Dr. James Cantor rebuts unscientific CAAPS statement on ROGD

Canadian sexologist Dr. James Cantor wrote an important rebuttal to a startling statement about ROGD that umbrella organization Coalition for the Advancement and Application of Psychological Science (CAAPS) put out in early August. In the statement, signed by about 40 psychology-oriented organization, CAAPS emphatically states that ROGD does not exist: “There are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. Further, there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents.”

In his piece, Dr. Cantor explains why CAAPS is wrong.

Despite the mission of the organization, CAAPS’ statement not only failed to arrive at the scientifically correct answer, but also it failed even to ask the correct scientific question.  The question has never been (and isn’t supposed to be) whether ROGD exists: The question is whether the recent and explosive increase in trans referrals being reported across the world (e.g., de Graaf et al., 2018; Frisén et al., 2017; Kaltialo-Heino et al., 2020; Wood et al., 2013) represents one of the previously well-characterized profiles of trans people (so we would know what to do) or something new (wherein we can’t).

In effect, Dr. Cantor is saying that ROGD by any other name is still the same: there is a new and rapidly growing presentation of gender dysphoria in adolescents that is severely understudied.

Scientifically, it doesn’t actually matter if ROGD exists as CAAPS considers: What matters is whether and what kinds of transition benefit the people fitting this profile, which we cannot know.  To declare that ROGD doesn’t exist without pointing this out, however, is to recommend treating ROGD as if it were ‘regular’ gender dysphoria by default, despite that we already know the people fitting the ROGD profile significantly differ from the samples represented in the gender dysphoria outcomes research.  One cannot conduct the ethical task of a risk:benefit ratio while lacking knowledge of the latter.

In the end, anyone in distress reporting to a clinician deserves help, but as Dr. Cantor so ably points out, it matters tremendously that we get the diagnosis correct: “[C]linicians need to do different things to help people with major depression vs. bipolar depression vs. postnatal depression, despite that they can feel similar and would be described similarly.  Although we do not yet have enough evidence to tell us exactly what ROGD is, we do have sufficient evidence to know what it is not.  Treating this demonstrably new presentation the same as the known ones is to declare, ‘They all look alike to me.’“