Skip to content

“Rapid onset gender dysphoria”: a disputed diagnosis

“Rapid onset gender dysphoria” (ROGD) is a disease model of gender identity promoted by Lisa Littman in 2018, based on ideas developed by Lisa Marchiano and other anti-transgender extremists. Littman proposes that some young people suddenly identify as transgender due to “social influences and maladaptive coping mechanisms.”

“ROGD” is not recognized as legitimate by any major professional association. The diagnosis was immediately controversial:

  • mainstream behavioral scientists and therapists criticized it.
  • conservative groups supported it:
    • an activist minority of researchers and therapists
    • conservative journalists and cultural critics
    • gender critical” feminists
    • conservative religious organizations
    • parents who reject the affirmative model of care recommended by mainstream experts.


In 2021 major behavioral health organizations supported eliminating the use of “ROGD” and similar concepts for clinical and diagnostic application. Signatories include:

  • American Psychological Association (APA)
  • Society for the Psychology of Sexual Orientation and Gender Identity, American Psychological Association, Division 44
  • Society for a Science of Clinical Psychology (SSCP)
  • Society of Clinical Child and Adolescent Psychology (SCCAP), American Psychological Association, Division 53
  • Society of Behavioral Medicine (SBM)
  • Society for the Psychological Study of Social Issues (SPSSI)
  • Association for Behavioral & Cognitive Therapies (ABCT)
  • National Association of School Psychologists
  • Council of University Directors of Clinical Psychology (CUDCP) Board
  • Asian American Psychological Association (AAPA)
  • Society for the Psychological Study of Culture, Ethnicity, and Race
  • MSU Research Consortium on Gender-based Violence
  • State, Provincial and Territorial Psychological Association Affairs (Division 31, APA)
  • American Psychological Association, Division 22 Rehabilitation Psychology 
  • New York Association of School Psychologists (NYASP)
  • Society for Community Research and Action (SCRA)
  • Society for the Study of School Psychology (SSSP)
  • Society for Child and Family Policy and Practice (Division 37 of the American Psychological Association)
  • Society of Personality and Social Psychology
  • Association for University and College Counseling Center Directors (AUCCCD)
  • Psychologists’ Association of Alberta
  • Saint Louis University, Clinical Psychology Program
  • American Psychology-Law Society; Division 41 of APA
  • Michigan State University, Department of Psychology, Clinical Science Area
  • Psychologists in Public Service, American Psychological Association, Division 18
  • American Psychiatric Association
  • Society of Pediatric Psychology (SPP), Division 54 of the American Psychological Association
  • Society for Research in Child Development
  • National Association of Psychological Research and Graduation Programs
  • Council on Social Work Education
  • Stony Brook University, Clinical Psychology Program
  • Michigan State University Twin Registry (MSUTR)
  • Society of Counseling Psychology, Division 17
  • National Latinx Psychological Association (NLPA)
  • Anxiety and Depression Association of America
  • The Society of Clinical Psychology, APA Division 12
  • Littman’s Brown University colleague Arjee Javellana Restar


The following conservative organizations have engaged in activism that promotes this alleged disease:

Individual activists for “ROGD” include:

Australian therapist Dianna Kenny summarizes the views of supporters:

Gender dysphoria in children and young people has become a significant health and welfare issue over the past 20 years as increasing numbers of young people declare themselves transgender and demand gender affirmation treatment, an experimental process involving social transition, puberty blockers, cross-sex hormones and mutilating surgery. Sadly, the voices of gender identity politics and a powerful transgender lobby have drowned out the desperate pleas of parents, young people and health professionals for a rational discussion based on available evidence regarding best treatment and management. In this set of collected papers, Dianna Kenny explores and integrates a number of key issues including the flawed ideology of transgender politics, gender development in young children, the safety of available medical treatments, the role of the internet and social contagion in the increasing numbers, key issues in decision making and the implications of transgender legislation on female sport participation.


Littman, Lisa (August 16, 2018). Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. PLOS ONE

Littman, Lisa (August 16, 2018). Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLOS ONE (March 19, 2019 corrected ed.). 13 (8): e0202330.

WPATH Global Board of Directors (September 4, 2018). WPATH Position on “Rapid-Onset Gender Dysphoria (ROGD)”

Wadman, Meredith (September 7, 2018). ‘Rapid onset’ of transgender identity ignites stormScience361 (6406): 958–959.

Duck-Chong, Liz (October 22, 2018). “\Rapid-onset gender dysphoria’ is a poisonous lie used to discredit trans peopleThe Guardian.

Brown University (March 19, 2019) Updated: Brown statements on gender dysphoria study.

Restar AJ (2020). Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria” Archives of Sexual Behavior volume 49, pages 61–66

Tannehill, Brynn (February 20, 2018). ‘Rapid Onset Gender Dysphoria’ Is Biased Junk Science. The Advocate

McCall B (September 13, 2018). ‘Rapid Onset Gender Dysphoria’ in Adolescents Stirs Debate. Medscape

Serano, Julia (August 22, 2018). Everything You Need to Know About Rapid Onset Gender Dysphoria. Medium

Jones, Zinnia (2018). “Rapid onset gender dysphoria” is not one thing: Mapping the claims of ROGD proponents. Gender Analysis

Jones Zinnia (May 31, 2021). What Parents Don’t Know: Trans Youth Study Reveals Fatal Flaw at the Heart of “Rapid-onset Gender Dysphoria.” An Injustice!

Resources critical of “ROGD”

Coalition for the Advancement & Application of Psychological Science (

Gender Dysphoria Affirmative Working Group (

Resources supportive of “ROGD”