The entire theory is based on a single poster abstract in 2017 by Dr. Lisa Littman. Poster abstracts are often published when not only is the material too weak to be a journal article, but of insufficient quality to even be accepted for oral presentation at a conference. As such, the academic bar for a poster abstract getting accepted is very low. It was, however, published in the Journal of Adolescent Health.
Littman's abstract suffers from so many methodological flaws, logical errors, and unacknowledged biases that it fits firmly in the category of junk science. Given how glaring these issues were, it is surprising that the Journal of Adolescent Health published it regardless of how low the bar was set.
Here's why this abstract by Littman is poor science.
1. The sample group has a heavy and unacknowledged bias which affects the results Littman posted a survey on three websites asking parents about their transgender teens. What she failed to mention in her abstract is that all three websites -- 4thwavenow.com, transgendertrend.com, and YouthTransCriticalProfessionals.org -- are all dedicated to parents who do not recognize the gender identities of their children, and do not support their transitions. Littman did not post her survey to sites where parents of transgender adolescents support their children or even neutral sites.
This creates an obvious bias, one she fails to acknowledge anywhere in her poster abstract. Given the obvious viewpoints of the websites she posted to, and the fact that she does not acknowledge this, it gives the appearance she is deliberately trying to hide the bias in her results. Other issues with her abstract support this perception of deliberate academic malfeasance.
2. One of her survey questions appears to be a deliberate attempt to hide her bias One of the survey questions asked respondents whether they believe "transgender people deserve the rights and protections as other people." The abstract notes that 87.7 percent answered yes, and is presented in such a way as to suggest that the respondents did not harbor anti-transgender animus. However, this question, and statistic, appear to be deliberately misleading.
This phrasing suggests a deliberate attempt to hide bias in the study, because even people who are vehemently against transgender people are likely to answer yes. For over a decade, anti-LGBT hate groups have framed protections for LGBT people, and even marriage equality, as "special rights."
A quick perusal of the websites where Littman drew her surveys from shows that the people posting there are often ideologically aligned with these anti-LGBT hate groups. There are frequent posts stating that transgender people are sexual deviants. They quote Paul McHugh, cite Michelle Cretella of the anti-LGBT hate group (and fake medical organization) ACPeds, oppose legal protections for transgender people, and call for legislation to prevent people from transitioning until they are in their late 20s.
Thus, at best, this 87.7 percent statistic provides no useful information about how the respondents feel about transgender people. Given how the author failed to mention any of the ideological biases of the places where she asked for respondents, it appears more likely to be a deliberate attempt to hide the bias within her sample.
3. The unacknowledged bias in Littman's sample leads her to ignore plausible explanations for her data supported by extant literature Littman asks "before and after" coming out questions in her survey. This includes things such as whether the parent-child relationship improved or got worse after they came out, and whether the mental well-being of the child improved or declined after the child came out. Based on parents' perceptions, both declined according to her survey. She notes that this observation contradicts the existing body of research, which shows improvement when trans youth come out.
She also notes in the data that parents perceived transgender youth as having a more LGBT-centric circle of friends, and as getting their information from transgender-friendly sources on the internet. However, Littman fails to note that this was a survey of parents who do not support their children. Viewing Littman's results through the lens of trans youth-unsupportive homes, her results do not contradict the current body of research. There is a large body of evidence showing that transgender youth in unsupportive homes have worse mental health outcomes than those in supportive ones.
Accounting for the bias in her sample, a picture consistent with the existing body of evidence emerges.
Transgender youth in unsupportive homes are much more likely to share their thoughts and feelings with LGBT friends at school and peers online than family. Questioning youth are unlikely to go to hostile sources of information online which label them as deluded, mentally ill, or sexually perverted. Given the social stigma and moral opprobrium associated with being transgender, they stick to "safe" LGBT social groups.
After coming to grips with their gender identity, transgender youth then delay telling hostile parents until they cannot bear not to, which makes it appear to the parents that this came out of nowhere. After they come out, and their parents do not support them, the parent-child relationship deteriorates, and the mental health of the youth declines. An interview I conducted with the (now adult) child of one of the parents who participated in this survey confirms this narrative as true for him.
Littman does not in any way pursue this plausible hypothesis which conforms with current findings. Instead, Littman appears to be deliberately ignoring the bias in her sample in order to claim that she has found a new phenomenon.
4. The conclusions reached by this abstract rely on poor logic and what appears to be a deliberately biased sample The abstract concludes that "rapid onset gender dysphoria" is dangerous, real, and is caused by interactions with friends and people on the internet. This conclusion is based on some rather heroic leaps of logic.
The most grievous logical error is the conclusion that this is a new phenomenon, when current literature in the context of youth living in unsupportive homes would explain the observations. The abstract conclusion also seems to imply that sources of information which encourage parents to reject the identities of transgender youth are mainstream voices.
"Rapid Onset Gender Dyshphoria" was first proposed as a diagnosis on anti-transgender websites in 2016, and this study appears to be a naked attempt to legitimize anti-transgender animus with a veneer of academic respectability. In the process, however, Littman's work shreds all standards of academic integrity.
Instead, with a sample which she makes no attempt to account for biased questions, lack of context, and with no attempt to understand her data within the context of existing research, she ignores Occam's Razor and leaps to a conclusion that what we are observing is sinister and new, rather than simply what we already expect from transgender youth in unsupportive environments.
The abstract is an egregious example of biased junk science, and it is surprising that the Journal of Adolescent Health allowed it to be published.
BRYNN TANNEHILL is a former naval aviator who currently serves on the boards of SPARTA and the Trans United Fund. She has nearly 300 published articles across a dozen platforms. She lives in Northern Virginia with her wife and three children.