ROGD and its Discontents

My new book chapter!

Rapid Onset Gender Dysphoria and its Discontents, by Jenny Poyer Ackerman 

(Adapted from the book Women’s Rights: Gender Wrongs, published by WDI.)

Imagine you’ve just hung a painting on your living-room wall. You step back to take a look, and  realize it should be a few inches to the left. Just then a neighbor pops in and tells you how to solve the problem: hire a builder to move the chimney, the door and the windows a few inches to the right.  

Seeing your look of doubt, she calls other neighbors to weigh in. Enter the doctor, teacher and therapist from down the street, each more emphatic than the last: yes, rebuilding your house is the only way to center the painting. True, there will be a lengthy, costly period of mess and discomfort; the doorbell will never work again, and you might have to come and go through a window. These are but small concessions to the feeling of Spatial Congruence that awaits you.  

Should this happen to you, it will be perfectly clear that the neighbors, not you, have lost their minds. But this clarity will not resolve the isolation or the bewilderment you will experience in the aftermath.

If my parable strikes a chord, you might be (like me) the parent of a teen daughter who suddenly became convinced she was actually a boy and has dedicated herself to persuading you, the world and herself that it's true. Her case typifies a subset of 'trans’-identifying young people (predominantly girls) who abruptly declare themselves to be the opposite sex.

Researcher Dr Lisa Littman named this phenomenon Rapid Onset Gender Dysphoria (ROGD), and described its evident spread via social contagion. 

Her studies sought to explain why so many girls were attracted to the prospect of changing sex. Littman observed that a crucial accelerant of ROGD is social media, whose popularity coincided with the mushrooming of cases.

Littman also identified online porn as an aggravating influence. Nearly every teen in the developed world owns a mobile phone, which provides access to a cesspool of unfiltered, unregulated pornography - virtually all of it skewed for a male audience that is unsentimental about women's dignity or pleasure. These videos are, for many if not most kids, an introduction to the ostensible experience of adult sex. This deserves far more study than it gets, as the impact seems pretty consequential.

So, what’s a girl to do if she feels alienated by violent, misogynist porn? One new option is to trade in her female-sexed body for a perceived safer vessel. For many girls, ROGD reflects a wish not to be female, while the notion of ‘becoming male' is merely the default consequence. 

A recent New York Times podcast reported that mental health disorders have surpassed physical conditions as the primary threat to adolescent health and ability to function. Additionally, adolescents are experiencing puberty earlier than ever before, but their brains and cognitive abilities are not developing any faster. While processing the emotions that come with puberty, pre-teens are simultaneously bombarded with images and stimuli for which they are not developmentally prepared. Moreover, ‘early-maturing females appear to be at increased risk for victimization, especially sexual assault’. All of this imbues womanhood with an ominous lack of agency. When becoming a woman is framed as just one of two options, it's not surprising that some girls will choose the other one. 

The idea of transitioning to a new identity has irresistible appeal for many adolescents struggling with anxiety, depression and eating disorders. Sexual trauma is prevalent among ROGD teens, as is autism. Other ROGD teens are same-sex attracted and find scant social support for lesbians, while young 'transmen' become famous media influencers by describing the highlights of their 'gender journeys' from their bedrooms. 

Even for high-functioning adolescents, the pressure to keep up can be overwhelming. In the absence of real-world support, many teens trying to cope with social pressures look online for solutions. Common search terms can lead to an interactive quiz that will point to an intriguing diagnosis: she's actually a boy. She finds endless sources of positive reinforcement for 'coming out as trans’: the algorithm feeds her newfound interest in one direction only. A new identity promises attention and approval from her peers, and some are likely to follow suit.

What happens when your daughter declares her newly-discovered 'trans' identity? 

The World Professional Association for Transgender Health (WPATH) is the body from which treatment guidelines emanate. Trans-identifying men are prominent among the ‘experts’ who hand down the guidance of care for all gender-questioning patients. This departs from the principle of clinical neutrality that governs good science. 

So, a new set of treatment protocols for children and adolescents is written by a recently-invented professional society, run by stakeholders, for the treatment of a novel condition that cannot be understood medically. 

What could go wrong?

WPATH's Standards of Care are premised on the infallibility of a child’s self-knowledge. When a child declares herself to be trans, her declaration must be affirmed by everyone around her, starting with the parents, in order for her (now him) to live as his true self.

Affirmation begins with believing, or pretending to believe, that your daughter is literally now a boy. It is signaled by changing the pronouns you use to refer to her -- even when she isn't present -- and using her new name. The name you gave her will be known as her 'dead name'. You are expected to provide a male-presenting haircut and clothing. You may be asked to provide her with a binder - a compression garment designed to flatten her breasts -- and/or a packer -- a rubber phallus worn in the pouch of specially-designed packer underwear (available on Amazon). These actions support her 'social transition'.

If social transition delivers a feeling of ‘congruence’ with the new gender, puberty-interfering drugs may be introduced. They are prescribed off-label because clinical trials have never been conducted to gauge their safety and efficacy. They are falsely promoted as safe and reversible. Children given puberty blockers followed by cross-sex hormones will reach adulthood without having experienced puberty at all. The human development trade-offs here are not confined to sex and reproduction: the whole brain matures with puberty. 

Teenage girls may embark on a lifelong relationship with synthetic testosterone administered weekly or bi-weekly. Known side effects include: elevated risk of heart attack, type 2 diabetes, thyroid disease, autoimmune disease, bone loss, premature menopause, impaired sexual function, cognitive impairments, and mood disorders including suicidality. This treatment is not shown to resolve dysphoria.

In the US, 'gender-confirming' bilateral mastectomies have been performed on girls as young as 13 to remove healthy breast tissue. Hospitals are not required to report cases to any government overseer, so there’s no official data. An article in the Journal of Clinical Medicine using data supplied by Boston Children’s Hospital  disclosed that between 2017 to 2020, 65 breast amputations were performed on minor girls at Boston's Center for Gender Surgery. An analysis of insurance claims by the health technology firm Komodo published by Reuters found that at least 776 gender-affirming double mastectomies were done on girls between the ages 13-17 between 2019-2021. 

Genital surgeries, perhaps the most extreme step, carry alarmingly high risks of complication. The aim is to resolve 'bottom dysphoria' - distress relating to the existence of sex organs -- by removing or disfiguring them. Even when genital surgeries go as planned, female patients don't get a functioning penis, nor do male patients gain anything resembling a woman's internal genitalia, but rather an empty cavity. Common complications are severe and include anal or rectovaginal fistulas, severe bowel injuries, infections, inflammation and, of course, sterility.

Human anatomy is more purpose-driven than aesthetic. Even if she 'passes' as male, a woman will neither get an erection nor produce sperm. She will never father a child. Testosterone will cause her female genitalia to atrophy. As her estrogen secretion is suppressed, early menopause ensues, and a hysterectomy may be indicated. Should she undertake these 'therapies', she will likely never experience an orgasm, much less bear a child. Image is, literally, everything.

What could possibly persuade a parent to consent to such macabre treatments for her minor child? In a word: suicide. Parents who confess their rational skepticism are routinely confronted with this ultimatum: ‘Would you rather have a living son, or a dead daughter?’ The message is unambiguous: 'trans' children, if not affirmed by their parents, will prefer to die rather than to live in their own bodies.

I have been posed this question, verbatim, by four different licensed professionals - a child and family therapist, a clinical child psychologist, a psychiatric hospital physician, and a public-school administrator. None of them had any academic training in youth gender distress. Each was a generalist who had received informal training from a 'trans rights' organization. When pressed for supporting data, none could provide it. In fact, a closer inspection of the available research shows a much greater likelihood of suicide among post-op transgender patients than among youth whose desire for medical transition is postponed or denied.

Teen suicide is a grim reality that is thankfully quite rare, but it’s known to be susceptible to peer contagion. When a putative expert warns a parent, in front of a gender-questioning child, that the parent’s questions place the child at risk of suicide, the expert is doing overt harm. 

How did we get here?

By the time many people noticed, ‘T’ had been quietly teamed with LGB, cloaking ‘transactivism’ in the righteousness earned by decades of struggle for legal recognition by lesbians and gay men. This cunning synthesizing of disparate interests served to inoculate ‘T’ from scrutiny, since a question about one letter could and would be framed as a bigoted attack on all. Using borrowed credibility, a legal framework codifying gender identity ideology was erected, deliberately outside public view, often by simply inserting the words ‘and/or gender identity’ into local and federal statutes, including those governing public schools in most US states. 

Astonishingly, activists have even persuaded medical societies including the American Academy of Pediatrics, the American Psychological Association and the Endocrine Society, as well as public education officials and the American Civil Liberties Union, that gender identity ideology is a civil rights issue, that sex-based medical experiments on children are a human right, and that dissenting or even questioning views constitute hate speech. 

Media style guides written by activists and adopted by most news outlets have 'transed' the English language to cleanse it of women and girls. Journalists now write about ‘pregnant people’ and ‘sex assigned at birth’, and present heroic stories about the 'gender-affirming', 'gender-confirming' or even 'life-saving' treatments that 'trans kids' receive, without addressing any of the risks or consequences. 

Meanwhile, existing terms are extravagantly repurposed: those who advocate psychotherapy and medical restraint are now accused of conversion therapy and framed as ‘transphobic’. How? Follow closely: in 'trans' ideology, conversion therapy means examining dysphoric feelings while keeping bodies intact. Affirmation supports the literal, physical conversion of a healthy body into a simulation of an opposite-sexed body. The logical derangement here is so complete as to seem intentional.

Widespread capitulation to these linguistic changes gives them the veneer of settled truth. The cumulative effect is the passive social transitioning of the culture writ large. 

One of the most serious casualties of this cultural re-education is the 'detransitioner.' With ROGD, detransitioners tend to be young women who believed they could transcend their adolescent agonies by ‘transitioning’, only to discover new, even less-familiar agonies attached to bodies they scarcely recognize. Because they represent inconvenient truths about 'transition', their complaints go unacknowledged by both the gender industry and the largely-compliant media. 

In the absence of support, detransitioners struggle to be seen and heard. More than 50,000* have joined an online detransitioner forum on Reddit, though some are allies who were never trans-identifying themselves. Because no data exist on the number of US 'trans' patients, it's difficult to extrapolate the rate of regret. However, if the rate at which the ‘r/detrans’ subreddit has grown is indicative, detransitioners may soon present an existential challenge to gender medicine. The industry's defense will be complicated by compelling evidence amassing in Europe. Pediatric gender medicine has been halted or sharply curtailed wherever qualitative research was conducted alongside experimental treatments. Their outcomes have led the Netherlands, Sweden, Finland and England to change or reverse course. American providers, along with the medical societies and WPATH, may soon be asked, in court depositions, why all that contra-indicative evidence was not considered relevant to American youth.

LGB does not equal T 

'Transgender' is categorically different from lesbian, gay and bisexual. L, G and B do not require amputation, nor lifelong drug therapy, nor the mandated complicity of others. No one asks a child to confirm whether she will grow up straight, lesbian or bisexual. No one is expected to declare their sexuality at work, or on Linked In profiles. We don't have to suspend disbelief when addressing a lesbian, gay or bisexual person. Sexual preference is not tied to biology: sex is. Gender, for all its strutting and fretting, signifies nothing real.

In our living-room scenario, you will eventually shoo away the misguided neighbors, move your picture hook to the left and enjoy your new painting. Less clear is how we're meant to protect our rights, and our children's bodies, against the harms being enabled – actually celebrated – by the self-styled Good Neighbors all around us. They breathe in the particulate matter of malign falsehood, confident they are exhaling kindness, and seem not to notice anything is amiss. 

*note: this number has been changed from the original posting. I apologize for my error.