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Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

Posted by jnoriega on 26 Aug 2018 at 19:41 GMT

Dr. Littman seems to hold her study as proof of a new hypothetical medical condition: Rapid Onset Gender Dysphoria.

A closer look at the data would seem to reveal that claim grossly premature: In Littman's admission, her evidence consists of little more than polls and surveys carried out from three politically bent websites. The websites according to Littman are: "4thwavenow, transgender trend, and youthtranscriticalprofessionals". A quick check of all websites would let anyone see they have an obvious political bent where all advocate for the criminalization of transition, bathroom bills, and a variety of anti-LGBT stances common to the religious right. Do Littman and the editors believe whatever the surveys there answer would be credible data? If yes, then wouldn't such a standard also force us to consider what "vaccine critical" websites say about vaccines and autism as proof? To my eyes and just about every other biomedical scientist's this seems like a gross overreach.

Equally concerning, only the politically active parents and their statements were examined and held as proof. At no point in this study did the author ever examine the allegedly ROGD youth or speak to their clinicians, so the only evidence we have comes from politically radical family members recruited from far-right websites that are involved with a variety of anti-LGBT initiatives including bathroom bills and attempts at having the state outlaw transition. Any of the good investigators I know would have taken their claims with a grain of salt, not held it as proof of a new medical condition. Why was there no attempt at obtaining objective information by assessing the purported ROGD cases and speaking to their clinicians?

Likewise, any credible reviewers and editors would have shown similar scrutiny. Going by the comments of the Journal of Adolescent Health in Twitter, Dr. Littman previously submitted this study in their journal; however it was rejected, likely because the gross overreach in claims. If Plosone continues to publish studies like this, which make spectacular claims but upon closer inspection have remarkably thin evidence, then the journal might come to be known as a repository for badly flawed studies that can't get published elsewhere. I'd be shy to have my work next to this study, provided it isn't corrected and I doubt I'm alone: Submissions to Plosone and it's impact factor have collapsed from their peak. No doubt in part because Plosone's string of flawed studies, which is continued by Littman's is increasingly driving those who can to pick journals with reputations for more rigor.

No competing interests declared.

RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

lmarchiano replied to jnoriega on 27 Aug 2018 at 14:45 GMT

It is not true that Littman submitted this paper to another journal and was rejected. As someone who provided feedback throughout the drafting and submission process, I can attest that this important paper was submitted only to this journal. It was never rejected from any other publication.

No competing interests declared.

RE: RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

ssingh526 replied to lmarchiano on 29 Aug 2018 at 00:13 GMT

Please declare your competing interests, as being someone involved in the drafting you certainly have some. Additionally what academic position do you hold and if you were involved in drafting this paper why are you not listed as an author?

No competing interests declared.

RE: RE: RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

jnoriega replied to ssingh526 on 30 Aug 2018 at 03:45 GMT

Indeed, that sounds like what's called "Ghost Authorship". If Ms. Lisa Marchiano played a critical part in this paper, why wasn't she given an authorship? I suppose that isn't a major concern. The methodology limitations are far more pertinent: claiming the discovery of a new disease but not assessing a single of the purported ROGD cases seems like overreach. I wonder why the authors of this paper couldn't have carried out a few case studies to confirm the existence of this ROGD condition they say they discovered.

No competing interests declared.

RE: RE: RE: RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

llittman replied to jnoriega on 30 Aug 2018 at 04:06 GMT

From the paper Acknowledgments section:

"I would like to acknowledge ... Lisa Marchiano, LCSW, for feedback on earlier versions of the manuscript..."

No competing interests declared.

RE: RE: RE: RE: RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

jnoriega replied to llittman on 01 Sep 2018 at 02:25 GMT

As I said, it's not a major concern if Ms. Marchiano declined an authorship despite her major intellectual contributions to this study, there's nothing wrong about that.

What's a much greater concern is if you could call this a descriptive study on ROGD? Not a single YAY alleged to be ROGD was assessed in this study, we have no case studies, polls of alleged ROGD cases or any other descriptive data regarding them. You say you discovered a condition distinct and unique from the Gender Dysphoria listed in DSM. If so, why didn't you have any data to corroborate this condition you say you found?

Polling websites where their alleged relatives hang out is a poor replacement for descriptive data of the ROGD cases. The sites you mentioned in your survey tag nearly all their stories with slurs such as this? https://4thwavenow.com/pa... Don't you think it likely their political bias may affect their answers? Are their responses proof of ROGD or merely diehard political crusaders saying anything they can to prove their world view?

I don't think anyone knows the answer just from a poll. This is why some form of descriptive data regarding the family members they claim are ROGD would have been invaluable. With nothing else to confirm we have no way to know if your 4thwavenow poll results were evidence of ROGD or just evidence of what political crusaders think. It would be very good if the strength of the claims in discussion could be amended to address we know very little from polling 4thwavenow and have no data to corroborate if ROGD exists.

Had this study also assessed the 256 youth and corroborated their parents claims that their children had ROGD instead of Gender Dysphoria as described in the DSM, I'm certain it would have been much better received and there would have been far less to critique from a technical standpoint. Why this wasn't done confuses me.

No competing interests declared.

RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

jchavez replied to jnoriega on 13 Sep 2018 at 12:19 GMT

The claim that parents recruited are "politically radical" is false. Table 1 shows they are well-educated, the vast majority support same sex marriage and the principle that transgender people deserve the same rights and protections as everyone else. https://journals.plos.org...

The claim that 4th Wave now tags its stories with slurs is also false. The link in this comment is a like to a search for "trans cult," which brings up every mention of the word "culture" as is obvious from the first result visible at the link provided in the above comment.

The website is further filled with first-person accounts of parents who were supportive of social transitioning but concerned about surgical and hormonal transitioning.

Littman does not claim to have found a new condition, she "describes a phenomenon where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood." Finally, parental reporting is a long-accepted way of gathering minor children's medical history. It is in fact the basis for some of the suicide-related claims made by activists.

No competing interests declared.

RE: Methodology Questions, Critiques: Why no verification with alleged ROGD cases and their clinicians, are politically radical family members reliable sources?

bconijn replied to jnoriega on 15 Sep 2018 at 18:05 GMT

You bring up a valid point. Especially in parent-child conflicts, which seem to be at play here, it matters a lot from who you collect your data [1]. Furthermore, the parents in this research seem reluctant to respect their child's psychological autonomy, which has already been well studied and linked to worse mental health, worse results at school and increased deviant behavior [2]. So I question whether ROGD is really something new, or just the well known struggle for autonomy that is characteristic for adolescence. Dr. Littman fails to address this in her paper.

[1] Steinberg, L. (2001). We know some things: Parent–adolescent relationships in retrospect and prospect. Journal of research on adolescence, 11(1), 1-19. https://doi.org/10.1111/1...
[2] Hennan, M. R., Dornbusch, S. M., Herron, M. C., & Herting, J. R. (1997). The influence of family regulation, connection, and psychological autonomy on six measures of adolescent functioning. Journal of Adolescent Research, 12(1), 34-67. https://doi.org/10.1177/0...

Competing interests declared: I have lived experience with the phenomenon described in the article. I'm a transgender woman, member of Mad Pride Nederland and seek to end coercion in mental health care.