Littman Statement about Republication

Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

The following is Dr. Littman’s statement regarding the publication of a revised version of her paper:

I am delighted to report that, after a rigorous post-publication review, a revised version of my paper has been published by PLOS ONE. I am pleased that my work has withstood this extensive peer-review process and that in the accompanying republication notice I’ve been able to expand the discussion around several topics including: parental approaches to gender dysphoria, ways in which parents can be supportive of their children, and the methodologies used in the paper. Additionally, I was able to add the Facebook group, “Parents of Transgender Children” to the list of sites sharing recruitment information about the study and to clarify that the term “rapid onset gender dysphoria” first appeared on the sites used for recruitment when the study information was posted (not before, as was claimed in some articles about the research paper).

 The post-publication reassessment of the paper included input from three senior members of PLOS ONE’s editorial staff, two Academic Editors, one statistics reviewer, and one external expert reviewer who treats adolescents with gender dysphoria. It was determined that the paper needed to be framed in a way that more clearly emphasizes that this is a study of parental reports, to expand the discussion of limitations, and to clarify that rapid onset gender dysphoria is not a clinical diagnosis at this time. Several sections of the paper were revised to achieve this goal.  The Methods section and the Findings section remained mostly unchanged except for the addition of details about recruitment sites and the addition of a few missing values from one of the tables. I am very happy with the final product.

Although this work is considered controversial in some circles, since publication I have received many appreciative emails from clinicians who have been seeing this type of presentation in their own patients, young adults who had de-transitioned and feel that the paper describes their own experiences with gender dysphoria, and many parents who are relieved to see research about something they were seeing in their own homes. I look forward to future research on this important topic. Gaining a better understanding of the development of gender dysphoria will allow us to better help the current population of teens and young adults experiencing it.

This Post Has 3 Comments

  1. Thank you! This is very helpful–great work.

  2. While listening to, respectfully, the highly varied self reports/expressions of children and adolescents has an honorable tradition it is only recently that these disclosures are given such dramatically high status. The overwhelming weight and reality of the developmental process and change is deemphasized or even ignored in the service of promoting the wishes, beliefs or fantasies of children.The essence of good parenting is to provide a stable container of reality framework and reality testing to hold the child safe and stable until maturation and development (physical and psychological) are more established.

    Much more curious than the existence of transgender expression from children is the social and political response to urgently promote and elevate these expressions to such high standing. Such high standing that mutilation surgery and hormones are used in an attempt to accommodate the expressed feelings, beliefs and wishes of the child.

    Parents and watchers of development are bombarded with all sorts of child wishes and demands with highly varied rationalizations/explanations by the child regarding their mood, fear, anxiety, sense of unfairness, envy, rage, self proclaimed certainty on dozens or hundreds topics, including their unhappiness with their sex or their idea of gender, which is a construct rather than a fact. Why are the expressions about gender identity given such high status when all the other fantasies and wishes are given the time honored response by parents of “lets wait and see how you feel when you are older”. This eagerness to affirm something so at odds with physical reality is not a healthy cultural occurrence and when amplified by social contagion and professional encouragement it becomes even more disturbing.
    My professional career (40 years) as a Child and Adolescent Psychiatrist and psychotherapist has been to struggle with children regarding their dysphoria, which they attribute to a wide variety of family and life factors (birth order, envy of siblings, parental preference, fear of being a man, resentment of female role or anatomy, shame and inadequacy assigned to external causes, etc..,etc).. The girls who would prefer to be a boy and the boys who wish to be a girl are garden variety psychotherapy occurrences historically held in the container of patient holding environment. So much is learned by this identity-self struggle over time and so much is lost by the rush to affirmation.

    What aspect of human nature is behind this destruction of the traditionally held container of parental and cultural protection?? Someday, those who advocate this break with psychological reality testing (the push to affirm) will be held to account, either clinically, through research, or legally, through the courts.

  3. Congratulations to Dr. Littman! The fruits of her work will begin to take hold when families are able to engage in more nuanced care that does not start with affirmation of a newly acquired gender identity and includes exploration of underlying causes in the AYA population! ROGD happened to us. I understand the need for evaluation of this provisional diagnosis, but when you see it, it is unreal, beyond frustrating, and deeply painful when no one will help your child and only want to affirm that the child’s belief is unchangeable and infallible. I thank Dr. Littman and this working group with the utmost respect and gratitude.

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