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

• 저자들은 현재의 근거가 ‘급성 발병 성별 불쾌감’을 입증된 설명으로 받아들이는 것도, 트랜스 혐오로 비난하는 것도 정당화하지 않는다고 주장합니다.
• 리트먼의 2018년 부모 256명 설문에서, 설명된 청소년의 83%가 출생 시 여성이었고 63%가 성별 불쾌감이 시작되기 전에 정신 건강 또는 발달 진단이 있었습니다.
• 2022년 클리닉 연구(Bauer 등)는 이 개념을 지지하지 않았습니다. 그러나 검토는 이 연구가 사춘기와 관련 없이 ‘최근에 자신의 성별을 알게 된 것’을 급성 발병으로 취급했다는 리트먼의 비판을 부각합니다.
• 인용된 디트랜지셔너 설문 중에는 237명의 디트랜지셔너 중 70%가 고통에 다른 원인이 있었다고 말한 것(Vandenbussche)과, 78명 중 53%가 자신의 경험이 급성 발병 개념에 맞는다고 느낀 것(Littman 등)이 있습니다.
• 친구들 사이에서 섭식장애와 자해가 퍼지는 방식에 대한 연구와 소셜 미디어의 해에 대한 연구는 일부 10대에게 사회적 영향이 그럴듯하게 만듭니다. 다만 인용된 한 종합 분석은 신체상에 대한 비슷한 영향이 남아와 여아 모두에게 있음을 발견했습니다.
• 저자들은 자신의 클리닉에서, 사춘기, 코로나19 봉쇄, 소셜 미디어 사용 증가와 함께 성별 불쾌감이 커진 심각한 정신 건강 문제가 있는 10대 집단을 설명합니다.
• 10대, 부모, 임상의의 견해를 결합한 장기 연구를 요구하며, 다른 정신 건강 상태도 있는 10대에게 대화 치료가 중심적 역할을 한다고 강조합니다.

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.