Kelley Winters, Ph.D.
updated 2021Dec19, 2022Jan08

A campaign of media disinformation, false stereotyping, and faux science against Trans and Non-Binary adolescents experiencing anatomic/somatic gender dysphoria, their affirming families, and supportive medical providers has escalated in recent months. Much of it is sourced from the political left, in an ideology known as Trans-Exclusive Radical Feminism (Serano, 2016; Williams, 2016), or TERFism. Rooted in the anti-trans writings of Janice Raymond (1980) and antithetical to established principles of feminism (Gleeson, 2021), this movement has long opposed fundamental civil rights and access to Trans-related health care for Trans people, especially targeting Trans women. This is a sad example of what I have termed horizontal minority scapegoating—when some members of an oppressed minority class willingly participate in oppressing an even more marginalized class of human beings, or even their own class.

In the midst of multinational rollbacks of Trans human rights and medical care access during the latter half of the 20-teens, TERFist factions redoubled psychopathologized stereotyping of Trans and gender-diverse people, shifting its focus to Trans men and Transmasculine youth. In an article in the pay-to-play journal, ”PLOS ONE”, Lisa Littman, M.D. (2018) introduced the pseudo-diagnostic term, “rapid onset gender dysphoria,” or “ROGD,” and the stereotype of “social contagion.” The former conflated closeted childhoods, whenever Trans youth are threatened by familial or societal intolerance, with cisgender childhoods that appeared to spontaneously transform into Trans adolescence—as reported by “surprised” parents who were surveyed exclusively from trans-intolerant social media groups (Winters, 2018). The latter asserted that Trans experience and gender dysphoria represent a communicable, mental disease that somehow infects cisgender youth through social media. Littman also speculated that childhood trauma and various mental illnesses are causally related to gender dysphoria and being Trans. Though widely discredited for biased sampling, slipshod scientific methodology, and faulty reasoning (WPATH, 2018; Ashley and Baril, 2018; Ashley, 2020; Serano, 2018), Littman’s defamatory stereotypes found enthusiastic audiences among anti-trans social media groups, such as “4thwavenow” (U.S.), “Transgender Trend” (U.K.), and “Youth Trans Critical Professionals” (the actual sources of Littman’s own study cohort); anti-trans pseudo-medical associations, such as the cynically-named “Society for evidence based gender medicine” and “Gender dysphoria working group;” and conservative extremist news and social media.

In June of (2020), transmisist writer Abigail Shrier (2020) popularized Littman’s “ROGD” and “social contagion” myths with publication of ”Irreversible Damage: The Transgender Craze Seducing Our Daughters”. She mischaracterized rising numbers of Trans and NonBinary people coming out of birth-assigned closets at earlier ages as a social fad or mentally-suspect “craze.” Shrier’s bias and vitriol toward Trans communities were illustrated by her cover graphic, which misgendered and demeaned all Trans men and Transmasculine youth as a vintage paper doll figure of a feminine, rosy-cheeked little girl with an enormous hole punched out of the torso.

In May of 2021, Dr. Erica Anderson, President of the U.S. Professional Association for Transgender Health (USPATH: a subsidiary of the World Professional Association for Transgender Health, or WPATH), and Dr. Laura Edwards-Leeper, of the WPATH Child and Adolescent Committee, were interviewed by host Lesley Stahl (2021) on the CBS 60 Minutes news series. The title of the segment concerned an unprecedented GOP attack on Trans health care in conservative state governments. However, Stahl quickly pivoted away from hate-biased laws, and instead launched her own attack on Trans health care. She positioned narratives of detransition community advocates to gaslight and scandalize modern, affirming medical practices. The implication of the CBS piece was that gender dysphoric Trans and NonBinary individuals who need care should be resisted with more “pushback” rather than affirmation—more of the psychopathological stereotyping of the past, with more compulsory psychotherapy, more prolonged psycho-gatekeeping assessment, and more barriers to medical care. NonBinary writer, James Factora (2021), observed that the Stahl report, “paints an incomplete — and biased — picture of the state of trans healthcare in America.” They continued, “the 60 Minutes segment will only be used to justify further gatekeeping trans people from the care they need to survive.”

In early October, Trans communities and affirming families, allies, and providers were shaken by Shrier’s (2021) interview of WPATH President-elect, Dr. Marci Bowers, and USPATH President, Anderson (both, publicly affirmed Trans women) on the anti-trans Bari Weiss blog site. Bowers and Anderson were quoted by Shrier with disparaging remarks about established, affirming Trans health care and puberty suppression policies (Winters, 2021). Shrier’s blog post associated Bowers’ and Anderson’s inflammatory statements with their positions of authority within the U.S. and World Professional Associations for Transgender Health. However, the WPATH and USPATH (2021) leadership and boards of directors quickly disputed the Shrier interview with a public statement that stood by the “appropriate care of transgender and gender diverse youth, which includes, when indicated, the use of ‘puberty blockers’ such as gonadotropin releasing hormone analogs and other medications to delay puberty, and, when indicated, the use of gender- affirming hormones such as estrogen or testosterone.”

In the Shrier blog post, Dr. Anderson revealed that the New York Times had rejected an op-ed that she had co-authored– “warning that many transgender healthcare providers were treating kids recklessly.” The recently-formed anti-trans web group, Genspect stated, “Dr. Edwards-Leeper is the coauthor of an opinion piece with Dr. Erica Anderson passed over by the New York Times…” (2021). It appears likely that the most recent November 24 ”Washington Post” hit piece by Edwards-Leeper and Anderson may be the same text that was turned away by the NYT or was derived from it.

On the same day as Shrier’s blog post, Dr. Edwards-Leeper was interviewed by Meghan Duam (2021) on The Unspeakable Podcast. The host exclusively referred to Trans/gender dysphoric teens in misgendering terms and pronouns. Edwards-Leeper did not challenge or question Ms. Duam’s disrespectful language. Edwards-Leeper emphasized psychotherapy as a first step for gender dysphoric adolescents, “to understand where it is coming from,” followed by a “comprehensive assessment” that “should always happen before any medical intervention.” In some ways, Edwards-Leeper was more moderate and less dogmatic about protracted psycho-gatekeeping in this particular interview. For example, she acknowledged that “sometimes it makes sense” to initiate blocker care before completing a “comprehensive assessment” for youth facing puberty, when assessment cannot be done in a timely manner. However, her remarks lacked comprehension and empathy for the intense, unbearable suffering that many gender dysphoric youth experience when urgently needed blocker or, as medically appropriate, hormonal care are denied or deferred for long periods of time. She flippantly dismissed this concern, remarking, “teenagers get very frustrated for having to wait.”

Edwards-Leeper acknowledged that the “ROGD” label may be influencing parents to “more quickly dismissing the idea that their child may actually be trans.” However, she uncritically repeated Littman’s “contagion” slur and defended the “ROGD” axiom, describing a hypothetical teen who “never even thought about being trans until a recommended YouTube video popped up.” “All teenagers are impressionable,” Edwards-Leeper repeated. It seems remarkable that Trans individuals, who face oppression and punishment at every turn in an intolerant world, are not similarly impressionable to reverse their gender identities, whenever a cis-normative YouTube “pops up.”

On October 19, Dr. Littman (2021) published an article in the ”Archives of Sexual Behavior,” describing an online survey of 100 individuals who had detransitioned from previous hormonal (or, very rarely, surgical) care. The ASB is reputed for anti-trans bias and ad hominem attack against Trans scholars who dissent from psychopathologized stereotyping (Serano, 2021). The journal’s editor is Dr. Kenneth Zucker, a historical figure in his opposition to affirming treatment of Trans youth and promotion of mental illness stereotypes and punitive methods to attempt to coerce cisgender outcomes (Winters, 2008). Littman declared that “prevalence of detransitioning after transition is unknown,” ignoring a large body of prior study that estimates these rates of detransition and regret as quite low, from less than 1% to 13.1% (MacKinnon, et al, 2021). She again emphasized her previous stereotypes of “ROGD,” trauma and mental illness causality, and “peer contagion.” Some of her respondents agreed with these axioms, as they were presented in survey questions. However, other than cessation of hormonal care, few clear patterns of validation were apparent in this very gender-diverse cohort. For example, only half (51%) of respondents identified exclusively with their birth-assigned genders after detransition. The other half identified as NonBinary, Trans, or some combination of the three. 17% of respondents described narratives of social pressures to transition; 29% described narratives of discrimination and external pressure to detransition. Notably, the latter, cis-normative influences were not termed as “contagion” in Littman’s paper.

On October 21, Arkansas Republican Senator Tom Cotton (2021) introduced a bill that would compel elementary and high schools to deny respectful, affirming pronouns, names, and access to facilities without express parental permission and to out Trans and gender-diverse students to even the most intolerant, abusive, and violent parents.

The previous day, Abigail Shrier appeared on the Fox News Tucker Carlson show to describe her central role in lobbying for Cotton’s hate-biased legislation (Daviscourt, 2021; Carlson, 2021):

“We have to fight gender ideologies in the schools…We have to get all this mumbo-jumbo out of the schools…We have to fight for girls sports and women’s protective spaces. We have to stop schools from undermining parents and giving kids gender identities that the parents don’t know about. And we have to reform pediatric gender medicine.”

Carlson responded to Shrier, “I hope you’re leading this effort. You already are and doing such a great job.”

Drs. Edwards-Leeper and Anderson teamed up a second time for a November 18 interview by Alicia Ault (2021) on the global online physician’s web portal, Medscape (Owned by the WebMD corporation). Under the sensational headline of “Transgender Docs Warn About Gender-Affirmative Care for Youth,” They reasserted fear, uncertainty, and doubt about established, affirming and harm reduction Trans health policies and practices, while propping up Littmanian “ROGD” and “social contagion” tropes with vague speculations and specious logic. For example, Anderson suggested that “peer influence is a factor for sexual or gender identity” because “teenagers influence each other.” Conflating correlation with causality, she failed to acknowledge that gender-nonconforming youth, under relentless threat of shaming, bullying, and violence, might be drawn together into the same peer circles for survival.

On November 20, Dr. Littman (2021A) was one of the featured speakers for Genspect, an anti-trans extremist group that promotes TERF axioms of psychopathology, trauma causality, and “ROGD.” The group opposes social and medical affirmation of Trans and NonBinary youth and adults below the age of 25. Littman spoke at Genspect’s online conference, dedicated to her own dubious “ROGD” stereotype. She listed her academic affiliation as The Institute for Comprehensive Gender Dysphoria Research. Littman stated her “ROGD” hypothesis as, “Psychosocial factors (such as social influence, maladaptive coping mechanisms, internalized homophobia, trauma, and mental health conditions) can cause or contribute to the development of gender dysphoria in some individuals.” This construction did not leave a lot of space for falsifiability. However, scientific rigor was not likely her priority. Her presentation relied uncritically on Zucker’s discredited 80% “desistance” stereotype for gender dysphoric children (Temple Newhook, et al., 2018). She brushed aside social pressures that have historically kept almost all young Trans children in birth-assigned closets before the most recent generations. Littman announced a new online survey of detransitioned subjects, not yet published. To inflict the greatest possible disrespect and indignity toward Trans communities, Genspect and Littman held their “ROGD” convention on the International Transgender Day of Remembrance. This is the one sacred day of the year that Trans and gender-diverse people around the world mourn and honor our murdered dead.

Four days later, anti-trans TERF wars against affirming health care for gender dysphoric adolescents took yet another turn in the pages of the Washington Post. An op-ed by Drs. Laura Edwards-Leeper and Erica Anderson (2021) doubled down on TERF-associated stereotypes of mental illness, trauma causality, and “social media, Internet and peer influences.” The authors’ positions of authority within the WPATH and USPATH associations were once again leveraged to legitimize their position to turn back the clock on adolescent Trans health policy to archaic psychopathology stereotypes and long-term psycho-gatekeeping—euphemized as “comprehensive assessment.” Compulsory psychotherapy that puts non-birth-assigned gender identities on trial for “months” or “years” would once again be prerequisite to medically necessary blocker or hormonal care.

On December 2, the World Professional Association for Transgender Health (WPATH) released draft chapters of the Standards of Care Version 8 (SOC8) for public commentary (2021). Initially, only two weeks were allowed for public review and response to WPATH, but after widespread outcry the deadline was extended another month to January 16, 2022. The draft document is enormously larger than previous versions, with 359 pages (so far), containing 17 chapters and 148 statements of recommended practice. The latter replace a much more concise set of “readiness criteria” for hormonal, surgical, and puberty suppression care in prior versions. There is a stunning degree of inconsistency and contradiction between chapters, statements, and supporting text of the draft SOC8. Established WPATH principles of depsychopathologization of gender diversity and medical necessity of pubertal suppression and transition-related care are emphasized in parts of the document and flagrantly undermined in others (ITH, 2021). The Adolescent chapter is particularly alarming, citing Littman’s discredited “ROGD” PLOS ONE paper and repeating for emphasis that “social influence on gender is salient,” “relevant in their experience of their gender during adolescence,” and “a relevant issue and an important differential” (WPATH, 2021). While the text offers a cursory acknowledgment of controversy around Littman’s methodology and reasoning behind the “ROGD” and “social contagion” stereotypes, its intended gaslighting of affirming approaches to adolescent care and promotion of psychopathologized stereotyping and protracted psycho-gatekeeping could not be more apparent.

Clearly, the draft SOC8 represents an unresolved, unmediated free-for-all between affirming policymakers and disaffirming, psycho-gatekeeping factions within WPATH. The heavy infiltration of Littmanian stereotypes of “ROGD” and “social contagion” in the draft SOC8 adds key historical context to the media campaign that preceded its release.

On January 3, Erica Anderson (2022) published yet another prominent op-ed that undermined affirming approaches to Trans and Nonbinary adolescent care and promoted Littman’s axiom of gender diversity as “contagion.” In fact, the actual URL (web address) of the piece was, “are-we-seeing-a-phenomenon-of-trans-youth-social-contagion.” The editorial demonized peer support among Trans and Nonbinary adolescents as “influencers” with inexplicable power to turn cisgender-privileged teens into marginalized and persecuted Trans youth by “specifically encouraging them to explore their gender identity freely.” Although Anderson carefully avoided Littman’s “rapid onset” term, the “ROGD” stereotype was clearly described and implied in her text. The op-ed offered no attempt to acknowledge the scientific and logical shortcomings in Littman’s research or her “ROGD” or “social contagion” stereotypes.

Since their emergence in mid-20th Century medicine, Trans health policies have always been influenced by exaggerated fears and myths about detransition and regret. While the data have shown detransition and regret incidence to be very low, medically necessary (and often life-saving) transition-related care is still commonly rationed, delayed, deferred, and denied to those around the world who need it most, because of these very fears and defamatory stereotypes. There is a place for psychosocial intake assessment and evaluation of capacity for informed consent in medical care for all human beings, Transgender and cisgender-privileged. However, returning to the days of psycho-inquisition gatekeeping, which prolongs suffering and burdens Trans individuals to continually demonstrate their mental competence and gender validity, would be a dark future, indeed.

References

Anderson, E. (2022). Opinion: When it comes to trans youth, we’re in danger of losing our way. San Francisco Examiner, January 3. https://www.sfexaminer.com/opinion/are-we-seeing-a-phenomenon-of-trans-youth-social-contagion/

Ashley, F. (2020). A critical commentary on ‘rapid-onset gender dysphoria.’ The Sociological Review Monographs, Vol. 68(4) 779 –79. https://www.florenceashley.com/uploads/1/2/4/4/124439164/ashley_a_critical_commentary_on_rapid-onset_gender_dysphoria.pdf

Ashley, F. and Baril, A. (2018). “Why ‘rapid-onset gender dysphoria’ is bad science,” The Conversation, Mar 22, https://theconversation.com/why-rapid-onset-gender-dysphoria-is-bad-science-92742

Ault, A. (2021). “Transgender Docs Warn About Gender-Affirmative Care for Youth,” Medscape Medical News, Nov. 18. https://www.medscape.com/viewarticle/963269

Carlson, T. (2021) Tucker: Biden open border policy resulted in a fentanyl crisis. Transcript, Tucker Carlson Show, Fox News Network, Oct. 20. https://www.foxnews.com/transcript/tucker-drugs-continue-to-pour-through-the-border

Cotton, T. (2021). Cotton Introduces Bill to Prevent Schools from Concealing Gender Transitions from Parents. Press release. Office of U.S. Senator Tom Cotton, Oct. 21. https://www.cotton.senate.gov/news/press-releases/cotton-introduces-bill-to-prevent-schools-from-concealing-gender-transitions-from-parents

Daviscourt, K. (2021). Abigail Schrier tells Tucker Carlson how to win America’s gender war. The Post Millenial, Oct 20. https://thepostmillennial.com/abigail-schrier-tucker-carlson-americas-gender-war

Duam, M. (2021). What Do We Mean By “Gender Affirming Care?” A Conversation with Dr. Laura Edwards-Leeper. The Unspeakable Podcast, October 4.
https://podcasts.apple.com/ca/podcast/the-unspeakable-podcast/id1524832743

Gleeson, J. (2021). Judith Butler: ‘We need to rethink the category of woman.’ The Guardian, Sept. 7, https://www.theguardian.com/lifeandstyle/2021/sep/07/judith-butler-interview-gender.
Uncensored full text:
https://web.archive.org/web/20210907102452/https://www.theguardian.com/lifeandstyle/2021/sep/07/judith-butler-interview-gender

Edwards-Leeper, L. and Anderson, E (2021). The mental health establishment is failing trans kids: Gender-exploratory therapy is a key step. Why aren’t therapists providing it? Washington Post, Nov. 24.

Factora, J. (2021). Dear 60 Minutes, There Is No “Both Sides-Ing” Trans Healthcare. Them, May 25. https://www.them.us/story/60-minutes-platforms-detransitioners-trans-healthcare

Genspect. (2021). Dr. Laura Edwards-Leeper: The urgent need for comprehensive assessment. Attributed to an anonymous “Guest Author,” Genspect, Oct. 6. https://genspect.org/dr-laura-edwards-leeper-the-urgent-need-for-comprehensive-assessment/

International Transgender Health Group (2021). ITH Group Collective Analysis: SOC8 Statement Feedback Worksheet. December 15. Archived: https://transpolicyreform.wordpress.com/2021/12/15/commentary-to-the-wpath-soc8-draft-from-the-international-transgender-health-group/

MacKinnon, K., Ashley, F., Kia, H., Lam, J.,Krakowsky, Y. and Ross, L. (2021). Preventing transition “regret”: An institutional ethnography of gender-affirming medical care assessment practices in Canada. Social Science & Medicine, Volume 291, 114477, ISSN 0277-9536.
https://doi.org/10.1016/j.socscimed.2021.114477.

Littman, L. (2018). Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. PLOS ONE 13(8): e0202330. doi.org/10.1371/journal.pone.0202330

Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior, 50:3353–3369. https://doi.org/10.1007/s10508-021-02163-w

Littman, L. (2021A). Gender dysphoria and psychosocial factors: emerging theories. Genspect, Nov. 20. https://genspect.org/conferences/
See also https://www.youtube.com/watch?v=tInYPMCHOzo

Raymond, Janice G. (1980). The transsexual empire. London : The Women’s Press

Serano, J. (2016). Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity, 2nd Edition. Seal Press. https://www.amazon.com/Whipping-Girl-Transsexual-Scapegoating-Femininity/dp/1580056229

Serano, J. (2018). Everything You Need to Know About Rapid Onset Gender Dysphoria. Medium, Aug. 22, medium.com/@juliaserano/everything-you-need-to-know-about-rapid-onset-gender-dysphoria-1940b8afdeba

Serano, J. (2021). The Dregerian Narrative (or why “trans activists” vs. “scientists” framings are lazy, inaccurate, and incendiary). Medium, Mar. 29. https://juliaserano.medium.com/the-dregerian-narrative-or-why-trans-activists-vs-276740045120

Shrier, A. (2020). Irreversible Damage: The Transgender Craze Seducing Our Daughters. ‎Regnery.

Shrier, A. (2021). Top Trans Doctors Blow the Whistle on ‘Sloppy’ Care. Blog post, Common Sense with Bari Weiss, October 4. https://bariweiss.substack.com/p/top-trans-doctors-blow-the-whistle

Stahl, L. (2021). State bills would curtail health care for transgender youth. 60 Minutes, CBS News, May 23. https://www.cbsnews.com/news/transgender-health-care-60-minutes-2021-05-23/

Temple Newhook, J., Pyne, J., Winters, K., Feder, S., Holmes, C., Tosh, J., Sinnott, M., Jamieson, A., & Pickett, S. (2018). A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children, International Journal of Transgenderism, 19:2, 212-224, DOI: 10.1080/15532739.2018.1456390

U.S. Professional Association for Transgender Health and World Professional Association for Transgender Health (2021). Joint Letter from USPATH and WPATH. Oct. 12. https://www.wpath.org/media/cms/Documents/Public%20Policies/2021/Joint%20WPATH%20USPATH%20Letter%20Dated%20Oct%2012%202021.pdf

Williams, C. (2016). Radical Inclusion: Recounting the Trans Inclusive History of Radical Feminism. TSQ: Transgender Studies Quarterly, Volume 3, Numbers 1–2, May. https://www.academia.edu/25141233/Radical_Inclusion_Recounting_the_Trans_Inclusive_History_of_Radical_Feminism

Winters, K. (2008). Blinded Me With Science: The Burden of Proof. Blog post, GID Reform Weblog, Oct. 21. https://gidreform.wordpress.com/2008/10/21/blinded-me-with-science-the-burden-of-proof/

Winters, K. (2018). The Slipshod Science in the “Rapid Onset Gender Dysphoria” Cliché and Psychology Today’s Attack on Young Trans Men. Blog post: Trans Policy Reform. November 29, https://transpolicyreform.wordpress.com/2018/11/29/the-slipshod-science-in-the-rapid-onset-gender-dysphoria-cliche-and-psychology-todays-attack-on-young-trans-men/

Winters, K. (2021). Transgender Affirmation in Retrograde: A Crossroad in the History of Trans Health. Blog post: Trans Policy Reform. October 9. https://transpolicyreform.wordpress.com/2021/10/09/transgender-affirmation-in-retrograde/

World Professional Association for Transgender Health (2018). “WPATH Position on ‘Rapid-Onset Gender Dysphoria (ROGD),’” Sept. 4. http://www.wpath.org/policies

World Professional Association for Transgender Health (2021). WPATH Standards of Care V8 (SOC8) – Public Comment Period Open Now. December 2. https://www.wpath.org/media/cms/Documents/SOC%20v8/SOC8%20Chapters%20for%20Public%20Comment/Letter%20eBlast%20-%20SOC8%20Public%20Comment%20Period%20December%202021%20FINAL.pdf

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