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

• 该研究考察了2017至2019年加拿大10家性别诊所首次就诊要求青春期阻断剂或激素的173名16岁以下青少年。
• “近期”指青少年目前的年龄与其所说意识到自己性别不同时的年龄相差在1年以内。由于年龄是以整年计算的，这可能涵盖近2年。
• 考虑年龄和出生性别后，近期意识到的人出现抑郁、痛苦、已记录的诊断、性别痛苦、自伤或自杀未遂的可能性并没有更高，对网络、跨性别或父母支持的依赖也没有更多。
• 近期意识到的人焦虑更少，过去一年使用大麻的可能性也低得多（约为十分之一），这与该观点所预测的相反。
• 整个群体的需求很高：51.6%有已记录的心理健康诊断，25.9%有自闭症或ADHD等发育诊断，67.9%报告过去一年有自伤。
• 采用更宽松的2年定义，结果大致相同，只是大麻方面的发现此时可能是偶然。
• Lisa Littman和Joanne Sinai发表的信函认为，该研究没有衡量快速发作的焦虑，因为它从未考察焦虑相对于青春期是何时开始的。

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.