Monthly Archives: August 2018

Rapid Onset Gender Dysphoria – the new hoax diagnosis.

Foreword

There is plenty of cultural evidence that a variety of transgender identities have existed all over the world for a very long time. What we understand as transgender in the west has been given different names all over the globe – American Indian “two-spirit”, India’s “Hijra”, Indonesian “Warias”, the “Kathoey” – each with their own long and varied culture, customs and values based around a transgender identity. Trans people identify differently because their internal sense of self differs from their external physical characteristics. For many people, this can be hard to understand, because those who have an identity that co-exists with their physical body will find it difficult to imagine what it feels like not to have such bodily disharmony.

In our society, as transgender identities have become more established we are also seeing an emergence of groups that seek to stigmatise and pathologise trans people. It’s something that is seen by non transgender people as a pathology, there is a fear that others may “catch” being transgender. Historically, this was a group of women seeking to exclude transgender women – who called themselves “trans exclusionary radical feminists”, later this was shortened to TERF. Transgender communities recognised this community as a group seeking to prevent access to healthcare and support provision (health, welfare, social support provisions) and used the term to label people with an anti-trans agenda. Today the term TERF is outdated and innacurate – feminism has grown past this and is now intersectional and trans inclusive – it is more accurate to say “anti-trans”, or simply bigoted or hateful people.

It follows a very similar pattern to when other stigmatised people – people who do things differently or are different in some way to the cultural majority. Gay people – homosexual men and women faced similar issues surrounding a pathologisation of their sexual attraction to people of the same sex. Their identity was similarly pathologised, before, over time they became accepted as normal and integrated into society – however there still remain groups today who claim that it’s “wrong” for whatever reason, usually based on bigotry and the vehicle for their bigotry is religious belief. Up to the 1900’s people’s fear of others who are different to them meant that even people who were left handed were criminalised by society and oppressed by people who didn’t understand!

Discussion

ROGD is described by the National Review, the right-wing Alliance Defending Freedom, Robert Stacy McCain and others as a phenomenon of teenagers “suddenly” coming out, sometimes “in groups”, after “total immersion” in social media related to transitioning. The aim of the “study” is to encourage parents of children to prevent them from accessing information about being trans, prevent them from meeting other trans people and deny them access to health, welfare and social support.

ROGD was invented by and whose data was collated, interpreted and disseminated by a group of anti-trans people. Their belief that being transgender is a disorder rather than a natural variation not only colours their results, but leaves them blind to a methadology with so much bias that the “study” is of no value. Pink News published a very readable article about why this study is “bad science”, which was analysed by Florence Ashley of McGill University and Alexandre Baril of the University of Ottawa. As a point of science, the burden of “proof” relies on the the individuals making the claim – not on those critical of the study (Lilianfield, Linn and Lorh – Science and Pseudoscience in Clinical Psychology, 2004). ROGD as a phenomenon is riddled with flaws, briefly summarised here:

* The study was based on parental reporting rather than evidence from the children themselves.
* The study was advertised, and participants were collated from websites who are well known to be anti-trans and was not representative of the general population. The published research into “rapid onset gender dysphoria” consists entirely of one 2017 abstract of an online survey of 164 parents sourced from anti-trans groups!
* There are no clinical features of “ROGD” that have been identified to distinguish it from the traditional form of dysphoria.
* What appears to a parent to be a “rapid” onset may not have been rapid for their child at all, as it is based wholly on parental reports
* There is no evidence presented to support the claim that children became gender dysphoric as a result of social coercion.

It is a part of a collection of anti-trans myths and propaganda whose aim is the oppression of trans children. Certainly from experience, and from discussion with many trans people in our support group, many trans adults say they did not persist with telling their parents they were transgender simply because they knew they were up against such little understanding. The occurrence of “gender dysphoria appearing for the first time during or after puberty”, as well as the surprise of parents, is already widely recognized in literature, to the extent that it is explicitly mentioned in the DSM-5’s description of gender dysphoria (American Psychiatric Association, 2013).

The sample group from the study come from websites which:

– Advocate for “legislation making it very difficult for young people to access these treatments until they are in their late 20’s”
– Describe medical transition as “clinical injury” and “a cult based on sexual fetishism and pseudoscience”
– Condemn transgender youth on the basis of “the harm it will cause their non-gender-discordant peers, many of whom will subsequently question their own gender identity, and face violations of their right to bodily privacy and safety”
– claim that transgender people are collectively “indoctrinating” “confused fetishists”

Afterword

The goal of gender affirmative therapy is very much contrary to the scaremongering, which is the tone of anti-trans groups, and is instead based around supporting children and young people to explore their identity. It is differentiated from gender expressions, and by differentiating gender expressions from gender identities, children who are insistent, persistent, and consistent in their affirmation of a cross-gender identity are sorted from those children who are either asserting or exploring gender-nonconforming expressions within acceptance of their natal gender assignment. Family acceptance related to sexual and gender identity/expression during adolescence are associated with positive self-esteem, increased social support, and overall health in early adulthood [Ryan et al., 2010]

Resources:

The Gender Affirmative Model: What We Know and What We Aim to Learn – Human Development 2013;56:285-290
Family Acceptance in Adolescence and the Health of LGBT Young Adults – Journal of Child and Adolescent Psychiatric Medicine (Ryan et al. 2010)
Revisiting Flawed Research Behind the 80% Childhood Gender Dysphoria ‘Desistance’ Myth – Winters (2017)
Why ‘rapid-onset gender dysphoria’ is bad science
“Rapid onset gender dysphoria”: What a hoax diagnosis looks like
Fresh trans myths of 2017: “rapid onset gender dysphoria”
Everything you need to know about rapid onset gender dysphoria – Julia Serano
D’Angelo and Marchiano’s response to Julia Serano on rapid-onset gender dysphoria
“Rapid onset gender dysphoria” study misunderstands trans depersonalization, ends up blaming Zinnia Jones