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.

Rodolfo: I'm a victim of sexual abuse in the United States and there was a police report made and everything. And I've also been a victim of gang violence. I was never, you can check my background and everything. I was never into gangs or anything, but around the area I lived in there was a bunch of gangs and... I was beat up two or three times bad just by walking home. And it was all documented, I had police reports and everything. And because of that I was in therapy for while. My mother sought out a help from a psychiatrist because of the sexual abuse I had as a child in California, as a matter of fact.Rodolfo: I took Risperdal and a Ritalin, Risperdal for the anxiety and the Ritalin and for the ADHD. So, we tried everything. The mental health side, the mental health asylum, everything. But it was just going to take longer and longer and longer and I was tired of it. I didn't want to be locked up anymore. So, finally I just told my mom, “You know what man, that's it, I'm done. I don't want to do this anymore.” She asked me, “Is this what you want to do?” And I told her, “Yeah.”Rodolfo: She told me, “You know what? I'd much rather see you over there and be free then not being able to see you here at all.” Because there was a lot of people that went to go visit their loved ones and they used to get picked up. Sometimes they wouldn't even let you see your loved ones and right away ask you for your identification, your social security card, your nationality and everything and they would get picked up.Rodolfo: And I always told my mom, “Don't ever come visit me. Don't ever come visit me because if you do, chances are they're going to take you too.” And you know, that would always break my heart because I would want to see my mom. I'd want to see my dad and everything, but I wasn't able to. So, that experience was just horrible.Sergio: When you were in the detention center what were the conditions? Did you have access the medicine you needed? Did you have access to food and water?Rodolfo: The company that made the jail was called GEO Corp and they were actually, I'm not going to lie to you, they actually were pretty good, health-wise, not so much security-wise. A lot of things would happen in there that definitely shouldn't have ever happened. But with the food and everything, it was good. In my opinion it was because of the company. I feel as though if it was up to the government... Thank God it was an independent company that was hired by DHS as opposed to if DHS were to make their own jail, I feel they would be completely different.Rodolfo: It was [Pause] a pleasantly... there's no way to describe it, it was bad. It was bad, but for what it was I guess it was okay. I don't see there being an in-between or any pretty way to paint that picture as to how good or bad it was in there. Because at the end of the day you're deprived of your freedom. You can't just pick up the phone whenever you want and call your loved ones because you've got to pay for that too. You got pay for that. And if you want to take a shower, you have to buy your soap, right? You've got to buy it yourself, you've got to buy everything. And now you're becoming a liability for your family, you're becoming another bill.Rodolfo: You're becoming another bill and that's what I didn't want. So, that's why I started working. And now, older, I'm becoming another bill. So, I don't get it. You're taking us away from the jobs that we have and everything. You know? So, take us back to our country. And I'm not sure if it this is a fact or not, but I was reading when I first got in here, there was a time where there wasn't enough field workers for, I think, avocado—or, not avocado, I think it was oranges or something like that.Rodolfo: And I remember me saying, “Well, there goes all the deportees. There goes all the people you guys deported. Where are the people that were so outraged because we took your jobs? Go ahead, there you go. There are a lot of vacancies, making these open for those jobs, go ahead, man. All yours buddy, knock yourself out.”Rodolfo: But nobody wants to work those jobs, right? You see what I'm saying though, right?