Table of ContentsView AllTable of ContentsDefinitionSymptomsOriginControversyCriticismStudy RevisionsConflicting Research
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Origin
Controversy
Criticism
Study Revisions
Conflicting Research
Rapid-onset gender dysphoria is a controversial theory that attributes a rise in gender dysphoria among teens to social contagion and suppressed sexual or gender trauma.
It is not a clinical diagnosis but a hypothesis from a 2018 study that was widely covered in the media.However, concerns over the paper’s methodology prompted a post-publication review, and it was later republished with substantial edits.Newer research casts further doubt on the rapid-onset theory.
This article discusses the theory of rapid-onset gender dysphoria. It explains the initial study, its controversy, and why it was edited after publication. It also looks at recent studies published in the aftermath and where the theory stands today.
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What Is Rapid-Onset Gender Dysphoria?
Rapid-onset gender dysphoria is a theoretical new subtype of gender dysphoria.
Gender dysphoriaoccurs when there is a conflict between an individual’s assigned gender at birth and the gender they identify with. Rapid onset means it appears suddenly.
Rapid-onset gender dysphoria is the seemingly sudden appearance of gender identity issues that first become evident during puberty or shortly thereafter.
It is not a recognized diagnosis but a controversial research theory.
Signs and Symptoms of Gender Dysphoria
People with gender dysphoria often experience a deep sense of unease and distress that their biological sex does not match their gender identity.
Gender dysphoria can cause emotional pain and distress that interferes with work, school, religion, and other social situations. It is associated with anxiety, depression, and suicidal thoughts.
Signs of gender dysphoria can be present in childhood or may not appear until after puberty.
Children with gender dysphoria may:
In addition to the symptoms in children, adults with gender dysphoria may also:
Origin of the Theory of Rapid-Onset Gender Dysphoria
The concept of rapid-onset gender dysphoria is based on research published in August 2018 in the journalPLOS One.
The study involved a 90-question survey of 256 parents with a child who developed gender dysphoria during or after puberty.
The researchers concluded that rapid-onset gender dysphoria is:
The study authors developed two hypotheses to explain the increase in teens identifying as transgender:
Additional Study FindingsAccording to the study, survey responses showed:Rapid-onset gender dysphoria is four times more common among those assigned female at birth than male (82.8%).The average age for coming out as trans to parents was 15.2 years.Almost two-thirds (62.5%) had a prior mental health disorder or neurodevelopment disability diagnosis.More than one-third (36.8%) socialize in friend groups where the majority of peers identify as trans.Almost half (47.2%) reported declines in their child’s mental health after identifying as trans.Over half (57.3%) reported a strain in the parent-child relationship after coming out.The majority (86.7%) reported their child’s sudden onset of dysphoria coincided with increased social media and internet use, friendships with peers who identify as trans, or both.
Additional Study Findings
According to the study, survey responses showed:Rapid-onset gender dysphoria is four times more common among those assigned female at birth than male (82.8%).The average age for coming out as trans to parents was 15.2 years.Almost two-thirds (62.5%) had a prior mental health disorder or neurodevelopment disability diagnosis.More than one-third (36.8%) socialize in friend groups where the majority of peers identify as trans.Almost half (47.2%) reported declines in their child’s mental health after identifying as trans.Over half (57.3%) reported a strain in the parent-child relationship after coming out.The majority (86.7%) reported their child’s sudden onset of dysphoria coincided with increased social media and internet use, friendships with peers who identify as trans, or both.
According to the study, survey responses showed:
Controversy and Response
The study’s publication led to an almost immediate outcry from the gender-diverse community and researchers in the transgender health field.
WPATH Response
TheWorld Professional Association of Transgender Health(WPATH), the International body that sets the standards of care for transgender medicine, quickly issued a statement criticizing the study.
The statement also cautioned against any term used “to instill fear about the possibility that an adolescent may or may not be transgender with the a priori goal of limiting consideration of all appropriate treatment options.”
Conservative Media Coverage
At the same time, conservative media hailed the study as validation for parents who don’t believe their children are truly transgender and have deep concerns about a medical establishment that supports gender-affirming care in youth.
Criticism of the Study
Critics of the study expressed concerns over methodology and researcher bias toward anti-transgender beliefs.
Methodology
A 2019 methodological critique of the study, published in theArchives of Sexual Behavior,found:
Limitations
One of the biggest criticisms of the study was that it failed to look at other possible explanations for the observations parents had made.
For example, youth are known to hide their gender questioning from their parents when they are concerned their parents will be upset, judgmental, or simply not understand.
Many gender-diverse youths actively seek out other gender-diverse youth as friends or support. Youth, particularly those who do not feel like their parents will accept their gender diversity, seek out information online and from their peers.
When gender dysphoria becomes overwhelming, youth may approach their parents to seek care in a way that seems sudden from the parents' perspective but has actually been a process that has taken place over a number of years.
The controversy surrounding the study promptedPLOS Oneto initiate a formal post-publication review process, which resulted in republishing the study with corrections.
The post-publication reassessment involved senior members of the journal’s editorial team and external reviewers. It identified several issues to address to meet the journal’s publication criteria.
The revised study was published in 2019 with the following changes:
What Is Gender Incongruence?Gender incongruence is another term for gender dysphoria. The 2022 update to the ICD-11 replaced outdated terms like transsexualism and gender identity disorder with gender incongruence. It also reclassified gender dysphoria issues from mental and behavioral disorders to a new classification focused on conditions related to sexual health.
What Is Gender Incongruence?
Gender incongruence is another term for gender dysphoria. The 2022 update to the ICD-11 replaced outdated terms like transsexualism and gender identity disorder with gender incongruence. It also reclassified gender dysphoria issues from mental and behavioral disorders to a new classification focused on conditions related to sexual health.
The publication of the 2018PLOS Onestudy prompted further research into so-called rapid-onset gender dysphoria. However, the research failed to replicate the claims.
Trans Youth CAN! Survey
A 2022 study in theJournal of Pediatricstested the hypothesis in a survey of 173 Canadian youths under age 16 who were undergoing gender-affirming care.
Researchers did not find evidence to support the rapid-onset theory or significant associations between more recent gender knowledge and the factors hypothesized in thePLOS Onestudy.
What’s more, survey participants reported lower levels of anxiety, which stands in contrast to the initial research.
U.S. Transgender Survey
A much larger study published in theJournal of Adolescent Healthin 2023 also contradicts the rapid-onset gender dysphoria hypothesis.
The analysis of 27,715 transgender or gender-diverse individuals who responded to the 2015 U.S. Transgender Survey found:
In other words, the adolescent onset of gender dysphoria is not a new phenomenon, and it does not come on suddenly. In most cases, it takes several years between self-identifying as another gender and telling others.
Summary
Rapid-onset gender dysphoria is a research hypothesis and not a diagnosis. The theory attributes the rise in transgender teens to social contagion and suppressed sexual or gender trauma. It is based on a small and controversial study that was later called into question, corrected, and republished with corrections.
According to the original research, rapid-onset gender dysphoria is a new phenomenon where symptoms of gender dysphoria appear suddenly during adolescence.
More recent research casts further doubt on the rapid-onset theory. Gender dysphoria often first appears during adolescence, but it can take more than a decade before a person shares that information.
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10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Littman L.Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2018;13(8):e0202330. doi:10.1371/journal.pone.0202330Brandelli Costa A.Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0212578. doi:10.1371/journal.pone.0212578Turban JL, Dolotina B, Freitag TM, King D, Keuroghlian AS.Age of realization and disclosure of gender identity among transgender adults.J Adolesc Health. 2023;72(6):852–9. doi:10.1016/j.jadohealth.2023.01.023Icahn School of Medicine at Mount Sinai.Gender dysphoria.Wadman M.‘Rapid onset’ of transgender identity ignites storm.Science. 2018 Sep 7;361(6406):958-959. doi:10.1126/science.361.6406.958World Professional Association for Transgender Health.WPATH position on “Rapid-Onset Gender Dysphoria (ROGD)". September 4, 2018.Political Research Associates.Anti-LGBTQ media outlets peddle myths about autism and trans identity.Restar AJ.Methodological critique of Littman’s (2018) parental-respondents accounts of “rapid-onset gender dysphoria”.Arch Sex Behav. 2019. doi:10.1007/s10508-019-1453-2Littman L.Correction: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0214157. doi:10.1371/journal.pone.0214157Bauer GR, Lawson ML, Metzger DL; Trans Youth CAN! Research Team.Do clinical data from transgender adolescents support the phenomenon of “rapid onset gender dysphoria”?J Pediatr. 2022;243:224-227.e2. doi:10.1016/j.jpeds.2021.11.020
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Littman L.Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2018;13(8):e0202330. doi:10.1371/journal.pone.0202330Brandelli Costa A.Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0212578. doi:10.1371/journal.pone.0212578Turban JL, Dolotina B, Freitag TM, King D, Keuroghlian AS.Age of realization and disclosure of gender identity among transgender adults.J Adolesc Health. 2023;72(6):852–9. doi:10.1016/j.jadohealth.2023.01.023Icahn School of Medicine at Mount Sinai.Gender dysphoria.Wadman M.‘Rapid onset’ of transgender identity ignites storm.Science. 2018 Sep 7;361(6406):958-959. doi:10.1126/science.361.6406.958World Professional Association for Transgender Health.WPATH position on “Rapid-Onset Gender Dysphoria (ROGD)". September 4, 2018.Political Research Associates.Anti-LGBTQ media outlets peddle myths about autism and trans identity.Restar AJ.Methodological critique of Littman’s (2018) parental-respondents accounts of “rapid-onset gender dysphoria”.Arch Sex Behav. 2019. doi:10.1007/s10508-019-1453-2Littman L.Correction: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0214157. doi:10.1371/journal.pone.0214157Bauer GR, Lawson ML, Metzger DL; Trans Youth CAN! Research Team.Do clinical data from transgender adolescents support the phenomenon of “rapid onset gender dysphoria”?J Pediatr. 2022;243:224-227.e2. doi:10.1016/j.jpeds.2021.11.020
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Littman L.Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2018;13(8):e0202330. doi:10.1371/journal.pone.0202330Brandelli Costa A.Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0212578. doi:10.1371/journal.pone.0212578Turban JL, Dolotina B, Freitag TM, King D, Keuroghlian AS.Age of realization and disclosure of gender identity among transgender adults.J Adolesc Health. 2023;72(6):852–9. doi:10.1016/j.jadohealth.2023.01.023Icahn School of Medicine at Mount Sinai.Gender dysphoria.Wadman M.‘Rapid onset’ of transgender identity ignites storm.Science. 2018 Sep 7;361(6406):958-959. doi:10.1126/science.361.6406.958World Professional Association for Transgender Health.WPATH position on “Rapid-Onset Gender Dysphoria (ROGD)". September 4, 2018.Political Research Associates.Anti-LGBTQ media outlets peddle myths about autism and trans identity.Restar AJ.Methodological critique of Littman’s (2018) parental-respondents accounts of “rapid-onset gender dysphoria”.Arch Sex Behav. 2019. doi:10.1007/s10508-019-1453-2Littman L.Correction: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0214157. doi:10.1371/journal.pone.0214157Bauer GR, Lawson ML, Metzger DL; Trans Youth CAN! Research Team.Do clinical data from transgender adolescents support the phenomenon of “rapid onset gender dysphoria”?J Pediatr. 2022;243:224-227.e2. doi:10.1016/j.jpeds.2021.11.020
Littman L.Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2018;13(8):e0202330. doi:10.1371/journal.pone.0202330
Brandelli Costa A.Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0212578. doi:10.1371/journal.pone.0212578
Turban JL, Dolotina B, Freitag TM, King D, Keuroghlian AS.Age of realization and disclosure of gender identity among transgender adults.J Adolesc Health. 2023;72(6):852–9. doi:10.1016/j.jadohealth.2023.01.023
Icahn School of Medicine at Mount Sinai.Gender dysphoria.
Wadman M.‘Rapid onset’ of transgender identity ignites storm.Science. 2018 Sep 7;361(6406):958-959. doi:10.1126/science.361.6406.958
World Professional Association for Transgender Health.WPATH position on “Rapid-Onset Gender Dysphoria (ROGD)". September 4, 2018.
Political Research Associates.Anti-LGBTQ media outlets peddle myths about autism and trans identity.
Restar AJ.Methodological critique of Littman’s (2018) parental-respondents accounts of “rapid-onset gender dysphoria”.Arch Sex Behav. 2019. doi:10.1007/s10508-019-1453-2
Littman L.Correction: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.PLoS One. 2019;14(3):e0214157. doi:10.1371/journal.pone.0214157
Bauer GR, Lawson ML, Metzger DL; Trans Youth CAN! Research Team.Do clinical data from transgender adolescents support the phenomenon of “rapid onset gender dysphoria”?J Pediatr. 2022;243:224-227.e2. doi:10.1016/j.jpeds.2021.11.020
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