Episode 52

52 - Gender Dysphoria & Detransition Research: A Conversation W/ Dr. Lisa Littman

Published on: 3rd December, 2021

Dr. Lisa Littman coined Rapid Onset Gender Dysphoria (ROGD) in her seminal 2018 parental report survey. ROGD is a descriptive term for the phenomenon of young people suddenly announcing a transgender identity and experiencing gender dysphoria for the first time around adolescence. Dr. Littman’s latest ground-breaking study on the experience of 100 detransitioners was published in the last few weeks and we reflect on some of the most astonishing findings. In this conversation, Lisa also reflects on what she’s learned since getting embroiled in a controversy she wasn’t expecting. She shares some possible reasons why the topic of affirmative medical care has become so polarized. Lisa points out that patients get hurt when clinicians pledge an allegiance to a particular approach rather than prioritizing the well-being of dysphoric people.


Dr. Littman’s Website:


Interview in Quillette: Quillette.com/2019/03/19/an-interview-with-lisa-littman-who-coined-the-term-rapid-onset-gender-dysphoria

Extended Notes:

  • Why has Dr. Lisa’s study on detransitioners received so much controversy? Dr. Lisa shares how she now feels about this.
  • There are a lot of ways to support people who are transgender but fast-tracking access to hormones in an effort to support transgender people, regardless if it’s more beneficial, is transphobic.
  • Dr. Lisa shares a bit about her background and what led her to the detransitioner’s study.
  • There are parents who believe transition will help their children and there are parents who don’t. We need to understand that they just want to help their children and there are multiple ways to do that.
  • Dr. Lisa shares further how her study was not accepted. She recruited respondents on social media where they orchestrated an event that undermined her data.
  • Dr. Lisa defines further what detransitioning means as this area of research is still early.
  • Affirmative model vs. exploratory model. The latter tries to understand why you are gender dysphoric whereas the former immediately concludes that you should transition.
  • Mental health conditions don’t have a targeted fix.
  • Psychosocial factors could contribute to the development of gender dysphoria.
  • Dr. Lisa also shares the effects of social influence such as pressure from a person, a group of people, or society on the interpretation of one’s own feelings. Can this lead to a misdiagnosis?
  • There are a variety of ways people can live their lives and they cannot solely be defined by rigid gender roles and stereotypes.
  • Language can be very powerful and if it was used in a way that doesn’t confine people’s feelings to a specific label, it wouldn’t create such a problem.
  • Where are the differences between male and female detransitions? Dr. Lisa explains further.
  • Stella concurs that if a detransition was because the person was more comfortable with their biological sex, this could have been avoided through a proper approach during therapy.
  • Exploring discomfort around sexual orientation would be a great place for trans therapists to help their patients.

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About the Podcast

Gender: A Wider Lens Podcast
Two therapists explore the expanding concept of "gender" from a psychological depth perspective.
Gender dysphoria has become a minefield for public discussion, with many afraid to express their views or question the narrative. Our mission is to examine this important and complex topic from a range of perspectives, but always through a psychological lens. By openly considering and examining gender identity, transition, and the transgender umbrella, we hope to give all interested parties permission to engage these fascinating topics with less fear and more honesty. Interviews and discussions will involve clinicians, medical professionals, academics, transgender people, parents, detransitioners and other interesting individuals whose lives have been touched by the concept of gender.

Conversations between two practicing therapists give listeners an opportunity to contemplate gender from a depth perspective not currently taken up in most of today’s accessible debates. As a result of their work with gender dysphoric therapy clients as well as their personal divergent experiences with gender, Stella and Sasha hold a refreshing and informed perspective.

Is gender identity a facilitation of development and expression of creativity, or can it be a defense against painful existential realities of living in a human body? What can we discover about masculinity, femininity, identity, gender performance, and sexuality when we peer beneath the surface and dive into a deeper psychological exploration? What is the relationship between body, mind, identity, culture, and psyche?

This podcast engages listeners in an intimate and fascinating behind-the-scenes inquiry about a topic as taboo as it is salient today.

Thank you to our sponsors:
Genspect - an international organization which offers an alternative to WPATH. Providing a range of education, resources and supports to anyone impacted by gender distress, Genspect unites many different organizations globally, and gives voice to 1,000s of previously untold stories. For more info, visit genspect.org.

GETA - an association of therapists who believe that individuals experiencing gender related concerns ought to be treated using a whole person approach. GETA connects like minded clinicians, provides educational resources and trainings, and helps people with gender dysphoria find support. For more info, visit genderexploratory.com.
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About your hosts

Stella O'Malley

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Stella O’Malley is a psychotherapist and author who works in private practice in Ireland. Her work focuses on parenting, family dynamics and working with teenagers.

Much of Stella’s counselling and writing focuses on mental health and the importance of well-being and she is a regular contributor to the media. She is also the resident psychotherapist for the current TV series, Raised by the Village, a family programme that helps troubled teenagers reconnect with themselves and their families.

Stella's first book, Cotton Wool Kids, was released in 2015 while Bully-Proof Kids: Practical tools to help kids grow up confident, resilient and strong was released in 2017. Stella’s latest book Fragile, was released in 2019 and focuses on overcoming anxiety and stress.

Stella was the presenter of the documentary Trans - Kids: It’s Time To Talk broadcast on Channel 4 in November 2018 and she contributed a chapter to the 2019 book, Inventing Transgender Children and Young People.

The Jungian analyst, Lisa Marchiano, and Stella launched Secrets of the Motherworld in September 2019, offering thoughtful exploration of the most intimate aspects of motherhood in a bid to help mothers feel less alone.

Stella is a Clinical Advisor for the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners. She is also the lead facilitator for the Gender Dysphoria Support Network.

Stella holds a B.A. in Counselling and Psychotherapy and a M.A. in Cognitive Behavioural Therapy.

Sasha Ayad

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Sasha Ayad is a Licensed Professional Counselor who works in private practice, and has treated adolescents for over 10 years. Her work focuses on teens and young adults struggling with issues of gender dysphoria and gender identity.

She became interested in the sharp rise in teenagers who declare a trans identity for the first time during adolescence. She discovered, through working with hundreds of families, that many teens were developing gender dysphoria only after adopting a transgender identity. She questions the practice of medical transition for children and teenagers, and her clinical work focuses on developmentally appropriate, least-invasive-first talk therapy.

Sasha is also a founding member and Clinical Advisor in the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners.

Sasha’s previous work experience includes:
- School counselor for middle and high school students at a charter school for underserved communities

- Behavioral therapy with children on the autism spectrum

- Individual and group counseling for women and children impacted by domestic abuse and sexual violence

- Developed and ran the first counseling program at a large state supported living facility for adults with intellectual disability

Sasha holds a B.S. in Psychology and an M.Ed. in Counseling Psychology.