A: There’s no good evidence that this is a real social phenomenon. I’ll give details in three parts: first, some true information about transition in children and adolescents; second, a quick critique of some misinformation about so-called “Rapid-Onset Gender Dysphoria” (with links to more thorough breakdowns), and third, some thoughts about broader perspective.
Best practices for managing transition in children and adolescents
Let’s start with some accurate information about how transition works in children, from the Standards of Care published by the World Professional Association for Transgender Health. While the Standards of Care are not legally binding, they are widely considered best practices, and, in the words of the document itself, “based on the best available science and expert professional consensus.”
- For a pre-pubescent child, the main intervention is social transition, meaning that the child is called by a different name and pronouns.
- Once someone hits puberty, they may be given a class of drugs that block the hormones that would otherwise cause puberty, in order to give them more time to make a decision about the irreversible changes that come with puberty.
- If they arrive at a firm decision that they want to transition, they are then given hormones to cause with the puberty of the gender they want.
- Genital surgery is not recommended until the person is an adult for the purposes of medical decision-making, and has been living in their preferred gender role for at least a year. For top surgery (to remove unwanted breasts), the Standards of Care recommendations are less one-size-fits all, but recommend that this happen only “after ample time of living in the desired gender role and after one year of testosterone treatment.”
To sum up: the main treatment for young children is to call them by a different name and pronouns, which is as medically non-invasive as you can get. Kids who are not sure about puberty can delay making a choice with hormone blockers. More permanent medical treatments happen only after the onset of puberty, and only after the adolescent has arrived at a firm decision about what they want.
The Myth of Rapid-Onset Gender Dysphoria
You may have read about “Rapid-Onset Gender Dysphoria (ROGD),” a made-up phenomenon in which teenage girls suddenly claim to be transgender due to a social contagion, and are pushed into transitions that they later regret. ROGD may sound scientific with its fancy name, but it was invented in 2016 by a handful of anti-trans websites, and then picked up and amplified by right-wing media. Julia Serano does a thorough job debunking ROGD here.
To date, there has been one paper published on ROGD. It appeared in the journal PLOS-ONE (which specializes in volume over quality control); the author interviewed twelve parents of transgender children (recruited through anti-trans websites) and zero transgender children. The article is debunked by Zinnia Jones here; and an earlier (similarly flawed) poster version is debunked by Brynn Tanhill here.
Bigger perspective
Finally, here’s some broader perspective on trans children and adolescents.
Withholding transition is not a neutral option. There are costs to forcing a trans child or adolescent to live in a social role they’re not comfortable with, and costs to forcing them to undergo an unwanted puberty (which has irreversible physical and psychological effects).
And sure, rushing kids into a transition you’re not sure they want would be bad, for the same reason that rushing kids into anything is bad. Fortunately, actual best practice is to listen to trans children, think about their needs, and try to provide age-appropriate, proportionate care.
Further reading