Summary

This 2025 Austrian review weighs the evidence for and against 'rapid-onset gender dysphoria'. This is the idea that some teens, mostly girls, with no childhood signs suddenly identify as trans at or after puberty, partly to cope with other mental health problems and under the influence of friends and social media. The authors find Littman's original parent survey limited but a fair starting point for an idea to test. They note that a 2022 clinic study that found no support (Bauer and others) may not have measured the right thing. They find indirect support in research on peer influence, social media and detransitioners' accounts, and report seeing such a group in their own clinic. Their verdict: unproven but worth serious study. As they did not search the research systematically, it is a map of the debate, not strong evidence either way.

Key findings

• 著者らは、現在のエビデンスは、「急速発症性性別違和」を実証された説明として受け入れることも、トランスフォビアだとして非難することも正当化しないと主張しています。
• Littmanの2018年の親256人への調査では、描写された若者の83%が女性として生まれ、63%が性別への苦痛が始まる前にメンタルヘルスまたは発達の診断を受けていました。
• 2022年のクリニックの研究（Bauerら）は、この考え方への支持を見つけませんでした。しかし、このレビューは、それが思春期に言及することなく「最近自分の性別を知ったこと」を急速な発症として扱ったというLittmanの批判を強調しています。
• 引用されたデトランジショナーの調査には、デトランジショナー237人の70%が苦痛には他の原因があったと答えたもの（Vandenbussche）と、78人の53%が自分の体験は急速発症の考え方に合うと感じたもの（Littmanら）があります。
• 摂食障害や自傷が友人の間で広がることについての研究や、ソーシャルメディアによる害についての研究は、一部の10代にとって社会的な影響がありうることを裏付けます。ただし、引用された統合分析の1つは、男子と女子でボディイメージへの同様の影響を見つけました。
• 著者らは自分たちのクリニックから、深刻なメンタルヘルスの問題があり、性別への苦痛が思春期、COVID-19のロックダウン、ソーシャルメディアの利用の増加とともに強まった10代のグループを述べています。
• 10代、親、臨床医の見解を組み合わせた長期的な研究を求め、他のメンタルヘルスの状態もある10代にとって、心理療法が中心的な役割を果たすことを強調しています。

Abstract

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of "rapid-onset" gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

Conclusion

The authors conclude that neither prematurely adopting ROGD as a valid explanatory model nor hastily condemning it as transphobic is an appropriate response, and that Littman's research has made an important contribution that the scientific community should build on. They acknowledge ROGD may offer a convenient explanatory model for those opposed to medical transition of adolescents, but argue the right response is to strengthen rather than suppress research so that its validity can be judged on evidence. They call for longitudinal, well-designed studies capturing co-occurring psychopathology, social influences and identity development, warn that neither generalized suspicion nor an uncritically permissive approach meets adolescents' needs, and stress that clinicians must be wary of their own ideological predispositions. If substantiated, the ROGD framework could refine clinical treatment.