Summary

Researchers used first-visit surveys and clinic records from 173 teenagers under 16 referred to 10 Canadian gender clinics. They tested predictions of the 'rapid-onset gender dysphoria' idea, which suggests some teens develop a trans identity suddenly, often under peer influence. They compared teens who said they had realised their gender was different within about the past year with those who had known longer. The recent group did not have more mental health or developmental diagnoses or self-harm, and did not rely more on online or trans friends. They had less anxiety. The authors concluded the data did not support the idea. Critics, including Littman, replied that time since realising is not the same as onset at or after puberty, so the study may not have tested the idea at all. The small recent group, the under-16 limit and the clinic-only sample further limit what it can show.

Key findings

• Studiet så på 173 teenagere under 16 år ved et første besøg for pubertetsblokkere eller hormoner på 10 canadiske kønsklinikker i 2017-2019.
• ‘Nylig’ betød, at en teenagers nuværende alder lå inden for 1 år af den alder, de sagde, at de indså, at deres køn var anderledes. Fordi aldre blev opgivet i hele år, kunne det dække op til næsten 2 år.
• Efter hensyntagen til alder og fødselskøn havde nylige erkendere ikke større sandsynlighed for depression, lidelse, registrerede diagnoser, kønslidelse, selvskade eller selvmordsforsøg eller for at støtte sig til online-, trans- eller forældrestøtte.
• Nylige erkendere havde mindre angst og havde meget mindre sandsynlighed for at have brugt marihuana det seneste år (cirka en tiendedel så sandsynligt), det modsatte af, hvad idéen forudsiger.
• Hele gruppen havde store behov: 51,6 % havde en registreret psykisk diagnose, 25,9 % en udviklingsmæssig diagnose såsom autisme eller ADHD, og 67,9 % rapporterede selvskade det seneste år.
• Resultaterne var stort set de samme med en løsere definition på 2 år, bortset fra at fundet om marihuana så kunne være tilfældigt.
• Offentliggjorte breve fra Lisa Littman og Joanne Sinai argumenterede for, at studiet ikke målte rapid-onset dysfori, fordi det aldrig så på, hvornår dysforien begyndte i forhold til puberteten.

Abstract

Although emergence of gender dysphoria at puberty is long established, a distinct pathway of rapid onset gender dysphoria was recently hypothesized based on parental data. Using adolescent clinical data, we tested a series of associations that would be consistent with this pathway, however, our results did not support the rapid onset gender dysphoria hypothesis.

Conclusion

We did not find support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence. Among adolescents under age 16 years seen in specialized gender clinics, associations between more recent gender knowledge and factors hypothesized to be involved in rapid onset gender dysphoria were either not statistically significant, or were in the opposite direction to what would be hypothesized. This putative phenomenon was posited based on survey data from a convenience sample of parents recruited from websites, and may represent the perceptions or experiences of those parents, rather than of adolescents, particularly those who may enter into clinical care. Similar analyses should be replicated using additional clinical and community data sources.