Gender Dysphoria: Testing Alternative Hypotheses(Review of Diaz and Bailey, 2023)

Samenvatting

The first author of this article is the mother of an ROGD (Rapid Onset Gender Dysphoria) youth, who is writing under a pseudonym, and the second author is an expert on transgenderism, homosexuality, and behavioral genetics, having written major works on the subject, such as The Man Who Would Be Queen (Bailey, 2003). This is important to mention because we presume that the first author has intimate knowledge of the nature of the current wave of transgenderism, whereas the second author has in-depth scientific knowledge of the characteristics of transgenderism in the past. Aside from establishing the credentials of both authors, which appear to constitute an optimal combination for addressing the alternative hypotheses proposed, we mention this to frame the basic problem posed by this paper. That question is whether the transgenderism of the current wave of gender dysphoria is identical to what has been traditionally known as such in the past (Hypothesis 1) or whether it is a novel phenomenon that the present paper designates as ROGD (Hypothesis 2).

Hypothesis 1 presupposes that the recent increase in gender dysphoria is more apparent than real, and produced by a greater societal openness to atypical sexuality that has disinhibited the reporting of sexual orientations that were previously suppressed by widespread social disapproval. Hypothesis 2 instead proposes that the recent increase is instead quite real, rather than attributable to reporting biases, but that the current wave of gender dysphoria is quite different from conventional transgenderism, and stems from an entirely different set of aetiologies.

In describing Hypothesis 2, the authors consider the role of psychopathology, an often ignored predictor, in developing ROGD. The study's results strongly suggest that a sizeable proportion of individuals experienced a psychopathological condition before the onset of ROGD. In particular, anxiety and depression were quite prevalent in the sample. According to the authors, mental health issues crystallized at 10.5 years of age, preceding ROGD by more than three years. The authors also considered the contribution of social influence, concluding that having a transgendered friend increased the likelihood of social transition, which is adopting formal measures to live as the opposite gender. These results, in conjunction with the reported cooccurrence of ROGD in close friends or acquaintances of the individual experiencing ROGD, suggest emotional contagion as part of an underlying affective disorder could operate as a risk factor for the consolidation of ROGD. Hence, the article provides a novel and unique understanding of social influences and mental health issues leading to the persistence of the condition. The article's results offer future avenues concerning the role of premorbid individual attributes, including mental health issues and the nature of social interactions increasing the risk of ROGD.

The data is almost completely descriptive rather than inferentially based on theory-driven tests derived from the stated alternative hypotheses. Nevertheless, the descriptive data does seem to support Hypothesis 2 in that the profile presented for ROGD does not look very much like that of conventional gender dysphoria, especially in the seemingly large role of social media as well as the developmentally late and sudden onset of the condition. However, only suspected ROGD cases were surveyed so there is no comparison group available, such as a sampling of individuals that had been chronically gender dysphoric from an early age or individuals that were not gender dysphoric at all. To be fair, these limitations are acknowledged in the Discussion as inherent in the way the data were collected. On the other hand, it would have been helpful for the authors to report any comparable data that might be available from non-ROGD cases, although formal significance testing might not be valid due to sampling differences between these data and previous findings. Table 9 comes close to what might be helpful, but only goes as far back as 2020. We are sure Professor Bailey should have some comparable statistics from his previous studies.