Proponents of ROGD Are Quietly Removing the Rapid-Onset Aspect

In 2018, Lisa Littman estimated that youth with ROGD declared their trans identity between one week and three months after displaying signs of gender dysphoria. When the data failed to back this up, she and other proponents did away with the rapidity.

by Evan Urquhart

In order for gender dysphoria to be rapid onset, does its onset have to be at all rapid? You’d think the answer would be right there in the name, but proponents of what’s called ROGD have been quietly moving away from any requirement for the onset to be rapid. This shift seems to have begun years ago, and coincided with data that failed to support the idea that there’s a novel form of gender dysphoria that comes out of a social contagion.

Rapid-Onset Gender Dysphoria is, or at least was, the theory that the increase in visibility of transgender people led to a population of young women who began to falsely believe that they were trans due to peer pressure and mental illness. Above all, this group was said to be identifiable by the rapidity with which their gender-dysphoric symptoms manifested, going from having no signs of gender incongruity at all to a fully articulated transgender identity in a short time period after being exposed to information about trans people, either online or in their peer group.

ROGD was formalized as a hypothesis in a survey parental attitudes by Lisa Littman in 2018. While Littman originally claimed her study provided actual evidence for the phenomenon, this was walked back when critics pointed out that she had surveyed parents from the very websites that popularized the idea of ROGD in the first place. Surveying these particular parents, and only these parents, was merely evidence that parents frequenting websites popularizing ROGD believed in it. In her correction to the paper, Littman clarified that she was merely formalizing the ROGD hypothesis and that more data would be needed to determine whether ROGD really described a distinct group within the population of trans people.

No such data has been forthcoming, but that doesn’t seem to have slowed down proponents. Instead, Littman and others have quietly begun retrofitting the theory to remove any requirement for rapid onset.

In Littman’s original paper it was never really clear how rapid “rapid onset” dysphoria needed to be to count within that framework, however it did provide some information about how quickly gender dysphoria was believed to manifest: The parents surveyed said their children went from having no signs of gender dysphoria at all to announcing they were trans over a period of one week to three months.

screenshot from Littman (2018)

This is important because rapidity is the only thing that can distinguish ROGD it from ordinary late-onset gender dysphoria, which is gender-dysphoria that shows up either during or after puberty. It has long been hypothesized that, while some children are aware of an incongruence between felt gender and assigned gender at a young age, for others the physical changes of puberty are what bring their gender difference into focus. Researchers have found sex and gender differences between late onset and early onset groups, with nonbinary people and female-assigned people being more likely to notice their incongruence during or after puberty. A variety of possible explanations for this have been suggested, from actual sex-based differences to social factors that heavily discourage male-assigned adolescents from exploring desires to be feminine. (While social factors also discourage gender exploration among female-assigned adolescents, transgressing norms of gender presentation may not be quite as harshly punished.)

So, if ROGD is to be distinct from ordinary GD, it has to be more rapidly developing. While ROGD proponents have never specified exactly how rapid (a common source of criticism of these fringe researchers by the mainstream scientific community), Littman’s paper leads us to expect a time frame that is recognizable rapid, between a week and three months only. A more recent ROGD paper by Diaz and Bailey that was retracted for ethics issues surveyed a similar group of parents, and it also failed to clearly define what rapid onset meant. However the call for participants made it clear they were looking for cases where children began identifying as transgender “suddenly, seemingly out of the blue.” In other words, a rapid onset.

screenshot from Diaz and Bailey (2023), RETRACTED

Rapidity, suddenness, and out-of-the-blue-itude is therefore the lynchpin of the entire hypothesis.

Or… is it?

More recently, proponents of ROGD, including Littman, seem to have quietly ditched the idea that rapid-onset gender dysphoria needs to have a rapid onset. Instead, when they describe the hypothesis they distinguish ROGD from other forms of gender dysphoria on the basis solely of what they hypothesize is causing it. This shifting of the goal posts on a supposedly distinct presentation of gender dysphoria can be observed as early as a 2021 paper by Littman that surveyed 100 detransitioners. The paper did not present evidence that the those surveyed had experienced a rapid-onset of their gender dysphoria, and when it defined ROGD it left out any mention of rapidity. Littman defined the ROGD hypothesis instead as being “that psychosocial factors (such as trauma, mental health conditions, maladaptive coping mechanisms, internalized homophobia, and social influence) can cause or contribute to the development of gender dysphoria in some individuals.”

A similar definition of ROGD that left out the rapidity can be found in a letter to the editor of the journal “Archives of Sexual Behavior” authored by the conservative activist Leor Sapir along with Littman and Michael Biggs, another ROGD proponent. It took issue with a 2023 analysis of data from the 2015 U. S. Transgender Survey by Jack Turban, which found that individuals with late onset gender dysphoria had waited years before disclosing their trans identity to anyone. Turban’s is just one of several papers that have suggested that Littman’s findings pointed to parents being surprised and upset to suddenly find out their children were trans, but not that the children’s gender dysphoria had actually developed suddenly.

Sapir, Littman, and Biggs criticized Turban for looking at the characteristics of people with late-onset gender dysphoria in the full sample. They argued that ROGD is a novel phenomenon that arose in the late 2000s to the 2010s, so results in a population that included many members who can’t have experienced it weren’t relevant. (For what it’s worth, this seems like a reasonable critique of Turban’s methods). Sapir and his co-authors reanalyzed the USTS data, looking at just the cohort of trans respondents who were adolescents after the late 2000s. The authors found, unsurprisingly, that among respondents with late-onset gender dysphoria the youngest respondents had gone a shorter time between realizing they were trans and coming out compared to what Turban found in the full survey which included much older individuals who could have been in the closet for decades. They declared that this finding of a shorter time frame supported the ROGD hypothesis.

But… what was that “shorter” time frame? Sapir, Littman, and Biggs found that this group came out about 3 years after they first felt an incongruence between their assigned-sex and their gender, and 1 year after they began understanding their feelings of incongruence as them being transgender. This is nothing like the ROGD as described in Littman’s 2018 paper, which held that youth rapidly began identifying as trans over a period of one week to three months. Nevertheless, the authors of the letter claim that this is evidence in support of ROGD. Conveniently, they define ROGD in terms that leave out any references to rapid onset, saying:

The ROGD hypotheses are, briefly stated, that this relatively new and distinct clinical presentation of late-onset gender dysphoria exists, and that psychosocial factors, including social influences (social media, social and peer contagion, etc.), maladaptive coping mechanisms, mental health conditions, and other stressors can contribute to its appearance in some individuals (Littman, 2018, 2021).

Notice that there’s no reference to what makes ROGD a distinct clinical presentation from late onset gender dysphoria? Any suggestion of a rapid-onset, the key defining characteristic, found right there in the name, seems to have fallen out of favor.

This is likely because there’s never been any evidence that some trans people are coming to identify as transgender rapidly in an environment characterized by peer pressure. Instead, adolescents with gender dysphoria overwhelmingly report waiting more than a year before seeking treatmentt. An article in Scientific American from August 2023 does an excellent job summarizing the current research and the opinions of experts in the field, all of whom agree that just aren’t finding two distinct groups of patients seeking treatment for gender dysphoria in a way that would fit the ROGD hypothesis.

screenshot from Scientific American

At an earlier time in its evolution ROGD once resembled an actual scientific hypothesis. It made specific claims, ones that could have been either supported or refuted by real world data. Chief among those claims was that ROGD was characterized by a sudden onset “seemingly out of the blue” in the words of ROGD researchers. However, the researchers who insist on clinging to this theory have more recently abandoned the core requirement that ROGD be a distinct presentation. Instead ROGD has come to resemble a pseudo-spiritual belief, a faith among these fringe figures that some gender dysphoria is false and some is true, but with nothing objective the proponents can point to that allows the two types of gender dysphoria to be distinguished from one another beyond fact-free speculations as to its disparate causes.