Less than two weeks ago, PLOS ONE published a paper about the parents of teenagers who appeared to immediately start questioning their gender identity around the time of puberty. Then the critiques flooded in.
The paper — about a highly contentious issue — surveyed parents who felt that their children had suddenly started to question their gender identity around the time of puberty, prompting author Lisa Littman at Brown University to coin a new phenomenon as “rapid-onset gender dysphoria.” Any discussion of transgender identity in young children can get politicized, and this paper was no exception.
The political aspect of the findings aside, readers have raised some serious concerns about the methodology behind the PLOS ONE paper. So far, multiple comments on the paper have pointed out potential issues in what one user dubbed a “fatally flawed paper” — such as the lack of a control group, the fact that Littman recruited study participants from allegedly biased websites, and only interviewed parents, not children or their clinicians. Brown University even took down a press release touting the study when it first appeared. And the journal has announced it’s taking a second look at the paper.
Earlier this year, The Advocate, a publication focused on LGBT issues, published a commentary titled “‘Rapid Onset Gender Dysphoria’” is biased junk science,” after the Journal for Adolescent Health published one of Littman’s poster abstracts. According the Advocate:
The narrative states that teens, particularly those assigned female at birth, are going on the internet and convincing themselves that they are transgender because being transgender is “trendy.” It treats transgender identities as a form of social contagion. This theory has been picked up on by numerous hate groups and conservative news outlets…
(Incidentally, the same journal, the Journal for Adolescent Health, is now facing backlash on Twitter for deleting a tweet earlier this week in response to the PLOS ONE paper that said Rapid Onset Gender Dysphoria “is not a thing.”)
No press, please
In a statement released Tuesday, Brown says it decided to withdraw its press release after learning about the concerns over Littman’s methodology. The statement includes a letter from Bess Marcus, the dean of the school of public health, which says that:
…the School of Public Health has heard from Brown community members expressing concerns that the conclusions of the study could be used to discredit efforts to support transgender youth and invalidate the perspectives of members of the transgender community.
Although Marcus’s letter notes that Brown and the school of public health “always affirmed the importance of academic freedom and the value of rigorous debate informed by research,” the fact that Brown noted in its explanation for retracting the press release that people in the community didn’t like the findings has raised some concerns. Alice Dreger, a historian of science and medicine who has written about attacks on academic freedom, told us:
What researcher would want to work at Brown when the value of your work is determined by political pressure? Is Brown a research institution or a marketing company that accidentally rolled out New Coke?
The research of supposedly unpopular ideas should be our goal in academia, not a source of shame. This is very worrisome indeed.
Here’s an excerpt from the now-retracted press release from Brown:
[Some of the findings] led [Littman] to the hypothesis that friends and online sources could spread certain beliefs. Examples include the belief that non-specific symptoms such as feeling uncomfortable in their own skins or feeling like they don’t fit in — which could be a part of normal puberty or associated with trauma — should be perceived as gender dysphoria; the belief that the only path to happiness is transition; and the belief that anyone who disagrees with the teen is transphobic and should be cut out of their life.
In the study, nearly half of surveyed parents said their teens had experienced a traumatic event before their gender dysphoria. The release notes:
This suggests that the drive to transition expressed by these teens and young adults could be a harmful coping mechanism like drugs, alcohol or cutting, Littman said. With harmful coping mechanisms, certain behaviors are used to avoid feeling negative emotions in the short term, but they do not solve the underlying problems and they often cause additional problems, she noted.
A journal reacts
A spokesperson for PLOS told us:
We are aware of the broad discussion around the topic of the paper as well as concerns raised on the study’s content and methodology. It is our established policy to follow up on all scientific criticism brought to us about published papers. As part of this follow-up we will seek further expert assessment on the study’s methodology and analyses. While we are aware of the broad discussions the study has initiated on gender dysphoria in adolescents, our focus is the scientific review of those aspects that may impact the strength of the conclusions drawn within the specific framework of this study, or that may warrant further clarification. This case is a priority for us, but at this point we do not have a time frame.
In “Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports,” Littman surveyed more than 250 parents who had reported their children raising doubts about their gender identity seemingly overnight. The surveys were posted on three websites. We contacted Littman, who said she has been getting many emails about the paper, and would respond to our questions when she could.
According to one posted criticism of the paper:
… for those of us with significant experience working with this population (and contrary to the article, very much in alignment with the current literature out there on gender dysphoria et. al.) know that often parents describe their child’s disclosure after puberty as coming completely out of the blue, influenced by social media, etc. This has even been described by parents of one kid who literally came out as transgender at age 6, again at age 9 and again at age 13. “this came out of nowhere!” they said. To rely only on parent report, particularly parent reports gathered from websites that exist because of skepticism about transgender identities seems methodologically flawed.
The paper was received October 7 and accepted August 1; we contacted the editor listed on the paper, Dan Romer at the University of Pennsylvania, for more insight into the review process of the paper. He told us:
I believe the editors at [PLOS] are considering what steps to take on this paper and whether to publish commentaries about it. I’ve told the editors that I would be glad to review those commentaries, but so far nothing has been decided as far as I know. So, I can’t say anything beyond that at this time.
The paper has already been viewed more than 29,000 times since it was published August 16.
A petition in support of Littman’s research has been signed by nearly 1400 people, including some parents who participated in the study. It notes:
We, the signatories to this letter, overwhelmingly support the rights of transgender people, but we want better diagnostic and mental health care for youth who suddenly demand serious medical interventions, particularly in the absence of a history of dysphoria. We believe that medical interventions that may benefit some individuals may not help, and may even harm, others, as already evidenced by the growing number of desisters and detransitioners, many of whom have already suffered from irreversible side effects of their earlier medical transition . We support more research to help distinguish between the two groups, and Dr. Littman’s study is an important first step.
We strongly urge Brown University and PLOS ONE to resist ideologically-based attempts to squelch controversial research evidence. Please stand firm for academic freedom and scientific inquiry.
This isn’t the first time a journal has pressed pause over a paper because of concerns about how the findings might be used (or mis-used); last year, the New England Journal of Medicine took the unusual step of adding a note to a nearly 40-year-old letter which warned readers that the letter has been “heavily and uncritically cited” by sources using it to suggest opioids are not addictive.
Update, 2000 UTC, 8/29/18: PLOS sent an additional statement:
The integrity and validity of the scientific record is very important to us, and we have a responsibility to address scientific concerns brought to our attention. This is not about censoring academic freedom or to suppress scientific research. The broad debate on gender dysphoria led by various parties is clear evidence that such research is needed, and we support this research and are committed as a journal to publish all scientifically valid research on the topic.
Hat tip: Melinda Wenner Moyer
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