The "Rapid Onset Gender Dysphoria" Controversy

Gender dysphoria is a term that many of us are still learning about and gaining understanding of. So when a researcher published a paper that undermined much of what advocates for transgender rights strive to help the general population understand and accept, it caused quite a stir.

Ahead, we will examine the controversial work and its impact on transgender and gender diverse individuals and families.

What Is "Rapid Onset Gender Dysphoria?"

The term "rapid onset gender dysphoria" was presented in a paper by Brown University's Lisa Littman, MD, MPH, in 2018 in a journal called PLOS One. Littman wrote the paper as if rapid onset gender dysphoria were an actual condition, but it wasn't based on studies, or even facts.

What the Paper Claimed

Littman's claim was that around the time of adolescence, children were becoming dysphoric about their gender suddenly as a result of peer pressure and social media, and using that dysphoria as a coping mechanism.

She postulated that gender dysphoria was like anorexia for teen girls, and wasn't an actual medical condition, which it is, so much as a cultural and temporary response to the difficulties of puberty. She also claimed that these children had not been transgender prior to puberty.

In the article, Littman defined rapid onset gender dysphoria as "a type of adolescent-onset or late-onset gender dysphoria where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood."

She made this claim based on anecdotal "evidence" from parents of children and teenagers, not from clinical research. As nearly 2% of youth identify as trans, this claim affected a substantial portion of the population.

The paper did not take into account the fact that it's normal and common for children to keep sensitive information to themselves, and to present it to their parents when they feel ready.

By framing the fact that children may not tell their parents about their dysphoria until they're in the pre-pubescent stage, Littman discounted the very simple way that humans of all ages deal with complex emotions: by expressing them when they are ready to.

The Harm of Claiming "Rapid Onset Gender Dysphoria" Is Real

Advocacy for trans rights is still in its youth, and many people remain unaware of the struggles that transgender, gender non-conforming, and other gender diverse people face on a daily basis.

There are numerous anti-trans rights bills in the legislature, and transgender and gender-nonconforming people are targeted for hate crimes regularly.

In addition to doing damage to advocacy for trans rights on a large scale, claiming that teenagers and pre-teens are not actually experiencing a very real medical condition can prevent them from getting the treatment they need and deserve. This can affect countless children who might otherwise get the appropriate medical and psychiatric care for their condition.

Puberty is the time when medical intervention becomes necessary. Hormone blockers stop the progression of changes that would otherwise occur, and that intervention leads to a higher survival rate of the children who receive it.

Transgender youth are more likely to suffer from depression than their cisgender peers. In fact, 1 in 3 have reported attempting suicide. When trans youth experience parental support, though, they are more likely to be healthy individuals.

That health encompasses everything from self-esteem to adequate food supply. That means that how parents feel about their child being trans, and how they deal with it, has a huge impact on the well-being, and the very survival, of their children.

Pushback From Psychiatric Professionals

Luckily, the psychiatric industry didn't take kindly to Littman's paper. Within months of the paper's release, PLOS One published a "corrected" version of it, which addressed the many concerns being brought up over the unscientific nature of the article.

WPATH, which stands for The World Professional Association of Transgender Health, was the most directly relevant authority organization that spoke out against the article. Because WPATH creates the standards of care used for transgender medical care, the medical and psychiatric industries listened when they published their rebuttal.

WPATH clearly stated that they advocate for science-backed and evidence-based literature to be used when theorizing about transgender issues and considering medical treatment for trans patients.

The organization also noted that the term could be used to instill fear in treating trans patients, which can cause lifelong harm to them. Considering the importance of hormone blockers during puberty, pushing parents to question their children's authenticity about their own medical condition could be seen as an attempt to block access to care at a vital time.

Others in the research community worked to upend the claims made by Littman. A fellow of Littman's at Brown University named Arjee Javellana Restar published a response to the piece entitled "Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of 'Rapid-Onset Gender Dysphoria.”

Restar notes that "in Littman’s case, the majority of methodological and design issues stem from the use of a pathologizing framework and language of pathology to conceive, describe, and theorize the phenomenon."

Where the Term "Rapid Onset Gender Dysphoria" Stands Now

After being thoroughly debunked, the concept of "rapid onset gender dysphoria" did not make it further into the mainstream. That said, it can still be accessed and still exists on the internet. When parents are told by their child about their gender dysphoria, the "corrected" version of the article, may be something they come across.

By keeping something that appears to be scientific research, but actually isn't, out in the world, further harm can be caused.

If a parent looking to understand their child's dysphoria is surprised by it, they could resonate with Littman's claims about the child's dysphoria being temporary and not real, but rather a coping mechanism caused by peer pressure or social media.

A Word From Verywell

Getting your child the proper care for gender dysphoria may be a lifesaver. While there is much misinformation on the internet about it, gender dysphoria is a real medical condition that is acknowledged in the DSM 5, and it can be diagnosed and treated by a medical professional.