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

• O estudo examinou 173 adolescentes com menos de 16 anos em uma primeira consulta para bloqueadores da puberdade ou hormônios em 10 clínicas de gênero canadenses em 2017–2019.
• 'Recente' significava que a idade atual do adolescente estava a menos de 1 ano da idade em que disse ter percebido que seu gênero era diferente. Como as idades eram em anos inteiros, isso podia abranger quase 2 anos.
• Levando em conta a idade e o sexo de nascimento, os que perceberam recentemente não tinham mais chance de ter depressão, sofrimento, diagnósticos registrados, sofrimento de gênero, automutilação ou tentativas de suicídio, nem de depender de apoio online, trans ou dos pais.
• Os que perceberam recentemente tinham menos ansiedade e eram muito menos propensos a ter usado maconha no último ano (cerca de um décimo da chance), o oposto do que a ideia prevê.
• O grupo todo tinha altas necessidades: 51,6% tinham um diagnóstico de saúde mental registrado, 25,9% um diagnóstico de desenvolvimento como autismo ou TDAH e 67,9% relataram automutilação no último ano.
• Os resultados foram praticamente os mesmos com uma definição mais ampla de 2 anos, exceto que o achado sobre a maconha poderia então ser acaso.
• Cartas publicadas por Lisa Littman e Joanne Sinai argumentaram que o estudo não mediu a disforia de início rápido, porque nunca examinou quando a disforia começou em relação à puberdade.

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.