Sexual Behavior Journal Under Fire Over Gender Dysphoria Paper

Controversy is swirling around a paper on “rapid onset gender dysphoria” (ROGD) published in the Archives of Sexual Behavior, with critics calling for removal of the journal’s editor.

Researchers and LGBTQ+ organizations penned an open letter to publisher Springer Nature, charging that the journal has a history of publishing questionable research under editor Kenneth Zucker, PhD. Signatories said they’ll refrain from submitting to the journal, acting as peer reviewers, or serving in any editorial capacity until Zucker is “replaced with an editor who has a demonstrated record of integrity on LGBTQ+ matters, and, especially, trans matters.”

They expressed two key critiques of the paper, which was written by J. Michael Bailey, PhD, of Northwestern University in Chicago, and “layperson” author Suzanna Diaz. One issue is that it lacks institutional review board (IRB) approval; the other is that it replicates “the severe methodological and interpretive flaws of previous research,” the letter stated.

Notably, critics said, data are based on a “lay survey” by Diaz — the parent of a transgender child — conducted online at ParentsofROGDkids.com and not intended for scientific publication. Recruitment material for the study used “leading and inflammatory language that is thoroughly inappropriate for a scientific study,” they wrote in the letter.

Bailey told MedPage Today that his institution’s IRB said Diaz didn’t need to get approval for her survey and that he could be a co-author on the paper. While he acknowledged that the survey used a “leading and opinionated recruitment blurb” and was subject to selection bias and could not be generalized, these limitations were stated in the paper.

Though editor Zucker is a close colleague and friend, Bailey said, “he put me through quite a bit of work to get that paper in shape that allowed him to accept it. … We did not get a pass.”

ROGD is a “highly controversial” idea, Bailey said, which posits that “vulnerable adolescents, mainly girls, come to believe they have gender dysphoria, even if they don’t, at least not in the traditional sense. It’s thought to be socially contagious. … The idea is that they might have emotional problems that make them more susceptible to believing this.”

Bailey said his is only the second major paper on ROGD. Lisa Littman, MD, MPH, of Brown University School of Public Health in Providence, Rhode Island, coined the terminology in a 2018 paper that was met with similar criticism when it was first published in PLOS One. The study was re-published with changes in 2019 following an investigation.

Among its problems were that it collected data from parents instead of the adolescents and young adults or clinicians involved “and therefore does not validate the phenomenon,” according to the correction notice on the article. The updated version also stated that ROGD “is not a formal mental health diagnosis at this time.”

Bailey hasn’t been a stranger to controversy, either. After the publication of his 2003 book, The Man Who Would Be Queen, critics took issue with the idea of autogynephilia, which suggests that transgender people who are born male are driven by an erotic fascination with themselves as women, Bailey said.

Northwestern launched an investigation into Bailey’s work on the book and concluded in 2004 that there was no wrongdoing. However, the issue raged on for years, Bailey said, and was covered by the New York Times in a 2007 story by Benedict Carey.

Zucker also has a history of controversy, as he was dismissed by the Toronto-based gender clinic that he ran for decades following allegations that he was practicing a type of “conversion therapy” rather than transgender medicine. Zucker ultimately won a defamation settlement of almost $600,000 against his former employer, but the hospital said it stood by its decision to close the gender clinic.

The Bailey and Diaz paper on ROGD was published on March 29. On May 10, a Publisher’s Note was added to the article, noting that concerns had been raised about its methodology and that an investigation was being conducted.

A spokesperson for Springer Nature said in an email to MedPage Today that the paper’s supplementary information “has been removed and a note added to record that this has been removed due to a lack of documented consent by study participants.”

“Beyond that, our investigation is still ongoing so it is not possible to provide further information at this time,” the spokesperson added.

One group has launched a counter-petition to support Zucker and the ROGD paper. FAIR in Medicine is part of FAIR (the Foundation Against Intolerance & Racism), which was created in 2021 and takes on a range of issues. Its stance on gender issues states that the group advocates for “age-appropriate instruction around sex, with biology and science as foundational before considering more controversial ideas around gender and gender identity.”

Littman is a signatory on the FAIR in Medicine petition, as is Jay Bhattacharya, MD, PhD, a Stanford-based physician and researcher who championed the controversial Great Barrington Declaration during COVID-19.

Signatories expressed support for Zucker, the paper, and an “unbiased editorial process” at the journal, and asked that Springer Nature take a “nuanced view of this situation.”

The letter argued that since Diaz was not affiliated with a university, she did not need to seek IRB approval for her survey. As for the study methodology, the group argued that parental reports are commonly used in gender research.

“While the paper by Diaz and Bailey — like all research — has limitations, it is vital to continue to study the ROGD hypothesis,” the letter stated. “Ongoing attempts to silence any research into the explosion of teens who are now identifying as transgender only stands to hurt the very patients the activists are claiming to help — young gender nonconforming people.”

Reubs Walsh, a PhD candidate and junior fellow/press officer at the Center for Applied Transgender Studies, one of the organizations that signed the open letter calling for Zucker’s removal, raised concerns in an email to MedPage Today that Zucker’s leadership at the journal appears to contribute to pathologizing and stigmatizing trans people.

“Articles published in the journal during Dr. Zucker’s editorship have repeatedly drawn criticism from the sections of the LGBTQ+ community about which the article claims to advance sexological knowledge,” Walsh said. “Now, the journal has ceased to uphold even the most basic ethical expectation of the scientific community — that research is only ever conducted on humans with suitable consent and ethical oversight — and has done so in order to publish a paper of astonishingly low scientific value authored by a friend and collaborator of the editor.”

“Science works because we trust each other and our scientific institutions, and Dr. Zucker has lost the trust of sexologists and psychologists and of the people whose lives are shaped by sexology and psychology,” Walsh added. “As a result, ASB [Archives of Sexual Behavior] is unable to function properly as part of the collective human effort toward scientific progress while he remains in post.”