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

• 作者主張，目前的證據既不足以把「快速發作性別焦慮」當作已證實的解釋來接受，也不足以把它譴責為恐跨。
• 在 Littman 2018 年對 256 位家長的調查中，所描述的年輕人有 83% 出生時為女性，63% 在性別困擾開始前有心理健康或發展診斷。
• 2022 年的一項門診研究（Bauer 等人）沒有發現支持這個說法。但回顧強調了 Littman 的批評：該研究把「最近才知道自己的性別」當作快速發作，卻沒有參照青春期。
• 所引用的去過渡者調查包括一項（Vandenbussche）中，237 名去過渡者的 70% 表示他們的痛苦有其他原因，以及一項（Littman 等人）中，78 人的 53% 覺得自己的經驗符合快速發作的說法。
• 關於飲食障礙和自傷如何在朋友間傳播，以及社群媒體所造成傷害的研究，使社會影響對某些青少年而言是可信的。不過，一項被引用的合併分析發現，對男孩和女孩的身體形象有類似的影響。
• 作者從自己的門診描述了一群有嚴重心理健康問題的青少年，他們的性別困擾隨著青春期、COVID-19 封城和更多社群媒體使用而增加。
• 他們呼籲進行結合青少年、家長和臨床人員觀點的長期研究，並強調談話治療對同時有其他心理健康狀況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.