(2018-09-18) Hall Rapid-onset Gender Dysphoria And Squelching Controversial Evidence

Harriet Hall: Rapid-onset Gender Dysphoria and Squelching Controversial Evidence. On August 16, 2018, Lisa Littman, an assistant professor at Brown University, published a study in PLOS One titled “Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports.”

The PLOS One twitter account was mobbed by transgender activists who disputed the existence of ROGD, and the journal promised to do a postpublication investigation

Previous studies had mainly dealt with children whose gender dysphoria started in childhood. There were no studies of people whose gender dysphoria appeared rapidly around the time of puberty

Only 32% had started to consciously question their gender before the age of 12

Only about half of gender dysphoric patients presented with an established transsexual identity.

They found that “In the majority of the applicants, gender dysphoria presented in the context of wider identity confusion, severe psychopathology and considerable challenges in the adolescent development.” They concluded: Adolescents seeking sex reassignment represent a variety of developmental pathways differentiated by the timing of onset of gender dysphoria, psychopathology and developmental difficulties. It is important to be aware of the different groups, or developmental pathways

Here’s how Littman described the purpose of her study: In on-line forums, parents have been reporting that their children are experiencing what is described here as “rapid-onset gender dysphoria,”

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.

Littman created a 90-item questionnaire for parents with gender-dysphoric adolescent or adult children and recruited volunteer parents from three websites where rapid onset gender dysphoria had been described

The study reported a mass of data. Some of the findings:
The children in question were predominantly natal females.
Gender dysphoria began during puberty for 49% and after puberty for 51%.
Parents felt that clinicians had not adequately evaluated the child and had failed to explore mental health, trauma, or alternative causes of gender dysphoria.
62.5% reported that the child had misrepresented information to the clinician.

Littman described two hypotheses arising from the data:
Social contagion is a key determinant of ROGD.
ROGD is a maladaptive coping mechanism.

Littman acknowledges that the study is a descriptive one designed to raise awareness of the previously unrecognized specific population of ROGD and to generate hypotheses; it was not designed to measure prevalence.

There are many things wrong with this study... The data was collected from parents who reported ROGD in their children.... Parental reports are not reliable. Parents may not know as much about their children as they think

Anecdotes are not acceptable as scientific data, but they are useful for identifying things that are worth studying scientifically. Late-onset gender dysphoria was recognized, but ROGD seemed to be a new category. She did a study that was exploratory and hypothesis-generating.

In my opinion, Brown University was wrong to remove the information about this study from their website. They gave two reasons for it. The first reason was the study’s poor methodology. There are thousands of other published studies with poor methodology, some of them with far worse methodology than this one, some of which have been eviscerated on Science-Based Medicine.

The second reason was “concerns that the conclusions of the study could be used to discredit efforts to support transgender youth”. I don’t think evidence should ever be suppressed because of fears that some people might mis-use it.

We want to try to find ways to better help each individual and to predict whose dysphoria will last.

More and more people, children and adults, are reporting gender dysphoria and seeking gender transition; and if we are to serve their best interests, we need to know more. We can only know more through well-designed studies, which this is not. It has not even been established that ROGD is a meaningful category. I await further, better-designed studies with great anticipation.