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

• 作者认为，目前的证据既不足以将“快速发作性别焦虑”作为一种已证实的解释而接受，也不足以将其谴责为恐跨。
• 在Littman 2018年对256名家长的调查中，所描述的年轻人83%出生时为女性，63%在性别痛苦开始之前有心理健康或发育诊断。
• 2022年的一项诊所研究（Bauer等人）没有发现支持这一观点的证据。但综述强调了Littman的批评，即它把“最近才知道自己的性别”当作快速发作，而没有参照青春期。
• 所引用的去过渡者调查包括一项（Vandenbussche）其中237名去过渡者中70%说自己的痛苦有其他原因，以及一项（Littman等人）其中78人中53%觉得自己的经历符合快速发作的观点。
• 关于饮食障碍和自伤在朋友之间如何传播，以及社交媒体危害的研究，使社会影响对一些青少年来说是可信的。不过，所引用的一项合并分析发现，对男孩和女孩身体形象的影响相似。
• 作者从自己的诊所描述了一群有严重心理健康问题的青少年，他们的性别痛苦随着青春期、新冠封锁和社交媒体使用增多而加剧。
• 他们呼吁开展结合青少年、家长和临床医生观点的长期研究，并强调谈话治疗对同时有其他心理健康状况的青少年的核心作用。

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.