The New Lisa Littman Study on ROGD and Detransition is a Total Mess
It starts by claiming there are three types of gender dysphoria (there aren’t) and goes downhill from there.
by Mira Lazine
It feels as if every week there’s a new headline about some study that claims to challenge something core to transgender folk. This week is no exception, with a new study from Lisa Littman entitled “Detransition and Desistance Among Previously Trans-Identified Young Adults.”
Joined by Stella O’Malley, Helena Kerschner, and J. Michael Bailey, this article was published in the journal Archives of Sexual Behavior, a journal infamous for platforming anti-trans actors - including Ray Blanchard, and his discredited hypothesis of autogynephilia. Its current editor-in-chief, Kenneth Zucker, is best known for spearheading conversion therapy attempts on trans youth in the 1980s through the 2010s at Toronto’s Centre for Addiction and Mental Health.
The paper follows in the footsteps of Littman and company’s previous works, with a heavy focus on the concept of ‘Rapid-Onset Gender Dysphoria’ (ROGD) in conjunction with the main theme of detransition. The academic literature purporting to support ROGD primarily consists of Littman’s much disputed original study and Michael Bailey’s retracted followup, which was also published in Archives of Sexual Behavior. ROGD has also been officially disavowed by the American Psychological Association.
The research consists of a survey of 53 detransitioners (those who cease transitioning) and 25 desisters (those who stop identifying as trans before starting to transition) and their self-reported experiences with the process of detransitioning, along with any associated internal changes and demographic information that the authors felt worth collecting. While the study may seem innocuous, the data within is extremely flawed and could be used to promote the idea that detransitioners are a huge group of people who changed their internal identity due to peer pressure to be trans.
The study’s weaknesses start in the introduction section. Included among the citations are the anti-trans site 4th Wave Now, various ‘radfem’ Twitter accounts, and a YouTube search query for ‘detransition.’ The study also cites Bailey’s retracted article as if it were legitimate, without mentioning the retraction beyond that being in the title of the study.
The introduction claims there are “three types of gender dysphoria,” though none are recognized by mainstream academics. The first two types are taken directly from autogynephilia theory ‘homosexual transsexuals’ and ‘autogynephilic/autoandrophilic transsexuals.’ The former imagines some trans people are really gay men or women who transition to appeal to heterosexual members of their assigned sex, the latter posits all other trans people (especially trans women) transition for sexual arousal. The third category, ROGD is, of course, the idea that many trans kids (especially trans boys) are transitioning due to social pressure from their friend groups. These types of gender dysphoria are unsupported by the research, and many trans people—including some of their own participants - don’t meet the criteria for any of these types!
To recruit the study participants, the authors rely on a mixture of online study listings on social media and ‘internet sites,’ as well as snowball sampling (getting participants to recruit friends or associates of theirs into the study). Snowball sampling is often criticized as it prevents results from being generalizable outside of the study. This is due to the likelihood of bias from recruiting - people who know each other enough to be comfortable suggesting a study to one another tend to resemble one another in various ways. A way to probe for this bias would be to do a separate analysis on the snowball sample, something Littman and company neglect to do.
Where you recruit participants for a study matters. It appears as though Littman and company have, in part, tapped into their own professional network as seen in the image below, as well as familiar detransitioning resources. This includes the r/detrans subreddit and Pique Resilience Project (two communities associated heavily with anti-trans political organizing) as well as individuals who they already know that have detransitioned. This introduces the bias of study participants being primarily recruited from sources likely to confirm the researchers’ beliefs. There also are other, more effective and well tested means of recruiting people online that simply were not used, such as relying on social media ads.
screenshot from Detransition and Desistance Among Previously Trans-Identified Young Adults
According to the authors, another issue with Littman’s recruitment included sabotage attempts. The paper mentions that people reported online that they were trying to ruin her data by sending in false information or otherwise trying to throw a wrench into the study. Littman’s poor relationship with the community she wishes to study clearly presents issues with obtaining unbiased samples, something most researchers work to avoid.
It should be noted that a substantial number of sources found the study through unknown routess making inferences about them impossible. However, those that are named are well-known anti-trans platforms. The study also has a low sample size, being only 78 participants drawn from the entire U. S. population. This is likely inadequate for quantitative results due to a higher rate of error with smaller sample sizes, further making the study non-generalizable.
screenshot from Detransition and Desistance Among Previously Trans-Identified Young Adults
Other methodological flaws can be seen in the scales the authors use. While space prohibits talking about them each individually, it should be noted that several of the scales were created specifically for the study, meaning they have not been validated by proper, external means to ensure construct validity (testing whether the scale measures what it claims to) and reliability (ensuring that the results are internally consistent). While it is sometimes acceptable to use novel scales in research, quality studies tend to implement multiple tests for them, and treat them with caution, specifically detailing all the limitations that they may have. We do not see this with Littman and company, a failure to abide by best practices.
Instead of validating their scales, the authors use a statistic called Cronbach’s alpha to measure reliability. However, there is no discussion as to how this or any of the measures are regarded by psychologists. High quality studies in the literature tend to be thorough with how they treat their statistics, or at least discuss to some degree how they relate to industry norms. Cronbach’s alpha, for example, is not regarded as worthwhile to use on its own. This means we don’t know if the scales the study uses and relies on actually measure what the authors claim they do.
The flaws do not just exist within the methodology of the study—they also exist in the interpretation. That is, even if we ignore the prior issues with the study and take it at face value, there are still problems to be found in how the authors interpret their results.
Twenty-five (32%) of the participants never medically transitioned, but there are no efforts made to see if the desisters and detransitioners have any differences between them, no information given on whether they met the diagnosis for gender dysphoria in childhood, and nothing about whether they were more or less likely to exhibit what Littman believes are signs of ROGD. Instead, detransitioners and desisters are lumped in as one group, adding much confusion to the results.
Only 53%* of the participants believed ROGD was the reason for their transition, although this had an inverse relationship with Littman’s measures of gender dysphoria. It is again unclear what, if any, differences may have existed between desisters and detransitioners in terms of this belief.
Although most of their study participants did not report having gender dysphoria in childhood, 16.7% of the sample did. (It should be noted that the scale they used to measure this did not ask about distress & impairment, with it being unclear as to why these were left out). We might expect this minimal number of participants meeting the gender dysphoria guideline by the authors’ own logic, as they believe young people are transitioning without any medical recognition, however a fair few of participants don’t seem to have met the criteria for gender dysphoria even while they identified as trans, with no information about whether those who medically transitioned were more likely to meet the criteria than those who never did. This can be seen in Figure 4 of the study, where many participants do not agree with at least two of six statements used to diagnose gender dysphoria in the DSM.
screenshot from Detransition and Desistance Among Previously Trans-Identified Young Adults
A core claim of the article is that detransitioners report internal change in identity as the primary reason for their detransition. This contradicts previous research on the topic with a much larger sample size. The heavy sources of sampling bias make it difficult to treat the results as independent from the authors’ personal beliefs about ROGD, detransition, and transgender folk. These problems are exacerbated by the methodological issues with novel scales and questionable statistical tools. Good research needs to be careful to ensure that bias from the authors is minimized and that there is a separation of the study participants from the authors themselves. Unfortunately, we see none of that here.
CORRECTION: An earlier version of this sentence incorrectly stated that the number of participants who believed ROGD described their experience as 23% based on a misreading of a sentence in the paper. The correct number is 53%, while 23% of respondents said they didn’t know whether or not ROGD described them.
Mira Lazine is a freelance journalist covering transgender issues, politics, and science. She can be found on Twitter, Mastodon, and BlueSky, @MiraLazine