The Fallacy of Rapid Onset Gender Dysphoria and The Importance of Calling Out Sloppy Science

Editor’s note: This article references trans and questioning/non-binary individuals as “female” when discussing the “sloppy science” referenced in the title.  The gendering in the research is from parents and those who conducted the “research,” and not from The Aspergian.  Please be advised that this article contains information referencing biases and phobia against trans and nonbinary adolescents.

Recently, the term “Rapid Onset Gender Dysphoria” (ROGD) has been cropping up frequently in both the trans and autistic communities, and I think that it is crucial to address it.

Advocates of ROGD define it as a mental illness in which biological girls who have always appeared to their parents to conform to traditional gender norms suddenly appear to be taking on unconventional gender identities.  Parents have seen this happen in clusters of adolescents and teens and chalk it up to a form of peer pressure.  Some particularly zealous voices are trying to tie ROGD to an autism diagnosis.

The core issue, however, is that ROGD is sloppy science and has not been conclusively proven to exist at all.  If the push for ROGD to be accepted by troubled parents as pathology is taken at face value, it will seriously traumatize many autistic and trans youths in our communities.

ROGD came onto the scene in 2016, thanks to a survey by Lisa Littman, MD, M.PH for her study published by Brown University in 2018.  The research was so widely criticized that Dr. Littman was forced to revise it in 2019, and I have linked the revised “Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria” here for readers who are interested:

The problem is that during 2018, the damage by Dr. Littman’s piece had already been done.  Parents of adolescent girls who did not want to see their daughters as part of the trans community had latched onto ROGD.  Psychologists such as well known “AspienGirl” author Tania Marshall also latched onto it and connected it to the autistic community, trying to spin it as a trait of high-functioning autistic women.  Parents desperate not to be raising autistic trans daughters quickly latched onto this.

But there are critical flaws in ROGD research.  Giving something a fancy scientific name and calling it a mental illness should not pass for scientific validity.

Before I was an autistic self-advocate and a social worker, I was a college student receiving her BA in Sociology from Hanover College, one of the finest private colleges in the United States.  Dr. Crone, my published sociology professor, used to tell us endlessly of the importance of evaluating all scientific research vigorously before accepting the findings.  Dr. Crone, this analysis of the ROGD farce is dedicated to you.

I am going to list some of the logical and scientific fallacies of ROGD and then explain them more clearly:

1. The correlation of the two variables of autism and LGBTQ+ identity does NOT equal causation.  There could be a third confounding variable.

This is one of the most insidious approaches that researchers use to manipulate uninformed readers.  They use a correlation or connection between two variables to imply that one causes the other.  But this is sloppy science.  There is often a third variable that links the two.

I will give you an example often used by sociologists:  You should be afraid of ice cream because an increase in ice cream sales can be correlated with an increase in serial killings!  Gasp!

Scared yet?

This is a classic example of a third variable spoiler.  In this case, the third variable is… summertime.  Summertime has been shown to be linked to an increase in both ice cream sales and serial murders.  But without that third variable, ice cream can look pretty sinister.

The point is that even if autistic people are shown to have unconventional gender identities more frequently, the correlation does not prove a causation.  We could be missing a piece of this puzzle, and likely are.  But correlations are great for raising fear in desperate people — and for capitalizing on that fear by creating a market around it.

2. Correlation does not imply the DIRECTION of causation even if causation does exist.  It is impossible to know which variable caused the other.

This point calls the entire premise of ROGD into question.  The research claims that if young women [men] tend to find their trans identities in peer clusters, then it must be the peers that are causing the supposed change in gender identity.  But this assumes that the peers are the causation variable.

What if it is the other way around?  What if subtle cues given off by a trans adolescent’s peers are drawing her to them because she senses kindred spirits?  What if these girls are finding each other as they more publicly come to terms with their gender identity?

This theory is an equally plausible cause of the peer correlation.  I know that when I was struggling to accept myself as a bisexual, I found myself drawn to the LGBTQ+ community, and I wasn’t sure why.  I must have sensed that these people would be able to help me.

Never allow a researcher to imply causational direction unless proper studies have been done.

3. The “distress” aspect of ROGD could be a symptom of emotional (and sometimes other types of) abuse from one’s family or society around the chosen gender identity, not the gender identity itself.  If this is truly the case, should ROGD even be VIEWED as a mental illness or a phenomenon internal to the autistic person?

What is said to set “gender dysphoria” in general apart from healthy trans identity is the distress caused to the individual, but I have been critical of this logic for a long time.  When the distress is caused by mistreatment by family or society, how does this make the gender identity itself pathological?

I will rephrase this in terms of race to make my argument plain.  Let’s say Black family lives in a small racist town in the United States where the Klu Klux Klan has risen, and the family can not afford to move.  There are weekly displays of blatant racist aggression on their lawn, and they are becoming increasingly frightened and depressed.  Would this render their RACE a mental illness?

Clearly, we could all agree that the family’s race is not what is causing the suffering.  It is a hostile living environment.  I am assuming, given the fact that the parents in this study were so quick to label their children with ROGD, that their home environment is, if not outright hostile, at least unaccepting of their child’s gender exploration.  This could just as easily explain the child’s “distress” as ROGD.

4. Parent reporting through a questionnaire and third-party observations as the sole sources of ROGD research makes for an inherently unreliable study.

Some simple behavioral phenomenons can be easily researched through third-party doctor or parent observation.  For example, “Is a child more likely to go for the same toy in a pink box or in a blue box?” can be easily observed.  The child picks a box, and the observer makes a tick.

Complex identity issues that involve behavior and internal working absolutely DO NOT lend themselves to solely observation analysis, however.  Even a parent or therapist CAN NOT get into a child’s head!  They can only observe the child’s behavior.  And they can do THAT only when the child is in view.

ROGD basically assumes that changes in a girl’s gender identity rapidly onset because the PARENT noticed behavior changes only at adolescence.  But this does not tell the full story of a child’s journey.  The child could have been wrestling with their identity for years.

Okay, smarty pants, you may say, then why would the parent see the changes in behavior only in adolescence?  Honestly, that’s an easy one.  Adolescence is the normal time for child exploration and rebellion against one’s parents.

Children are very perceptive and tend to learn from a very young age what pleases a parent and what does not.  A daughter of a more conservative parent likely caught on quite quickly that her parent smiled more often and bragged on her more when she wore dresses and acted like a “little girl” according to gender norms.

As a child enters adolescence, they are more likely to find like-minded peers and seek out peer approval rather than approval from the parents.  This would empower them to rebel against social gender constructs by joining the LGBTQ+ community and exploring gender identity with a decreased fear of parental rejection.

This is all obvious due to basic child development theory.

So no, a conservative parent’s documentation of adolescent rebellion in the direction of gender identity as proof of a fast-onset mental illness is not valid or reliable.

Frankly, I find the very concept laughable!

5. Autism is viewed as a neurodevelopmental disability, but this does not render everything correlated with autism a disorder!

Ah, the last refuge of sloppy science, which feels emboldened to characterize autism without the input of autistics anyway: If we can not sell ROGD as a mental illness on its own merits, let’s correlate it with autism and use it to imply a co-morbid mental illness!  After all, ADHD and OCD are correlated with autism!  This could work!

I am going to call shenanigans on this and label it as fear-mongering and pandering to the wallets of conservative parents.  After all, eidetic memory is correlated with autism and is not a mental illness.  Math, art, music, and tech savviness are correlated with autism and are not mental illnesses.  Left-handedness is correlated with autism.  Not a mental illness.

This takes me back full circle to serial murder and ice cream!  Correlation alone is never a smoking gun for anything!

I will simply close by advising people to be wary of people, even real medical professionals, who use sloppy science to fearmonger.  Do your own research.  Read studies carefully to see if they actually prove what they claim to prove!

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10 Responses

  1. I have this anecdote to share about parental observations: When I was living with my parents, any time I wanted to buy clothes from the men’s section, my mom would get upset and ask why I didn’t just buy the “same style” from the women’s section. I didn’t have my own money at the time, so what could I do? I tried to embrace women’s clothing instead.

    When I came out as trans, my mom’s first reaction was literally to not believe me, claiming I had been happy dress shopping for prom just a couple years before and now I’m “suddenly” identifying as a man…? They don’t realize how their own biases affected us. “Rapid onset,” my ass. lol.

    1. I don’t know why I can’t register a “like” on that. I wish I could.

  2. I think my blog writing is very influenced by autistic hive mind or what’s being discussed online as I literally decided to write about this topic this morning. Now I have your excellent article to link to so thank you for that.

  3. Hi,

    Great article, and breakdown of the correlation/causation fallacy.

    To be a bit “nit-picky”: ‘ROGD is sloppy science and has not been conclusively proven to exist at all’, science and its products are all provisional, not subject to being conclusively proven, and up for revision in light of new evidence.

    As a query, and this isn’t an attempt to troll, do people categorically think ROGD does not have any legitimacy? For instance, I agree that observational data and proxy reports are not an appropriate methodology to address this phenomena. Hence any conclusions drawn from it are highly suspect. But that does not defeat the concept of ROGD outright. I wonder if it could be a legitimate phenomena in a small subset of this population, with the remainder being those you describe in your article (i.e. Parents latching onto it and using it)?


    1. Do I personally think that ROGD exists? No. Does this prove it couldn’t possibly exist ever in life? Absolutely not! 🙂 One could not prove a negative. That said, though “mass hysteria” as a form of peer pressure has been documented, the effects are usually short lasting and not associated with a lifelong identity issue. Could gender dysphoria itself exist is a question I find more interesting, since I personally believe having spoken with many LGBTQ+ people, that rapid onset at least is a crock. But my opinions are just that. Opinions. My problem is with research that tries to make proof out of bigoted opinions. 🙂

  4. Your comment to NewlyMintedAspie reveals your own bias, no? What evidence do you have that Drs. Littman or Marshall–or anyone else who has worked with many people with gender/identity issues–hold “bigoted opinions”? Just because they do not agree with your personal and self-serving ideologies does not mean they are bigoted. That kind of ugly assumption is even more egregious than any of the allegations you level against Dr. Littman’s work.

    Moreover, in that comment you wrote, “though ‘mass hysteria’ as a form of peer pressure has been documented, the effects are usually short lasting and not associated with a lifelong identity issue.” Have you done any reading on “pro-Ana” sites? They are a clear example of social contagion and can cause lifelong problems for the poor kids/teens who end up being influenced by literally sick individuals. If you do not believe that eating/body image disorders constitute a lifelong struggle, then you know nothing about it.

    In other words, you are wrong to assert or to imply that the kind of social contagion that is making many young vulnerable kids believe they are “Trans” will not cause lasting issues for these youth. More importantly, you conveniently ignore the ever-increasing number of teens and young adults who are now finding the courage to fight back against those who wrongly convinced them that they were “Trans,” when they really were not. They are reacting *exactly* how one would expect if they were misled via social contagion to believe something that is not true and that definitely can cause them great harm, sometimes permanently/irreversibly.

    And before you try to dismiss my concerns with false allegations of bigotry, Transphobia, ignorance, etc., I have taught about these issues very many times for nearly 20 years. I have stated clearly that I do believe a tiny proportion of people would benefit from even surgical transitioning. I have taught and have worked with numerous Trans people and others who struggle with various forms of sexual, gender and/or identity issues. Additionally, my brother and sister are both part of the LGBTetc “community” and my eldest daughter has many Trans/non-binary/gender-queer friends, most of whom have eaten and/or slept at our home.

    (On an entirely unrelated note, it’s “Ku Klux Klan,” not “Klu Klux Klan.”)

    1. I don’t see any proof that the social contagion you are describing permanently harmed anyone. I also find it hard to know if these teens fighting back were “wrongly convinced” they were trans, which is entirely possible btw, or “wrongly convinced” they weren’t down the road by other interested parties. Peer pressure works both ways after all. No, I don’t think your support of certain trans people makes your conviction about this any more convincing.

      1. My apologies for the delay. First, my support of “certain” Trans people–are you trying to imply something with that adjective?–is not intended to make my “conviction about this any more convincing.” Rather, it is a preemptive statement of fact so that anyone lacking in facts or rational arguments does not resort to the typical Transphobia trope.

        As for your choice to ignore the *fact* that social contagion has harmed anyone, please watch the ever-increasing number of Youtube videos by people who, for instance, have mutilated themselves permanently via double mastectomy. You do not consider that permanent damage? And are you going to deny those people’s *lived experiences*? They themselves state that social contagion led them down the misguided path of believing they were “Trans,” when in fact they simply had issues with their sexuality/sexual orientation and/or “gender identity/expression.”

        If you listen to even one of their stories–and most of their stories are eerily similar, thus providing further proof of social contagion–and still wish to insist ridiculously that somehow they were “wrongly convinced” they are *not* “Trans,” then that is obviously further proof of your bias. Of course, you may be as biased as you wish.

        Unfortunately, your words could have a horrible impact on vulnerable young people; you of all people should appreciate that. I find it equally sad and frustrating that you choose to ignore such facts–along with all of the other facts, science, evidence, logic and common sense you are avoiding considering–for what appears to be your own personal/self-serving ideology and agendas.

    2. ” What evidence do you have that Drs. Littman or Marshall–or anyone else who has worked with many people with gender/identity issues–hold “bigoted opinions”?” <– Along with Zucker, it would be their lifelong effort to produce work which puts transgender people into a bad light, even fraudulent work such as this which claims such are necessarily mentally ill, certainly at least those with the mooted myth ROGD. They are a troglodytic throwback to the heroic age of psychiatry, where rigorously collected data and statistics took a back seat to having a popularly sold beautiful theory. For Zucker in particular to be involved is quite a red flag — he was exonerated only of the charge of verbally assaulting a child patient, the charges against him RE fraud in claiming he could "cure" children of being transgender at a high rate stuck quite well. For him to be involved in an "editorial" role in approving other like fraud for publications is rather like Mengele approving a piece by Schumann.

      "More importantly, you conveniently ignore the ever-increasing number of teens and young adults who are now finding the courage to fight back against those who wrongly convinced them that they were “Trans,”" <– You mean liars who lied their way into being treated for a condition they did not have? You mean the fraction of people who transition stuck at below 1% for the last decade at least? That sort of percentage predates and persists through the age of "social media".

      " I have taught about these issues very many times for nearly 20 years." <– It is quite open to question at this point if you have done so competently.

      " I have stated clearly that I do believe a tiny proportion of people would benefit from even surgical transitioning. " <– Apparently as many as 1 in about 450, as 1 in 150 say they are transgender rand apparently when inexpensive enough 1 in 3 of them transition medically. Of those, less than 1 in 100 regret it, as cited. So, at most 1 in 45,000 might fall prey to ROGD, of which there is no evidence for which in this paper because it's sources are suspect enough as to demand their dismissals and for the paper, dismissal.

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