ESPE Yearbook of Paediatric Endocrinology

PLoS One. 2018 Aug 16;13(8):e0202330.

doi: 10.1371/journal.pone.0202330. Erratum in: PLoS One. 2019 Mar 19;14(3):e0214157.

A sharp and unexplained rise in the incidence of gender dysphoria has been observed worldwide among adolescents, especially natal girls. The causes and outcomes (in terms of persistence-desistence rates) of adolescent-onset gender dysphoria are currently unknown.

This study describes a recently observed phenomenon, ‘rapid-onset gender dysphoria’ (ROGD). It may represent a specific sub-entity of adolescent-onset gender dysphoria that has an atypical presentation. In order to generate hypotheses around the factors contributing to ROGD, the authors recruited participants by advertising through three websites, and asked parents of children with ROGD to complete a custom-made online questionnaire – as such, parents had to notice this to be active. 256 parents completed the survey. The results suggested that ROGD may be triggered by what the authors describe as “social contagion” and “maladaptive coping strategies”.

This study generated a very heated debate, due to the methodological difficulties in its design, the presumed tendentious interpretation of results, and its potential negative impact on the transgender community (1). Nevertheless, this report has an important merit in that it is the first to describe and try to understand a recently observed trend that may be possibly harmful for some vulnerable young individuals. It reminds the pediatric endocrine community to remain cautious that some gender dysphoric adolescents may present with a very complex clinical picture and that long-term outcomes of atypically-presenting and/or rapid onset GD are currently unknown. Even when faced with an increasing pressure to rapidly alleviate the psychological suffering of gender dysphoric youth, careful diagnosis and multidisciplinary follow-up remain crucial in the management of gender dysphoric youth who seek medical transition.

Reference: 1. Wadman M. Rapid onset’ of transgender identity ignites storm. Science. 2018 Sep 7;361(6406):958–959.