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

• 研究觀察了 2017–2019 年在加拿大 10 家性別門診因青春期阻斷劑或荷爾蒙首次就診的 173 名 16 歲以下青少年。
• 「近期」指青少年目前的年齡，與他們表示意識到自己性別不同時的年齡相差在 1 年之內。由於年齡以整歲計算，這可能涵蓋將近 2 年。
• 在考慮年齡和出生性別後，近期意識到的人並沒有更可能有憂鬱、痛苦、紀錄中的診斷、性別困擾、自傷或自殺未遂，也沒有更依賴網路、跨性別或父母的支持。
• 近期意識到的人焦慮較少，且過去一年使用大麻的可能性低得多（約為十分之一），與這個說法所預測的相反。
• 整個群體的需求很高：51.6% 有紀錄的心理健康診斷，25.9% 有發展診斷如自閉症或ADHD，67.9% 回報過去一年有自傷。
• 採用較寬鬆的 2 年定義時，結果大致相同，只是大麻的發現可能就只是偶然。
• Lisa Littman 和 Joanne Sinai 發表的信函主張，這項研究沒有衡量快速發作的焦慮，因為它從未觀察焦慮相對於青春期開始的時間。

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.