Rapid-onset gender dysphoria controversy

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Rapid-onset gender dysphoria (ROGD) is a controversial, scientifically unsupported hypothesis which claims that some adolescents identify as transgender and experience gender dysphoria due to peer influence and social contagion, particularly those assigned female at birth. [5] ROGD is not recognized as a valid mental health diagnosis by any major professional associations. The APA, WPATH and 60 other medical professional organizations have called for its elimination from clinical settings due to a lack of reputable scientific evidence for the concept, major methodological issues in existing research, and its stigmatization of gender-affirming care for transgender youth. [3] [4] [6] [7]

Contents

The paper initially proposing the concept was based on surveys of parents of transgender youth recruited from three anti-trans websites; [3] [4] following its publication, it was re-reviewed and a correction was issued highlighting that ROGD is not a clinically validated phenomenon. [11] Since the paper's publication, the concept has frequently been cited in legislative attempts to restrict the rights of transgender youth. [3] [4] [6]

History

According to bioethicist Florence Ashley, "Rapid-onset gender dysphoria" (or ROGD) is "a hypothesized new clinical subgroup of transgender youth, which would be characterized by coming out as transgender out of the blue in adolescence or early adulthood." Ashley states that ROGD is often associated with the work of Dr. Lisa Littman, who attempted to validate the ROGD hypothesis by publishing a study based on the reports of parents recruited from well-known, anti-trans websites. [12]

Initial surveys (2016–2018)

Lisa Littman, who had not previously studied transgender health care or gender dysphoria, noticed a few teenagers in the same friend group who started identifying as trans, and decided to survey parents. [3] The term first appeared in a July 2016 notice that was posted to a gender-critical blog asking parents to respond to a research survey if their child showed "a sudden or rapid development of gender dysphoria". [13] In total, three websites posted notices. [1] An article published in Science described the first two websites (4thWaveNow and Transgender Trend) as "gathering places for parents concerned by their children's exploration of a transgender identity", with the third, Youth TransCritical Professionals (YTCP), being closed to non-members. [1] Florence Ashley described the first as "dedicated to opposing gender-affirmative care for trans youth", and the latter two as dedicated to opposing what they call "trans ideology". [14]

The study was based on 256 responses to an online survey of parents recruited from three anti-trans websites: 4thWaveNow, Transgender Trend, and Youth TransCritical Professionals (YTCP), [3] though Littman said she encouraged wide distribution of the survey beyond these three sites. [1] The study states that participants were encouraged to distribute the study only to "individuals or communities that they thought might include eligible participants", which the study defined as parents who believed "their child had a sudden or rapid onset of gender dysphoria". [15]

An email leak in 2023 revealed Lisa Marchiano, a Pennsylvania-based psychotherapist, was the author of YTCP; Marchiano also contributes to 4thWaveNow and Transgender Trend. [16] Littman's manuscript thanked Marchiano for her "feedback on earlier versions of the manuscript" but did not disclose that she was the publisher of the YTCP. [16] In August 2016, the Alliance Defending Freedom sent an email to members warning of the "danger" of ROGD, linking to a column in the National Review . [16] [17] In October 2016, Lisa Marchiano published a blog post discussing ROGD. [16] [18] In 2017, Marchiano argued in a paper in Psychological Perspectives that "social contagion" was a component of ROGD. [16] [19] The same year, Ray Blanchard and J. Michael Bailey, whose work has been criticized for suggesting non-heterosexual transgender women transition due to sexual arousal, wrote for the website 4thWaveNow to promote the concept of "rapid-onset gender dysphoria". [20] [21] Kenneth Zucker, whose clinic was closed due to allegations of conversion practices, also referred to Littman's poster presentation on ROGD in publications in 2017 and 2018. [21]

Publication sparks debate

The study, originally titled "Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports" was initially published in PLOS One in August 2018. [22] [1] Littman's poster abstract for the study was published in February 2017, using the phrase "Rapid Onset of Gender Dysphoria" in the title. [23] Littman presented preliminary results at a 2017 conference.[ citation needed ] Littman's study reported on information the parents reported about their children's peer group dynamics, social media use, and prior mental health issues. [24] Littman speculated that rapid onset of gender dysphoria could be a social coping mechanism for other disorders, such as depression and anxiety caused by trauma. [15] Of the parents surveyed, 76.5% "believed their child was incorrect in their belief of being transgender" and over 85% said their child had increased their internet use and/or had trans friends before identifying as trans; Littman acknowledged "parent-child conflict may also explain some of the findings." [25]

The publication immediately sparked a debate. [1] The publisher of the study, PLOS One, announced two weeks after publication that it would open a post-publication review of the study's methodologies and analyses. [26] [1] [27] [28] On the same day that PLOS One announced its review, Brown University took down a press release it had earlier posted about the paper. [26] [29] Responding to critics, Brown University president Christina Paxson and Provost Richard M. Locke said they had not infringed on academic freedom, noted that the paper was still accessible online, and stated that Brown's commitment to only "publicize research that unassailably meets the highest standards of excellence" required Brown to remove the press release after PLOS One opened an investigation on the paper in question. [30] They said that "given the concerns raised about research design and methods, the most responsible course of action was to stop publicizing the work published in this particular instance. We would have done this regardless of the topic of the article." [31]

Common criticism

The paper was immediately met with criticism from health researchers and transgender activists. The main criticisms of the study were: only parents were interviewed, the websites used to recruit those parents were biased, it suggested that gender dysphoria or a transgender identity could be "socially contagious", it relied on a pathologizing framework, and it made premature diagnostic suggestions. [1] [12] [32] Another common concern was that the study had been politicized to give ammunition to those who opposed gender affirming care. [32] [33]

Post-publication review and correction (2019)

In March 2019, PLOS One completed its post-publication review, and Littman's corrected version of the paper was published on March 19, 2019. [2] In the journal's blog, PLOS One editor Joerg Heber apologized "to the trans and gender variant community" for the previous review and publication, saying "the study, including its goals, methodology, and conclusions, were not adequately framed in the published version, and that these needed to be corrected." [9] Heber noted that the hypothesized condition of ROGD had "not yet been clinically validated". [9]

In a notice of correction prefacing her updated version of the study, Littman stated:

[T]he post-publication review identified issues that needed to be addressed to ensure the article meets PLOS ONE's publication criteria. Given the nature of the issues in this case, the PLOS ONE Editors decided to republish the article, replacing the original version of record with a revised version in which the author has updated the Title, Abstract, Introduction, Discussion, and Conclusion sections, to address the concerns raised in the editorial reassessment. The Materials and methods section was updated to include new information and more detailed descriptions about recruitment sites and to remove two figures due to copyright restrictions. Other than the addition of a few missing values in Table 13, the Results section is unchanged in the updated version of the article. [10] [ undue weight? – discuss ]

Littman also noted that "Rapid-onset gender dysphoria (ROGD) is not a formal mental health diagnosis at this time." [10] [ undue weight? – discuss ] She wrote:

This study of parent observations and interpretations serves to develop the hypotheses that rapid-onset gender dysphoria is a phenomenon and that social influences, parent-child conflict, and maladaptive coping mechanisms may be contributing factors for some individuals. ... This report did not collect data from the adolescents and young adults (AYAs) or clinicians and therefore does not validate the phenomenon. [10] [ undue weight? – discuss ]

PLOS One's editor wrote that "the corrected article now provides a better context of the work, as a report of parental observations, but not a clinically validated phenomenon or a diagnostic guideline". [9] On behalf of the journal, Heber wrote: "Correcting the scientific record in this manner and in such circumstances is a sign of responsible publishing", where further scrutiny was called for to "clarify whether the conclusions presented are indeed backed up by the analysis and data of that original study". [9] Heber later stated, "At its core, the survey of the parents stands as it is... We let the original results stand." [2]

In a formal comment published by PLOS One at the conclusion of its review, academic editor and professor of social psychology Angelo Brandelli Costa wrote, "the level of evidence produced by the Dr. Littman's study cannot generate a new diagnostic criterion relative to the time of presentation of the demands of medical and social gender affirmation." [34] Costa suggested, "Several procedures still need to be adopted to generate a potential new subcategory of gender dysphoria that has not yet been clinically validated. One of these procedures is the assessment of mental health professionals trained according to the World Professional Association for Transgender Health (WPATH) and the American Psychological Association (APA) guidelines, interviewing not just the family, but the youth (longitudinally)." [34]

Reactions

Professional commentary

Following publication of the original report in PLOS One, the World Professional Association for Transgender Health (WPATH) released an official statement on the proposed clinical phenomenon "rapid-onset gender dysphoria", stating that the term is not recognized by any professional association, nor listed in the DSM or ICD lists of disorders and diseases. [7] They said in summary that "it is nothing more than an acronym created to describe a proposed clinical phenomenon that may or may not warrant further peer-reviewed scientific investigation." [7] They affirmed the need for academic freedom and scientific exploration without censorship, and that much is still unknown about the factors contributing to the development of gender identity in adolescence, and said it was "premature and inappropriate" to use "official-sounding labels" that might influence professionals or the public to reach conclusions about how or when adolescents decide to come out as transgender. [7] [35] WPATH concluded by warning against the use of any term intended to cause fear about an adolescent's possible transgender status with the goal of avoiding or deterring them from accessing the appropriate treatment, in line with the standards of care appropriate for the situation. [7] [36]

The Gender Dysphoria Affirmative Working Group (GDA) of 44 professionals in transgender health wrote an open letter to Psychology Today citing previously published criticism of the study, stating it had multiple biases and flaws in methodology, as it drew its subjects from "websites openly hostile to transgender youth" and based its conclusions on the beliefs of parents who presupposed the existence of ROGD. Noting Littman had not interviewed the teens, the GDA stated onset may only have been "rapid" from parents' point of view because teens often delay coming out. [37] [38] [14]

In 2021, the Coalition for the Advancement and Application of Psychological Science released a statement calling for the elimination of the concept of ROGD from clinical and diagnostic use, as "there are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science." The statement also states that the term "ROGD" is likely to stigmatize and cause harm to transgender people, and that misinformation surrounding ROGD is used to justify laws suppressing the rights of transgender youth. The statement was cosigned by the American Psychological Association, the American Psychiatric Association, the Society of Behavioral Medicine, and dozens of other professional and academic organizations. [6]

In 2022, the eighth edition of WPATH's Standards of Care (SOC-8)—a publication providing clinical guidance for healthcare professionals working with transgender and gender diverse individuals—criticized the study due to its methodological flaws. The study's focus on parents of transgender youth recruited from communities with skepticism towards gender affirming care presents difficulty in establishing social influence as a possible factor in development of gender dysphoria. According to the SOC-8, the study's results also have not been replicated by other researchers. [39]

In 2024, the European Academy of Paediatrics described ROGD as a controversial and polarised concept, criticised by many experts and scientific bodies. It also stated "others recognise the need to thoroughly investigate one of the few offered explanations for the recent demographic changes", citing a 2019 article by Kenneth Zucker. [40]

Academic

Several critiques of the study have been published in peer-reviewed journals. In a 2020 paper published in The Sociological Review , bioethicist Florence Ashley described the study as an attempt to circumvent existing research supporting gender-affirming care. [14] Sociologists Natacha Kennedy and Victoria Pitts-Taylor, in two separate 2020 publications in the Journal of LGBT Youth and Sexualities, described ROGD as a moral panic and argued that trans youth are often aware of their identity long before coming out to their parents. [41] [42]

Shortly after PLOS One published the corrected study, a critique of the original study's methodology appeared in Archives of Sexual Behavior . [27] The author, Arjee Restar, argued that Littman's study was fatally methodologically flawed, beginning with the choice to sample exclusively from users of three websites "known for telling parents not to believe their child is transgender", with the result that three-quarters of those surveyed had rejected their child's gender identity; 91 percent of respondents were white, 82 percent were women, and 66 percent were between the ages of 46 and 60. She wrote that the study was mostly composed of "white mothers who have strong oppositional beliefs about their children's trans identification" and that there was very little evidence that Littman's survey responses were representative of trans youth and young adults as a whole. She additionally argued "the majority of methodological and design issues stem from the use of a pathologizing framework and language of pathology to conceive, describe, and theorize the phenomenon [of ROGD] as tantamount to both an infectious disease…and a disorder". [27] [43]

In a letter to the editor, Littman responded that her methodologies were consistent with those that had been used, without controversy, in widely cited studies supporting gender identity affirmation health care. [44] [ non-primary source needed ]

The SAGE Encyclopedia of Trans Studies describes ROGD as "an anti-trans theory" that "violates principles of research methods by using a pathologizing framework and language", [45] : 39  using terminology that compares gender dysphoria and transgender identification to a contagious disease, in opposition to organizations such as WPATH, the American Psychiatric Association, and the World Health Organization who state that being trans is not a mental disorder. [45] : 39  The encyclopedia further states that bias appears to be present at every stage of the study, including its basic premise, the absence of random sampling, self-selection bias in the recruitment process, and the data collection procedure, which was described as "fundamentally flawed in a number of critical ways". [45] : 40  Additionally, the encyclopedia entry notes that, although the parents may have believed the development of their child's gender identity to have been abrupt, the data were not collected from the youths themselves, and so Littman's study cannot ascertain whether these individuals had simply chosen not to reveal their gender identity at an earlier time. [45] : 40 

According to MIT Technology Review , "while theories and rumors about something like ROGD had quietly percolated online before the paper was published, Littman's descriptive study gave legitimacy to the concept. ... The ROGD paper was not funded by anti-trans zealots. But it arrived at exactly the time people with bad intentions were looking for science to buoy their opinions." [3]

Anti-transgender activism and legislation

Multiple anti-LGBT groups and activists have used ROGD to undermine access to gender-affirming care globally despite the lack of scientific support for the concept. [46] [47] ROGD is often cited by gender-critical groups as a reason not to allow children to socially transition at school. [48] Littman serves as the president of the Institute for Comprehensive Gender Dysphoria Research (ICGDR), formed in January 2021, [49] and serves on the board of the Gender Dysphoria Alliance with Ray Blanchard. [50] [51] The ICGDR funds open-access articles that question gender-affirming care and promote ROGD. It receives programmatic support and shares personnel with the overlapping groups Genspect, the Society for Evidence-Based Gender Medicine, and the Gender Exploratory Therapy Association. [50] The Southern Poverty Law Center has described these organizations as involved in producing anti-LGBTQ+ pseudoscience and stated "many of the groups' members have made numerous misleading, false and conspiratorial claims." [50]

In 2019, representative Doug Collins of Georgia read part of the study when voicing his opposition to the US Equality Act. [25] In 2021, there were over 100 bills in the United States targeting transgender adolescents, many of which were based on the unsupported claims of ROGD. [6] In 2022, over 25 states introduced anti-trans bills which often cited ROGD. [25] In Florida, it was cited multiple times to justify banning Medicaid funding for adult transition-related healthcare. [25]

In December 2023, the Southern Poverty Law Center published an analysis of citations used in anti-LGBT expert reports, declarations, and legal complaints in 4 high-profile ongoing cases regarding gender-affirming care. They reported Littman's 2019 paper, described as "a centerpiece for anti-trans arguments in general" was tied for most cited paper and stated that despite the flaws that led to the paper's correction it "is a staple of arguments against gender-affirming care for minors[22] because if it were true, it would suggest that the bulk of youth presenting for care: (a) are dissimilar enough from prior samples that any evidence for benefits could not be applied to them, and (b) are unlikely to be really trans, and therefore will likely regret transition should they access it. The expert witnesses thus uncritically accept Littman‘s (2018) findings as established fact, and either ignore widespread criticisms of the paper (e.g., Levine, Hruz) and/or dismiss them as authoritarian “silencing” of sound science (e.g., Levine, Hruz, and Kaliebe)." [52] They had previously stated "The rise of anti-trans sentiment among anti-LGBTQ groups has fueled a cottage industry of anti-trans research that in turn is promoted by anti-LGBTQ groups, including ACPeds, which has become a go-to for expertise in anti-trans pseudoscience", listing the original study as an example, further stating "anti-LGBTQ media circulated the study widely, and ACPeds' Cretella touted the study at the 2018 Values Voter gathering (sponsored by anti-LGBTQ hate group Family Research Council)." [53]

The Human Rights Campaign stated "anti-LGBTQ+ activists often use concerns about internet safety in order to spread harmful rumors about the LGBTQ+ community. You may see opponents of trans people specifically use junk science by Lisa Littman at Brown University to falsely claim that access to social media and the internet has created a 'contagion' that causes many youth to mistakenly identify as transgender." [54]

Gillian Branstetter, a communications strategist at the American Civil Liberties Union said the paper "laundered what had previously been the rantings of online conspiracy theorists and gave it the resemblance of serious scientific study" and "It is astonishing that such a blatantly bad-faith effort has been taken so seriously". [3] Littman rejected the characterization, describing it as a "very good-faith attempt" to "find out what's going on" and adding, "As a person I am liberal; I'm pro-LGBT. I saw a phenomenon with my own eyes and I investigated, found that it was different than what was in the scientific literature." Littman has also stated that her paper "does not apply to all cases of gender dysphoria" and "doesn't imply that nobody benefits from transition". Littman stood by the core claims she made in her study, including its conclusion that more research needs to be conducted. [3]

Scholars writing in The Conversation and journalists in Slate columns have condemned what they saw as politicization of science by social conservatives. [33] [55] Madeleine Kearns, a contributing writer at National Review , called for further study into the proposed phenomenon. [56] Writer and transgender advocate Liz Duck-Chong described the hypothesized condition as "a poisonous lie used to discredit trans people" in an op-ed published in The Guardian , [57] while Abigail Shrier, who later published the controversial book Irreversible Damage about the concept, called it an explanation for the experiences of parents in an op-ed published in The Wall Street Journal . [24] [58] [59] [60]

In a Psychology Today opinion piece, Rutgers University psychology professor Lee Jussim described the PLOS -requested rewrite of the paper as an "Orwellian correction" involving additions and minor changes where no errors had existed. [61] Jeffrey Flier, a former dean of Harvard Medical School, called Brown University's failure to defend Littman "an indictment of the integrity of their academic and administrative leadership", and described Brown's explanation of the retraction as "anti-intellectual" and "completely antithetical to academic freedom". [1]

Conservative media outlets such as Fox News, The Daily Caller, The Federalist, Breitbart, and Quillette heavily publicized the article and criticized Brown recalling its initial press release concerning the paper. Conservative outlets cite the paper to claim that transgender identity is a "trend, phase, or disease". [62] [63] [64]

Further research

Some clinicians state that an increasing prevalence of trans youth first presenting in early adolescence, as described in Littman's research, is consistent with their patient population, though they are uncertain as to causes or implications for clinical treatment. [65] [66] [67] In a 2020 commentary in Pediatrics , citing Littman's paper among others, Annelou de Vries wrote that gender identity development was diverse and called for more research into this demographic cohort. [68]

A November 2021 study by Bauer et al. published in the Journal of Pediatrics examined data on a cohort of 173 trans adolescents from Canada to assess whether there was evidence for a rapid-onset pathway for gender dysphoria. The authors noted that while it was common to see adolescents presenting with gender dysphoria around puberty, in many cases patients had been aware of gender dysphoria from a younger age. The authors sought to establish whether there was any link between later awareness of gender ("rapid onset") and other factors including mental health problems, lack of parental support, and high level of support from online and/or transgender friends. [69] No evidence was found for any link between "rapid onset" and mental health problems, lack of parental support, or high level of support from online or transgender friends. Where relationships were found, they were in the opposite direction to that suggested by Littman's work. For instance, trans adolescents who had been dissatisfied with their gender for longer were more likely to suffer anxiety and more likely to misuse marijuana. The authors considered that they found no evidence of "rapid onset gender dysphoria" being a distinct clinical phenomenon. [69]

Littman critiqued Bauer et al., saying that Bauer had used an incorrect definition of 'ROGD', by relating it to having a short history of gender incongruence, whereas it actually refers to not having gender incongruence before puberty. [70] [71]

Ferrara et al. noted the controversy that rose around the possibility of a rapid-onset of gender dysphoria condition and the position of major medical associations not to recognize ROGD and to discourage its use, due to a lack of consistent scientific evidence for the concept. [72] They also cited the Bauer finding of no support for ROGD being a distinct phenomenon, [69] and concluded that the issue is still open, citing Sinai [73] and the Littman response to Bauer. [70]

Arnoldussen et al. suggested that there may be different gender identity developmental pathways and described ROGD as one subtype that has been proposed, but their data did not allow a conclusion as to whether or not the ROGD subtype exists, though they noted "our results show that there was gender nonconformity in childhood in older presenters, although less extreme than in the younger presenting group, which speaks against this suggested subtype". They noted the Bauer finding [69] as well as the Littman response to it, [70] and concluded that better insight into this question would require more studies using both self and parent report measures. [71]

An August 2022 study published in Pediatrics investigated claims of trans identities as "social contagion" for youth assigned female at birth (AFAB) by analyzing the ratio of assigned male at birth (AMAB) youth to AFAB trans youth in the US in 2017 and 2019 by using the Youth Risk Behavior Survey from these years. The study found that AMAB trans youth were more common than AFAB youth in both years, that the number of total trans youth declined between 2017 and 2019, and that there was a relative increase in AFAB youth over time—but this was due more to a decrease in AMAB youth than an increase in AFAB youth. It also found trans youth were more likely to be bullied than cisgender lesbian, gay, and bisexual (LGB) youth and a substantial percentage of trans youth identified as LGB as well. This lack of increase in AFAB youth was interpreted as inconsistent with the social contagion hypothesis. The higher rates of bullying for trans youth compared to cisgender LGB youth and substantial percentage of transgender youth who also identified as LGB were also interpreted as evidence against the hypothesis that youth are transitioning to avoid stigma related to being a sexual minority. [74]

In 2023, Springer retracted a paper by Diaz and Bailey on the rapid onset gender dysphoria (ROGD) hypothesis "due to concerns about lack of informed consent", which had been published in the Archives of Sexual Behavior . [75] [76] This followed an open letter signed by a number of researchers and LGBTQ organizations criticizing the journal's publication of the paper, stating that Bailey's paper did not have institutional review board (IRB) approval, and requested the journal's editor Kenneth Zucker be replaced. [77] Critics also argued that the paper disregarded countervailing evidence and used a biased method of gathering study participants. [75]

In July 2024, a paper examining the ROGD hypothesis noted the limitations of Littman's original study, and called for further research. The paper described the rise in clinical presentations of gender dysphoria in female adolescents as a "paradigm shift". The paper stated that ROGD may provide a "convenient pathogenic explanatory model" for those opposed to adolescent transition, but argued for further research into ROGD, concluding "neither prematurely adopting ROGD as a valid explanatory model nor its hasty condemnation as transphobic is an appropriate response". [78]

See also

Related Research Articles

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder. The International Classification of Diseases uses the term gender incongruence instead of gender dysphoria, defined as a marked and persistent mismatch between gender identity and assigned gender, regardless of distress or impairment.

The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity and gender dysphoria, and creating standardized treatment for transgender and gender variant people. WPATH was founded in 1979 and named HBIGDA in honor of Harry Benjamin during a period where there was no clinical consensus on how and when to provide gender-affirming care.

The Standards of Care for the Health of Transgender and Gender Diverse People (SOC) is an international clinical protocol by the World Professional Association for Transgender Health (WPATH) outlining the recommended assessment and treatment for transgender and gender-diverse individuals across the lifespan including social, hormonal, or surgical transition. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.

<span class="mw-page-title-main">Ray Blanchard</span> American-Canadian sexologist (born 1945)

Ray Milton Blanchard III is an American-Canadian sexologist who researches pedophilia, sexual orientation and gender identity. He has found that men with more older brothers are more likely to be gay than men with fewer older brothers, a phenomenon he attributes to the reaction of the mother's immune system to male fetuses. Blanchard has also published research studies on phallometry and several paraphilias, including autoerotic asphyxia. Blanchard also proposed a typology of transsexualism.

Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for distress caused by incongruence between assigned sex and gender identity in some pre-pubescent transgender and gender diverse children.

The American-Canadian sexologist Ray Blanchard proposed a psychological typology of gender dysphoria, transsexualism, and fetishistic transvestism in a series of academic papers through the 1980s and 1990s. Building on the work of earlier researchers, including his colleague Kurt Freund, Blanchard categorized trans women into two groups: homosexual transsexuals who are attracted exclusively to men and are feminine in both behavior and appearance; and autogynephilic transsexuals who experience sexual arousal at the idea of having a female body. Blanchard and his supporters argue that the typology explains differences between the two groups in childhood gender nonconformity, sexual orientation, history of sexual fetishism, and age of transition.

<i>PLOS One</i> Peer-reviewed open-access scientific journal

PLOS One is a peer-reviewed open access mega journal published by the Public Library of Science (PLOS) since 2006. The journal covers primary research from any discipline within science and medicine. The Public Library of Science began in 2000 with an online petition initiative by Nobel Prize winner Harold Varmus, formerly director of the National Institutes of Health and at that time director of Memorial Sloan–Kettering Cancer Center; Patrick O. Brown, a biochemist at Stanford University; and Michael Eisen, a computational biologist at the University of California, Berkeley, and the Lawrence Berkeley National Laboratory.

Kenneth J. Zucker is an American-Canadian psychologist and sexologist known for the living in your own skin model, a form of conversion therapy aimed at preventing pre-pubertal children from growing up transgender by modifying their gender identity and expression.

<span class="mw-page-title-main">Transgender youth</span> Children and adolescents who are transgender

Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they face different challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.

Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. Puberty blockers are used to delay puberty in children with precocious puberty. Since the 1990s, they are also used to delay the development of unwanted secondary sex characteristics in transgender children, so as to allow transgender youth more time to explore their gender identity under what became known as the "Dutch Protocol". They have been shown to reduce depression and suicidality in transgender and nonbinary youth. The same drugs are also used in fertility medicine and to treat some hormone-sensitive cancers in adults.

Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:

Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world. Gender affirming health care can include psychological, medical, physical, and social behavioral care. The purpose of gender affirming care is to help a transgender individual conform to their desired gender identity.

Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social or economic pressure, discrimination, stigma, political beliefs, or religious beliefs.

<i>Irreversible Damage</i> 2020 book by Abigail Shrier

Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, published by Regnery Publishing, which endorses the controversial concept of rapid-onset gender dysphoria (ROGD). ROGD is not recognized as a medical diagnosis by any major professional institution nor is it backed by credible scientific evidence.

<span class="mw-page-title-main">Autism and LGBTQ identities</span>

Current research indicates that autistic people have higher rates of LGBTQ identities and feelings than the general population. A variety of explanations for this have been proposed, such as prenatal hormonal exposure, which has been linked with sexual orientation, gender dysphoria and autism. Alternatively, autistic people may be less reliant on social norms and thus are more open about their orientation or gender identity. A narrative review published in 2016 stated that while various hypotheses have been proposed for an association between autism and gender dysphoria, they lack strong evidence.

<span class="mw-page-title-main">Transgender Trend</span> British pressure group

Transgender Trend is an anti-trans British pressure group, which describes itself as a group of parents, professionals and academics who are concerned about the number of children diagnosed with gender dysphoria. It was founded in 2015 by Stephanie Davies-Arai.

<span class="mw-page-title-main">Genspect</span> Organization opposing transgender rights

Genspect is an international group founded in June 2021 by psychotherapist Stella O'Malley that has been described as gender-critical. Genspect opposes gender-affirming care, as well as social and medical transition for transgender people. Genspect opposes allowing transgender people under 25 years old to transition, and opposes laws that would ban conversion therapy on the basis of gender identity. Genspect also endorses the unproven concept of rapid-onset gender dysphoria (ROGD), which proposes a subclass of gender dysphoria caused by peer influence and social contagion. ROGD has been rejected by major medical organisations due to its lack of evidence and likelihood to cause harm by stigmatizing gender-affirming care.

<span class="mw-page-title-main">Society for Evidence-Based Gender Medicine</span> Group opposing gender-affirming care

The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. The group routinely cites the unproven concept of rapid-onset gender dysphoria and mistakenly claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. SEGM is often cited in anti-transgender legislation and court cases, sometimes filing court briefs.

<span class="mw-page-title-main">Abigail Shrier</span> American freelance journalist and author

Abigail Shrier is an American author and former opinion columnist for the Wall Street Journal.

False and misleading claims about gender diversity, gender dysphoria, and gender-affirming healthcare have been used to deny healthcare to trans people. These include claims that most pre-pubertal transgender children "desist" and cease desiring transition after puberty, that most people who transition regret it, that gender dysphoria can be socially contagious, and that gender dysphoria is caused by mental illness, among others.

References

  1. 1 2 3 4 5 6 7 8 9 Wadman, Meredith (September 7, 2018). "'Rapid onset' of transgender identity ignites storm" . Science . 361 (6406): 958–959. Bibcode:2018Sci...361..958W. doi:10.1126/science.361.6406.958. ISSN   0036-8075. PMID   30190384. S2CID   52169673 – via TWL. See also Wadman, Meredith (August 30, 2018). "News: New paper ignites storm over whether teens experience 'rapid onset' of transgender identity". Science . doi:10.1126/science.aav2613. ISSN   1095-9203. Archived from the original on August 31, 2018.
  2. 1 2 3 Bartlett, Tom (March 19, 2019). "Journal Issues Revised Version of Controversial Paper That Questioned Why Some Teens Identify as Transgender". The Chronicle of Higher Education. ISSN   0009-5982. Archived from the original on December 21, 2020. Retrieved March 19, 2019.
  3. 1 2 3 4 5 6 7 8 9 10 Kesslen, Ben (August 18, 2022). "How the idea of a "transgender contagion" went viral—and caused untold harm". MIT Technology Review . Archived from the original on August 31, 2022. Retrieved September 4, 2022.
  4. 1 2 3 4 5 Broderick, Timmy (August 24, 2023). "Evidence Undermines 'Rapid Onset Gender Dysphoria' Claims". Scientific American. Retrieved 2024-02-13.
  5. ↑ Multiple sources.
    • For the controversy, see Wadman (2018) [1] and Bartlett (2019). [2]
    • For the lack of scientific evidence, see Kesslen (2022) [3] and Broderick (2023). [4]
  6. 1 2 3 4 "ROGD Statement". Coalition for the Advancement & Application of Psychological Science. 26 July 2021. Retrieved August 4, 2021.
  7. 1 2 3 4 5 WPATH Global Board of Directors (September 4, 2018). "WPATH Position on "Rapid-Onset Gender Dysphoria (ROGD)"" (PDF). World Professional Association for Transgender Health . Retrieved May 30, 2019.
  8. ↑ Knutson, David (16 September 2016). "PLOS appoints Dr. Joerg Heber Editor-in-Chief of PLOS ONE | The Official PLOS Blog" . Retrieved 13 March 2024.
  9. 1 2 3 4 5 Heber, Joerg (March 19, 2019). "Correcting the scientific record on gender incongruence – and an apology". PLOS Blogs. Archived from the original on August 8, 2020.
  10. 1 2 3 4 Littman, Lisa (March 19, 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. Bibcode:2019PLoSO..1414157L. doi: 10.1371/journal.pone.0214157 . PMC   6424391 . PMID   30889220.
  11. ↑ Not a clinically validated phenomenon:
    • From the MIT Technology Review: "PLOS One reissued the study with a large correction emphasizing that Littman's paper was simply a 'descriptive, exploratory' one and had not been clinically validated." [3]
    • From Scientific American: "The American Psychological Association and 61 other health care providers’ organizations signed a letter in 2021 denouncing the validity of rapid-onset gender dysphoria (ROGD) as a clinical diagnosis." [4]
    • Joerg Heber, speaking in 2019 as editor-in-chief of PLOS One, [8] which published Littman's article and the correction, wrote the following, in an apology published at PLOS One: "In our view, the corrected article now provides a better context of the work, as a report of parental observations, but not a clinically validated phenomenon or a diagnostic guideline." [9]
    • In a correction of the original article published in PLOS One in 2019, author Lisa Littman stated: "Rapid-onset gender dysphoria (ROGD) is not a formal mental health diagnosis at this time. This report did not collect data from the adolescents and young adults (AYAs) or clinicians and therefore does not validate the phenomenon." [10]
  12. 1 2 Ashley, Florence (December 3, 2018). "There Is No Evidence That Rapid-Onset Gender Dysphoria Exists". PsychCentral. Archived from the original on July 19, 2019. Retrieved May 30, 2019.
  13. ↑ Andersson, Jasmine (June 12, 2020). "Rapid onset gender dysphoria: what we know about the term amid JK Rowling trans row". i news . Archived from the original on July 5, 2020. Retrieved January 9, 2022.
  14. 1 2 3 Ashley, Florence (July 2020). "A critical commentary on 'rapid-onset gender dysphoria'". The Sociological Review . 68 (4): 779–799. doi:10.1177/0038026120934693. ISSN   0038-0261. S2CID   221097476.
  15. 1 2 Littman, Lisa (August 16, 2018). "Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria". PLOS ONE . 13 (8) (March 19, 2019 corrected ed.): e0202330. Bibcode:2018PLoSO..1302330L. doi: 10.1371/journal.pone.0202330 . PMC   6095578 . PMID   30114286. (Erratum:  doi:10.1371/journal.pone.0214157, PMID   30889220,  Retraction Watch . If the erratum has been checked and does not affect the cited material, please replace {{ erratum |...}} with {{ erratum |...|checked=yes}}.)
  16. 1 2 3 4 5 "Foundations of the Contemporary Anti-LGBTQ+ Pseudoscience Network". Southern Poverty Law Center. December 12, 2023. Retrieved 2023-12-28.
  17. ↑ Arnold, James (24 August 2016). "The Weekly Digest: 8-24-16". Archived from the original on 9 December 2016. Retrieved 29 December 2023.
  18. ↑ Marchiano, Lisa (27 October 2016). "Guidance for Parents of Teens with Rapid Onset Gender Dysphoria". The Jung Soul. Archived from the original on 6 November 2017. Retrieved 29 December 2023.
  19. ↑ Marchiano, Lisa (2017-07-03). "Outbreak: On Transgender Teens and Psychic Epidemics". Psychological Perspectives. 60 (3): 345–366. doi: 10.1080/00332925.2017.1350804 . ISSN   0033-2925.
  20. ↑ Bailey, J. Michael; Blanchard, Ray (7 December 2017). "Gender Dysphoria is Not One Thing". 4thWaveNow. Retrieved 10 November 2022.
  21. 1 2 Ashley, Florence (10 August 2020). "A critical commentary on 'rapid-onset gender dysphoria'". The Sociological Review . 68 (4): 779–799. doi:10.1177/0038026120934693. S2CID   221097476.
  22. ↑ Littman, Lisa (August 16, 2018). "Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports". PLOS ONE . doi: 10.1371/journal.pone.0214157.s001 .
  23. ↑ Littman, L. L. (February 2017). "Rapid Onset of Gender Dysphoria in Adolescents and Young Adults: a Descriptive Study". Journal of Adolescent Health . 60 (2): S95–S96. doi:10.1016/j.jadohealth.2016.10.369. Supplement 1.
  24. 1 2 Melchior, Jillian Kay (September 9, 2018). "Peer Pressure and 'Transgender' Teens". The Wall Street Journal . ISSN   0099-9660. Archived from the original on September 25, 2018.
  25. 1 2 3 4 Kesslen, Ben (August 18, 2022). "How the idea of a "transgender contagion" went viral—and caused untold harm". MIT Technology Review. Retrieved 2022-09-04.
  26. 1 2 "Reader outcry prompts Brown to retract press release on trans teens". Retraction Watch . August 29, 2018. Archived from the original on March 4, 2023. Retrieved August 30, 2018.
  27. 1 2 3 Restar, Arjee Javellana (April 22, 2019). "Methodological Critique of Littman's (2018) Parental-Respondents Accounts of 'Rapid-Onset Gender Dysphoria'". Archives of Sexual Behavior . 49 (1): 61–66. doi:10.1007/s10508-019-1453-2. PMC   7012957 . PMID   31011991.
  28. ↑ "Updated: Brown statements on gender dysphoria study". August 22, 2018. Archived from the original on April 5, 2019. Retrieved March 21, 2019.
  29. ↑ Rudgard, Olivia (August 28, 2018). "Brown University in row with transgender activists over claims gender dysphoria spreading among children". The Telegraph . London. ISSN   0307-1235. Archived from the original on August 29, 2018.
  30. ↑ Paxson, Christina (September 9, 2018). "Paxson '19, Locke '18: University committed to academic freedom, faculty support". The Brown Daily Herald . Brown University. Archived from the original on September 29, 2018.
  31. ↑ "Updated: Brown statements on gender dysphoria study". Expanded Brown University Statement – Tuesday, Sept. 5, 2018. News from Brown (Press release) (March 19, 2019 ed.). Providence, R.I.: Brown University. September 5, 2018. Archived from the original on March 27, 2019.
  32. 1 2 Call, David C.; Challa, Mamatha; Telingator, Cynthia J. (2021-04-13). "Providing Affirmative Care to Transgender and Gender Diverse Youth: Disparities, Interventions, and Outcomes". Current Psychiatry Reports. 23 (6): 33. doi:10.1007/s11920-021-01245-9. ISSN   1535-1645. PMID   33851310. S2CID   233224949.
  33. 1 2 "Why 'rapid-onset gender dysphoria' is bad science". The Conversation . 22 March 2018. Archived from the original on April 10, 2018.
  34. 1 2 Costa, Angelo Brandelli (March 19, 2019). "Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria". PLOS ONE . 14 (3): e0212578. Bibcode:2019PLoSO..1412578B. doi: 10.1371/journal.pone.0212578 . PMC   6424477 . PMID   30889187.
  35. ↑ Literski, Nicholas S. (July 3, 2021). "Defacing Dionysus: The Fabrication of an Anti-Transgender Myth". Psychological Perspectives. 64 (3): 360–368. doi:10.1080/00332925.2021.1996137. ISSN   0033-2925. S2CID   247295519.
  36. ↑ Farley, Lisa; Kennedy, R. M. (July 2, 2020). "Transgender Embodiment as an Appeal to Thought: A Psychoanalytic Critique of "Rapid Onset Gender Dysphoria"". Studies in Gender and Sexuality. 21 (3): 155–172. doi:10.1080/15240657.2020.1798184. ISSN   1524-0657. S2CID   225077992.
  37. ↑ Adams, Noah; Almås, Elsa; Anderson, Erica E.; The Gender Dysphoria Affirmative Working Group; et al. (December 1, 2018). "Psychology Today Response — Gender Dysphoria Affirmative Working Group". GDA. Retrieved June 3, 2019.
  38. ↑ Dubreuil, Émilie (May 13, 2019). "Je pensais que j'étais transgenre" [I thought I was transgender]. ICI Radio-Canada (in French). Retrieved December 24, 2021.
  39. ↑ Coleman, E.; Radix, A. E.; Bouman, W. P.; Brown, G. R.; de Vries, A. L. C.; et al. (August 19, 2022). "Standards of Care for the Health of Transgender and Gender Diverse People, Version 8". International Journal of Transgender Health . 23 (sup1): S1–S259. doi:10.1080/26895269.2022.2100644. ISSN   2689-5269. PMC   9481143 . PMID   36121402. One researcher attempted to study and describe a specific form of later-presenting gender diversity experience (Littman, 2018). However, the findings of the study must be considered within the context of significant methodological challenges, including 1) the study surveyed parents and not youth perspectives; and 2) recruitment included parents from community settings in which treatments for gender dysphoria are viewed with scepticism and are criticized. However, these findings have not been replicated. For a select subgroup of young people, susceptibility to social influence impacting gender may be an important differential to consider (Kornienko et al., 2016). However, caution must be taken to avoid assuming these phenomena occur prematurely in an individual adolescent while relying on information from datasets that may have been ascertained with potential sampling bias (Bauer et al., 2022; WPATH, 2018).
  40. ↑ Brierley, Joe; Larcher, Vic; Hadjipanayis, Adamos A.; Grossman, Zachi (2024-02-05). "European Academy of Paediatrics statement on the clinical management of children and adolescents with gender dysphoria". Frontiers in Pediatrics. 12. doi: 10.3389/fped.2024.1298884 . ISSN   2296-2360. PMC   10875134 . PMID   38374879.
  41. ↑ Kennedy, Natacha (September 10, 2020). "Deferral: the sociology of young trans people's epiphanies and coming out" (PDF). Journal of LGBT Youth . 19: 53–75. doi:10.1080/19361653.2020.1816244. S2CID   225241518.
  42. ↑ Pitts-Taylor, Victoria (November 17, 2020). "The untimeliness of trans youth: The temporal construction of a gender 'disorder'". Sexualities . 25 (5–6): 479–501. doi:10.1177/1363460720973895. S2CID   228846045.
  43. ↑ Lockmiller, Catherine (October 2, 2023). "Decoding the Misinformation-Legislation Pipeline: an analysis of Florida Medicaid and the current state of transgender healthcare". Journal of the Medical Library Association. 111 (4): 750–761. doi:10.5195/jmla.2023.1724. ISSN   1536-5050. PMC   10621716 . PMID   37928129.
  44. ↑ Littman, Lisa (January 2020). "The Use of Methodologies in Littman (2018) Is Consistent with the Use of Methodologies in Other Studies Contributing to the Field of Gender Dysphoria Research: Response to Restar (2019)". Archives of Sexual Behavior (Letter to the Editor). 49 (1): 67–77. doi:10.1007/s10508-020-01631-z. PMID   31953699. S2CID   210708422 . Retrieved December 11, 2020.
  45. 1 2 3 4 Rider, G. Nic; Tebbe, Elliot A. (2021). "Anti-Trans Theories". In Goldberg, A. E.; Beemyn, G. (eds.). The SAGE Encyclopedia of Trans Studies, Volume 1. Thousand Oaks, Calif.: SAGE Publications. pp. 39–43. doi:10.4135/9781544393858.n12. ISBN   978-1-5443-9382-7. S2CID   241937306.
  46. ↑ Caraballo, Alejandra (2022). "The Anti-Transgender Medical Expert Industry". Journal of Law, Medicine & Ethics. 50 (4): 687–692. doi:10.1017/jme.2023.9. ISSN   1073-1105. PMID   36883410.
  47. ↑ Crosse, Leonie (2023-09-01). "Respecting the free will, authenticity and autonomy of transgender youth". Nursing Ethics. 31 (2–3): 331–341. doi:10.1177/09697330231180743. ISSN   0969-7330. PMID   37654245. S2CID   261431214.
  48. ↑ Amery, Fran (2023-12-11). "Protecting Children in 'Gender Critical' Rhetoric and Strategy: Regulating Childhood for Cisgender Outcomes". DiGeSt - Journal of Diversity and Gender Studies. 10 (2). doi: 10.21825/digest.85309 . ISSN   2593-0281.
  49. ↑ "Timeline: Building a Pseudoscience Network". Southern Poverty Law Center . December 12, 2023. Retrieved 2023-12-21.
  50. 1 2 3 "Group dynamics and division of labor within the anti-LGBTQ+ pseudoscience network". Southern Poverty Law Center . December 12, 2023. Retrieved 2023-12-21.
  51. ↑ McCall, Becky (November 4, 2021). "Transgender Detransitioners Got Poor Care When Transitioning" . Retrieved 2024-02-08.
  52. ↑ "Manufacturing the doubt that fuels the network". Southern Poverty Law Center . December 12, 2023. Retrieved 2023-12-21.
  53. ↑ "American College of Pediatricians". Southern Poverty Law Center . Archived from the original on September 4, 2018. Retrieved October 9, 2022.
  54. ↑ "How Online Communities and Resources Help LGBTQ+ Youth Live Authentically". Human Rights Campaign . Archived from the original on October 21, 2021. Retrieved October 19, 2022.
  55. ↑ "Criticism Is Not Censorship". Slate . August 30, 2018. Archived from the original on November 1, 2018.
  56. ↑ Kearns, Madeleine (January 19, 2019). "Rapid Onset Gender Dysphoria Should Be Investigated, Not Smeared". National Review . Archived from the original on January 19, 2019.
  57. ↑ "Rapid-onset gender dysphoria' is a poisonous lie used to discredit trans people". The Guardian . London. October 22, 2018. Archived from the original on November 1, 2018.
  58. ↑ Valens, Ana (November 13, 2020). "Bari Weiss Defends Transphobic Book Pulled From Target". The Daily Dot. Archived from the original on December 3, 2020.
  59. ↑ Turner, Janice (December 30, 2020). "Irreversible Damage by Abigail Shrier review — resisting the 'transgender craze'" . The Times . Archived from the original on December 30, 2020. Retrieved August 4, 2021.
  60. ↑ Shrier, Abigail. "When Your Daughter Defies Biology". The Wall Street Journal . ISSN   0099-9660. Archived from the original on March 30, 2019.
  61. ↑ Jussim, Lee (March 20, 2019). "Rapid Onset Gender Dysphoria: A saga of outrage and science reform". Psychology Today . Archived from the original on March 30, 2019.
  62. ↑ Ford, Zack (Aug 31, 2018). "People noticed that anti-trans junk science is, in fact, junk. Conservatives aren't taking it well". Think Progress. Retrieved October 10, 2022.
  63. ↑ Burns, Katelyn (December 27, 2019). "The internet made trans people visible. It also left them more vulnerable". Vox . Archived from the original on December 27, 2019. Retrieved October 10, 2022.
  64. ↑ Keating, Shannon (April 22, 2019). "Gender Dysphoria Isn't A "Social Contagion," According To A New Study". BuzzFeed News . Retrieved October 10, 2022.
  65. ↑ Hutchinson, Anna; Midgen, Melissa; Spiliadis, Anastassis (January 1, 2020). "In Support of Research Into Rapid-Onset Gender Dysphoria". Archives of Sexual Behavior (Letter to the Editor). 49 (1): 79–80. doi:10.1007/s10508-019-01517-9. ISSN   1573-2800. PMID   31317286. S2CID   197541624.
  66. ↑ Giovanardi, Guido; Fortunato, Alexandro; Mirabella, Marta; Speranza, Anna Maria; Lingiardi, Vittorio (December 19, 2020). "Gender Diverse Children and Adolescents in Italy: A Qualitative Study on Specialized Centers' Model of Care and Network". International Journal of Environmental Research and Public Health. 17 (24): 9536. doi: 10.3390/ijerph17249536 . ISSN   1660-4601. PMC   7766564 . PMID   33352745. With regards to the referrals, in line with international trends [9–12], Italian's population of trans* youths seem to be growing, particularly with respect to AFABs. Some respondents depicted referrals with traits of the so-called 'rapid onset' [15] of gender incongruence, especially when describing AFABs, with pressing requests to start soon hormone therapies and an (apparent) lack of history of gender incongruence. However, this is a very complex phenomenon that needs further exploration.
  67. ↑ Zucker, Kenneth J. (October 2019). "Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues". Archives of Sexual Behavior . 48 (7): 1983–1992. doi:10.1007/s10508-019-01518-8. ISSN   0004-0002. PMID   31321594. S2CID   197663705.
  68. ↑ de Vries, Annelou L. C. (October 2020). "Challenges in Timing Puberty Suppression for Gender-Nonconforming Adolescents". Pediatrics . 146 (4): e2020010611. doi: 10.1542/peds.2020-010611 . ISSN   0031-4005. PMID   32958612.
  69. 1 2 3 4 Bauer, Greta R.; Lawson, Margaret L.; Metzger, Daniel L. (November 15, 2021). "Do Clinical Data From Transgender Adolescents Support the Phenomenon of "Rapid-Onset Gender Dysphoria"?". The Journal of Pediatrics . 243: 224–227.e2. doi: 10.1016/j.jpeds.2021.11.020 . ISSN   0022-3476. PMID   34793826. S2CID   244283360.
  70. 1 2 3 Littman, Lisa (2022). "Saying that Bauer et al studied rapid onset gender dysphoria is inaccurate and misleading". The Journal of Pediatrics . 245: 250. doi:10.1016/j.jpeds.2022.03.003. PMID   35276124. S2CID   247343540.
  71. 1 2 Arnoldussen, Marijn; de Rooy, Frédérique B. B.; de Vries, Annelou L. C.; van der Miesen, Anna I. R.; Popma, Arne; Steensma, Thomas D. (2023). "Demographics and gender-related measures in younger and older adolescents presenting to a gender service". European Child & Adolescent Psychiatry. 32 (12): 2537–2546. doi:10.1007/s00787-022-02082-8. ISSN   1018-8827. PMC   10682114 . PMID   36370316.
  72. ↑ Ferrara, Pietro; Ruiz, Roberta; Corsello, Giovanni; Giardino, Ida; Carrasco-Sanz, Angel; Vural, Mehmet; Namazova-Baranova, Leyla; Indrio, Flavia; Pop, Tudor Lucian; Pettoello-Mantovani, Massimo (2022). "Adequate Training and Multidisciplinary Support May Assist Pediatricians in Properly Handling and Managing Gender Incongruence and Dysphoria". The Journal of Pediatrics . 249: 121–123.e2. doi:10.1016/j.jpeds.2022.07.009. PMID   35853484. S2CID   250629468.
  73. ↑ Sinai, Joanne (2022). "Rapid onset gender dysphoria as a distinct clinical phenomenon". The Journal of Pediatrics . 245: 250. doi:10.1016/j.jpeds.2022.03.005. PMID   35276122. S2CID   247332740.
  74. ↑ Turban, Jack L.; Dolotina, Brett L.; King, Dana (August 3, 2022). "Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents in the United States". Pediatrics . 150 (3). doi:10.1542/peds.2022-056567. PMID   35918512. S2CID   251282056.
  75. 1 2 Kincaid, Ellie (2023-05-30). "Parent Survey of Children With Gender Dysphoria Retracted". Medscape. Retrieved 2023-08-11.
  76. ↑ Diaz, Suzanna; Michael Bailey, J. (2023). "Retraction Note: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases". Archives of Sexual Behavior. 52 (8): 3577. doi: 10.1007/s10508-023-02635-1 . ISSN   0004-0002. PMC   10703958 . PMID   37314659.
  77. ↑ Fiore, Kristina (2023-05-24). "Sexual Behavior Journal Under Fire Over Gender Dysphoria Paper". MedPage Today. Retrieved 2023-08-11.
  78. ↑ Leonhardt, André; Fuchs, Martin; Gander, Manuela; Sevecke, Kathrin (2024-07-01). "Gender dysphoria in adolescence: examining the rapid-onset hypothesis". Neuropsychiatrie. doi: 10.1007/s40211-024-00500-8 . ISSN   2194-1327. PMID   38951367.

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