“Rapid onset gender dysphoria” (ROGD) is a term derived from a theory that social influence and flawed coping mechanisms may contribute to gender dysphoria. Many experts object to the term and consider it harmful.

ROGD is not a clinically recognized term.

This article looks at the definition of ROGD, how the theory behind the term came about, and why healthcare professionals consider it harmful.

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In 2018, a single-authored exploratory study in PLOS ONE suggested ROGD as a potential new subcategory of gender dysphoria.

The study defined ROGD as a sudden onset of gender dysphoria in adolescents or young adults who did not display signs of gender dysphoria in childhood.

It hypothesized that ROGD might occur due to social influence from peer groups and social media use in combination with limited coping mechanisms to deal with strong or negative emotions.

Learn more about gender dysphoria here.

According to the 2018 exploratory study, parents in online forums reported that gender dysphoria in their children began around puberty.

They claimed that this occurred at a similar time to peers experiencing gender dysphoria and alongside an increase in social media or internet use.

Study design

The study used results from 256 surveys asking parents to complete 90 questions, including multiple-choice and open-ended questions and Likert-type scales.

Its author posted recruitment information on the following three websites and a Facebook page in which parents reported a sudden onset of gender dysphoria in their children:

  • 4thWaveNow
  • Transgender Trend
  • Youth Trans Critical Professionals
  • Parents of Transgender Children Facebook group

The Facebook group may have been supportive of gender affirming care. However, the other three websites express cautious or negative opinions about gender dysphoria and transgender issues.

It is not clear how many participants signed up from each site.

Conclusions

The study author suggests that gender dysphoria may occur suddenly in young people and be the result of:

  • social influence from peers also experiencing gender dysphoria
  • social media
  • other online content

The paper also hypothesized that having limited coping strategies to deal with strong and negative emotions contributed to ROGD.

However, it acknowledged that parent-child conflict may have contributed to some survey responses.

The study concluded that further research is necessary to explore the theories it proposes, including data from adolescents and young adults with gender dysphoria and clinicians.

Amendments

After the initial publication of the study, PLOS ONE issued a post-publication reassessment in 2019 to make corrections to the original paper.

The reassessment stated the following:

  • ROGD is currently not a formal mental health diagnosis.
  • The study consists of observations from parents, which only creates a hypothesis.
  • The study does not validate the hypothesis, as it includes no data from adolescents or young adults with gender dysphoria or clinicians.
  • Researchers require further evidence from adolescents or young adults and experts in gender dysphoria before using the term ROGD in any descriptive, clinical, or diagnostic way.
  • The original paper was a descriptive study, meaning it was an initial inquiry into a research area to develop a hypothesis and requires further research.
  • Limitations of the study include potential parental biases, a lack of knowledge of certain information among parents, and selection bias through recruiting from a small, self-selected population.

While the 2018 study used the term ROGD, this term has no clinical validation.

Several professional psychological and medical organizations have signed a statement that does not support using the term ROGD.

The statement adds that ROGD is not a recognized condition or subtype in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) or the International Classification of Diseases, and experts are not considering it for future editions.

Studies

Many articles in scientific journals have opposed the term ROGD.

A 2020 article states that the 2018 study used flawed research methods. The critique also explores the potential bias of the paper and the use of language that falsely compares transgender identity to an infectious disease or disorder.

A 2022 article from the Journal of Pediatrics also did not support the hypothesis of ROGD and suggests that the survey responses may represent the experiences and perceptions of parents rather than adolescents or young adults with gender dysphoria.

Objections

The Coalition for the Advancement and Application of Psychological Science (CAAPS) issued a statement that objected to the use of the term ROGD due to the following:

  • a lack of rigorous scientific evidence to support it
  • a lack of evidence from lived experiences of young transgender people
  • the significant potential of the use of the term to cause harm

Several organizations cosigned the statement, including the American Psychiatric Association, the American Psychological Association, and the Society of Behavioral Medicine.

The World Professional Association for Transgender Health (WPATH) also points out that ROGD is not a medical term that any major professional association recognizes.

WPATH adds that it is not appropriate to use the acronym ROGD in an official-sounding way that may mislead people to make unsupported conclusions about gender identity.

A study that appears in a scientific journal and uses official-sounding language to sound reputable can be harmful when the study uses flawed research methods and does not take into account existing research on the benefits of gender-affirming care.

Flawed methods and a lack of evidence

The original study used a method called snowball sampling, which allows study participants to recruit other participants. It also encouraged potential participants to share the survey link and recruitment information with other people or communities they felt may include eligible participants. This may create biased results.

In addition, parental responses may not accurately represent the experiences and symptoms that adolescents or young adults face. Three of the criteria in the DSM-5-TR for a diagnosis of gender dysphoria include information that a parent may not be aware of unless an adolescent or young adult tells them directly.

According to a statement from CAAPS, the theory of ROGD has the potential to cause significant harm. A lack of rigorous evidence to support it means that people may misuse the term or cite the study behind it without full context.

Effects on transgender rights and policies

Misinformation around ROGD is also affecting decisions on policies around transgender rights.

Many bills currently under review that aim to limit the rights of young transgender people are using the claims of ROGD to support their arguments.

For example, a 2022 report cited the 2018 study in the campaign to prevent Medicaid from providing transition-related healthcare in Florida.

A representative of Georgia also cited the study in a 2019 speech before the U.S. House Committee on the Judiciary to oppose the Equality Act.

The American Academy of Child and Adolescent Psychiatry states that legislation against providing transition-related healthcare to children and young people may be detrimental to their health.

It can also increase the risk of mental health issues and suicidal ideation.

Effects on access to support and resources

The study suggests that ROGD may occur due to “social contagion,” which refers to the supposed process through which behaviors, emotions, or conditions spontaneously spread through a group. This may lead people to believe social media use or connecting with people who share similar experiences may be a cause of sudden gender dysphoria in young people.

However, according to the Human Rights Campaign (HRC), the internet and social media use may provide LGBTQIA+ youth with social support, resources for mental health support, and education about sexual and gender identities.

HRC also adds that young LGBTIA+ people may now begin expressing their sexual or gender identity at a younger age than previous generations, which may be due to society as a whole becoming more accepting.

Gender dysphoria may make a young person feel:

Next steps

If a parent or caregiver notices signs of gender dysphoria in a child, some next steps to consider may include the following:

  • asking the young person how they feel and how to best support them
  • listening to them and helping them express their emotions
  • researching transgender issues and gender dysphoria online, particularly from the perspective of transgender people
  • looking for support groups, transgender networks, and LGBTQ+ youth groups that a young person may want to join
  • seeking out medical professionals who provide transgender health services if a young person requires gender-affirming care

ROGD is a suggested subcategory of gender dysphoria that clinicians do not recognize as legitimate. The study that hypothesized the existence of ROGD suggests social influence and limited coping mechanisms may contribute to the sudden development of gender dysphoria.

Many professional organizations have objected to the theory due to a lack of rigorous evidence and state that the idea causes harm.