize mental illness, to dehumanize people of color and queer people, and to police the bodies and behavior of cisgender women. Introducing the concept of “affective drift,” I consider how ROGD rhetorics draw from ableism, racism, and heteronormativity to fuel transphobia and vise versa. In direct opposition to the logics of ROGD, then, I propose that rhetorical studies is equipped to foster connections across contrived social divides, and to enact solidarity in one another’s struggles.

Panoptical Time, Cissexism, and Heterosexism: How Discourses of Adultism Discipline Queer and Trans Youth

In this article, I apply Nancy Lesko's concept of panoptical time to a critical analysis of the interconnectedness between adultism, cissexism, and heterosexism. I explore the impacts of these interconnections on LGBTQ youth in the United States through two case examples: rapid-onset gender dysphoria and its links to the transtrender phenomenon in digital spaces, and the It Gets Better Project. I use an intersectional feminist lens to examine media and scholarly discourses that exemplify the instruments and techniques of panoptical time, as well as the mechanisms that reinforce it. The first case example draws from blog posts, YouTube videos, and scholarly literature about rapid-onset gender dysphoria and transtrenders to illustrate how disciplines that support these phenomena reflect ties between adultism, cissexism, and other systems of subordination. The second case example uses footage from the original It Gets Better video and findings from previous studies to demonstrate how this campaign relies on similar instruments of discipline to normalize heterosexism and cissexism in youth-related contexts. Finally, I discuss the implications of this analysis and explain why LGBTQ communities have a personal stake in advocating for the rights of LGBTQ youth.

The untimeliness of trans youth: The temporal construction of a gender ‘disorder’

This article explores a quasi-diagnosis, “rapid-onset gender dysphoria”, which constructs the pathologized untimeliness of trans youth. I argue that rapid-onset is a concept with multiple, shifting meanings that encompass various dimensions of temporality. I show how constructions of rapid or fast time are used to call into question the claims of trans youth and the judgment of clinicians who treat them. The discourse of rapid, hasty, and etiologically suspect gender dysphoria assumes a view of gender as essential, fixed, and asocial, and of adolescence as a developmental stage of passivity, susceptibility, and risk. The study’s treatment of its research subjects as untimely obscures their varied, emergent, and dynamic experiences, I argue, which should not be read as signs of “incorrect” gender identity, but rather as indications of gender’s material performativity.

Deferral: the sociology of young trans people’s epiphanies and coming out

This paper presents data characterizing young trans people’s experience during the period prior to coming out to parents as transgender. By analyzing data obtained directly from young trans and non-binary people it produces a sociological characterization of this period overall as the ‘Deferral’ period. The Deferral Period is further characterized as consisting of two parts; a ‘Tacit Deferral’ period, prior to epiphany as trans, and subsequent ‘Discursive Deferral’ period. The data indicate that both these deferral periods vary in length quite considerably but usually seem to be measurable in months and years. In particular these data contest the validity of concept of ‘rapid-onset gender dysphoria’ and the way young trans people are positioned by ‘passive victim’ narratives in many academic and media accounts. The analysis of the different ways young trans people construct their identities, prior to and after epiphany produces a ‘Timeline of Revelation’. The data suggest many commonalities of experience among young trans people, and well as some differences and in particular the data exemplify how, young trans and non-binary people’s own agency is key in negotiating barriers to transition.

Transgender Embodiment as an Appeal to Thought: A Psychoanalytic Critique of “Rapid Onset Gender Dysphoria”

ABSTRACT In this article, we offer a psychoanalytic reading of controversies over “rapid onset gender dysphoria” (popularly known as ROGD), defined as a sudden expression of gender dysphoria in late adolescence and young adulthood where there had not purportedly been evidence of childhood dysphoric experience. We begin by tracing the emergence of the term in relation to contemporary debates about gender, free speech, and academic freedom. Turning to the psychoanalytic concept of free association, we reframe speech as bound to the unconscious and theorize the ethical qualities of animating this linkage in relation to discussions of gender diversity and ROGD in particular. Our discussion supports theorists, clinicians, parents, teachers, and other caring adults who encounter the term to distinguish between collective anxiety and the labor of thought that involves working through feelings of coming undone in the undoing of cisgender.

Transgendering Speech: Discussion of Farley and Kennedy’s “Transgender Embodiment as an Appeal to Thought”

ABSTRACT Farley and Kennedy’s incisive and challenging essay unpacking the controversy surrounding “rapid onset gender dysphoria” (ROGD) draws upon psychoanalysis to examine the complicated interplay among freedom of speech, truth, power, privilege, and transgender rights and desire. My response frames theirs within the intersecting gaps that psychoanalysis reveals—between materiality and gender, between materiality and speech, between speech and desire—in order both to highlight how freedom of speech and transgender issues are inevitably vulnerable to collision and to guide intervention: We must insistently pry open the seemingly seamless order between biology and gender, and between gendered desire and speech. Absent such dedicated intervention, I fear, the transgender subject will be left to bear this onto-ethical burden for all of us. We need to engender—and perhaps also to transgender—robust radically inclusive “spaces between” for all gendered subjects and for the disruptive, vibrational motions of desire, its freedom of speech.

A critical commentary on ‘rapid-onset gender dysphoria’

The term ‘rapid-onset gender dysphoria’ (ROGD) was coined in 2016 to describe an alleged epidemic of youth coming out as trans ‘out of the blue’ due to social contagion and mental illness. The term reflects a deliberate attempt to weaponise scientific-sounding language to dismiss mounting empirical evidence of the benefits of transition. This article offers an introduction to the theory of ROGD and its history, presents a detailed critique of the empirical and theoretical claims associated with the theory, and highlights structural concerns with the ROGD discourse. The article argues that claims associated with ROGD, including assertions of declining mental health and degrading familial relationships following coming out, are best explained by the leading ROGD study’s recruitment of parents from transantagonistic websites against a background of growing visibility and social acceptance of trans people. ROGD theory is best understood as an attempt to circumvent existing research demonstrating the importance of gender affirmation, relying on scientific-sounding language to achieve respectability.

(De)trans visibility: moral panic in mainstream media reports on de/retransition

ABSTRACTThe current increase in the visibility of trans people in the media has been accompanied by a backlash in the form of an increased deployment of narratives of ‘sex change regret’ or ‘de/retransition.’ Through analysing mainstream media articles from 2015–2018, this paper identifies and discusses three main themes detected in discussions of de/retransition. First, the articles claim that the social and political climate has become too accepting of trans identities and, thus, any discussion of de/retransition is silenced because of ‘political correctness.’ Second, while the articles collected tend to begin with a general discussion of the phenomenon of de/retransitioning, they slide into addressing (White, cisgender) children and the need to protect them from misdiagnosis. Third, the fear about misdiagnosis of (White, cisgender) children is intensified by the focus on a recently hypothesised category of gender dysphoria – rapid-onset gender dysphoria – that suggests some children’s and adolescents’ dysphoric feelings are a result of ‘social contagion.’ Mainstream media discussions of de/retransition focus on the aforementioned themes in an attempt to question contemporary approaches to regulating access to gender-affirming medical care for trans individuals.

Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues.

This article provides an overview of five contemporary clinical and research issues pertaining to adolescents with a diagnosis of gender dysphoria: (1) increased referrals to specialized gender identity clinics; (2) alteration in the sex ratio; (3) suicidality; (4) "rapid-onset gender dysphoria" (ROGD) as a new developmental pathway; (5) and best practice clinical care for adolescents who may have ROGD.

In Support of Research Into Rapid-Onset Gender Dysphoria

In Support of Research Into Rapid-Onset Gender Dysphoria

Comment on “Outbreak: On Transgender Teens and Psychic Epidemics”

In “Outbreak: On Transgender Teens and Psychic Epidemics,” Lisa Marchiano discusses a purported social contagion called “rapid-onset gender dysphoria.” Her article ignores substantial current research on the outcomes of transition for transgender adolescents and young adults. It further portrays gender dysphoria in adolescence as a psychic epidemic rather than a legitimate medical condition, urging parents to encourage their transgender children to accept their assigned gender—an approach that has already been abandoned in the consensus standard of care because of the documented harm it causes.

Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.

Purpose In on-line forums, parents have reported that their children seemed to experience a sudden or rapid onset of gender dysphoria, appearing for the first time during puberty or even after its completion. Parents describe that the onset of gender dysphoria seemed to occur in the context of belonging to a peer group where one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same timeframe. Parents also report that their children exhibited an increase in social media/internet use prior to disclosure of a transgender identity. Recently, clinicians have reported that post-puberty presentations of gender dysphoria in natal females that appear to be rapid in onset is a phenomenon that they are seeing more and more in their clinic. Academics have raised questions about the role of social media in the development of gender dysphoria. The purpose of this study was to collect data about parents’ observations, experiences, and perspectives about their adolescent and young adult (AYA) children showing signs of an apparent sudden or rapid onset of gender dysphoria that began during or after puberty, and develop hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among this demographic group. Methods For this descriptive, exploratory study, recruitment information with a link to a 90-question survey, consisting of multiple-choice, Likert-type and open-ended questions was placed on three websites where parents had reported sudden or rapid onsets of gender dysphoria occurring in their teen or young adult children. The study’s eligibility criteria included parental response that their child had a sudden or rapid onset of gender dysphoria and parental indication that their child’s gender dysphoria began during or after puberty. To maximize the chances of finding cases meeting eligibility criteria, the three websites (4thwavenow, transgender trend, and youthtranscriticalprofessionals) were selected for targeted recruitment. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. Data were collected anonymously via SurveyMonkey. Quantitative findings are presented as frequencies, percentages, ranges, means and/or medians. Open-ended responses from two questions were targeted for qualitative analysis of themes. Results There were 256 parent-completed surveys that met study criteria. The AYA children described were predominantly natal female (82.8%) with a mean age of 16.4 years at the time of survey completion and a mean age of 15.2 when they announced a transgender-identification. Per parent report, 41% of the AYAs had expressed a non-heterosexual sexual orientation before identifying as transgender. Many (62.5%) of the AYAs had reportedly been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to the onset of their gender dysphoria (range of the number of pre-existing diagnoses 0–7). In 36.8% of the friendship groups described, parent participants indicated that the majority of the members became transgender-identified. Parents reported subjective declines in their AYAs’ mental health (47.2%) and in parent-child relationships (57.3%) since the AYA “came out” and that AYAs expressed a range of behaviors that included: expressing distrust of non-transgender people (22.7%); stopping spending time with non-transgender friends (25.0%); trying to isolate themselves from their families (49.4%), and only trusting information about gender dysphoria from transgender sources (46.6%). Most (86.7%) of the parents reported that, along with the sudden or rapid onset of gender dysphoria, their child either had an increase in their social media/internet use, belonged to a friend group in which one or multiple friends became transgender-identified during a similar timeframe, or both Conclusion This descriptive, exploratory study of parent reports provides valuable detailed information that allows for the generation of hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among AYAs. Emerging hypotheses include the possibility of a potential new subcategory of gender dysphoria (referred to as rapid-onset gender dysphoria) that has not yet been clinically validated and the possibility of social influences and maladaptive coping mechanisms. Parent-child conflict may also explain some of the findings. More research that includes data collection from AYAs, parents, clinicians and third party informants is needed to further explore the roles of social influence, maladaptive coping mechanisms, parental approaches, and family dynamics in the development and duration of gender dysphoria in adolescents and young adults.

Informed Consent for Transgendered Patients

The request of a transgendered-identified patient for psychiatric, medical, or surgical services creates ethical tensions in mental health professionals, primary care physicians, endocrinologists, and surgeons. These may be summarized as follows: Does the patient have a clear idea of the risks of the services that are being requested? Is the consent truly informed? While this question is starkly evident among cross-gender identified children contemplating puberty suppression and social gender transition and young adolescents with rapid-onset gender dysphoria, it is also relevant to young, middle-aged, and older adults requesting assistance. Many patients cannot tolerate detailed discussion of the risks. This article reviews the history of informed consent, presents the conflicts of ethical principles, and presents three categories of risk that must be appreciated before informed consent is accomplished. The risks involve biological, social, and psychological consequences. Four specific risks exist in each category. The World Professional Association for Transgender Health’s Standards of Care recommend an informed consent process, which is at odds with its recommendation of providing hormones on demand. With the knowledge of these 12 risks and benefits of treatment, it is possible to organize the informed consent process by specialty, and for the specific services requested. As it now stands, in many settings informed consent is a perfunctory process creating the risk of uninformed consent.