First peer-reviewed study of rapid onset gender dysphoria released today

The research, conducted by Dr. Lisa Littman, examines parent reports of the heretofore little-studied phenomenon of rapid onset of gender dysphoria in adolescence, also called ROGD.

The full paper can be accessed here (open access):

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330

Stay tuned for an interview with Dr. Littman here on 4thWaveNow within the next few days.

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31 thoughts on “First peer-reviewed study of rapid onset gender dysphoria released today

  1. God how I wish this study was published when my kid was seeing the therapist. It highlights all my concerns. I know they couldn’t stop hormone treatment because my kid was 19 but all I ever asked them to do was discuss and present different perspectives. Too late for my kid but I hope it helps future kids . Thank you for at least listening and taking seriously our concerns. I am so tired out from this battle. I have had to admit to myself that I cannot save my child . I fear that in a few years my kid is going to face some very deep emotional questioning.

    Liked by 8 people

      • In our case, the therapist warned us that, once she turned 18, we would lose control. She’s 19 and was put on T at her university. We wrote to the president of the university and the director of the “health center”, who replied that the university is “a safe space for LGBT students”. Our daughter said, “Don’t be mad at me, be mad at the doctors if you have to!” Yes, we ARE mad. She is a naive autistic kid — they are supposedly mature adults who will have to bear no consequences for their actions of prescribing non-FDA-approved hormones to young people based on no objective medical tests whatsoever.

        Liked by 6 people

  2. Finally! My partner and I read this together and it sounds exactly like what we are experiencing with our now 18-year old daughter on the autism spectrum, who decided a couple of years ago that she was gender-fluid, then “leaning male” and now just “a guy.” And the result, as this paper suggests, has been increasing emotional dependence on, and reinforcement from, her nearly exclusively trans/gay/gender-bending peer group, both online and off, and alienation from her family which she treats as a sort of necessary enemy.

    Unfortunately, the entire mainstream culture seems to be joining in to affirm these kids in the damaging choices they are making. It makes it very hard to steer them away from a direction that is doing nothing for them but burying their pre-existing psychological issues under layers of new, body-damaging pathology.

    I hope Dr. Littman’s next paper gives us some idea of what we can DO.

    Liked by 7 people

  3. I could cry with relief.I would be content if my young adult child transitions physically if everything surrounding her self diagnosis were to be carefully, kindly and professionally explored and treated first. That’s all I want.

    Liked by 3 people

  4. My 27 yr old daughter has just begun hanging around with a group of transgender young adults – now she is seeming to take on the idea that she is a trans-guy. She has a lot of self esteem issues, suffers from PTSD and other emotional issues. I have been feeling like she is only trying to fit in with this new group who is encouraging this decision. I have no problem if she truly is trans, but i feel strongly that she is being influenced by her new friends. This article gives me hope that with the therapy she is starting she will be able to decide for herself who she truly is.

    Liked by 2 people

  5. I am a pediatrician completely astounded by how gripping this issue has become. I am tracking multiple patients with a similar narrative. I had never heard of ROGD; I was not on twitter, reddit, or any other such platform to come across the idea. However, I did start to see some alarming activity in my clinic, which led me to the medical literature. I was more alarmed after reading what little there was. After some time, I found this and other websites as well as several accounts on twitter describing exactly what I’m seeing. I don’t feel comfortable coming out and saying what I think because I will be ostracized and black balled if I come out publicly against rapidly transitioning these teens.

    Liked by 8 people

    • Doctor. I am an Oregon parent with a tomboy autistic daughter who I would transfer to your practice with relief if I knew who you were. It’s getting scary out here.

      Liked by 2 people

    • I posted earlier this year with the exact same comments! I am also a pediatrician who, in the last year, has had an ALARMING number of patients with gender identity issues. I didn’t find anything in our professional literature that acknowledged both this trend and provided any logical explanation for it; rather, the narrative has been exclusively affirm and treat. I have had two patients started on blockers and cross-sex hormones on their very FIRST VISIT to a “reputable” (academic, well-respected) gender clinic. No psych. No therapy. No counseling. Shocked!

      I found myself on the internet, digging for anything I could find. 4th Wave Now has been SO enlightening and very rational, unbiased, and incredibly helpful. And Dr. Marchiano, your contributions have been FABULOUS. I shared one of your recent articles about human feelings with a struggling patient–it spoke to us both. Thank you.

      I’ll definitely check out the professional resource. I’m very frightened to come out publicly. Turns out that I also happen to practice in a state with a newly passed conversion therapy law that seems to state I must affirm gender identity…or else!

      Liked by 6 people

    • DrinOregon, you don’t have to come out against all forms of transition in young people – I would love if some OR dr.’s would at push back against the trend of accelerating medical transition for better ‘aesthetic outcomes.’

      My stepchild has T1 diabetes as well as medicated bipolar 1, and began to exhibit ROGD in 2012 at age 13 shortly after gaining unfettered access to internet sites where trans was trending. The kid’s endocrinologist at OHSU did not hesitate to offer blocking hormones directly to the child at the same appointment that the child announced he was questioning his gender. This dr. did not consult the MHP’s that had been treating the kid since age 8, nor did the dr. give us any information regarding the potential for interactions between other endocrine medications and his diabetes treatments. Irresponsible. We parents declined the puberty blockers for the above reasons. This dr. continued to offer, we continued to decline. We changed to the other peds endo in the area, and she too offered hormones at the first visit after seeing pronoun preferences on the chart. This time the kid was 15 and old enough to dictate his own choices, and as he was on OHP, transition medication would have been FREE to him.

      [Thankfully by then, some critical thinking had started to set in and he was no longer convinced that he was a girl, because we had removed the kid’s access to online trans peer groups while facilitating IRL friendships and teaching radfem critical analysis of media/popular gender roles, as well as detailed information about anatomy and physiology, all while respectfully using gender-neutral pronouns and chosen names and allowing the kid to wear whatever he wanted (within modest reason.)
      Two years after declaring himself “a girl,” he changed his mind to “nonbinary.” Two years after “nonbinary” he decided that genderism was absurd and that his biological sex was simply all there was to declare.]

      Liked by 4 people

      • I think your experience is how I became aware of how it works here. I was trained in a different part of the country and I maybe saw one gender questioning person in all of my training years. Granted, I did a large chunk of my practice in critical care, so gender doesn’t really come up when kids are critically ill. At first, I was just taken aback at how common it was, but didn’t really feel pressured to think critically until I came into direct contact with the care of gender nonconforming kids. It started when a 13 year old demanded hormone therapy, and I told them that I was not able to do such treatment. I, according to how I was taught, referred to OHSU and local mental health services. Within a week, the child was seen at the gender clinic, and without ever even seeing a mental health professional was recommended to start on hormone blockers. The doctor did call a local mental health worker (who I now know is a trans activist) who offered support, again with no formal evaluation. Furthermore, OHSU called me to tell me how to order and administer the medication. I politely told them I was not comfortable with the situation, and within a short while they had a new pediatrician who would give the medication.

        I plan to be more actively challenging to this way of practicing. I questioned OHSU doctors when they came for a Grand Rounds presentation and they truly seemed flummoxed by the questions that I was asking. There is a long road to go, but I plan to be a quiet voice of caution in my practice. I am not necessarily against transition for rational persons that have not been pressured and have been completely counseled and have a reasonable chance to consider all options, not just the railroad to affirmation and transition early.

        Liked by 3 people

    • DrinOregon, we’ve been waiting for doctors to recognize this. I hope you and liked minded peers can help. As a parent I feel the fear of being ostracized also, so don’t speak out about it much

      Like

  6. Recommend you read psychoanalyst Gerald Schoenewolf’s 2012 book “Psychoanalytic Centrism,” esp. chapter “Gender narcissism and its manifestations.” In terms of social / professional context, this is a subset of what Christopher Lasch was warning about in his 1979 “The Culture of Narcissism.”

    Liked by 3 people

  7. Missing daughter- by the time my daughter was sent to her second therapist she had already begun hormone treatment as a legal adult. I had a very limited input about my child’s therapy. I was also accused by therapist that I was unsupportive and that is why my child’s mental health was suffering. Needless to say that led to a very heated argument btw therapist and myself. I suppose technically they could have reached out to the informed consent clinic to express their concerns but I don’t really think that would have made the clinic reconsider hrt . Also I think the therapist really believed that my kid just needed to be affirmed by me that she was doing the right thing and then everything would get better. All the red flags were there that pointed to social contagion but my concerns were discounted and trivialized.

    Liked by 4 people

    • How can they do this if you are the one paying for it? I have just refused to do this and my child, who is a legal adult at this point, is not getting hormones. I know this is not possible if your kid has a job, but it is definitely a form of leverage that, I believe, parents should feel fine about exercising where they can.

      Like

      • Here’s what’s happening: we are not “paying for it” either. These kids can get hormones basically for free or with a small co-pay at Planned Parenthood and other clinics around the country. It costs our daughter almost nothing to get them at her university. Bottom line: once the kid is 18, there’s a way to find affordable hormones, no matter what the parent says or does.

        Liked by 3 people

  8. I am also not paying for any transition related procedures. I told my child flat out that I as a parent could not do it because if any harm came to her because of it I could never live with myself. I don’t think hormones are very expensive. Even though she is on hormones at least not having a steady income is the ONLY thing slowing her from going further into this. I feel my boundary of not taking financial responsibility is a fair boundary. If I am to be expected to pay for something this life altering than someone had better show me some damned convincing evidence. So far none of the evidence I have seen is very convincing or reassuring.

    Liked by 2 people

  9. Many thanks to Dr. Littman for conducting this much needed research and putting it out on a public forum. The two hypotheses, that social contagion and maladaptive coping mechanisms play a key role in ROGD, fit my young adult daughter’s circumstances quite well. I do believe that undue influence leading to dissociative behaviors is also a much needed research area as it relates to ROGD. Obviously much more research is needed but as a parent this is hardly comforting when our children’s bodies are being drugged and surgically mutilated. Social contagions are indeed bizarre and quite difficult to first RECOGNIZE and then to CONTROL and UNDERSTAND, and lastly to TREAT. Society is merely in this first stage of recognizing and inching it’s way to some understanding. Those of us parents on 4thwave are well beyond the recognition phase as we are living this surreal nightmare daily. The unbelievable has become our reality. Those with underage children are running a marathon every single day with their children. Many with adult children have sadly lost them to this new phenomenon. If my daughter ever makes it back into the family fold, she will need an incredible amount of support to undo the harm that has been done. If she does not make it back into the family fold, I fear her ending. Social contagions have a mind of their own and no one social contagion is like another. The histories of social contagions tell countless stories of frenzied hypotheses, diagnostic bickering, families and their caregivers in disagreement, and infighting among victims. The hypotheses proposed here by Dr. Littman are backed up by a legitimate and well documented study. I hope it leads the medical community to the recognition phase. This is real and it is not going away. The feminist critic Elaine Showalter argues in her book, Hystories, that hysterical epidemics require physician-enthusiasts and theorists, unhappy and vulnerable patients, and supportive cultural environments. Indeed we have these factors with ROGD.

    How do we collectively get to the next phase – CONTROLLING and UNDERSTANDING? Surely we cannot press on with trickles of studies, blogs, and articles and expect this social contagion to ever be controlled, for those caught up in this to ever get treatment, for families to ever heal. This has been going on unchecked for years. In Erica Weir’s paper ‘Mass Sociogenic Illness’ she states: “The confluence of 8 symptoms or conditions typically indicates mass sociogenic illness and permits a presumptive diagnosis while investigations are underway. These include symptoms with no plausible organic basis; symptoms that are transient and benign; symptoms with rapid onset and recovery; occurrence in a segregated group; the presence of extraordinary anxiety; symptoms that are spread via sight, sound or oral communication; a spread that moves down the age scale, beginning with older or higher-status people; and a preponderance of female participants.” The full article can be read here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC543940/

    What I would like to propose : Can Dr. Littman’s research to be officially recognized as a presumptive diagnosis? With a presumptive diagnosis, the ethics of medicine (first do not harm) should require the halting of treatment with hormones and surgeries while investigations are underway. The current trajectory of these young people caught up in this presumptive social contagion could be slowed down. It would give the families running these marathons the time to catch their breaths. It would allow these young people the benefit of time and maturity. It would allow us the movement from RECOGNITION, to CONTROLLING and UNDERSTANDING, to TREATING.

    Liked by 8 people

    • “What I would like to propose : Can Dr. Littman’s research to be officially recognized as a presumptive diagnosis?”

      The answer to this, I would guess from the current response, is no. This will be pushed down as transphobic by those in power right now. There are a lot of gender clinics out there that would be opened up to litigation if this diagnosis gained any traction in medical literature. The current persons in charge of this theory have already ignored past studies that show that less than 50% of kids with GD will go on to transition IF LEFT TO THEIR OWN DEVICES.

      It’s telling that popular media and scholarly discussion is calling for more access to care for transition services. It’s being billed as a crisis in some corners of the literature/media. But, it doesn’t reflect reality. One of my patients was referred by another doctor to the academic endocrine clinic here and she had to wait 23 days. Recently I had a new onset type I diabetic that had to wait 30 days for the next available new diabetes appointment. Type I diabetes will absolutely result in death if it is not treated, but this patient has to wait longer than the one referred for hormone blockers….

      Liked by 4 people

      • Ah, but don’t forget that the trans patient may kill himself/herself from the distress of gender dysphoria without treatment, so equally as harmful as DKA, I suppose.

        Is your Planned Parenthood now prescribing hormones/blockers? Most of the Washington clinics are. I’m still waiting for a call back to ask one of their “providers” (I believe she is a mid-level) about their policies regarding children and adolescents.

        Liked by 1 person

  10. Beyond mad. You raise some very good questions. I have wondered about all these same questions as well. My opinion is (I hope to hell that I’m wrong) that this social contagion will go on for a while yet. There is no way that informed consent clinics are going to admit that they could be harming vulnerable people. They have an agenda. The media in the US is still too wrapped up in the fascination of the “gender revolution” and therefore keep producing a very one sided feel good narrative of gender journeys and authentic selves and brace supportive affirming families. Mainstream society sees this as a civil or human rights issue. They are not aware of how fast and easy it is to get hormones or surgery. They are not yet aware of the huge increase of young people (mostly female and lesbian)seeking these treatments. It’s all about being kind but they don’t realize how cruel it is in reality. Conversion laws are being passed and therapists are caught up in all of this. So no I don’t have much hope that this will end anytime soon. As a parent this breaks my heart and makes me so angry . My adult child has been on T for almost a year. I worry everyday about the effects of this drug on her once healthy body. I worry everyday that she will find true peace and self love and be able to live fully in society as a healthy,connected and happy person. I have worked very hard to keep our relationship. That meant I had to let go of certain things however. We don’t discuss her decision anymore. It caused to much strain on our relationship and I don’t want to lose her in my life. I cannot say the things she wants me to say. She wants me to be happy that she is becoming her authentic self and be happy she is on T. I CANT say those things. It would be so hollow and such a lie. I won’t ever lie to my children. If she wants to ever have an honest open conversation about this than I would welcome it with open arms. So for now I focus on showing her my love and supporting her in other ways. I think as time goes on detransitioners will continue to grow as a population. I’m so happy many are speaking out online. There stories cannot continue to be ignored or belittled like they currently are. If this self diagnosis is allowed to continue than more and more people will detransition. Some will be very angry at the professionals that were supposed to help them. Some will be very angry at their parents. Most I think will be very angry at what our society has led them to believe about their bodies. And what a righteous anger it will be! I believe these are the people who will finally cause our society to wake up as to this dangerous contagion. Ray Blanchard said he can’t understand why trans activists would not want to recognize ROGD and separate themselves from it. I agree. This will only hurt those who truly would benefit from medical transition if allowed to continue as is. I can’t say I feel sorry for them ! I hope I am wrong about all this but for young adults parents have very little control. My family is very close and loving. I didn’t have strict gender roles that I made my children live by. I was a very involved and supportive mother and yet this happened to my daughter at break neck speed. It will keep happening and more parents will speak out in frustration and heartbreak and anger. I pray everyday for all these young people and their families.

    Liked by 4 people

    • I don’t know if my daughter is considering starting any meds, but since she is dependent on me for total financial support, I will not pay for any. She is 27 and just within the last 5-6 months began hanging out with a transgender crowd. She has never even shown signs of being trans or gay – so this is all new. Interestingly, she has only been interested in trans-girls, so we’re still talking boy-girl relationships, just role reversal. She has PTSD, severe depression and other issues. I just got her into therapy with a new therapist for EMDR therapy for the PTSD (she was bullied in school and verbally abused by her father), and am hoping the new therapist will also be able to help her with this ROGD. I have seen her go through similar phases where she totally immerses herself in a new group of friends and takes on their likes, dislikes, etc. to fit in. I truly feel that is what is happening now, but the thought of the hormones makes this more serious as far as I am concerned. I have also taken her car away for insurance reasons, so this will make it harder for her to drive to the gay/trans bar she has been hanging out at several times a week.
      She doesn’t live with me, so that makes it complicated also. I’m just hoping the therapy will do some good to help her with all of her issues. She is my heart.

      Liked by 2 people

  11. I believe what a lot of this young generation is seeking is freedom from gender expectations. This is a good thing however it got hijacked by the born in the wrong body message. For any of this to change we as a society need to start being very vocal about allowing people to express gender in a much freer way WITHOUT implying or assuming it means anything other than preference or personality. We also as a society need to realize that just because homosexuality is more accepted than in the past we still need to actively and very vocally support homosexuals. Bullying is still rampant for these populations. We need to be aware of it and adress it. Young gender nonconforming people (whether gay or straight) need a lot of support to feel good about themselves in a society that places all emphasis on appearance. Telling girls to be strong isn’t enough. Society and peers have a much stronger voice than parents about what a girl is supposed to look like. I was very naive about society being accepting of lesbians and gays. Some of the narratives of detransitioners just broke my heart. Unfortunately I think a lot of therapists are also naive about this …especially if they are older than 30 and heterosexual .

    Liked by 1 person

  12. How can I,as a loving mother, not see the comfort in the lie that transitioning holds for my daughter? Now it doesn’t matter how she dresses or if she holds her girlfriends hand in public. This is safety to her. I see that. But it is built on a lie and at the expense of herself,her past and her healthy body.

    Like

  13. I just finished reading “The Six Seductions of Anorexia” in Psychology Today. I was struck by many parallels between anorexia and gender dysphoria. I have heard many detransitioners talk about the “honey moon period” which anorexics experience as well. Anyway… the article was very interesting and I believe for many women and girls these two things (eating disorders and gender dysphoria) have many similarities. The problem is however that therapists see anorexia as something to be treated by many different methods but gender dysphoria has only one treatment.. hormones and surgery. it would be so nice if therapists could see that simplistic treatments for complex human feelings very rarely works. It may be a good band aid for awhile but the original wound or suffering will only fester and grow worse if never treated properly.

    Liked by 6 people

    • It’s not just eating disorders. Self harm and suicide is also known to cluster in populations. No one disputes these clusters when it comes to eating disorders, cutting, and suicide, but somehow noting the same clustering in trans identifying teens is considered transphobia.

      Liked by 4 people

    • “I was struck by many parallels between anorexia and gender dysphoria.”

      There is an overlap between anorexia and autism spectrum disorders in young women as well. The whole area is under-researched. If the academies had any sense, ethics or even old-fashioned scientific curiosity remaining then they would be setting up programmes to look at this and to look at the impact on health and public policy.

      Lisa Littman’s paper needs to be a springboard for much more research, but we are up a against a very well-resourced mountain of opposition unfortunately.

      Like

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