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Feminism: Sex and gender discussions

Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports

78 replies

CholloDeNombre · 16/08/2018 20:07

Link here http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330

Conclusion
Rapid-onset gender dysphoria (ROGD) describes a phenomenon where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood. ROGD appears to represent an entity that is distinct from the gender dysphoria observed in individuals who have previously been described as transgender. The worsening of mental well-being and parent-child relationships and behaviors that isolate AYAs from their parents, families, non-transgender friends and mainstream sources of information are particularly concerning. More research is needed to better understand this phenomenon, its implications and scope.

I hope this brings ROGD into more public discourse.

OP posts:
InsaneVampire · 21/08/2018 18:18

Yep thought so. You can use impressive terms like "socially mediated" and "maladaptive coping mechanism" but you don't seem to understand its results aren’t reliable because of basic study design.

OldCrone · 21/08/2018 20:21

InsaneVampire

Why do you think the results are not reliable? The author says:

The onset of gender dysphoria seemed to occur in the context of belonging to a peer group where one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same timeframe... The purpose of this study was to document and explore these observations and describe the resulting presentation of gender dysphoria, which is inconsistent with existing research literature.

She wanted to look specifically at children who had first experienced gender dysphoria as adolescents, often 'coming out' as transgender in groups of friends. Who would you put in a 'control group', and why do you think one is required for this sort of study?

WeAreGerbil · 21/08/2018 20:27

Um, no, it seems pretty fatal to this study. More to the point, it's intentional selection bias. She didn't even try to mitigate for it, she only asked sceptical parents. There's not even a control group!

Same question as OldCrone, I also don't understand what a control group would do because it wouldn't negate the experiences of the people in the research.

InsaneVampire · 22/08/2018 11:19

No, she's looking at parents of children who, they think, had first experienced gender dysphoria as adolescents. For starters I would control for people resistant to having a transgender child, using clinic populations and "gender-affirmative" groups, because the screening questions are inadequate there.

FWIW I'm sure there is some social contagion, as in anorexia, but to identify it as a whole separate condition and preach to parents about it seems a recipe for moral panic.

InsaneVampire · 22/08/2018 11:20

*because Littman's screening questions are inadequate, I mean.

OldCrone · 22/08/2018 11:50

No, she's looking at parents of children who, they think, had first experienced gender dysphoria as adolescents.

And it's a qualitative study of the experiences of those children.

For starters I would control for people resistant to having a transgender child, using clinic populations and "gender-affirmative" groups, because the screening questions are inadequate there.

What would be the point of this? She is looking at one particular demographic. There is no need to include others.

FWIW I'm sure there is some social contagion, as in anorexia

Which is precisely the point of the study.

Starkstaring · 22/08/2018 13:16

And the potential for unnecessary harm is very high, particularly as many of the teens involved have other difficulties already.

The fact is this study has been able to highlight a potential problem which needs to be investigated further. What it describes is what I am sure many clinicians have observed but dare not raise in public for fear of being accused of transphobia.

What we need is for those clinicians to publish what they are experiencing so that we can see whether in fact Littman's research is confined to parents who are transphobic bigots, or actually parents who are very concerned about the long term wellbeing of their vulnerable adolescent children.

TransplantsArePlants · 22/08/2018 13:27

Insane.

You don't seem familiar with qualitative research. It's perfectly legitimate to select a group of individuals in order to gain insight into a phenomenon.

InsaneVampire · 22/08/2018 13:52

And it's a qualitative study of the experiences of those children.

No, it's explictly a qualitative study of the experiences of parents who disbelieve their children.

You don't seem familiar with qualitative research. It's perfectly legitimate to select a group of individuals in order to gain insight into a phenomenon.

Yes, and that phenomenon is "parents who believe in ROGD". ROGD is a disputed phenomenon. You can't prove its existence by only asking parents who already believe it exists. Ritual Satanic Abuse, anyone?

What we need is for those clinicians to publish what they are experiencing

That I'd agree with. Ask the clinicians.

OldCrone · 22/08/2018 13:57

No, it's explictly a qualitative study of the experiences of parents who disbelieve their children.

Where does it say this? I can't find any evidence of that.

OldCrone · 22/08/2018 14:18

ROGD is a disputed phenomenon.

It is mentioned in this paper in the Lancet.

Gender incongruence can also emerge for the first time during pubertal development, with no history of gender-discordant behaviours or feelings reported in childhood or prepubertal adolescence.

Their reference for this statement is this paper, which states that 17.9% of the young people in their study first experienced gender dysphoria between the ages of 13 and 18.

Twice as many natal females as natal males fell into this category, and the majority were sexually attracted to people of their birth sex. This suggests the possiblity of homophobia playing a part in their gender dysphoria, as well as social contagion.

FloralBunting · 22/08/2018 14:48

Yep, parents who see their contented children reach adolescence and suddenly decide, after discovering the internet, that they hate their body so much they must be the opposite sex, are totally analogous to the Ritual Satanic Abuse stuff.

Don't you trust your lying eyes and instincts, mum. You know nothing.

RedToothBrush · 22/08/2018 15:00

ROGD is a sex specific phenomenon. As in, it is disproportionately appearing in females, with dysphoria in males following a different pattern.

I'm afraid that we DO need to point out that gender dysphoria fits into the same box and DOES present differently between sexes. Politically this is never going to sit well with trans activists, but this isn't a political point and ideology should be kept out of medical research.

This is important and its valid, due to the age of the people involved, that parents be involved in examining the subject. Precisely because the capacity for informed consent without undue pressure, is a major facet of this debate. Social issues which are relevant SHOULD be being considered by researchers.

The young age of females reporting symptoms makes it distinct and have different issues compared to how gender dysphoria in males presents. How you then treat it stems from here.

I'm minded to remind people that women have suffered from the medical profession being lacking in identifying how women present differently to men in all manner of health conditions which has ultimately harmed them. For example heart attacks.

In this case parents are voicing concerns that highlight that they feel decisions are being made in a vacuum where informed consent is impossible because of undue pressure. Parents who have both a legal and moral responsibility to their children, but are being sidelined by various institutions. This raises the question of whether adequate safeguarding is happening.

In terms of whether this study is therefore biased or self selecting is somewhat irrelevant in this context.

If just one parent comes out and says, they think that informed consent without duress has occurred, that is worthy of investigation and should be followed up. If there are multiple people saying the same thing, then the question arises about whether this is indeed a medical condition which parents are ignorant about OR whether its a symptom of a systematic failure of institutional safeguarding policy.

In other words, is this a medical study or is it in fact potentially a whistleblowers study? Thats the direction the question that needs to go, to ensure that its indeed not highlighting something other than a medical issue.

Bias and self selection as an argument when it comes to research is very important to assessing the quality of a research project, but you also have to look at what the study was concerned about too.

In this case, the presence of a control group isn't necessarily relevant.

To illustrate the point, if you were doing a research project Post Traumatic Stress after childbirth and asked whether MNetters felt they had been able to make informed decisions during childbirth without undue duress, you wouldn't request a control group to determine whether those women who said they didn't feel they were able to consent freely were liars or ignorant.

The mere presence of a certain percentage of women feeling like this, even if it were small, should create pressure and raise questions about the nature of the medical condition they were presenting with.

This is about whether symptoms are a product of policy and treatment and whether those processes can be improved so that children are not harmed and parents can have more confidence and trust in the system.

THAT is ultimately the intent of doing the study in the first place. Its about how you go about improving treatment for young people particularly females. And that does include the involvement of parents.

Comments about the need for a control group are therefore straw man arguments in this context.

RedToothBrush · 22/08/2018 15:02

Slight correction to the above:

If just one parent comes out and says, they think that uninformed consent under duress has occurred, that is worthy of investigation and should be followed up.

Starkstaring · 22/08/2018 15:09

I've mentioned it before. If a parent or close family member is needed to get a secure diagnosis for autism, what is the problem for getting their input for a secure GD diagnosis?

I would also add that the high proportion of young people with ASD presenting to the GD clinics - is thus a group at risk of unnecessary intervention due to inaccurate diagnosis?

InsaneVampire · 22/08/2018 18:49

I'll concede some points here, MN, but I think there's a difference between overdiagnosis, the rapid onset of gender dysphoria, and Rapid Onset Gender Dysphoriaâ„¢. I expect that some overdiagnosis will come to light, just as underdiagnosis has been going on for generations. I can't in conscience listen to arguments from people who think transgenderism is a delusion, and this study doesn't show that it's not the parents being indoctrinated, it can only make extremely modest claims.

OldCrone · 22/08/2018 19:15

I expect that some overdiagnosis will come to light

Doesn't the prospect of overdiagnosis worry you, InsaneVampire? Given that the treatment is medication with powerful drugs which have not been shown to be safe for use in children. Followed by a lifetime of more medication and irreversible surgery.

I can't in conscience listen to arguments from people who think transgenderism is a delusion

What do you think transgenderism is? It is not possible to change sex. It is not possible to be 'born in the wrong body'. A belief that someone is born in the wrong body is just that, a belief, similar to a religious belief, of a gendered soul which is somehow distinct from the body. So perhaps not a delusion, but a belief which cannot be proven.

It is wrong to force others who do not share your belief system to pretend that they do. I respect the rights of others to hold any religious belief that they want to, but they cannot force me to hold the same beliefs.

Datun · 22/08/2018 19:23

I can't in conscience listen to arguments from people who think transgenderism is a delusion

I'd also be interested in a different definition to 'being born in the wrong body'.

tiredandweary · 22/08/2018 19:27

InsaneVampire
When you said I expect that some overdiagnosis will come to light I wonder what number of children will be the acceptable collateral for you in terms of ending up sterilised, mutilated and on drugs for the rest of their life? At what stage will it just be unfortunate 'over diagnosis' and how many will be needed to constitute a scandal?
You may notice that women are usually tenacious in terms of protecting / safeguarding both our own and all children. And that's why I find the arguing over a rare piece of research (given that TRAs stop all research that they don't like - James Caspian etc) very cynical. You don't have to care about children's welfare - but coming onto FWR to argue with women that we're wrong for doing so is ....odd... in the extreme.

InsaneVampire · 22/08/2018 20:20

I wonder what number of children will be the acceptable collateral for you in terms of ending up sterilised, mutilated and on drugs for the rest of their life?

Well, how many genuinely trans children have to be harmed by disbelief? The prospect of overdiagnosis does worry me, but let's not kid ourselves, medicine does tons of harm in all directions. We're all its collateral.

OldCrone · 22/08/2018 20:30

Well, how many genuinely trans children have to be harmed by disbelief?

How does 'disbelief' harm anyone?

How do you recognise a 'genuinely trans' child? What does 'genuinely trans' mean?

The prospect of overdiagnosis does worry me, but let's not kid ourselves, medicine does tons of harm in all directions.

So you see no reason to try to avoid such harm?

TransplantsArePlants · 22/08/2018 20:35

What is a mistaken belief other than a delusion?

tiredandweary · 22/08/2018 20:43

Wow! Thank you InsaneVampire for your clarification. Very illuminating.

RedToothBrush · 22/08/2018 21:29

A dictionary definition:
Delusion: an idiosyncratic belief or impression maintained despite being contradicted by reality or rational argument, typically as a symptom of mental disorder.

In terms of the phraseology of delusion and trans, its interesting to see what some people who have a diagnosis of gender dsyphoria. There are a number of sufferers who describe it themselves as a condition which is at odds with reality and they can not logically describe.

Words and phrases like irrational and mind playing tricks do pop up. A diagnosis is merely a way of acknowledging that and treatment merely a way of alleviating how they feel. Its not a cure. Nor is there any evidence to suggest that medicalisation or even social transition are the only ways to remedy how people feel. Because there has been such limited research in this field, and what has been done has been hampered by political ideology and lobbying interfering with the process of evidence based medicine.

In other words you do have at least a small number of trans people with dsyphoria saying themselves that their condition is akin to being delusional (delusional not quite being the right word, but the sentiment being similar).

There are some big unanswered questions here which are in the best interests of sufferers of gender dsyphoria, which are being obscured by the political agenda of the trans lobby and their unwillingness to acknowledge the mental health aspect of dsyphoria and how there is often comorbitity with other mental health conditions.

This disconnect and unwillingness to accept this as a issue which has some considerable evidence for existing (from pro-trans sources too I might add), is in itself a suspension of reality. And a suspension of reality is a....

The word delusional isn't a slur or even saying that some lacks capacity entirely - but by its very nature people who suffer from a health condition with an aspect which might hamper their ability to process things that someone who wasn't ill can, is more vulnerable and they do need protecting from undue pressure and influences in order to make properly informed decisions.

This is further complicated if the person concerned does happen to be a minor.

Using the word delusional, is seen as controversial and inflammatory. It shouldn't be, but I think the stigma of it and the idea of admitting that you might have a problem you don't want to confront sticks and can be difficult to get past too.

People want to retain control of their lives and are afraid that if they acknowledge they have some sort of delusion that they will be forced to surrender to what someone else says is best.

I'd also add that if you've invested your identity as being trans, then your identity almost becomes your medical condition. If you find alternative ways to tackle your health condition, are you abandoning your identity in the process? Is the intertwining of the two, problematic in its own right, especially if your society circle also relates to your identity? And does that in itself constitute undue pressure to 'consent' to a particular course of action?

As I say, the problem here is that health is ending up playing second fiddle to politics and normal safeguarding frameworks with regard to ethical practice and the concept of consent are highly questionable when it comes to gender dysphoria across the board, and these questions are much more acute in teenage girls.

Sadly, I don't see how the interests of any girl regardless of whether they trans or dont trans is best served in this bubble of refusing to sit down and hammer some of these really difficult points of conflict and concern out properly. Without adequate research, every single kid who says they identify as trans is being ultimately failed in one way or another.

Starkstaring · 22/08/2018 22:11

Well put Red. In summary, it's complicated and every person deserves to have their own personal condition understood and treated using the best evidence based treatment. Not some social justice one size fits all affirmation.

A particularly vulnerable group are those aged 18-25. Legally adult yet still adolescent, autistic young adults especially who tend to be a couple of years behind their peers in terms of emotional maturity.

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