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

• この研究は、2017～2019年に、カナダの10か所のジェンダークリニックで、思春期ブロッカーまたはホルモンの初診を受けた16歳未満の10代173人を調べました。
• 「最近」とは、10代の現在の年齢が、自分の性別が違うと気づいたと言う年齢の1年以内であることを意味しました。年齢は整数で記録されていたため、最大でほぼ2年をカバーしうるものでした。
• 年齢と生まれつきの性別を考慮した後、最近気づいた人は、うつ病、苦痛、記録された診断、性別への苦痛、自傷、自殺未遂が多いわけではなく、オンライン、トランス、親の支えに頼る割合も高くありませんでした。
• 最近気づいた人は不安が少なく、過去1年間にマリフアナを使った可能性が大幅に低く（約10分の1）、これはその考え方が予測することとは逆でした。
• 集団全体のニーズは高く、51.6%にメンタルヘルスの診断の記録があり、25.9%に自閉症やADHDなどの発達の診断があり、67.9%が過去1年に自傷を報告しました。
• より緩やかな2年という定義でも結果はほぼ同じでしたが、マリフアナに関する知見は偶然でもありうるものになりました。
• Lisa LittmanとJoanne Sinaiによる公表された書簡は、この研究は、違和感が思春期との関係でいつ始まったかを調べていないため、急速発症性の違和感を測定していないと主張しました。

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.