What I wish the Atlantic article hadn’t censored

by Jenny Cyphers

Jenny Cyphers is a homeschooling parent. She has been writing about that experience for many years, in various online forums. Jenny has been married for 24 yrs to the father of their two children, one adult and one teenager. They all live, work, and create, in Oregon. Jenny and her teen daughter were recently interviewed for an article about gender-dysphoric youth in The Atlantic.

4thWaveNow editorial note: We are grateful for Jesse Singal’s reporting on this complex issue and appreciate that he included the seldom-heard voices of teens who desisted from a trans identity, and their parents, in his article. We are aware that in some circles, the discussions we host on our site are considered transphobic and that we, a loosely-organized group of parents writing on this site, have been defamed as a “hate group” by those on the extreme end of the activist spectrum.

As always, we encourage those interested in the issue to read as widely as possible so they may come to their own conclusions. We contend that by leaving out all mention of 4thWaveNow, The Atlantic not only failed to offer parents the alternative opinions and resources we offer, but they also contributed to an environment that, due to censorship of critical voices, continues to propagate the distorted idea that cautiousness around medical interventions for minors is inherently harmful to trans-identified people in general.


I knew, when I agreed to be interviewed for The Atlantic article “When Children Say They’re Transgender,” that some of my words might be cut, or changed in ways I didn’t intend. But Jesse Singal is a good journalist. He’s personable and honest and willing to take on some really difficult subjects. He digs deep, records, researches, cites sources and ties things together in a nuanced way. Along with editors, he carefully adds and discards words, phrases, sources, quotes, and relevant ideas that lend themselves to the overall picture of what people will read and take away from what they’ve read. That’s what good journalism is.

There are a few things about our story and the way it was presented in The Atlantic that I’d like to clarify. First and foremost, the last-minute editorial decision to unlink the essay “A Careful Step into a Field of Landmines,” I’d written for 4thWaveNow, combined with removal of all mention of the site, needs to be highlighted because in doing so, The Atlantic failed to include important resources created to help parents support their gender dysphoric and nonconforming youth. The result is an article focused on the “situation” of “trans kids” that obscures parent-led examination and support for youth to explore identity without harmful medical interventions, the consequences of which can last a lifetime.

There are more choices for families than to either support their teens’ requests for pharmaceuticals and surgery on the one hand, and disowning or otherwise invalidating their interest in exploring their identity and nonconformity on the other. The Atlantic editors’ choice to remove 4thWaveNow from the discussion in effect denied parents access to important analysis that offers a balanced and middle ground.

Delta pic

The Atlantic photo editor had to dig deep in the several photos we provided to find the pensive one they chose for their article. Here’s one my daughter likes better; she suggested it be included with this post.

Part of my agreeing to contribute to this important debate is helping to create a platform. This website is such a platform. In talking with Jesse, I was upfront about my beliefs, which in part have been informed by 4thWaveNow and the great many array of voices shared here. It isn’t a monolith. Some of us are very liberal, left-leaning people in liberal left-leaning parts of the country, doing liberal left-leaning activities. Some of us are middle-of-the road, a minority of us are conservative, some of us are doctors, therapists, professors, and teachers. Some of us have allowed full social transition to give space to figure things out while still not agreeing to medical transitioning, and some have not. Excluding mention of 4thWaveNow, a site that gets 60K hits a month, fails to tell the whole story. Why do that? Why leave out one of my main sources of information and the ways that information helped me help my child?

Two of the most important aspects of my family’s experience that are not adequately addressed in the Atlantic article, are: 1) my daughter was given a clinical diagnosis of gender dysphoria, so she was just as “truly trans” as the next kid, and 2) it was my insistence that my child wait to medically transition, not her therapist’s. My teen’s therapist, Laura Edwards-Leeper, listened to me and agreed. We were lucky. While there are some cautious, thoughtful providers, the current situation in the US is that there is also no oversight. The most vocal professionals are firmly in the affirmation camp which believes, without any long-term data to validate, that withholding hormonal interventions is tantamount to abuse.

I didn’t know, going into Delta’s first appointment, what the outcome would be. That’s how difficult this is for parents; we have no idea what the outcome will be when we have very “insistent, consistent, and persistent” children requesting immediate medical interventions. It’s a matter of luck to find a therapist who respects parents’ knowledge of their children, who takes parental concerns and insights seriously, and who are not afraid to support slow, cautious progression.

While many transgender activists argue that they understand our children better than we do, there is no evidence to support their claim. Rapid Onset Gender Dysphoria is seen primarily, although not exclusively, in natal females during puberty. It is important to understand that what separates my daughter and many of the kids of 4thWaveNow parents, is this: None of these kids experienced distress over their sexed bodies until they came into contact with the idea that there might be something wrong with them. In other words, the dysphoria is what was “rapid onset,” not necessarily their gender atypicality. These are not kids with “early-onset,” nor do they resemble later in life transitioning people who frequently claim to have always “felt like” a girl but were too afraid or oppressed by family dynamics to admit their feelings. Then, making wide sweeping projections of their own experiences, they mark our children as being in need of the help they believe they should have had. With our kids, as with the group of young people described in Lisa Littman’s survey where ROGD was first named, their dysphoria set in quickly during puberty, often after spending hours online watching/reading others discuss their distress.

Another outlandish claim (made repeatedly by some activists and “affirming” clinicians) is that we simply missed all the signs our children were suffering earlier. I can assure you that, as a homeschooling mom who spent all day every day with my daughter, she never thought she was or wanted to be a boy prior to encountering the idea from transgender kids in her social circle. In fact, between ages 9-11, she was often “misgendered” (referred to as “he” or “him”) and hated it. It saddens me that these activists experienced such awful childhoods. However, their childhoods seem to have been negatively influenced by the religious fundamentalism and/or abusiveness of their parents; their childhoods do not remotely resemble the experiences of my daughter or the many other young people experiencing ROGD whom I’ve met.

atlantic coverTeens and tweens with ROGD often meet all the clinical diagnostic criteria for transitioning. They are often “insistent, persistent, and consistent” for more than six months, or in our case, for two years. Teens with ROGD also typically meet the clinical threshold for gender dysphoria, as mine did. It’s in her medical file. That’s correct, my “never really trans kid” had a clinical diagnosis of gender dysphoria under the DSM-V. This is what we hope others understand: our kids are suffering, they hate their bodies, they want and need help. In many cases, our kids had trouble making friends, experienced some form of earlier trauma, and struggle in other important ways, completely unrelated to gender, that should not be overlooked or seen as secondary to their dysphoria.

I know, because I was in pro-transitioning parent support groups, that parents are going to “gender specialists” and demanding medical interventions for their children without thoroughly considering why their children feel the way they do. I know, because I’ve heard from parents, that some therapists will give the green light to medical pathways without addressing any mental health issues. Dr. Johanna Olson-Kennedy, who treats 900 youth at her LA clinic, is quoted in Singal’s article as saying that she “believes that therapy can be helpful for many TGNC young people, but she opposes mandating mental-health assessments for all kids seeking to transition.” As many 4thWaveNow parents and teens will tell you, this attitude denies young people the opportunity to deeply explore why they want to alter their bodies and shuts down learning about other non-medical means of managing their distress.

When I was approached to do an interview, I needed to carefully consider my motivation for doing so, and if I should agree to discuss my family’s situation at all. Ultimately, I agreed because people need to hear that there are other ways to support trans-identifying kids. Gender dysphoria is very real and it hurts. My child’s life wasn’t easy because of the intense pain of GD. I knew there had to be answers other than what I saw everywhere around me, that suggested agreeing to medical interventions was the loving and kind thing to do, and that these interventions were harmless and helpful. I agreed to be interviewed because I wanted to highlight for other parents that there are other choices: most notably, offering support (buying clothing, getting haircuts, using a new name, finding a decent therapist) while also saying “I don’t think there is anything incongruent about your body/feelings.” The Atlantic axed this part of our story, the part where parents can offer tremendous support for their children without ever setting foot in a gender clinic in search of medical interventions.

I used to be a lot more open to the idea of transitioning children, in part because I know and like many transgender people. It wasn’t until I found that in the US, girls as young as 13 are getting mastectomies, that I began to question gender affirming medicine. In the new genderist language it’s called “chest,” “top,” or “confirmation” surgery. It sounds so much nicer than a double mastectomy, almost positive and pleasant. Cutting healthy body parts off of children should not be a thing. Ever. That was the moment I decided I would never stop talking about this.

My part of the interview with Jesse Singal–although about my daughter–was really more about how to support, in general, a child going through this very difficult experience. It is challenging, if not impossible, to find places to discuss supporting teens as they explore their identity in non-medical ways. 4thWaveNow is the only US-based resource that allows this. We need to talk about how to support gender non-conforming kids; things like buying clothing from the boys’ department if you have a daughter, or buying girl clothing if you have a son. My part of the interview wasn’t aimed at kids, but at parents who really need more and better tools for helping their distressed children than the “transition or die” option. Without choices, how can people really make one? Pick one of the two? No thanks.

Someone asked me the other day why I care. Why can’t I just let people do what they want? The answer is really simple. As humans we are guided to protect our young. If our culture fails to do so, each of us have failed to protect our children. This is why there are laws against abusing children, laws preventing minors from smoking or drinking, laws to keep kids from driving, laws for educating children. We can argue against any one of those things, but the cultural “we” have agreed that this is for the good of protecting children from harm, and for promoting welfare. In the US, unlike in other countries, there are no laws or regulations about transitioning children. Until there are, this is up for debate and I’m weighing in.

The fact that so many parents are left with this narrative that there is only one right way to help a confused kid, is what drives a wedge between the parent and child, leaving children vulnerable to self-proclaimed internet “experts”, like Zinnia Jones, who are more than willing to validate their feelings, further dividing parent and child.

Look, I understand that there are some truly not-very-nice parents out there, but we should not be making policy around them. That’s the sort of thing that creates bad case law. Let’s assume that the vast majority of parents want what’s best for their children, even if they have no idea what that looks like.

I was even more puzzled about the Atlantic‘s last-minute editorial decisions when I saw thaZinnia Jones cheap puberty blockers onlinet, not only was any mention of 4thwavenow scrubbed in the final version of the article, but a statement by Jones and reference to Jones’ website were included. Jones has written multiple screeds denying the existence of the rapid-onset dysphoria in adolescent girls that more and more people (including clinicians) are noticing. Further,  Jones recommends (on Twitter) that young people secretly obtain puberty blockers online if their parents aren’t onboard.

Unfortunately, many therapists, and others invested in the transgender narrative, seem to be heavily influenced by activists like Zack Ford, an opinion writer for the website Think Progress who, in response to Singal’s article, enunciates the activist-notion that parental concern and insight is irrelevant to the discussion. He writes,

“Whether a parent doubts the legitimacy of a child’s transition has zero relevance to whether transitioning is best for their child. Humoring this doubt is exactly what makes the story so harmful.”

Read that quote again. Read it several times to see just how dismissive it is of parents, the very people transgender and gender non-conforming kids rely on for support. You know–the people who would be signing the informed consent paperwork at the doctor’s office, agreeing to allow doctors to prescribe permanent, sometimes sterilizing, experimental off-label use of medications, and body-altering irreversible surgeries.

The collective, cultural “we” cannot dismiss parents as trivial when we are discussing our children, whom we will protect with our lives. This protective mechanism is the prime role of parents and an important part of being human and all the moral and ethical things that come with it. This is not a divide between liberal and conservative. There are too many divisions in this world, and this country, as it is. This is about whether “we” have an ethical imperative to protect our children. Yes, we need to listen to kids. We also need to listen to parents who are not interested in stifling their children’s interests or gender presentation, but who also know their children better than any therapist ever will.

 

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Detransitioned man blasts “transworld”

Angus is the pseudonym of a mostly-retired clinical epidemiologist on the faculty of a major health sciences university. We asked Angus to provide a short bio, and this is what he wrote:

“Angus is in his late 50s now, but back in his 40th year of life, his arrogance and folly led him to think it was fine to transgress, wear the dress, and pretend to be a “woman.” He did this for 13 long years, taking the synthetic estrogen drug every day, self-absorbed and entirely content. He was so convinced that he would carry on as a fake “lady” until the day he died, he decided to have some surgery. Not the more drastic option, it’s true, but most men would do anything to avoid the one he got. Quite unexpectedly one morning Angus snapped out of his transfugue trance state and felt compelled to examine his life. He rapidly ceased his masquerading and mimicry and re-engaged with material reality. He has the blog at autogynephiliatruth.wordpress.com but hasn’t put anything up there for a while. Angus can sometimes be observed causing trouble on Twitter @iforgetalready.”

As with all articles submitted by our contributors, the opinions expressed by the author are his own. He is interacting in the comments section of his post under the moniker “Awesome Cat.”


by Angus

The trans industry must concede that rapid onset gender dysphoria is a social contagion and they must cease recruiting efforts among young people.

Girls and young women increasingly make the claim in recent years to have “gender dysphoria,” an inversion of the male-dominant pattern that has been observed over many decades. More than just flipping the chart, this represents a major surge in the rate at which women are inducted into the illusory realm of TransWorld. The trans industry’s nonsensical position is that practically all “cis” people are potentially “trans,” but it’s impossible to know for sure whether anyone is a man, a woman, or some innovation unless they tell you. Even then, you may need to ask again tomorrow.

Clinicians have struggled to explain why there has been such an appalling growth in adolescent “gender dysphoria,” especially in girls and women.  One possible explanation, recognized as far back as 2010 and 2012, is the impact of social expectations, including the Internet, on the development of a transgender identity.

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And even further back, in 1999, WPATH (formerly called the Harry Benjamin International Gender Dysphoria Association) advised clinicians to proceed with caution when treating adolescents because of the changeability of “gender identity.”

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Then, in 2016, a physician named Lisa Littman conducted a study which, in part, investigated whether social contagion could be a contributing cause; in other words, perhaps some kids caught up in this mix do not really have a long-standing discomfort with their sex. It’s possible for many that the trap door could open below their feet, and within a short time, they’d be injecting testosterone. That’s truly how they roll with “affirmative transcare.”

Trans activists raged over the anticipatory invalidation they already felt with this story, as it dramatically undermined their alibi of “born this way” innocence. They seek transrecruits among children and youth, and at least in the USA, have an alarming interest in giving kids hormone drugs and surgeries at the earliest possible ages. Along with academic and clinician running dogs and other personnel getting paid in the trans industry’s multifarious dimensions, they worried that the mainstream public might see through transvested interests of its pseudoscience. They tried to kill this story with fire. Their efforts only made the story better known.***

Let me just say that I don’t believe that anyone on Earth is “transgender,” “transsexual,” trans-anything except perhaps transvestite, because that term is specific to clothes (Latin vestīre). In English the word just means crossdresser, which is accurate in a simplistic way. Nor is anyone “cis.” Evolution would not allow development of a heritable trait cluster or quasi-sub-species in which a woman or man in good physical health would have an insatiable obsessed yearning to mimic the sociocultural sex stereotypes (i.e. “gender”) for appearance and mannerisms of the opposite sex. There is no way that little Johnny likes to play with dolls or that little Jenny likes to play with trucks because as “trans kids,” they are on the spear point of an ancient evolutionary process that manifests at a certain prevalence in a given population. Had there been such genetic innovation back when we roamed the savannahs, folks with those characteristics would have all died out pretty quickly due to the lack of skilled plastic surgeons and endocrinologists. After all, along with voice coaches, such professionals are the only ones who can deliver “the basic health care they need to survive.” Our illustrious forebears in the painted caves would not have been pleased with the maladaptive meltdown and tantrum behaviour that would have emerged in proto-trans people in response to rampant “misgendering,” and excess mortality due to other people declining to play along would have been high. In real life, simpler explanations are more likely to be true, and there are far more compelling approaches to exploring the question of why women and men with healthy bodies might get it into their minds that they are really the opposite sex.

It should be pretty obvious that the “transition” one hears too much about is also a bogus mind-game. No-one “transitions” to anything except a likely-shortened lifestyle with lots more trips to the doctor, massive surgeries, aftercare; complications (some quite filthy), surgical revisions, risk of cardiovascular trouble; and lifelong drugs. Men may look forward to practicing fake voices & mincing walks, incessant “dilation” of the pseudo-“vagina” seeping void space created through flaying & inverting their genitals, heightened risk of multiple sclerosis and still being 100% male. Women may anticipate the potential for luxuriant back hair growth and being rather shocked that after mastectomies and having the organs of their reproductive systems ripped out, they are still as female as the day is long. Also, a greater risk of kidney failure, even if they are vegans.

Men and women who bought into the transprop and believe its lies have paid with their bodily integrity, and many times with their health. They are victims of it themselves, and I wish healing and wholeness for them. In the moment, however, many contribute to transgenderism’s harms.

For nearly 100 years, since doctors began misleading confused men and women to believe that this might be an option, vastly more males than females have desperately demanded to go under the knife and “change sex.” Such “change” is only illusion, but many men and women have fixated on that fraudulent goal in the vain hope to escape the miseries and melodrama of their own real lives. It is thus a matter of tremendous public health concern, indeed it’s a public health emergency, that over the course of a few years the rate of young women and girls who newly claim to be trans has gone through the roof. Doctors in Amsterdam and Toronto reported in 2015 that in their clinics there were now more females than males getting transbees in their bonnets. These women and girls had never previously shown profound dissatisfaction with being female; their “gender dysphoria” seemed to be new. Investigators used their Discussion to propose that among other reasons why women now greatly outpaced men, perhaps more secretly trans heterosexual women were now hopping on board the transwagon. Alternatively, maybe this decade’s grossly overblown propagandizing of all things trans has resulted in an Exodus of silently-suffering transfolk, women and men both, from “cisnormative” agony; women lead the way, enjoying their female privilege, as many already owned a few pairs of blue jeans or had short hair.

Newcomers to the trans industry, Helsinki then piped up to say that in their first two years running a child transing center they were stunned to find that 41 of 46 (87%) of adolescents were girls. Inconveniently for trans industry bigwigs, the Finns continued. It seems that 35/47 (75%) of these youth were already in treatment for serious psychiatric comorbidity unrelated to “gender”; and 12/47 (26%) were on the autism spectrum. The ratio of females to males, autism prevalence and levels of comorbid psychopathology were far higher than had ever previously been reported. Investigators were flummoxed by all of this, pointing out the ways that it contradicted the lying official translore, and could propose no solid explanations; least of all for the massive overrepresentation of girls.

Reports from the United Kingdom of huge spikes in the rate of child referrals to transing centers also show far more girls than ever before. The most recent of these papers from the UK suggests that from 2009-2016, the average year-on-year increase in referrals for children under age 12 was “only” 48.6% for boys, while it was 92.7% for girls; in adolescents the corresponding rates were 54.9% and 88.6%.

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Naturally, the new transcenario posed a problem for TransHQ. Most industry clinicians maintained the party line, more or less saying “gee, we didn’t know there were so many transkids.” When two of the more notorious pediatric trans industry doctors were asked about the startlingly high proportions of girls, Johanna Olson-Kennedy seemed taken aback but then acknowledged that it was true, before uttering a few more incoherent half-thoughts. Joshua Safer seemed evasive and glassy-eyed as he answered in terms of both sexes.

None of the researchers reporting this outbreak of “girlpower denied” was apparently able to imagine a possibility that would require coloring outside the lines of the trans cult’s hijacked rainbow; an answer that was much more likely to be true than their mouthfuls of bloated transjargon.

In 2016, however, Dr. Lisa Littman (now at Brown University in Rhode Island, USA) published a summary description of her survey undertaken with parents of youth purporting to have “gender dysphoria.” Results of her survey suggested something pretty obvious: This new type of rapid-onset gender dysphoria (ROGD) is a whole different animal than the usual kind observed in adolescents. It was really sort of a youth craze, exacerbated via social contagion through the influence of peer groups and shady characters who promote trans ideology and recruit adolescents aboard the transwagon. Psychotherapist Lisa Marchiano also wrote eloquently on ROGD in several articles, including this piece from the perspective of Jungian psychology.

Littman

The discussion of ROGD came upon trans activists unawares, but as the story continued to gain traction, the transmachine hotly blew up its transmissions, spewing towering tizzies of refutation, torrid pseudoscientific tirades, aggrieved attacks on academic integrity. Many trans industry academics and clinicians who have desperately tried for years to show that “gender identity” is innate now faced the possibility that the public would begin to catch on: “Innate gender identity” was complete garbage. Ice cold embarrassment and waves of sweaty invalidation flew from the ridgetops of their enormous brows. Social media was also transflamed with outrage, scorn, popcorn and flipped wigs.

But what can these trans cult & industry personnel and enablers really say in their dizzy diatribes? They raged against ROGD, called it a “hoax diagnosis,” scoffed at the study design and impugned Dr. Littman’s academic integrity. Yet they knew full well that the entirety of the “affirmative model of care” for people confused about what sex they are has much flimsier underpinnings, in addition to cherry-picking, confirmation bias, same-team replication & review, in-house “bioethicists” and financial or other conflicts of interest. What can they say, when reports from around the world confirm not only an explosion in the rate of children and adolescents getting hooked into TransWorld, but a reversal of the old familiar sex ratio? What can they say when there is in real life no “trans”?

Young people are systematically gaslighted in their indoctrination about all things trans. Like many adults, adolescents are usually overstimulated, sleep-deprived and eating suboptimal food; often somewhat traumatized and fragmented far away from knowing their own wholeness. Trans ideology is now presented to kids in USA schools as truth, “settled science” that helps people to “become their authentic selves,” masquerading through life as the opposite sex. But based on both my personal experience as a former “transwoman” and my ongoing research,  trans itself actually doesn’t exist, at least not in material reality. It exists only through mind-games; reversals, inversions & perversions of meaning; language-policing; and bureaucratic paperwork.

All human beings are “valid,” but transgenderism is a cultish ideology that leads to serious harms. Rich countries of the world have fallen grotesquely into error and if there is any justice, the people who promote and take advantage of the transcraze in young people someday will be held accountable.

WPATH & The Advocate aim to suppress new research on adolescent gender dysphoria

by Brie Jontry

Brie is public spokesperson for 4thWaveNow. For more about her, see this interview. For more about Brie’s formerly trans-identified daughter, Noor, see here.


On February 20, The Advocate, one of the leading LGBT publications in the US, ran an article which attempted to invalidate data collected by physician and researcher Lisa Littman from parents whose children experienced Rapid Onset Gender Dysphoria (ROGD). The author, Brynn Tannehill, immediately posted the article to the WPATH Facebook page.

Tannehill ROGD WPATH post

In the thread,  Tannehill (along with Jo Hirst, author of the Gender Fairy), suggested The Journal of Adolescent Health should be asked to retract and/or apologize for publication of Littman’s preliminary findings. UCSF’s Dan Karasic, MD (moderator of the Facebook page and WPATH official) agreed.

Littman’s abstract had been accepted for poster presentation and the poster was presented at the March 2017 Annual Meeting. (The full paper has not been published yet, and we look forward to its availability).

karasic retract poster

Note: Interestingly, as of this writing, four days after they were written, the last three comments have been deleted from the original thread.

The dismissal of Littman’s work, and the move to suppress it, is unconscionable. For one thing, some young people (like my daughter)  who experienced ROGD have already desisted. Others, who were supported in procuring medical intervention, have already experienced regret. Many more desisters and detransitioners are sure to follow.

This trend has not gone unnoticed by at least some in WPATH. For example, veteran WPATH clinician Rachael St. Claire, in a Facebook post on January 5 of this year, made this comment (notice that commenting was turned off immediately after St.Claire posted):

WPATH jan 5 2018 detrans therapist

This concern is echoed by UCSF clinical psychologist Erica Anderson, herself a transgender woman, in a recent Washington Post article:

“I think a fair number of kids are getting into it because it’s trendy,” said Anderson, who was married for 30 years and fathered two children before transitioning seven years ago.

I’m often the naysayer at our meetings. I’m not sure it’s always really trans. I think in our haste to be supportive, we’re missing that element. Kids are all about being accepted by their peers. It’s trendy for professionals, too.”

In addition, clinics around the world have noted a sharp increase in the number of girls presenting for treatment in the last few years.

increase in girls

A once-rare condition is now increasingly common. It is surely in the interest of all people who care about gender dysphoric youth to investigate the reasons for the increase, and Littman’s work is an early contribution to this effort.

The ostensible reason given for Karasic et al’s desire to have Littman’s abstract retracted is that the data comes from a self-selected group of parents, culled from websites where such parents gather, in an anonymous survey format, and is thus deemed to be worthless. Yet advocates for pediatric transition constantly promote other survey studies, also culled from “self selected” groups (such as the Williams Institute suicidality survey), as well as research conducted by investigators who only recruit subjects from pro-early transition organizations (such as Kristina Olson’s two studies), with no attempt to broaden their samples to children who are not socially or medically transitioned.

In fact, Littman’s work is the first to study this new presentation of gender dysphoria, and she collected information from the people who know these children and teens better than any transgender advocate, endocrinologist, psychologist, or therapist ever could — their parents.

But you’re not listening to us.

Littman’s study, according to its critics, is contentious for a few reasons, but most notably for using the term “Rapid Onset Gender Dysphoria” as a descriptor for a new kind of trans-identifying youth, primarily natal females, who during or after puberty, begin to feel intense unhappiness about their sexed bodies and what it means to feel/be/present as a woman.

Let me emphasize: What is “rapid onset” in this population is the dysphoria, not the gender atypicality. What distinguishes these young people from the early-onset populations studied previously is that they may have been happily gender nonconforming throughout childhood (though some were more gender typical), but they were not unhappy (which is all “dysphoric” really means), nor did they claim or wish to be the opposite sex. The unhappiness set in suddenly, in nearly every case only after heavy peer influence, either on- or offline.

This phenomenon has only recently been noted by clinicians directly involved in treating gender dysphoric youth, as well as other mental health professionals. While there is no lack of evidence for adolescent emotional and behavioral social “contagions,” Littman’s research is the first to collect data on this phenomenon as it relates to identifying as transgender.

Even though rapid onset gender dysphoria has been noted by other researchers and clinicians who work with these populations, The Advocate and WPATH’s Dan Karasic consider the descriptor “junk science.” In a swift attempt at censorship, Karasic deleted all but one of my comments on the public WPATH Facebook page and then banned me from the group when I asked him to please consider the experiences of young people, like my daughter, for whom gender dysphoria set in hard and fast after being exposed to the idea that her gender nonconformity was in fact a sign of being transgender.

Interestingly, after I was purged, Karasic posted links to both my and my daughter’s stories on 4thWaveNow, and unfounded accusations were leveled against me and 4thWaveNow; since I was banned, I was not able to respond to them.

Interested readers may refer to these Twitter threads should you want more blow-by-blow details:

It is concerning, given Karasic’s reaction to Littman’s research, that he and others evidently leave no room for a teenager to be incorrect about how they are interpreting their feelings, no room for a clinician to be incorrect when recommending transition, and no room for a parent to understand what is going on with their own child. It is narrow minded and short-sighted, especially considering there is no long-term data supporting the benefits of early medical transition for gender dysphoria or consensus from the medical community about best treatment methods.

This lack of consensus, while well known and acknowledged by the international medical community, has been ignored by many transgender advocates, along with the “gender affirmative” recipients of a $5.7 million NIH grant, who, with the help of the mainstream media, have manipulated the public into believing early social transition, pubertal blockade, and early cross-hormone treatment constitute settled science.

To be clear, in “Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study,” a 17-clinic international study published in The Journal of Adolescent Health, the authors explain that:

As still little is known about the etiology of GD and long-term treatment consequences in children and adolescents, there is great need for more systematic interdisciplinary and (world- wide) multicenter research and debate. As long as there are only limited long-term data in support of the guidelines, there will be no true consensus on treatment. To advance the ethical debate, we need to continue to discuss the diverse themes based on research data as an addition to merely opinions. Otherwise ideas, assumptions, and theories on GD treatment will diverge even more, which will lead to (even more) inconsistencies between the approaches recommended by health care professionals across different countries. (372)

I am sure some WPATH members, like the treatment teams in Lieke et al., “feel pressure from parents and adolescents to start with treatment at earlier ages.” I know there are others, besides those reported in Lieke et al. who:

[…] wondered in what way the increasing media attention affects the way gender-variant behavior is perceived by the child or adolescent with GD and by the society he or she lives in. They speculated that television shows and information on the Internet may have a negative effect and, for example, lead to medicalization of gender-variant behavior.

“They [adolescents] are living in their rooms, on the Internet during night-time, and thinking about this [gender dysphoria]. Then they come to the clinic and they are convinced that this [gender dysphoria] explains all their problems and now they have to be made a boy. I think these kinds of adolescents also take the idea from the media. But of course you cannot prevent this in the current area of free information spreading.” –Psychiatrist

It is unconscionable that transgender advocates, and the leading international body concerned with transgender medicine, would seek to quash data that address unsettled and mostly unexplored areas of concern. It is incredibly important that ROGD be included as a research point because the main studies used to justify the use of puberty blockers, cross-sex hormones and surgery in adolescents required “persistent gender dysphoria since childhood” and “no serious comorbid psychiatric disorders that may interfere with the diagnostic assessment” before the patients were eligible for medical intervention. In other words, none of the participants in these treatment studies had adolescent-onset of their gender dysphoria and none of the participants had serious psychiatric issues.

It is a huge leap to assume that an entirely different population of adolescents with a different presentation of symptoms will have the same results as the adolescents in the Amsterdam cohort.  An additional gap in the research is that because all the desistence and persistence studies are about adolescents who had childhood onset of gender dysphoria, the persistence and desistence rates for adolescent-onset gender dysphoria are unknown.

In all areas of medicine, best practices come from intense discussion and research into indications and contraindications, and into risks, benefits, and alternatives. Yet, WPATH’s Karasic, along with the trans advocates who have prominent roles in the organization, appear to believe it is in their community’s best interest to shut down all discussion about contraindications, risks and alternatives. This is inappropriate and undermines the very concept of informed consent.

Furthermore, The Advocate article suggests that Littman’s sample is biased because it gathered data from “unsupportive” parents. This framing is both fallacious and dangerous to gender nonconforming and dysphoric youth. It suggests that the only path for gender dysphoric youth, even those with a rapid onset, is full affirmation including fulfillment of requested medical interventions. It also implies that parents aren’t able to be both supportive and cautious.

I have spoken to some of the parents who participated in the study. Few could be described as “unsupportive.” In fact, almost overwhelmingly, these parents supported their children in thinking about their gender identity and helped facilitate their preferences for atypical gender presentation and interests (taking them for haircuts, new clothing, and so forth). Many sought professional mental health consultations and treatment for their children. But what many of these parents did not support for their underage teenagers were hormonal and surgical interventions. This is an important distinction: Littman’s sample were supportive parents who were unsupportive of a particular medical treatment option.

It is entirely possible to be supportive parents invested in our child’s well-being and not agree to unproven medical procedures for which there is no consensus from the medical community of long-term safety or benefit to the majority of dysphoric youth. However, the loudest voices in pediatric transgender medicine often cite Kristina Olson’s descriptive research about early social transition for children which relies on the methods that they decry as “junk” when used in Littman’s research (targeted recruitment and the collection of data from parents). Kristina Olson recruited her sample from support groups and conferences to find parents who have socially transitioned their children, which might consist only of parents who are supportive of early social and medical transition. So is it an acceptable method for both studies, junk for both studies, or are the WPATH activists simply going by whether they like or dislike the findings?

As all parents know, we can tell when our children are suffering. To remain credible, advocates for gender dysphoric youth and the international organization which claims to be concerned with generating best practices in the field of transgender medicine must acknowledge that ROGD exists and there are some trans-identifying youth who arrive at their identity from external social pressures, and at times, internalized homophobia.

Related to this last point, the WPATH Facebook page wasn’t the only place my respectful questions were deleted. In a comment on The Advocate article itself, I asked Tannehill and Advocate readers to consider the recent research into how homophobic name-calling influences (hint: greatly) children’s perceptions of their gender identity.

brie advocate comment

My comment was swiftly scrubbed from existence. For those interested in reading “The Influence of Peers During Adolescence: Does Homophobic Name Calling by Peers Change Gender Identity?” the full text is here.

Finally, the fact that ROGD is being discussed by the conservative media is not, no matter how many “incriminating” links Tannehill dropped in the Advocate piece, a legitimate reason to discredit the data. The irony is not lost on many 4thWaveNow parents that our stories are covered by media outlets we typically avoid. In this politically charged climate, it is important for researchers, clinicians, and parents to work together to “first do no harm” even when those we otherwise disagree with call for the same cautions.

Clearly, Brynn Tannehill and Dan Karasic do not speak for all members of WPATH. I know for certain that they do not speak for many professionals currently working with gender dysphoric youth who see in their own practices what can only be described as “rapid onset gender dysphoria” in an increasing number of adolescents, particularly girls. Clinicians are aware of the rapidly growing numbers of young people requesting services and the possibility of social contagion; there are those among you who are concerned by the potential for misdiagnosis and the subsequent harm that will come to some of your patients as a result.

It is time for those with concerns to speak out. Please do not allow your ethical and professional concerns to be held hostage by ideology.

Gender dysphoria is not one thing

by J. Michael Bailey, Ph.D  and Ray Blanchard, Ph.D

This is the second in a series of articles authored by Drs. Bailey and Blanchard; see here for their first piece.

Many parents who are part of the 4thWaveNow community have daughters who fit the profile of a sudden onset of gender dysphoria in adolescence. This phenomenon is discussed in detail by the authors after the first two types, in the section “Rapid-onset Gender Dysphoria (Mostly Adolescent and Young Adult Females).” Some 4thWave parents will also find the section “Two Rarer Types of Gender Dysphoria” of particular interest (near the end of the article).

We recognize that regular readers and members of 4thWaveNow will not agree with all of what Bailey and Blanchard have to say, but as always, if you wish to challenge the authors, your comments will be more likely to be published if they are delivered respectfully.

As their time permits, Drs. Bailey and Blanchard will be available to interact in the comments section of this post.


Michael Bailey is Professor of Psychology at Northwestern University. His book The Man Who Would Be Queen provides a readable scientific account of two kinds of gender dysphoria among natal males, and is available as a free download here.

 Ray Blanchard received his A.B. in psychology from the University of Pennsylvania in 1967 and his Ph.D. from the University of Illinois in 1973. He was the psychologist in the Adult Gender Identity Clinic of Toronto’s Centre for Addiction and Mental Health (CAMH) from 1980–1995 and the Head of CAMH’s Clinical Sexology Services from 1995–2010.


One problem with the current mainstream narrative regarding gender dysphoria is that it makes no distinctions among apparently very different kinds of persons. For example, Bruce Jenner appeared to be a very masculine man, an Olympic athlete who was married to three different women and had six children with them, before becoming Caitlyn Jenner. In contrast, Jazz Jennings, a natal male, was so feminine that she earned a diagnosis of gender identity disorder at the age of four. She is attracted to males. Jenner and Jennings are so different in their presentation and history that it is surprising to us that anyone thinks they have the same condition. Jenner and Jennings are examples of two very different kinds of gender dysphoria that have been scientifically well studied, and have fundamentally different motivations, clinical presentations, and likely causes.

The failure of so many therapists and activists to acknowledge this distinction is disturbing for at least two reasons. First, it suggests they are either ignorant of relevant scientific evidence or are purposefully ignoring it. Second, failure to make scientifically valid and fundamental distinctions among different kinds of gender dysphoric persons can only prevent progress toward finding the best approach to helping each. Measles, influenza, and strep throat are all associated with fever. But if we had merely lumped them together as “fever,” we would not have effective treatments for them.

 Types of Gender Dysphoria

Gender dysphoria isn’t common. But there are at least three distinct types of gender dysphoria that, presently, regularly occur in children and adolescents. We summarize these at length here. Two other kinds of gender dysphoria are much less common in these age groups, and so we address them less fully near the end of this essay. The main three types differ in their age of onset (childhood, adolescence, or adulthood), their speed of onset (gradual or sudden), their associated sexual orientations (members of the same sex or the fantasy of belonging to the opposite sex), and their sex ratio (equally or unequally likely in males and females).

The first type—childhood-onset gender dysphoria—definitely occurs in both biological boys and girls. It is highly correlated with homosexuality–the sexual preference for one’s own biological sex–especially in natal males. (Sexual orientation is usually not apparent until a child reaches adolescence or adulthood, however.) This is the type that Jazz Jennings had before her gender transition. The second type—autogynephilic gender dysphoria—occurs only in males. It is associated with a tendency to be sexually aroused by the thought or image of oneself as a female. This type of gender dysphoria sometimes starts during adolescence and sometimes during adulthood, and its onset is typically gradual. (Onset may appear sudden to family members, however.) Although Caitlyn Jenner has not discussed her feelings openly, we strongly suspect she is autogynephilic. The third type—rapid-onset gender dysphoria—mostly occurs in adolescent girls. This type is primarily characterized by the age and speed of onset rather than the associated sexual orientation, and it may not be limited to one sex, as the second type is. Our impression is that rapid-onset gender dysphoria is especially common among daughters of parents who read 4thWaveNow as well as those who post on the support board at gendercriticalresources.com.

The first two types (childhood-onset gender dysphoria and autogynephilic gender dysphoria) have been well studied, although autogynephilic gender dysphoria has primarily been studied in adults. The third (rapid-onset gender dysphoria) has only recently been noticed, and it is possible that it didn’t occur much until recently.

How do you know which type of gender dysphoria your child has? If there were clear signs well before puberty that your child was gender dysphoric, s/he has child-onset gender dysphoria. (You would certainly have noticed signs at the time; at the very least you would have coded your child as extremely gender nonconforming.) If your child showed signs of gender dysphoria for the first time during adolescence, s/he has one of the other types. Remember, autogynephilic gender dysphoria occurs only in natal males, and it starts either during adolescence or adulthood. (And to a parent, it usually seems sudden.) We describe the three types more thoroughly below.

Childhood-onset Gender Dysphoria (Boys and Girls)

The most obvious feature that distinguishes childhood-onset gender dysphoria from the other types is early appearance of gender nonconformity. Gender nonconformity is a persistent tendency to behave like the other sex in a variety of ways, including preferences of dress and appearance, play style, playmate preferences, and interests and goals. A very gender nonconforming boy may dress up as a girl, play with dolls, dislike rough play, show indifference to team sports or contact sports, prefer girl playmates, try to be around adult women rather than adult men, and be known by other children as a “sissy” (a term generally used to ridicule and shame feminine boys). A very gender nonconforming girl shows an opposite pattern, with the less derogatory word “tomboy” replacing sissy.

Onset of gender nonconformity is childhood cases is very early, typically about as early as gendered behavior can be noticed.

It is important to understand that not all gender nonconforming children (even very gender nonconforming children) have gender dysphoria. Probably most don’t, in fact. But we know of no cases of childhood-onset gender dysphoria without gender nonconformity.

Gender dysphoria in the childhood cases requires that children are unhappy with their birth sex. Furthermore, they typically yearn to be–or even assert that they are–the other sex.

What do we know about childhood-onset gender dysphoria?

Childhood-onset gender dysphoria has been systematically studied by two high quality international research centers (one in Toronto, which was led by Kenneth Zucker, and one in the Netherlands, which was led by Peggy Cohen-Kettenis). Both centers have assessed and followed representative samples of gender dysphoric children seen at their clinics. Reassuringly, results are fairly similar across the two sites. Furthermore, their results are similar to less representative samples studied earlier in the United States.

The published literature shows that at least in the past, 60-90% of children whose gender dysphoria began before puberty adjusted to their birth sex without requiring gender transition. That may be changing, however, due to changes in clinical practice that encourage gender transition. (See below.)

It is important to realize that childhood-onset gender dysphoria is the only kind of gender dysphoria that has been well-studied in children and adolescents. This means, for example, that the persistence and desistance figures we have provided apply only to that type. We do not know comparable figures about autogynephilic or rapid-onset gender dysphoria. Furthermore, most people, when they think of “transgender children and adolescents” have childhood-onset gender dysphoria in mind. (And they think of happy Jazz more than they think of Jazz’s serious medical surgeries and hormonal treatment for life.) But this association is misleading for all cases of gender dysphoria that are not childhood-onset. Autogynephilic and rapid-onset gender dysphoria have very different causes and presentations than childhood-onset gender dysphoria.

Sexuality

Children with childhood-onset gender dysphoria have a much higher likelihood of non-heterosexual (i.e., homosexual or bisexual) adult outcomes compared with typical children. Childhood-onset gender dysphoric boys who desist usually become nonheterosexual men. A smaller percentage have reported that they are heterosexual at follow up. Those who transition become transwomen attracted to men.

Although most childhood-onset gender dysphoric girls who have been followed identify as heterosexual, those who desist have a much higher rate of nonheterosexuality compared with the general population. Among those who transition, most are attracted to women.

We repeat: there is no evidence that parents can change their children’s eventual sexual orientation, and we don’t think they should try.

Risk Factors for Persistence of Childhood-onset Gender Dysphoria

Which childhood-onset gender dysphoric children will persist, and which will desist? Evidence suggests that we can’t distinguish these two groups with high confidence, although we can distinguish them better than chance.

There is some evidence that the severity of gender dysphoria distinguishes these two groups, although it is far from a perfect predictor. Children who not only say they want to be the other sex but who assert that they are the other sex may be especially likely to persist. The reasons why a child’s expressed belief that s/he is the other sex predicts persistence remain unclear, and this variable does not allow even near-perfect prediction. The idea that it is the essential test of “true trans” is an overstatement.

Other empirically supported risk factors include being of lower socioeconomic status and having autistic traits, both of which predict persistence. Why should these factors matter? Researchers have speculated that socioeconomically disadvantaged families are more likely to have problems that prevent them from providing the consistent supportive social environment that may be most likely to help the gender dysphoric child desist. Autistic traits include perseverative and obsessional thinking, both of which may make desistance more difficult. Furthermore, parents of children with autistic traits may be so concerned about other problems that they are permissive about things likely to foster gender transition.

One powerful predictor of persistence is social transition, or a child’s living as the other sex. Until recently this was practically unheard of. Increasingly, however, it is not only known but encouraged by many gender therapists. (Watch an episode of “I am Jazz.”) In the Netherlands social transition has been common longer than in the United States. A recent study found that social transition was the most powerful predictor of persistence among natal males. That is, gender dysphoric boys allowed to live as girls strongly tended to want to become adult women. (The same trend occurred for natal females, but it was less robust.) This is not surprising. If a gender dysphoric child is allowed to live as the other sex, what will change his/her mind? No one disputes that gender dysphoric children really, really would like to change sex.

What should you do?

The necessary studies have not been conducted to be certain. But based on the overall picture, we suggest:

If you want your childhood-onset gender dysphoric child to desist, and if your child is still well below the age of puberty (which varies, but let’s say, younger than 11 years), you should firmly (but kindly and patiently) insist that your child is a member of his/her birth sex. You should consider finding a therapist if this is difficult for you and your child. You should not allow your child to engage in behaviors such as cross dressing and fantasy play as the other sex. Above all else, you should not let your child socially transition to the other sex.

At the same time, you should recognize that despite your best efforts, your child may ultimately need to transition to be happy. If your child’s gender dysphoria persists well into adolescence (again, the ages vary by child, but let’s say age 14 or so), s/he is much more likely to transition. At that point, in our opinion, parents should consider supporting transition.

Autogynephilic Gender Dysphoria (Adolescent Boys and Men)

From a parent’s perspective, autogynephilic gender dysphoria (which occurs only in natal males) often seems to come out of the blue. This is likely to be true whether the onset is during adolescence or adulthood. A teenage boy may suddenly announce that he is actually a woman trapped in a man’s body, or that he is transgender, or that he wants gender transition. Typically, this revelation follows his intensive internet research and participation in internet transgender forums. Importantly, the adolescent showed no clear, consistent signs of either gender nonconformity or gender dysphoria during childhood (that is, before puberty).

There is an important distinction between rapid-onset gender dysphoria and autogynephilic gender dysphoria that happens to have an adolescent onset. Rapid-onset gender dysphoria is suddenly acquired, whereas autogynephilic gender dysphoria may be suddenly revealed, after having grown in secret for a number of years. We will talk more about this later.

Where does autogynephilic gender dysphoria come from? We know a lot about the motivation of this kind of gender dysphoria. Most of our knowledge comes from studies of adults born male who transitioned during adulthood. Some of these adults had gender dysphoria during adolescence, but all of them had the root cause of their condition: autogynephilia.

(Warning: Autogynephilia is about sex. We understand that it is awkward and uncomfortable for any parent to consider their children’s sexual fantasies. But you can’t understand your son with this kind of gender dysphoria without doing so.)

Autogynephilia is a male’s sexual arousal by the fantasy of being a woman. That is, autogynephilic males are turned on by thinking about themselves as women, or behaving like women. The typical heterosexual adolescent boy has sexual fantasies about attractive girls or women. The autogynephilic adolescent boy’s may also have such fantasies, but in addition he fantasizes that he is an attractive, sexy woman. The most common behavior associated with autogynephilia during adolescence is fetishistic cross dressing. In this behavior, the adolescent male wears female clothing (typically, lingerie) in private, looks at himself in the mirror, and masturbates. Some autogynephilic males are not only sexually aroused by cross dressing, but also by the idea of having female body parts. These body-related fantasies are especially likely to be associated with gender dysphoria.

It is important to distinguish between autogynephilia and autogynephilic gender dysphoria. Autogynephilia is basically a sexual orientation, and once present does not go away, although its intensity may wax and wane. Autogynephilic gender dysphoria sometimes follows autogynephilia, and is the strong wish to transition from male to female. A male must have autogynephilia to have autogynephilic gender dysphoria, but just because he is autogynephilic doesn’t mean he will be gender dysphoric. Many autogynephilic males live their lives contented to remain male. Furthermore, sometimes autogynephilic gender dysphoria remits so that a male who wanted to change sex no longer does so.

In general, adolescent boys are unlikely to divulge their sexual fantasies to their parents. This is likely especially true of boys with autogynephilia. Furthermore, many boys who engage in cross dressing feel ashamed for doing so. The fact that autogynephilic fantasies and behaviors are largely private is one reason why autogynephilic gender dysphoria usually seems to emerge from nowhere. Another reason is that autogynephilic males are not naturally very feminine. An adolescent boy with autogynephilia does not give off obvious signals of gender nonconformity or gender dysphoria.

It is likely that most autogynephilic males do not pursue gender reassignment, but this is difficult to know. (We would need to conduct a representative survey of all persons born male, asking about both autogynephilia and gender transition. This has not been done and won’t be done anytime soon.) Many males with autogynephilia are content to cross dress occasionally. Some get married to women and many also have children. Family formation is no guarantee against later transition, although that may slow it up somewhat. In past decades, when autogynephilic males have transitioned, they have most often done so during the ages 30-50, after having married women and fathered children. It is possible that autogynephilic males have recently been attempting transition at younger ages, including adolescence.

The relationship between autogynephilia and (autogynephilic-type) gender dysphoria is uncertain. One view is that gender dysphoria may arise as a complication of autogynephilia, depending perhaps on chance events or environmental factors. Another view is that autogynephiles who become progressively gender dysphoric were somewhat different from simple autogynephiles from the beginning (for example, more obsessional). Because we do not actually know the causes of autogynephilia, it is quite difficult to sort out these various interpretations at present.

Autogynephilia—the central motivation of autogynephilic gender dysphoria—can be considered an unusual sexual orientation. As with other kinds of male sexual orientation, we do not know how to change it, and we shouldn’t try. The dilemma is how to live with autogynephilia in a way that allows the most happiness. For some with autogynephilia, this will mean staying male. For others, it will mean transitioning to female.

What do we know about autogynephilic gender dysphoria?

Much of what we know about autogynephilic gender dysphoria comes from research conducted on adults. Most of the early research was conducted by the scientist who developed the theory of autogynephilia, Ray Blanchard. This work was subsequently confirmed and extended by other researchers, especially Anne Lawrence, Michael Bailey, and Bailey’s students.

Blanchard’s research identified two distinct subtypes of gender dysphoria among adult male gender patients. One type, which he called “homosexual gender dysphoria” is identical to childhood onset male gender dysphoria. Males with this condition are homosexual, in the sense that they are attracted to other biological males. Blanchard provided persuasive evidence that the other male gender patients were autogynephilic. We currently favor the theory that there are only two well established kinds of gender dysphoria among males, because no convincing evidence for any other types has been offered. This could change­–we are committed to a scientific open-mindedness. In particular, it is possible that some cases of adolescent-onset gender dysphoria among males are essentially the same as Rapid-onset Gender Dysphoria that occurs among natal females. This will require more research to establish, however.

Autogynephilia is a probably rare, although it is difficult to know for certain. Among males who seek gender transition, however, it is common. In fact, in Western countries in recent years, including the United States, autogynephilia has accounted for at least 75% of cases of male-to-female transsexualism.

Given how important autogynephilia is for understanding gender dysphoria, it may surprise you that you had never heard of it. Autogynephilia remains a largely hidden idea because most people–including journalists, families, and many males with autogynephilia–strongly prefer the standard, though false, narrative: “Transsexualism is about having the mind of one sex in the body of the other sex.” Many people find this narrative both easier to understand and less disturbing than the idea that some males want a sex change because they find that idea strongly erotic.

Although many autogynephilic males find discovery of the idea of autogynephilia to be a positive revelation–autogynephilia has been as puzzling to them as it is to you–some others are enraged at the idea. There are two main reasons why some autogynephilic males are in denial. First, they correctly believe that many people find a sexual explanation of gender dysphoria unappealing–discomfort with sexuality is rampant. Second, they find this explanation of their own feelings less satisfying than the standard “woman trapped in man’s body” explanation. This is because autogynephilia is a male trait, and autogynephilia is about wanting to be female.

It is good to be aware of autogynephilia’s controversial status, because transgender activists are often hostile to the idea. You will not learn more about it from the activists. And if your son has frequented internet discussions, he may also resent the idea. We emphasize that autogynephilia is controversial for social reasons, not for scientific ones. No scientific data have seriously challenged it.

Sexuality

Males with autogynephilia can have a variety of autogynephilic fantasies and interests, from cross dressing to fantasizing about having female bodies to enjoying (for erotic reasons) stereotypical female activities such as knitting to fantasizing about being pregnant or menstruating. One study found that autogynephilic males who fantasize about having female genitalia also tended to be those with the greatest gender dysphoria.

Autogynephilic males sometimes identify as heterosexual (i.e., attracted exclusively to women); sometimes as bisexual (attracted to both men and women), and sometimes as asexual (i.e., attracted to no individuals). Blanchard’s work has shown that autogynephilia can be thought of as a type of male heterosexuality, one that is inwardly directed. Autogynephilia often coexists with outward-directed heterosexuality, and so autogynephilic males usually say they are also attracted to women. Some autogynephilic males enjoy the idea that they are attractive, as women, to other men. They may have sexual fantasies about having sex with men (in the female role); some may even act on these fantasies. This accounts for the bisexual identification among some autogynephilic males. In some others, the intensity of the autogynephilia–which is attraction to an imagined “inner woman”–is so great that there are no erotic feelings left for other people. This accounts for asexual identification. (Asexual autogynephilic males have plenty of sexual fantasies, but these fantasies tend not to involve other people.)

When autogynephilic males receive female hormones as part of their gender transition, they typically experience a noticeable decrease in their sex drive. Some have reported that this has diminished their desire for gender transition as well. Others, however, have reported no change in their desire for transition. (In any case, hormonal therapy is a medical intervention with serious potential side effects, and we do not recommend it as a way to treat gender dysphoria, except in cases in which after very careful consideration, gender transition is pursued.)

Autogynephilia is a paraphilia, meaning an unusual sexual interest nearly exclusively found in males.

We repeat: Autogynephilia is a sexual orientation–to be sure, an unusual orientation that is difficult to understand. There is no evidence that parents can change their children’s sexual orientations. And we don’t think they should try.

What should you do?

Consistent with our values, knowledge, and common sense, we believe that males with autogynephilic gender dysphoria should not pursue gender transition right away, as soon as they first have the idea. Transition ultimately requires serious medical procedures with irreversible consequences. But we are unsure what the right approach to autogynephilic gender dysphoria is. In part, this is because there has been too little outcome research conducted by scientists knowledgeable and open about autogynephilia.

First, we recommend that your son be informed about autogynephilia. The best way to do this is up to you. There is probably no non-awkward way. Consider showing them this blog. People should make important life decisions based upon facts, and for males autogynephilic gender dysphoria, autogynephilia is a fact. The standard “female mind/brain in male body” is a fiction.

Some males become less motivated to pursue gender change when they understand their autogynephilia. However, some do not become less motivated. We know far less about patterns of persistence and desistance of autogynephilic gender dysphoria than we do about childhood onset gender dysphoria.

If an autogynephilic male has become familiar with the scientific evidence, has patiently considered the potential consequences of gender transition over a non-trivial time period, and still wishes to transition, we do not oppose this decision. It is possible that many autogynephilic males are happier after gender transition. But there is no rush for any adolescent to decide.

Rapid-onset Gender Dysphoria (Mostly Adolescent and Young Adult Females)

Rapid-onset gender dysphoria (ROGD) seems to come out of the blue. We think this is because ROGD does come out of the blue. This is not to say that all adolescents with ROGD were happy and mentally healthy before their ROGD began. But importantly, they had no sign of gender dysphoria as young children (before puberty).

The typical case of ROGD involves an adolescent or young adult female whose social world outside the family glorifies transgender phenomena and exaggerates their prevalence. Furthermore, it likely includes a heavy dose of internet involvement. The adolescent female acquires the conviction that she is transgender. (Not uncommonly, others in her peer group acquire the same conviction.) These peer groups encouraged each other to believe that all unhappiness, anxiety, and life problems are likely due to their being transgender, and that gender transition is the only solution. Subsequently, there may be a rush towards gender transition, including hormones. Parental opposition to gender transition often leads to family discord, even estrangement. Suicidal threats are common.*

We believe that ROGD is a socially contagious phenomenon in which a young person–typically a natal female–comes to believe that she has a condition that she does not have. ROGD is not about discovering gender dysphoria that was there all along; rather, it is about falsely coming to believe that one’s problems have been due to gender dysphoria previously hidden (from the self and others). Let us be clear: People with ROGD do have a kind of gender dysphoria, but it is gender dysphoria due to persuasion of those especially vulnerable to a false idea. It is not gender dysphoria due to anything like having the mind/brain of one sex trapped in the body of the other. Those with ROGD do, of course, wish to gender transition, and they often obsess over this prospect.

The subculture that fosters ROGD appears to share aspects with cults. These aspects include expectation of absolute ideological agreement, use of very specific jargon, thinking of the world as “us” versus “them” (even more than typical adolescents do), and encouragement to cut off ties with family and friends who are not “with the program.” It also has uncanny similarities to a very harmful epidemic that occurred a generation ago: the epidemic of false “recovered memories” of childhood sexual abuse and the associated epidemic of multiple personality disorder. We discuss these more below. First, however, we review what little we know about ROGD.

What About Natal Males?

Why do we keep emphasizing natal females versus natal males? There are three reasons. First, the single study that has been conducted on ROGD found substantially higher numbers of females than males (more than 80% female cases). Second, there has been a striking surge in the number of adolescent females identifying as transgender and presenting at gender clinics. Third, there is a different kind of gender dysphoria–Autogynephilic Gender Dysphoria–that likely accounts for most or all of the apparent cases of ROGD in natal males. However, we cannot be completely sure that the smallish number of ROGD cases in natal males are due to autogynephilia. It’s possible, therefore, that what we discuss here applies to some natal males as well.

What Do We Know?

ROGD is such a recent phenomenon that we know little for certain. We have four sources of data. First, an important study of ROGD has been presented by Lisa Littman at the annual meeting of the International Academy of Sex Research. (It has not yet been published, but we suspect it will be soon.) This is the only systematic empirical study to date. Second, we have had numerous conversations with mothers of girls with ROGD. Third, we have read several case studies of the phenomenon. Fourth, we have been in touch with clinicians who work (either as therapists or consultants) with children with ROGD, or their families. Fortunately, the sources have provided convergent findings. We are fairly confident about the following generalizations:

–The large majority of persons with ROGD are female, and the most typical age of onset ranges from high school to college ages.

–Persons with ROGD have a high rate of non-heterosexual identities before the onset of their ROGD.

–Signs of extreme social contagion are typical. For example, this includes multiple peer group members who all began to identify as transgender. Sometimes this occurs after school-sponsored transgender educational programs.

–Persons with ROGD have high rates of certain psychiatric problems, especially aspects related to borderline personality disorder (e.g., non-suicidal self-harm) and mild forms of autism (that used to be called “Asperger Syndrome).

–In general, the mental health and social relationships of children with ROGD get much worse once they adopt transgender identities.

–Parents resisting their children’s ROGD are not “transphobic” or socially intolerant. These are parents who, for example, usually approve of gay marriage and equal rights for transgender persons.

Our Current Take on ROGD

Rapid-onset Gender Dysphoria (ROGD) occurs when a young person (generally an adolescent female) is persuaded that she is transgender, despite strong evidence that the young person had few or no signs associated with established forms of transgender. How and why does this happen?

Despite the very limited available research to date, we have strong intuitions and hunches about what is going on, based on its similarity to similar phenomena in the past: the recovered memories and multiple personality epidemics. We spend considerable effort in this section both explaining these past epidemics and drawing the parallels to the current one that concerns us now: Rapid-onset Gender Dysphoria. We believe that she who forgets (or ignores) the past is doomed to repeat it.

During the 1990s there was an explosion of cases in which women came to believe that they had been sexually molested, usually by their fathers and often repeatedly and brutally. They believed these things even though prior to “recovering” these “memories”–most often during psychotherapy–they did not remember anything like them. They believed in the memories even though the memories were often highly implausible (for example, family members would have noticed). Many women with recovered memories cut off relationships with their families. Some developed symptoms of multiple personality disorder. We know now that the recovered memories were false. And multiple personality disorder doesn’t exist, at least in the way those affected and their therapists believed. We refer to recovered memories and multiple personality disorder, which have similar causes–and also some similar causes to ROGD–as RM/MPD

Here are the main similarities between ROGD and RM/MPD:

  1. Cases consistent with RM/MPD were very rare prior to the 1980s but became an epidemic. The same appears to be happening with ROGD.
  2. Both have primarily affected young females, although RM/MPD began substantially later (on average, age 32) than ROGD (typically during adolescence). (Another destructive epidemic of social contagion–witch accusations in colonial Salem–primarily involved adolescent girls.)
  3. The explanations of both RM/MPD and ROGD by “true believers” are contradicted by past experience, common sense, and science. Memory and personality integration did not work the way that therapists treating RM/MPD believed they did. For example, children and adults who experienced trauma can’t repress them–they remember them despite their best attempts. And gender dysphoria in natal females does not begin after childhood–unless it is the acquired condition that is ROGD.
  4. Both show ample evidence of social contagion of false, harmful beliefs. In RM/MPD, the “infection route” usually went from therapists who strongly believed in RM/MPD to their suggestible patients, who acquired a similar belief, applied it to their own lives, and manufactured false and monstrous accusations against previously loved ones. (A harmful result of therapy or medical treatment is called iatrogenic,) In ROGD, the infection route appears to be primarily directly from youngster to youngster. To be sure, therapists get into the act after the person with ROGD acquires the belief that she is transgender, and then they are complicit in tremendous harm. But it seems rarely to occur (yet) for a youngster to be talked into ROGD by a therapist.
  5. Both are associated with sociopolitical ideologies. (Interestingly, both ideologies still find comfortable homes in Gender Studies programs in many universities.) For RM/MPD, the ideological system was that men’s sexual abuse of children has not only been too common (true), but that it has been rampant, even the rule (false). Couple this ideology with a belief in Freudian theory and methods (like hypnosis), and what could go wrong? Plenty, it turned out. For ROGD, the relevant ideology is less coherent, but includes the seemingly contradictory ideas that gender is “fluid” (here meaning that not everyone fits into a male-female dichotomy); that forcing people into rigid gender categories is a common cause of societal and personal anguish; but that gender transition is an underused way of helping people.
  6. Both RM/MPD and ROGD are associated with mental health issues, generally, and especially a personality profile consistent with borderline personality disorder (BPD). This is not to say that all persons with either RM/MPD or ROGD have BPD; simply that evidence suggests that it is common in these groups. For example, the high rate of non-suicidal self-injury we have noticed from the aforementioned sources is striking. Such behavior is strongly associated with BPD. (For a discussion of BPD among those with RM/MPD, see this article, pages 510ff.)
  7. Adopting the belief that one has either RM/MPD or ROGD has been associated with a marked decline in functioning and mental health.

Some of the factors that seem to be common in ROGD–and some that are similar between ROGD and RM/MPD–likely encourage the adoption of false beliefs and identities. These include a fragile sense of self (BPD), attention seeking (BPD), social difficulties (BPD and autistic traits), social malleability (BPD, and adolescence), social pressure (adolescence), and strongly held (if irrational and poorly supported) beliefs that make embracing false conclusions especially likely (sociopolitical indoctrination). Adolescents with an actual history of gender nonconformity, or whose sexual orientations are non-heterosexual, may be especially vulnerable to believing that these are signs they have always been transgender. Adolescents whose lives have not been going well may be especially looking for an explanation and may be especially receptive to drastic change.

Based on the aforementioned data sources with which we are familiar, and on our informed hunches, we suspect that many persons with ROGD were usually troubled before they decided they were gender dysphoric and many will lead somewhat troubled lives even after their ROGD (hopefully) dissipates. Of course, ROGD can only make things worse, both for the affected person and her family.

What to do

Because ROGD is such a recent phenomenon, there is very little guidance about helping affected persons. Lisa Marchiano has written two excellent essays abounding with good sense, and we recommend starting with those.

Second, set aside, for now, rapid-onset gender dysphoria. Identify your child’s problems that existed before ROGD and that may have contributed to it. Attending to these problems will be useful for everybody, and perhaps your child will even agree.

Third, with respect to ROGD, do what you can to delay any consideration of gender transition. Of the different kinds of gender dysphoria, ROGD is the type for which gender transition is least justifiable and least researched. Remember, ROGD is based on a false belief acquired through social means. None of the aforementioned factors that have caused your child to embrace this false belief will be corrected by allowing her to transition.

Two Rarer Types of Gender Dysphoria

For the sake of completeness, we include two other kinds of gender dysphoria. We suspect that both are rare, even among persons with gender dysphoria. One of us (Blanchard) has seen cases of the first type, autohomoerotic gender dysphoria, which appears to be an erotically motivated gender dysphoria. In this case, sexually mature natal females (i.e., not biologically still children) become sexually preoccupied with the idea of becoming a gay man and interacting with other gay men. Neither of us has seen someone clearly fitting the second type, gender dysphoria resulting from psychosis. (Our inclusion of this type was motivated in large part by the argument of Dr. Anne Lawrence, an important scholar we both respect.) In this type, a person (either male or female by birth) acquires the delusion that s/he is the other sex, because s/he is suffering from gross thinking deficiencies.

Superficially, both of these conditions have some similarities to some other kinds of gender dysphoria. For example, a female with rapid onset gender dysphoria may be sexually attracted to males and thus strive to become a gay man, similar to autohomoerotic gender dysphoria. The important difference is that the female with rapid onset gender dysphoria is not primarily motivated by an erotic desire to be a gay man. Instead, having the prospect of having sex with gay men is a by-product of her condition, not the main point of it. The female with rapid onset gender dysphoria acquires it via social contagion, broadly speaking (i.e., including cultural signals that gender dysphoria is in some crucial ways desirable). With respect to the other rare subtype, we have both known gender dysphoric persons with psychosis. However, in these cases, the psychosis was not the cause of the gender dysphoria. It was simply an additional problem that the gender dysphoric person had. In the case of gender dysphoria resulting from psychosis, the belief that one is transgender (or the other sex) is clearly a delusion resulting from disordered thinking–and not, for example, from social contagion or autogynephilia.

Autohomoerotic Gender Dysphoria

This rare type of gender dysphoria is limited to females. Published cases have consisted of women whose gender dysphoria began in late adolescence or adulthood. (It is conceivable that it might begin earlier in some cases.) It occurs in (heterosexual) females who are sexually attracted to men, but who wish to undergo sex reassignment so that they can have “homosexual” relations with other men. These females appear to be sexually aroused by the thought or image of themselves as gay men. We have created the label autohomoerotic gender dysphoria to denote this sexual orientation. There are little systematic data on this type of gender dysphoria, although clinical mentions of heterosexual women with strong masculine traits, who say that they feel as if they were homosexual men, and who feel strongly attracted to effeminate men go back over 100 years.

It is well documented that at least a few autohomoerotic gender dysphorics have undergone surgical sex reassignment and were satisfied with their decision to do so. There is no compelling reason to question such self-reports of postoperative satisfaction, although current surgical techniques do not produce fully convincing or functional artificial penises, and it is difficult to imagine that autohomoerotics find it easy to attract gay male partners who can overlook this.

This type of gender dysphoria does not appear to be the female counterpart of autogynephilic gender dysphoria, although the differences might appear subtle. Autogynephilic (male) gender dysphorics are attracted to the idea of having a woman’s body; autohomoerotic (female) gender dysphorics are attracted to the idea of participating in gay male sex. For autogynephiles, becoming a lesbian woman is a secondary goal—the logical consequence of being attracted to women and wanting to become a woman. For autohomoerotics, becoming a gay man appears to be the primary goal or very close to it.

The few available case reports suggest that autohomoerotic gender dysphoria may have ideational or behavioral antecedents in childhood. However, these females are not as conspicuously masculine as girls with (pre-homosexual) Childhood Onset Gender Dysphoria. For this reason, and because it is rare to start with, it is unlikely that many parents will detect this syndrome in daughters. It is conceivable, however, that when they occur, cases of autohomoerotic gender dysphoria may be perceived by others as Rapid Onset Gender Dysphoria. This is not because their gender dysphoria arose suddenly, but rather because their early, atypical erotic fantasies were invisible to their parents.

Gender Dysphoria Caused by Psychotic Delusions

The idea that gender dysphoria can sometimes reflect psychotic delusions is certainly plausible. Delusions in schizophrenia, for example, are often bizarre but compelling to the person who has them. Unfortunately, neither of us (Ray Blanchard or Michael Bailey) has had direct contact with a person clearly meeting this profile, and so we have less confidence in this gender dysphoria category than in the others. Our lack of direct familiarity doesn’t necessarily mean that much. Even if gender dysphoria due to psychosis were fairly common (compared with other forms of gender dysphoria), we wouldn’t have expected to come across it. Persons with severe mental illness have generally been treated for their mental illness and not for gender dysphoria. Until recently, clinics treating persons with gender dysphoria would have screened out patients with severe mental illness, because of concerns that their diagnosis and treatment might be compromised. But we are hesitant to embrace this kind of gender dysphoria as “definitely existing,” because we worry that psychiatrists who have claimed to see it may have been insufficiently trained to notice other kinds of gender dysphoria, such as autogynephilia. Thus, they may have concluded that psychosis caused the gender dysphoria, when in fact, psychosis may have simply occurred with autogynephilia within the same person. One of us (Bailey) has recently been in touch with a mother of a young man who appears to have the profile we would expect for gender dysphoria due to psychotic delusions, and there was no evidence that this young man was autogynephilic. Still, we are least sure about the existence–much less the prevalence–of this kind of gender dysphoria.

Not Just One Type of Gender Dysphoria: Some Implications

It should be clear by now that “gender dysphoria” is not a precise enough term. Parents of gender dysphoric children should know which type of gender dysphoria their child has. To do so it is necessary to learn about all three of the most common types. That is, in order to understand why one’s child is Type X, it is necessary to know why s/he is not Type Y or Type Z. This is not simply academic. There are essential differences between the different types of gender dysphoria.

If knowledge is power, then lack of knowledge is malpractice. The ignorance of some leading gender clinicians regarding all scientific aspects of gender dysphoria is scandalous. To do better, they should start here. We recommend against hiring gender clinicians who are hostile to our typology. Ideally, they would agree with it.

Knowing there are very distinct kinds of gender dysphoria also raises questions–and concerns–about transgender persons of one type using their own experiences to make recommendations for children/adolescents of other types. Nothing in Caitlyn Jenner’s experience allows her to understand what it was like to be Jazz Jennings–and vice versa. Yet a number of vocal transgender activists who have histories typical of autogynephilic gender dysphorics do not hesitate to pressure parents, legislators, and clinicians for acquiescence, laws, and therapies that do not distinguish among types of gender dysphoric children. Moreover, they not infrequently claim inside knowledge based on their own experiences. Yet their experiences are irrelevant to the two types of gender dysphoria that they don’t have. And even with respect to autogynephilia, these transgender activists are nearly all in denial. This means that their public recollections of their experiences are either distorted or outright lies. A notable exception is Dr. Anne Lawrence, who has become an important researcher of gender dysphoria, and who has been honest and open about her autogynephilia. Dr. Lawrence has taken the time to learn the scientific literature regarding different types of gender dysphoria and does not insist that her personal experiences apply to non-autogynephilic gender dysphorics. The biggest victims in the attempts by autogynephiles-in-denial to steer the narrative towards sameness are, in fact, other persons with autogynephilia. These include honest autogynephiles, who frequently contact us but are fearful of public attacks by those in denial. Most relevant to this blog as potential victims are autogynephilic youngsters, who are at risk of being swayed toward decisions they would not otherwise make, on the basis of inaccurate fantasies embraced by those who cannot face the truth of their own condition.

To us, the most tragic group, along with their families, includes those who have acquired rapid-onset gender dysphoria. That condition appears to be the tragic interaction of the current transgender zeitgeist (“It’s everywhere, and it’s great!”) and social media with the vulnerability of troubled adolescents, especially adolescent girls. They are at risk for unnecessary, disfiguring, and unhealthy medical interventions.


*Note. Suicide is tragic and awful, and because of this, we recommend taking seriously your child’s suicidal ideas, threats, and gestures. We have written elsewhere about the risk of suicide among gender dysphoric persons, and we think that this risk is elevated compared with non-gender-dysphoric persons, but still unlikely.


 

An inconvenient survey: Activists scheme to squelch research on teen social contagion

One might think that purported pediatric gender experts would have a vested interest in investigating all facets of the current worldwide massive increase in kids wanting to chemically and surgically transition to the opposite sex. After all, in most civilized societies, adults want to protect young people and seriously ponder what’s best for them—all of them. Certainly, when it comes to permanent, lifelong medical interventions, most responsible professionals who work with youth would realize that not everyone who wants a treatment is necessarily a good candidate for it; as one bioethicist memorably put it, “a doctor is not a candy seller.

But at least one director of a well known pediatric gender center and national trans activist lobbying group in Portland, OR—a full-grown adult who nevertheless takes to Facebook to brand anyone not fully on board with the organization’s mission as a “TERF ” or “anti-trans hate group” —evidently cannot tolerate a researcher even studying the phenomenon of teens who came quite suddenly to the idea of transgender identity. [Note: All screen captures are from Burleton’s publicly accessible Facebook page.]

burleton on survey

The survey study, “Rapid onset gender dysphoria, social media, and peer groups” (still actively recruiting participants) seeks to better understand, via parent survey, the phenomenon of teenagers who (after never previously expressing gender dysphoria) suddenly announce they are the opposite sex.  Many parents in the 4thWaveNow community have teens who, in many cases, have demanded immediate access to medical transition, with all that entails—cross sex hormones (with concomitant permanent body changes, particularly for biological females), and major surgery, often involving removal of both breasts. Some of these teens changed their minds about transition, while others have not–but all are worth studying in the interests of discovering whether there is (as many of us have observed) a social contagion contributing to the increase in teens (especially teen girls) who express a desire to become the opposite sex.

Wouldn’t any reputable purveyor of a treatment which will change the lives of teenagers forever have even a modicum of intellectual curiosity about what such a survey might reveal? One would think, also, that Jenn Burleton might feel slightly chastened after recently hearing from a detransitioned, former teen client who was unhappy about the fast-track transition that was enabled by TransActive gender counselors. Instead, Burleton (whose Facebook description lists only studying “Resilience at the University of Life“ as professional credentials) would rather  cast aspersions on the MD/MPH conducting the “bogus” study, as well as the organizations and websites (including this one) which have publicized the research effort.

Commenters on Burleton’s post (who were obviously approved by Burleton) go even further, with one intending to deliberately “throw off the statistics” on the survey.

burleton commenters 2.jpg

Burleton obviously approves of the “throw off the statistics” scheme:

burleton+likes

If trans activists are so confident that kids as young as 3 or 4 can be legitimately and reliably diagnosed as “transgender” and in dire need of intervention by organizations like TransActive, why would the executive director need to stoop to childish tactics like screaming “TERF” and encouraging Facebook followers to gum up a survey study? What’s the worry? Why wouldn’t someone with such a huge responsibility for the well being of teenagers want to learn more about teens who were simply following a social trend, later changed their minds, or who actually might not be appropriate for treatment?

Burleton’s open hostility and the jeering, sophomoric reaction of the post’s followers lead inexorably to a question: Are some key activists in the forefront of pediatric transition genuinely interested in looking at all the evidence about “trans kids”? Or are they, instead, driven by a desire to shut down any and all inconvenient fact-finding efforts when it comes to promoting drastic medical interventions for other people’s children?

Anyone with a rudimentary understanding of the meaning of a Facebook “like” won’t have much difficulty answering that question.

Rapid-onset gender dysphoria: New study recruiting parents

UPDATE August 18, 2016: The National Review is reporting this morning that the study was “launched” by 4thWaveNow. While we are very glad to see this research effort take place, the study was initiated and is being carried out by Lisa Littman, MD, MPH at Mt. Sinai in New York. Please see below for details.


Many members of the 4thWaveNow community are parents of teens who became convinced they were the opposite sex after a steady diet of social media and/or peer influence. In most of our cases, the transgender identity came on suddenly and with little warning.

Our families’ experiences haven’t been acknowledged nor reflected in the mainstream media, but now a researcher has decided to systematically investigate the phenomenon.

The survey study is being conducted by Lisa Littman, MD, MPH, Adjunct Assistant Professor, Icahn School of Medicine at Mount Sinai, New York. Dr. Littman’s survey description is below. The SurveyMonkey link at the bottom of this post contains more detailed information.

If you are–or know of–a parent in this situation, please consider participating in the survey. Note that responses are kept anonymous.


Rapid onset gender dysphoria, social media, and peer groups

GCO# 16-1211-00001-01-PD

We have heard from many parents describing that their child had a rapid onset of gender dysphoria in the context of increasing social media use and/or being part of a peer group in which one or multiple friends has developed gender dysphoria and come out as transgender during a similar time frame. Several parents have described situations where entire friend groups became gender dysphoric. This type of presentation is atypical and has not been studied to date.  We feel that this phenomenon needs to be described and studied scientifically.

If your child has had sudden or rapid development of gender dysphoria beginning between the ages of 10 and 21, please consider completing the following online survey. If you have more than one child with gender dysphoria who fits the above description, please complete one survey per child.

This survey is completely anonymous and confidential and conducted through Survey monkey, an independent third- party. There is no way to connect your name with your responses. We do not track email or IP addresses. The survey should take 30-60 minutes. Participation in this research study is voluntary, and you may refuse or quit at any time before completing the survey.

If you know of any individuals with a similar experience who might be eligible for this survey, or any communities where there might be eligible parents, please copy and paste this recruitment notice and survey link to share.

https://www.surveymonkey.com/r/SCX9RZY

Littman ressearch study