Signs at a protest against President Trump’s transgender policies in New York City, July 2017. (Carlo Allegri/Reuters)

Psychiatric conditions may underlie ‘rapid-onset gender dysphoria.’ That finding, and the call for more research, brought out the activist bullies.

Last week, the Brown University School of Public Health removed a press release linking to a study on gender dysphoria, after anonymous members of the transgender community said they were offended.

Gender dysphoria is a clinical term describing a distressing incongruence between an individual’s birth sex and his or her “experienced gender.” For children, there are two competing therapeutic approaches to this condition. The first is to help the individual feel at ease with his or her birth sex (and original gender); the second is to affirm the “experienced” gender, by either social or medical intervention. Across the world, trans activists are doing everything in their power to ensure that the latter approach — which many experts consider medically and morally wrong — becomes orthodoxy.


Lisa Littman, an assistant professor of behavioral and social sciences at Brown, stumbled into the spotlight of this ethical controversy when she published a paper in the science journal PLOS One. There she described a new phenomenon of “rapid onset gender dysphoria.” This, Dr. Littman says, is when a young person who did not show signs of gender dysphoria in childhood develops symptoms rapidly during or after puberty. Dr. Littman has reason to believe that some may be suffering from underlying (and preexisting) psychiatric conditions. (As shown elsewhere, these adolescents are mostly girls, which is of interest to feminists who are already fiercely divided over the issue of transgenderism.)

Dr. Littman’s study of “parental reports” was qualitative, not quantitative. She made her observations based on the little survey data she had. She acknowledged the study’s limitations — of which there were many — then called for further research. In any case, her paper was peer-reviewed, passed the ethical requirements, and was published in a science journal of high repute. So why did the university consider the withdrawal of their support to be “the most responsible course of action”?


The answer, predictably, is that they succumbed to political pressure. As some suggest, possibly unfairly, so has PLOS One.


PLOS One explained that in response to “readers’ concerns,” they were seeking “further expert assessment on the study’s methodology and analyses.” If so, that’s fair enough. But in an unusual display of transparency, Brown added their own statement that their “community members” had been “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.”

However, Jeffrey S. Flier, M.D., a professor of medicine and neurobiology and a former dean of Harvard Medical School, wrote in Quillette:

In all my years in academia, I have never once seen a comparable reaction from a journal within days of publishing a paper that the journal already had subjected to peer review, accepted and published. One can only assume that the response was in large measure due to the intense lobbying the journal received, and the threat — whether stated or unstated — that more social-media backlash would rain down upon PLOS One if action were not taken.

At this juncture, there are two questions worth asking. 1) Are there any out-of-the-ordinary methodological flaws with Dr. Littman’s study? 2) Is ideological unpalatability — a factor, by Brown’s own admission — reasonable grounds for withdrawing support for an academic paper?

On the first question, Dr. Littman’s study is certainly flawed, by its limited data, for instance. But, as far as we know, it is not unusually flawed.


In the realm of behavioral science and psychiatry, observation and subjective experience form an integral part of diagnosis. “Oftentimes I only have what a patient is telling me, to go on,” a psychiatrist with over 30 years’ experience (including work with transgender patients) told me.


No doubt, social science is even murkier territory. Even within the field, it has been suggested that too many studies are merely exercises in confirmation bias and suffer from serious flaws such as prejudicial study design. Perhaps PLOS One’s review will find that Dr. Littman’s study shares some of these weaknesses. But are the existing critiques convincing?

Diane Ehrensaft, the director of mental health at a gender clinic in San Francisco, took great issue with where Dr. Littman sourced her data and suggested that the sites she used (such as 4thWaveNow) were akin to “recruiting from Klan or alt-right sites to demonstrate that blacks really are an inferior race.” Others complained that the paper asked not the patients themselves but rather parents. To be fair to Dr. Littman, the study’s purpose was, as the title says, “a study of parental reports.”

A fairer criticism might be to point out that Dr. Littman’s 256 sources are difficult to verify. Indeed, reproducibility is a widespread problem in social science. But as Dr. Flier points out in his Quillette essay:

There is a real problem with a lack of reproducibility of published science in many academic fields. Efforts to understand and respond to this problem are receiving justified attention. But that is not what has happened in regard to Dr Littman, whose critics have not performed any systematic analysis of her findings, but seem principally motivated by ideological opposition to her conclusions.

Which brings us to the second question. Why was political controversy a factor in Brown University’s decision to disassociate with the study? Brown, like other elite colleges, appears more concerned with its marketability than with finding truth. This is a serious problem, clearly: It stunts the entire purpose of higher education and research and significantly undermines academic freedom.

But Brown isn’t alone in its cowardice: The abdication of leadership at top universities is part of a bigger trend, one the moral psychologist Jonathan Haidt (co-author of The Coddling of the American Mind) discussed at length in two recent interviews with National Review.

However, in this instance there is an even more serious problem. From politics to higher education, a radical ideological lobby has, once again, been highly effective in bullying dissenters into silence. This is a global effort. Last week in Britain, for instance, the minister for women came under heavy fire for saying that she was “a little cautious” about sex changes for teenagers. Or recall that, in 2016, Dr. Kenneth Zucker, perhaps the leading expert on gender dysphoria in children, was ousted from his clinic in Toronto on baseless charges of professional misconduct (i.e., “transphobia”), in what the science reporter Jesse Singal subsequently called “a show trial.”

With Brown, Dr. Flier notes another problem, the abdication of leadership:

Another key point is notable for its absence: There is no suggestion whatsoever of support for Dr Littman, a faculty member in good standing for whom the personal and professional consequences of these events could be devastating. The dean of a school is in effect the dean of the faculty. While she must exercise balance and objectivity when controversial issues arise, her responsibilities include the expression of appropriate support for a beleaguered faculty member until and unless clear evidence emerges to impugn that scholar’s behavior or work. And yet, Dean Marcus is mute on this subject.

Dr. Littman’s study was considered publishable by a reputable science journal and worthy of promotion by a leading university. But when activists claimed offense, the university quickly sacrificed its core principles of scientific inquiry and truth-seeking to the feelings of “some members” of their community. It would be tempting to roll one’s eyes, mutter about political correctness, and move on to more-interesting things. But the truth is that there is much at stake here. Behind Brown’s cowardice lurks one of the most suppressed debates of our time. For even if every single fact in Dr. Littman’s study was wrong — which no one credibly suggests — her conclusion that “more research is needed” is entirely correct. Make no mistake: If we are not free to follow the evidence, the plight of children with gender dysphoria will become far worse.