Operation: Bury ROGD

The 2017 Memo (had it existed) that Started it All

No evidence exists of a memo in 2017 launching a campaign to suppress Lisa Littman’s then-emerging theory of Rapid Onset Gender Dysphoria (ROGD), which sought to explain the sudden upsurge in teens identifying as trans. Still, we imagine it might have gone something like this.

Subject: CONFIDENTIAL – IMMEDIATE ACTION REQUIRED: ADDRESS ROGD RISK

Date: October 1, 2017

Dear Colleagues,

We are confronting a significant and immediate challenge: Rapid Onset Gender Dysphoria (ROGD). This emerging concept poses a direct risk to the stability and growth of our industry. Since 2014, we have been tracking parents and professionals on the 4thWaveNow, TransgenderTrend and Youthtranscriticalprofessionals websites, initially viewing their activities as a minor disturbance. As of 2017, their influence has escalated, and our analysis indicates that ROGD, if validated, could undermine our clinical operations, revenue streams, and public standing. We must respond decisively to protect our interests.

Let us review the timeline. In 2014, 4thWaveNow emerged as a platform for parents alarmed by abrupt shifts in their teenage daughters’ gender identities. These were not children with long histories of dysphoria but adolescents—often high-achieving, socially anxious—who, after engaging with online platforms like Tumblr and YouTube, began identifying as transgender. Requests for binders, hormones, and surgical consultations followed swiftly. The parents labeled this a “social contagion,” a theory we initially dismissed as an overreaction akin to past moral panics. However, their persistence has proven consequential. By 2016, they had gained the attention of academic researchers, and now, Dr. Lisa Littman, a public health scholar, is preparing a study that could eventually formalize ROGD as a credible diagnosis. This development demands our full attention. Earlier this year Dr. Littman presented this concept as a poster and it has been published in The Journal of Adolescent Health.

The implications for our industry are profound. The sex reassignment sector—encompassing gender clinics, surgical practices, and hormone therapies—has experienced unprecedented growth. Referral rates have surged, with facilities like the UK’s Tavistock reporting an increase from 97 cases in 2009 to over 2,500 by 2017, and our U.S. affiliates documenting a 20% annual rise in surgical procedures since 2015. The growth of the sex reassignment industry depends on a steady flow of patients seeking affirmation through medical intervention. ROGD challenges this foundation by suggesting that a significant portion of these adolescents—our core demographic—may not have innate dysphoria but are instead influenced by social dynamics. Should this narrative gain traction, it could reframe our work as premature or unnecessary, jeopardizing our legitimacy and financial viability.

Consider the potential fallout. Public perception could shift, casting every hormone prescription or surgical referral as a risk of future regret. Lawmakers, already scrutinizing healthcare costs and age-related consent laws, may seize on ROGD to impose restrictions. Hormone access could face new barriers, reducing both pharmaceutical sales and clinical demand. Insurance providers, wary of rising detransition claims—however anecdotal—might scale back coverage for procedures like mastectomies or vaginoplasties, which average $20,000 per case. Our patient pipeline would shrink as parents and providers opt for “watchful waiting” over intervention, eroding our caseloads and profitability. The stakes are clear: unchecked, ROGD threatens to dismantle the infrastructure we’ve built.

Our data underscores the urgency. Since 2014, 4thWaveNow’s reach has grown threefold, now engaging hundreds of parents and generating thousands of comments. These individuals are not merely voicing concerns—they are organizing, forming private groups on Facebook, and lobbying healthcare professionals to question rapid transitions. Littman’s forthcoming study, reportedly based on parental surveys, could amplify their claims. If published and picked up by mainstream outlets—such as the Daily Mail or Fox News—ROGD could become a household term, fueling legislative and public backlash. Politicians have a history of capitalizing on such fears; this could become their next rallying cry, with consequences we cannot outmaneuver through lobbying alone.

To mitigate this risk, we present the following action plan—Operation: Bury ROGD:

1. Shape the Narrative: Enhance our presence on social platforms like Tumblr and emerging sites like X. Deploy patient testimonials emphasizing lifelong dysphoria—“I knew since childhood”—to counter ROGD’s “sudden onset” claim. Partner with influencers to reinforce the medical necessity of our services.

2. Neutralize the Source: Monitor 4thWaveNow closely. Engage discreetly to dilute its momentum—support alternative voices within their forums promoting acceptance over skepticism. Avoid direct confrontation to maintain our credibility.

3. Challenge the Research: Preempt Littman’s study. Collaborate with allied academics to critique its methodology—highlight its reliance on parent reports rather than clinical data. Position ROGD as speculative, not evidence-based, before it gains footing.

4. Reinforce Medical Authority: Strengthen ties with the APA and WPATH. Secure statements affirming that dysphoria is complex and individual, not a contagion. Ensure our clinics issue unified messaging to reassure insurers and regulators.

5. Engage Policymakers: Activate our government affairs team. Emphasize the proven outcomes of timely intervention—cite reduced suicide rates (41% pre-treatment vs. 4% post)—to frame ROGD as a fringe theory threatening patient care. Head off restrictive legislation.

6. Adapt Strategically: If ROGD breaks through, pivot. Expand outreach to younger patients and parents, framing early intervention as prevention against social influence. Maintain revenue through proactive adaptation.

We have the resources to act. Our industry has weathered scrutiny before—recall the 2015 insurance expansions—and emerged stronger. ROGD is a credible threat, but not an inevitability. Since 2014, these parents have gained ground, and Littman’s work could tip the scales. We cannot assume our current momentum will suffice; ROGD risks redefining gender affirmation as a cautionary tale rather than a solution.

Our mission—expanding clinical care and financial success—hangs in the balance. This is a matter of strategic preservation, not debate. Implement these measures immediately and report progress by November 1st, 2017.

The Committee to Bury ROGD

This memo depicts a fictional scenario imagining how the efforts to suppress Rapid Onset Gender Dysphoria (ROGD) might have been strategized. The broader details—such as timelines, organizations, and data—are based on documented facts.

Littman’s 2018 study and the ROGD studies that followed faced an apparently coordinated campaign by the academic community and trans activists to discredit them.

We invite any evidence that could shed more light on this history. Please write to us at: