Littman publishes ROGD paper

In August 2018, American physician and researcher Lisa Littman published a study in the journal PLOS ONE on young people whose gender dysphoria appeared to emerge suddenly during or after puberty. She used the term rapid-onset gender dysphoria, abbreviated as ROGD.

What the study showed

Littman surveyed 256 parents using a questionnaire. The parents described children—girls in more than eight out of ten cases—who had shown no signs of gender dysphoria during childhood. Many parents reported that the change coincided with intensive social media use or with friends who identified as transgender during the same period. Mental health problems were also often present before the onset of dysphoria. Littman suggested that social influence might play a role for some of these young people.

The criticism

The study immediately sparked heated debate. The main objections were that only parents had been surveyed, not the young people themselves, and that the parents had been recruited through websites where gender care is discussed critically. PLOS ONE had the article reviewed again and published a revised version in March 2019 with a new title and greater emphasis on its limitations. The results themselves remained unchanged.

What happened afterward

The change in the group seeking care was later also documented by others. In 2024, the British Cass Review reported that the number of referrals to the English gender clinic had increased twentyfold over ten years and that the balance had shifted from young boys to teenage girls. There is no consensus on the cause: greater social acceptance, social influence, and links with other mental health problems have all been suggested. See also the page on ROGD.

The university's response

Littman was affiliated with Brown University in the US state of Rhode Island. Shortly after publication, the university removed its press release about the study from its website, citing concerns that the conclusions could harm transgender young people. This led to a second debate, alongside the one about the methodology: whether a university may withdraw research from public view because its findings are sensitive. Critics, including a former dean of Harvard Medical School, called it an infringement of academic freedom.

Later research

The concept has since been investigated several times, with conflicting results. A 2022 Canadian study of young people referred to gender clinics found no support for the existence of a distinct, suddenly emerging form. In 2021, Littman herself published a study of one hundred people who had reversed their transition; some of them said that social influence had played a role in their earlier decision. A large American study of parents published in 2023, which appeared to support the hypothesis, was retracted by the publisher because of concerns about how participant consent had been obtained. Research following the young people themselves over a longer period is still largely lacking. In 2026, Kenneth Zucker reviewed the evidence again; see the study arguing for recognition as a distinct clinical presentation. The shift toward teenage girls and the explanations offered for it are discussed on transtijd.nl in the article about the increase in girls with gender dysphoria since 2010.

Significance

ROGD is not an official diagnosis, and its scientific status is disputed. It is clear, however, that the group seeking care at gender clinics has changed significantly since around 2014: there are many more teenagers and many more girls than before. Littman's study was the first to attempt to offer a possible explanation for this. More information is available on the page about Littman's study.