“Rapid-onset gender dysphoria”

and journalistic integrity

Jesse Singal should make it clear to his readership that there isn't good scientific evidence for the existence of "ROGD" as a mental health phenomenon.

 Despite its official sounding label, “rapid-onset gender dysphoria” (ROGD) is not a formal mental health diagnosis recognized by professional associations. It is, rather, the idea that a specific phenomenon exists whereby a child or young adult rapidly develops gender dysphoria during or after puberty as the result of social influences such as exposure to social media, transgender friends, or family conflict. It is sometimes also referred to as “social contagion” of transgender identity. The Coalition for the Advancement & Application of Psychological Science (CAAPS) recently released a statement that advises against the use of this concept for clinical and diagnostic application, given the lack of rigorous empirical support for its existence.    

This caused a commotion in “gender critical” circles on social media (people who take issue with the inclusion of trans people in situations such as public bathrooms and competitive sports). Others are afraid that their children might be influenced to become transgender through exposure to trans people or positive social messages about trans people. One of the journalists who took issue with the CAAPS statement is Jesse Singal, who has previously written an Atlantic article that is based on a collection of anecdotes about “gender-questioning children and teens” who later change their minds about their desire to transition.  

Here we see Singal implying that by signing the CAAPS statement the American Psychological Association (APA) has refused to endorse the concept of “rapid-onset gender dysphoria” because they lack the courage to face down “the activists” -- rather than because of “the lack of rigorous empirical support for its existence”, as is claimed in the statement.  

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But the very idea that “rapid-onset gender dysphoria” is a specific social or mental health phenomenon is supported by little more than anecdotes, and is undermined by peer-reviewed scientific studies, such as Kennedy 2020, Sorbara et al. 2020, and Puckett et al. 2021, which indicate that young people who experience gender incongruence tend to delay disclosure for a few years after self-realization, which may give the impression to others of the “rapid onset”of a transgender identity.     

Advocates of ROGD typically rely on an article by Dr. Lisa Littman, published in the scientific journal PLOS One, in support of the existence of the phenomenon. However this article was the subject of significant controversy, and was republished with a new title, abstract, introduction, discussion and conclusion as the result of significant corrections that were recommended in a post-publication review. To simplify the matter, the corrections address errors of omission and interpretation in the original study. The republished article makes it clear that the study is a descriptive report of the observations of parents who believe their children to have experienced a rapid onset of gender dysphoria rather than a clinical validation of the existence of the phenomenon. The limited nature of the potential application of the findings of the study was not made clear enough in the original, hence the need for the substantial revisions that were made in the republished version.    

Critics of Littman’s study point out that some of the parents involved in the study were recruited via websites that are characterized as having negative attitudes towards medical or surgical interventions for transitioning. This is the context, I believe, that led researcher Nathan Oseroff-Spicer to compare Littman’s study to a now retracted anti-vax article in the Lancet by Andrew Wakefield, whose research participants were recruited from families that were involved in litigation against the manufacturers of the MMR vaccine.  

Jesse Singal, calling the comparison “insane”, pointed to the fact that Littman’s article has not actually been retracted.  

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But, as we have already seen, the article was subject to heavy corrections that walk back the idea that the study is validation of the existence of “rapid onset gender dysphoria”. Surely Jesse Singal’s readership deserve some kind of account of this specific limitation of the study? 

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But instead of addressing the shortcomings of the research paper, Singal disputed my claim that the article was subject to “heavy corrections”, as I phrased it.  

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Singal seems to have based his assessment on a correspondence he had with a Communications Manager of PLOS One, in which Singal enquired whether the corrections were based on false information. The response he got was that no false information was printed but that the corrections were made so as not to “overreach what could be concluded from this story of parental reports” because “rapid onset gender dysphoria” is not a clinically validated term. Of course, Singal could have come to this understanding by himself from the published correction,and the apology for publishing the article in its original form authored by the editor-in-chief of PLOS One.  

The truth of the matter is that the republished paper was heavily corrected, and the original paper was flawed in that it treated the parental reports as if they were evidence for the existence of “rapid onset gender dysphoria”, which it did not and could not possibly do, given the inherent limitations of its methodology. The editors at PLOS One and the author of the study have conceded as much. Isn't it time that Jesse Singal got to grips with the scientific literature, and made it clear to his readership that there isn't any good scientific evidence that supports the existence of "rapid onset gender dysphoria" as a mental health phenomenon? 


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* A previous version of this article refers to Nathan Oseroff-Spicer as a grad student. My thanks to him for his kind correction of this misconception on my part. CT Fri Aug 6 @ 4:46 PM.