Rapid Onset Gender Dysphoria: Does it Exist?

workshop on resiliency and overcoming traumaThe American Psychiatric Association (APA) defines a person as having gender dysphoria when they feel strongly that they don’t identify with the biological gender they were born with, when it causes them distress, and when they have felt this way for at least six months. Although children as young as age four may express gender nonconformity, often a person isn’t aware of their gender dysphoria until they reach puberty and recognize they are not comfortable with the new changes going on in their bodies. Because this realization may take their families by surprise, some researchers have been recently exploring a new subset of gender dysphoria called Rapid Onset Gender Dysphoria (ROGD). On the surface, ROGD seems to occur very suddenly and without the child having expressed any prior distress with their physical gender.

What is Rapid Onset Gender Dysphoria?

The term “Rapid Onset Gender Dysphoria” has only sprung up within the past decade or so. ROGD has not been established as a distinct syndrome and this type of dysphoria has only been casually – but not scientifically – observed.

In ROGD, an adolescent or young adult who has seemingly always identified as their physical (birth) gender abruptly starts to identify as another gender. It is important to note that the child would not have met the APA’s criteria for gender dysphoria prior to this, nor would they have shown any discomfort with their birth gender. Moreover, often multiple friends within the child’s same peer group simultaneously begin to identify with another gender and become gender dysphoric around the same time.

Why is ROGD Controversial?

A Brown University researcher recently published a study designed to empirically describe teens and young adults who did not have symptoms of gender dysphoria during childhood but who were observed by their parents to rapidly develop gender dysphoria symptoms over days, weeks or months during or after puberty.” The study author, Lisa Littman, is an assistant professor of the practice of behavioral and social sciences at Brown’s School of Public Health.

For the study, Littman surveyed more than 250 parents who had reported their children developing gender dysphoria within a very short time period. Of these parents, about 45 percent noticed that their child had increased their social media use before announcing their dysphoria. They also told Littman that the child had one or more friends who had become transgender-identified around the same time as their child.

These findings led to Littman’s hypothesis that gender dysphoria could be spread, at least partially, by social contagion. She proposed that a child’s peers, coupled with information obtained from social media, could cause the child to embrace certain beliefs, such as the idea that feeling uneasy with the gender you were born with meant you were gender dysphoric. Because many gender nonconforming teens also push for medical transition to the gender with which they identify, Littman went further and suggested that medical transition could be a harmful coping tool in much the same way that alcohol or substance abuse are negative coping mechanisms.

Her hypotheses set off a firestorm. Transgender advocates aggressively condemned Littman’s study saying, in part, that it was methodologically flawed because Littman only interviewed parents and did not get input from the transgender-identifying children. They also called the study “antitransgender” and a denial of transgender affirmation while citing the fact that a person who is questioning their gender would naturally read up on the subject and communicate with supportive friends who had similar thoughts and feelings. Advocates also pointed out that a true gender dysphoria diagnosis requires evaluation by specialists, but the Rapid Onset Gender Dysphoria study only required the parent’s perspective.

As a result of the criticism, Brown University withdrew their press release about the study. They also released a statement explaining their decision to conduct a post-publication re-review of Littman’s Rapid Onset Gender Dysphoria study. They worried that the study “could be used to discredit efforts to support transgender youth and invalidate the perspectives of members of the transgender community.”

Gender Dysphoria Treatment

We know that gender dysphoria exists, but clearly more research is needed in order to settle the question of whether Rapid Onset Gender Dysphoria is real.

For those with gender dysphoria, early diagnosis, gender-affirming approaches by parents and family, as well as individual and family counseling can help the transgender person and their loved ones deal with the emotional challenges of gender transition.

Often, transgender people take some type of action to outwardly embrace the person they feel they are. They may change their name to one more aligned with the gender they express or may dress as that gender. Other options may include taking puberty blockers, hormones to develop the physical traits of the gender they identify with, or completing sex-reassignment surgery.

We know that people with gender dysphoria have higher rates of mental health conditions like depersonalization disorder, anxiety, depression and mood disorders, and suffer from an increased rate of substance abuse. They also have higher suicide rates, therefore it is important for them to seek mental health treatment. The objective of this treatment is not to change the person’s feelings about their gender, rather it is to give them a way to deal with the emotional issues that come with their gender dysphoria.

Get Answers about Gender Dysphoria and Rapid Onset Gender Dysphoria

If you or a loved one are distressed, anxious, or depressed about your gender identity or worried about ROGD, we can help. Contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida for more information or call us today at 561-496-1094.

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