The researchers did observe a change in their referral population in recent years, however. More kids assigned female at birth have been transitioning in recent years than those assigned male at birth. Many studies have captured this difference—including the 2018 survey proposing ROGD—but experts are unsure of its cause.

A recent analysis of 10 Canadian medical centers in the Journal of Pediatrics found that 98.3 percent of young people seeking gender-affirming care had realized more than a year prior that they may have been transgender.

Almost 40 percent of transgender youth experience homelessness or housing instability, according to a 2022 report from the Trevor Project, a nonprofit that provides crisis support for young LGBTQ+ people.

The participants in both the 2018 and the retracted 2023 studies were recruited from online communities that were explicitly critical about many aspects of gender-affirming care for transgender kids.

As legislation targeting trans people has reached an all-time high in the U.S., ROGD’s alleged social contagion has been invoked by lawmakers in states such as Missouri, Utah and Arkansas to justify banning or restricting gender-affirming care for young people.