Controversial Gender Researchers Launch Long-Term Study of Gender Dysphoric Youth and Their Parents
Branded as gender heretics by the pediatric gender-medicine establishment and transgender-rights activists, Michael Bailey, Dr. Lisa Littman, and Kenneth Zucker say they "won't be intimidated."
They’re three of the most controversial figures in pediatric gender medicine. Between them, they’ve been fired, forced to correct or retract papers, and branded gender heretics by transgender-rights activists and the gender-medicine establishment alike. They’re seen, fairly or not, by that powerful crew across the gender divide as a threat to the integrity, health and well-being of transgender people, especially youths.
And yet they’re not going anywhere.
On Monday, psychologist Michael Bailey, physician-researcher Dr. Lisa Littman and psychologist Kenneth Zucker announced they’re launching a long-term survey study of gender dysphoric youths and their parents.
“We won’t be intimidated. Resistance to knowledge is futile.”
—Northwestern University psychologist Michael Bailey
The trio seek with their nascent, years-long research venture to fill in some of the gaping gaps in the knowledge about young people who suffer from gender dysphoria—which is severe distress about a disconnect between one’s sex and gender identity. In the face of what will likely be activist or blowback, these dogged investigators hope their research will help foster a better understanding of what forces have been driving the recent surge in gender dysphoria and transgender identification in young people across the Western world.
In particular, they seek to investigate the wildly controversial concept of rapid-onset gender dysphoria, or ROGD, which was coined by Dr. Littman to nuclear effect six years ago.
“So far, we haven’t encountered ideological roadblocks, but we certainly may,” Dr. Bailey told me of their years-long efforts to get their study off the ground. “All three of us are quite used to resistance, and none of us are deterred by it. We won’t be intimidated. Resistance to knowledge is futile.”
The research team
The study is called the Adolescent and Young Adult Gender Dysphoria Outcomes Study, which generates the rather clunky acronym AYAGDOS. The three investigators behind it each boast quite the grand CV of gender controversies.
Dr. Bailey, a professor of psychology and veteran sex researcher at Northwestern University, is the principal investigator of the study. Having offended people across the political spectrum across his career, he has been reviled by trans activists in particular for decades, thanks in large part to his unsparing 2003 book, The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. He also endorses the psychological concept, which is considered anathema among many mainstream transgender health and mental-health experts, of autogynephilia. A man with AGP, the theory holds, eroticizes the notion of being a woman and this can compel him to engage in a gender transition. This is considered an offensive suggestion by many transgender people for, as they see it, reducing their gender identity to a perversion.
The publication of Dr. Bailey’s book two decades ago spawned a baroque saga of vengeance that would be worth of Ryan Murphy’s American Crime Story anthology series, but for the fact that producing it for Netflix would get the Hollywood mogul cancelled. Historian Alice Dreger chronicled the psychodrama in a lengthy account published in the Archives of Sexual Behavior in 2008. As Dreger wrote: “Dissatisfied with the option of merely criticizing the book, a small number of transwomen (particularly Lynn Conway, Andrea James, and Deirdre McCloskey) worked to try to ruin Bailey.”
They did not, as it turns out, succeed.
The second principal investigator of the new study is Dr. Littman, who as an assistant professor of the practice of behavioral and social sciences at Brown University published the 2018 paper that coined the term ROGD. Dr. Littman and the paper alike have been put through the wringer, to say the least; but since leaving Brown on less than amicable terms, she has continued to research and publish about gender dysphoria and trans identity, including the hot-button subject of detransitioning.
In the wake of the first ROGD paper’s publication, Dr. Littman was excoriated for recruiting parents to the survey study from websites perceived as transphobic. Dr. Littman has also weathered withering criticism for not interviewing gender dysphoric youths themselves—a problem she is evidently seeking to rectify with the launch of the new study.
A fleet of gender-medicine researchers, such as University of California, San Francisco, child psychiatrist Dr. Jack Turban, have published papers seeking to debunk ROGD and send it to what they see as the trash heap of scientific quackery. But it remains an open question as to whether, prompted by peer and online influence, many adolescent girls in particular have suddenly developed gender dysphoria in substantial numbers as a maladaptive coping mechanism in the face of myriad other psychiatric comorbidities. ROGD therefore cuts to the heart of so-called gender essentialism and asks the provocative question of whether many of these children are truly transgender.
Rounding out the research team is co-investigator Kenneth Zucker, a veteran psychologist specializing in pediatric gender dysphoria and incongruence in Toronto. For decades, Dr. Zucker was considered a venerable pillar of the pediatric gender medicine field—until his methods suddenly went out of style, to put it mildly. Dr. Zucker was the target of a sustained, vocal campaign against his practice, branded by activists as conversion therapy, of seeking to prompt gender dysphoric children—or those with a now-retired DSM-IV diagnosis of gender identity disorder—into reconciling with their natal sex. Research conducted by Dr. Zucker and others indicated that most boys in this category grew out of their dysphoria by adolescence, and many grew up to be gay men. He reasoned that the life of a transgender person is a harder path, and one that often involves taking transition medications that may pose health risks; living as one’s natal sex, if possible, is at least in theory easier.
Ultimately, the activist campaign against Dr. Zucker got so heated, it got him fired from the Toronto gender clinic he had cofounded, the Child Youth and Family Gender Identity Clinic. Jesse Singal reported on the conflict in detail for New York magazine in 2016.
After Dr. Zucker sued the clinic, it settled with him for $586,000 and issued an apology. Now in his mid-70s, he continues to care for gender dysphoric children in private practice.
In March 2023, Dr. Bailey published in the Archives of Sexual Behavior, of which Dr. Zucker is the editor, a paper entitled Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases. The paper, which reported that the more troubled gender dysphoric youth were particularly likely to have transitioned both socially and medically, ignited yet another firestorm in the gender-medicine field. Activists and academics alike issued scathing criticisms over the fact that Dr. Bailey had coauthored the paper with a woman who used a pseudonym, and that they had, the detractors claimed, not secured informed consent from the parents who had completed the survey on which the paper was based.
In the face of such an adamant campaign, the paper was swiftly retracted by Springer Nature Group in June 2023 over the informed-consent issue. Dr. Bailey republished it the following October in The Journal of Open Inquiry in the Behavioral Sciences.
Trans activist-Substacker Erin Reed quickly crowed: “‘Rapid Onset Gender Dysphoria’ Republished In Junk-Science Journal With A Shady Record.”
In the wake of the forced retraction, Dr. Bailey announced in a defiant article in Bari Weiss’ The Free Press that he was seeking to conduct a long-term survey that would shed much needed light on ROGD.
Dr. Bailey wrote:
Retraction of scientific articles is associated with well-deserved shame: plagiarism, making up data, or grave concerns about the scientific integrity of a study. But my article was not retracted for any shameful reason. It was retracted because it provided evidence for an idea that activists hate.
…
Speaking for myself, this episode has guaranteed that I will study ROGD until we understand it.
That’s why I am about to launch a large, long-term survey of adolescent gender dysphoria, in collaboration with Lisa Littman and Ken Zucker. We will survey both gender-dysphoric adolescents and their parents, following them for at least five years. Among other things, we’ll have better information about adolescents’ early gender dysphoria, mental health, and sexuality; about parents’ attitudes, behaviors, and beliefs; and about the correspondence between adolescents’ and parents’ accounts of the same phenomena.
I guarantee two things. First, it will be a huge, important study with the potential to establish the validity of ROGD. (And if ROGD is an incorrect idea, we will show and publish this.) Second, between the three of us—Littman, Zucker, and me, three previously cancelled scientists who are among the world’s foremost experts in what we are studying—we don’t have a chance in hell of receiving government funding for this project.
The New Study Launches
The AYAGDOS study has been in the planning stages for several years, as the team has navigated a thicket of logistics, including obtaining ethical approval from two institutional review boards. They are now officially recruiting youth between the ages of 13 and 21 who have gender dysphoria, plus parents and guardians of such youth. Ideally, the investigators will succeed in recruiting family sets, but they are also open to only surveying either the youth or the parents from any given family.
It is quite evident from the wording of the study website and the word choice of its lead investigators in conversation with me that they are not studying transgender identity per se, rather gender dysphoria in particular. Nor are they presuming that the young people they want to survey are necessarily transgender.
Gender dysphoric youth will be asked to fill out a 45- to 90-minute survey online that, according to the study website, is “related to the development and expression of their gender dysphoria.” This includes questions about their childhood and adolescence, family, history and symptoms of dysphoria, sexuality and mental health.
The parents or guardians will be asked to complete a similar survey, in part to assess whether they have contrasting perspective on the key details about their children.
Dr. Bailey said: “We want to know: what the youth were like as children; when their gender dysphoria was first evident, and what were the symptoms; what was the family’s reaction; what decisions will the youth make and when; how will these affect their happiness? And much else.”
The participants will be asked if they are willing to stay in touch during the coming years for follow-up surveys, which will be conducted approximately annually.
The study is looking for participants across the Western world, including the U.S., Canada, Australia, the U.K. and the European Union.
“We hope to follow research participants over several years to study their outcomes,” the study’s web page states. “For example, what percentage of gender dysphoric youth transition to the other sex, and what percentage of them decide not to transition? What factors predict what gender dysphoric youth decide? Are gender dysphoric youth happier if they transition?”
Other questions the study seeks to answer include: “what are the most common outcomes for adolescents and young adults with gender dysphoria? Does this depend on whether birth sex is male or female? Is gender transition associated with long term happiness? What kinds of differences do parental attitudes and behaviors make?”
Additionally, the study looks to address the woefully unanswered question of what has driven the surge in gender dysphoria in young people over the past two decades. Has this shift been the result of an unveiling of trans identity that always occurred among young people, only hidden by stigma? Has it been driven by peer influence, also known as social contagion? Some combination of the two?
Calling the study “sorely needed,” Dr. Bailey said it is supported by “generous private donations so far.” He said he wasn’t certain whether the research team would try for federal grants. Referring to the National Institutes of Health, he said, “ideological bias is rampant at NIH, and it would be a waste of time.”
A conversation with the researchers
Dr. Zucker was the one who first proposed conducting the study to Drs. Bailey and Littman. He saw it as an outgrowth of his own observations, ultimately widely documented by other gender-clinic specialists, that a new cohort of gender dysphoric young person was presenting in his office: natal girls whose dysphoria only presented in adolescence. As recently as the mid-2000s, the typical gender dysphoric minor was a natal boy whose discomfort with his natal sex began in early childhood. Now pediatric gender clinics across Western nations are inundated by natal girls identifying as male beginning in adolescence, who also have multiple other psychiatric conditions and a high rate of autism.
According to Dr. Zucker, “Because we plan to follow our participants for at least 5 years, we hope to learn about the developmental trajectories of the youth regarding gender dysphoria. Parents of ROGD youth in particular want to know if their child's gender dysphoria is going to continue, if it's ‘just a phase,’ etc. As a clinician, I often tell parents that because ROGD is such a relatively new phenomenon that we are only beginning to learn what evolves over time.”
Dr. Littman told me that the team “will be reaching out to communities that have different perspectives about pediatric and young adult gender transition. This is, unfortunately, a very rare approach in the space of research about transgender-identified young people. However, to get a fuller understanding of this phenomenon, we feel it is important to seek families where there are parents who believe that transition will harm their child, parents who believe that transition will help their child, and parents who are unsure.”
Dr. Bailey said they are particularly interested in determining whether their survey data are consistent with the ROGD hypothesis. Addressing how controversial the concept has been, he said, “Both Lisa Littman and I have experienced direct attempts at suppressing our research, and Ken Zucker has experienced secondary pressure in his role as editor of a journal for publishing research about ROGD.”
Seeking to reassure those who might suspect the three of them of engaging in a grand academic journey fueled by confirmation bias, Dr. Bailey added: “It’s important to emphasize that we’re conducting scientific research, and we aim to be unbiased. We will publish what we find, even if it refutes ROGD. All of us have shown determination to do good science on gender dysphoria despite external pressures.”
I asked Dr. Littman whether she erred in coining the term ROGD and might have averted some of the criticism and quibbling, such as from Dr. Turban, over what exactly qualifies as “rapid” onset, by calling it “adolescent-onset gender dysphoria” instead.
The term ROGD, Littman said, “was meant to be descriptive and neutral. As a starting point for the first study to explore this I think it is reasonable and I don’t regret it. As it turned out, providing a name for what parents and clinicians were seeing was powerful and opened the door for much needed public, private, and clinical discussions about the complexity of gender dysphoria and trans identification in the most recent population of teens and young adults. I believe that no matter what I called it there would have been backlash and splitting hairs because the very concepts of complexity and contributors to gender dysphoria are threats to the belief system that justifies fast-tracking gender transitions.”
Dr. Bailey added: “I’ll just point out that activists like Turban would find ways of criticizing ROGD regardless of what it is called. It is a mistake to think they are principled.”
I am an independent journalist, specializing in science and health care coverage. I contribute to The New York Times, The Guardian, NBC News and The New York Sun. I have also written for the Washington Post, The Atlantic and The Nation.
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I hope that online survey is propery surveilled, because trans activists will use every trick in the book to access and poison it: DDOS attacks, phony respondents...you name it, TRAs will try it.
I long for the day when we will look back on this gender stuff with the same disdain as recovered memories and multiple personality disorder.
Turban was on the Dr. Mike podcast. It was about 2 hours. Every trans question answer was some version of “it’s complicated”. Dude doesn’t actually assess or challenge a new patient’s trans claims because he’s not gatekeeping & it could be trauma-inducing. It’s straight to affirmation. Also claimed every negative study was biased and attacked the researchers while ignoring the data.