Note: We are looking to connect with trans academics or researchers to develop a formal response to this paper. If this sounds like you, you can contact us here.
Update 10.23.2021: For the compilation of this analysis and future work, we retain a copy of the original questionnaire in full. This information has been confirmed to be legitimate by Lisa Littman. We are releasing the transcript of the questionnaire to the public in the interest of open science. Full screenshot verification can be provided directly to interested, reputable researchers and academics. Enormous thanks to Mallory Moore for dedicating the time to compile this for us.
Lisa Littman, a US-based researcher famed for popularizing “rapid onset gender dysphoria” (ROGD), recently released a new paper on detransition titled Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners.[1] Analysis of the paper, its questionnaire, and its recruitment pool reveals a number of methodological and factual errors. The errors demonstrate a clear attempt to find support for the existence of ROGD. In actuality, the data collected contradicts Littman’s conclusions and, in the process, identifies a key shift in the political climate on trans health when ideological detransition emerged as a narrative.
Methodological and Factual Errors
Initial analysis revealed a number of errors pertaining to the history of detransition, sampling bias, use of old data to “prove” still-developing theory, leading questions pertaining to ROGD and autogynephilia, conclusions that contradict the core data, and the retconning of findings to fit recent publications pertaining to detransition.
Historical inaccuracies on the emergence of detransition. Littman claims that “[b]etween 2015 and 2017, a handful of blogs written by individual detransitioners started to appear online, private support groups for detransitioners formed, and interviews with detransitioners began to appear in news articles, magazines, and blogs[.]”[p. 1] However, detransition blogs and, subsequently, small internal networks began forming in at least 2013.[2] Detransitioned radical feminists had begun sharing their stories online and in panels at events such as Radfems Respond in 2013 and 2014. The online writings included guides for parents, which prompted outreach from Denise C., the founder of 4thWaveNow, as she planned the development of her site. This context is critical for understanding Littman’s findings, given her recruitment pool and the shift in social narratives from detransition through a radical feminist lens to ROGD.
Biased sampling pools. Littman (2021) reported that “[r]ecruitment information with a link to the survey was posted on blogs that covered detransition topics and shared in a private online detransition forum, in a closed detransition Facebook group, and on Tumblr, Twitter, and Reddit.”[1, p. 3] Both the private online detransition forum and closed Facebook group that were available at the time were overwhelmingly frequented by detransitioned women who were white, trans-exclusionary radical feminists, and based in the United States.[3] At least one Tumblr recruitment post was through detransitioned radical feminist circles, initially posted on Cari Stella’s blog.[4] Reddit groups included r/GenderCritical, which was later banned from Reddit for hate speech, and a new group r/DysphoricWomen with a political stilt similar to the private forum.[5] Respondents were also asked to forward the survey to people they felt it would apply to (i.e. the snowball recruitment method). While attempts were made to post in r/ftm, r/mtf, and r/asktransgender, the postings were removed by moderators because the survey hadn’t been reviewed prior to posting. Attempts were also made to recruit through professional listservs, though there’s no indication how successful this effort was.
These recruitment methods led to a pool of respondents whom were predominantly from privileged backgrounds in the Global North, many of whom had radical feminist or gender critical politics. On average, 90% of the respondents were white, with 56.5% to 61.3% being of average to above average socioeconomic status. Upwards to 58.1% had a Bachelor’s or graduate degree, with an additional 32.2% to 44.9% having at least some secondary education. Two-thirds of respondents were from the United States, with an additional 3.2% to 11.6% from the United Kingdom. Few identified themselves as people of color, with only 1.4% to 3.2% who were Asian or Latinx and none who were Black. 69% were assigned female at birth, versus 31% for those assigned male, and intersex experiences were left out entirely. Ultimately, the demographics of the respondents cannot be generalized to detransitioned experiences outside of the white, Euro/American-dominent sphere, nor is it able to effectively speak to the experiences of detransitioned people assigned male at birth, intersex people, or those who support affirmation models for transition.
Use of old, inapplicable data to “prove” theories that were still in development. Littman initially recruited for this study from late 2016 to early 2017, prior to her publication of her ROGD paper in 2018. Curiously, recruitment periods for the two papers are within months of each other. Littman’s initial ROGD paper recruited on websites such as 4thWaveNow in July of 2016.[6] The recruitment window for Littman (2021) ran from December 15, 2016 to April 30, 2017.[1, p. 3] Not only does this raise question of how much time was available for proper analysis of the data from her parent surveys, but also what this meant for the overlapping construction of the survey for her following detransition survey.
In addition, she used similar recruitment channels as Cari Stella for the 2016 community survey, despite profound differences in their construction. Cari Stella had initially found that 62.9% of assigned female respondents detransitioned for political/ideological reasons, as well as 59.4% reporting having found alternative ways to cope with dysphoria, 30.7% for mental health concerns that weren’t hormone related, and 28.7% noting that they had resolved the mental health issues they felt led to their dysphoria.[7] In contrast, Littman (2021) claims that for respondents assigned female, 44.9% reported that their reason for detransitioning was that their mental health didn’t improve, 39.1% reported that their mental health worsened, 36.2% found other ways of coping with their dysphoria, and a mere 8.7% had resolved the issue that they feel was the cause of their dysphoria.[1, p. 9] Littman did not include a question surrounding political or ideological reasons, the category that was highest in Stella’s survey. The profound difference in percentages and failure to effectively inquire about political or ideological changes opens questions as to whether or not Littman (2021) was truly reflective of the populations she was surveying at the time.
Reasons for detransitioning
| Political/ideological changes | 62.9% | N/A |
| Found alternative ways to cope with dysphoria | 59.4% | 36.2% |
| Mental health concerns | 15.3% (hormone related), 30.7% (non-hormone related) | 39.1% (worsened), 44.9% (no improvement) |
| Resolved the mental health issues they felt led to their dysphoria | 28.7% | 8.7% |
Leading questions to fish for data supporting ROGD and autogynephilia. The majority of the questionnaire involved phrasing designed to prompt respondents to fit their experiences into the coded narratives. Such questions included, but were not limited to: if respondents’ “personal definition of female or male changed”, assumptions that stopping hormones or puberty blockers was “for the purpose of de-transitioning”, how many friends in the respondents’ friend groups transitioned before and after they transitioned, and how strongly “traditional sex roles” were enforced at home or in the respondents’ communities. Questions regarding reasons for transition and detransition were similarly heavily stilted, and included options such as “I had erotic reasons for wanting to transition” and “I realized that my desire to transition was erotically motivated” in attempts to connect to Blanchard’s typology on autogynephilia. Inquiries about the onset of dysphoria offered no clarity between social and body dysphoria, which can lead respondents to be flagged as “late onset” if other cultural or social cues are not explored. This resulted in respondents reporting, on average, that their dysphoria started around age 11. Littman then proceeds to shove these “late onset” cases into the box of ROGD because of the close proximity to puberty. This is a point of criticism pointed at Littman’s ROGD paper, when Florence Ashley points out that “[p]uberty is known for its role in intensifying or unearthing gender dysphoria in part due to changes and development in secondary sexual characteristics[.]”[8] Furthermore, just because a person’s dysphoria starts or worsens around puberty, this doesn’t inherently mean that it’s a result of trauma or mental health conditions, or that transition isn’t in the person’s best interest.
In addition, despite collaborating with members of the detransitioned radical feminist scene, the survey left out questions pertaining to internalized homophobia. This was an area initially explored by Cari Stella in her community survey, and several respondents (23%) filled in the gap themselves.[1, p. 10] While assigned female answers for Littman’s question about how one’s “personal definition of female or male changed” were statistically similar to Cari Stella’s question about political/ideological changes (65.2% versus 62.9%), because of the phrasing of Littman’s question, it is impossible to know how many respondents chose this question to reflect their politics versus their gender dysphoria being temporary. This is particularly true when we consider the fact that for the detransitioned radical feminist community being surveyed, an essential part of “[becoming] more comfortable with identifying as [their] natal sex” is reinterpreting and expanding the idea of woman to include their experiences with gender dysphoria through a trans-exclusionary radical feminist framework.
The conclusions contradict the data. As mentioned previously, Littman (2021) didn’t initially ask about internalized homophobia, though she concluded that people’s responses “adds to the existing evidence that gender dysphoria can be temporary[.]”[p. 13] However, there is no indication that their dysphoria was actually temporary instead of suppressed. It also doesn’t address a key question about how many trans youth identify as gay, bi, or queer after transition, a question posed by Florence Ashley in Littman’s own citations.[9] Littman’s attempts to frame respondents assigned male as fitting Blanchard’s typology on late onset dysphoria and sexuality is also questionable. She uses citations for the debunked concept of fetishistic transvestism, or “autogynephilia,”[10] and yet, despite her efforts, only 16.1% of respondents asserted that their desire to transition was erotically motivated. In the end, Blanchard’s typology and Littman’s subsequent use of it oversimplifies the experiences of lesbian or bi trans women and tries to frame them as sexual perverts, all while ignoring the impact of societal homophobia combined with transmisogyny that could play a factor in detransitioning for trans women or transfeminine people.
Another key contradiction is in regards to “finding better ways of coping with gender dysphoria.” The majority of respondents responded with community supports (44%), mindfulness/meditation (41%), and exercise (39%). Conversely, only 24% noted that they sought therapy or trauma work, and even fewer for psychiatric medications (18%).[1, p. 10] Yet she posits the need for “adequate evaluation” prior to transition, as well as “exploratory” forms of therapy prior to transition. There’s not a clear indication that “exploratory” therapy would have actually been of benefit. If anything, it poses the risk of harm, as Littman’s ROGD paper is frequently cited by anti-trans clinician and parent groups that collaborate with conversion therapists.[11, 12] Furthermore, the other ways of coping with gender dysphoria can in turn be a form of peer- or self-imposed conversion practice,[13] leading to feelings of depression, shame, suicidal thoughts and impulses, and increases in dysphoria and dissociation during detransition.[14]
Probably most critically is the fact that in Littman’s social influence narrative, only 20% reported feeling pressured by a person or people to transition.[1, p. 11] In contrast, a higher percentage of her respondents reported pressure to detransition, at 29%.[p. 10] Ironically, her paper confirms that there’s more pressure for trans people to stop being trans than for cis people to be trans.
Retconning of findings to match and leverage selective support from new publications. Despite the fact that the data was originally collected from 2016 to 2017, Littman didn’t submit her paper until October 2020, after her ROGD paper was published. Littman revised her initial detransition paper in September 2021, after the publication of Eli Vandenbussche’s paper Detransition-Related Needs and Support: A Cross-Sectional Online Survey this April.[15] Significant portions of Littman (2021) relied on Vandenbussche (2021) to corroborate her premises and, ultimately, her findings. This begs the question of how much of the paper has been altered since its initial drafting in 2020 to fit with Vandenbussche’s findings that, in turn, supported her own hypotheses. While Vandenbussche recruited in some of the same channels, as well as their own, they did so in 2019 after ROGD was already firmly established in the social narrative. Given how the framework of popular detransition narratives shifted from radical feminism to ROGD over the years, use of data from detransitioned communities prior to the spread of ROGD as a concept makes Littman’s insistence that the data proves its existence questionable at best, and dishonest at worst.
The Average Year of Detransition In Historical Context
An interesting piece of data is the fact that the mean calendar year that respondents reported detransitioning was 2014 in both groups assigned male and assigned female.[1, p. 8] The year reported was not statistically significant between groups. This correlates with the emergence of ideological detransitioned narratives through blogs, Facebook groups, and YouTube channels, as well as politically motivated organizing described previously.[2] Since then, one respondent and interviewee in the cited Stranger article by Herzog (Ky Schevers/”Cass”) has since come forward about how her detransition was ideologically motivated and enforced by her peer group.[13] As only 3% of the respondents reported having retransitioned after detransition, and the data is predominantly from 2017, it is possible that other respondents have also retransitioned and come to a different understanding of what their reasons for transition and detransition were. Instead of finding evidence of “rapid onset gender dysphoria,” it is quite possible that Littman (2021) has found corroborating evidence for findings by Health Liberation Now!, Turban et al,[16] and the 2015 U.S. Transgender Survey[17] that societal and interpersonal transphobia plays a key role in detransition for many. While Littman (2021) attempts to play lip service to this through her discrimination narrative (reported at 29%), she fails to account for how it impacts her own findings.
It is evident that, in this latest publication, Littman is attempting to shove old data gathered through biased channels and with shoddy methodology into the ROGD framework instead of analyzing the true complexity of transition and detransition. In doing so, she continues to reinforce the work of those that benefit from her and vice versa. Given how her work is being continuously used to argue in favor of conversion therapy for trans people, particularly youth, we caution that her attempts to “prove” her theory will cause more harm in both social and professional spheres.
References
- 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, doi:10.1007/s10508-021-02163-w. Advance online publication.
- Leveille, L. (2021, July 5). The Mechanisms of TAnon: Where it Came From. Health Liberation Now! Link
- Schevers, K. (2021, March 13). Rules and Guidelines from Support Groups for Detrans Women. Reclaiming Trans. Link
- Stella, C. (2016, December 14). Recruitment posting on Tumblr for Littman study on detransition. Guide On Raging Stars. Link
- @ImplausibleGrrl. (2020, May 15). [Tweet thread]. Link
- Denise C. (2016, July 2). Rapid-onset gender dysphoria: New study recruiting parents. 4thWaveNow. Link
- Stella, C. (2016, September 3). Female detransition and reidentification: Survey results and interpretation. Guide On Raging Stars. Link
- Ashley, F. (2020). A critical commentary on ‘rapid-onset gender dysphoria.’ The Sociological Review, 68(4), 779–799. Link
- Ashley, F. (2020). Homophobia, conversion therapy, and care models for trans youth: Defending the gender-affirmative approach. Journal of LGBT Youth, 17(4), 361–383. Link
- Serano, J. M. (2010). The case against autogynephilia. International Journal of Transgenderism, 12(3), 176–187. Link
- Moore, M. (2021, August 26). SEGM uncovered: large anonymous payments funding dodgy science. Trans Safety Network. Link
- Leveille, L. (2021, September 26). When Ex-Trans Worlds Collide. Health Liberation Now! Link
- Schevers, K. (2020, December 21). Detransition as Conversion Therapy: A Survivor Speaks Out. An Injustice! Link
- Schevers, K. (2021, June 20). Risks/harms of ideological detransition/“alternative treatments for gender dysphoria.” Reclaiming Trans. Link
- Vandenbussche, E. (2021). Detransition-related needs and support: A cross-sectional online survey. Journal of Homosexuality. Link
- Turban, J. L., Loo, S. S., Almazan, A. N., & Keuroghlian, A. S. (2021). Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT health, 8(4), 273–280. Link
- James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. Link