Many transgender activists argue gender dysphoria is innate, even biological, as justification for the medical transition of children, but the sharp rise in adolescent girls identifying as transgender has garnered the interest of researchers who argue they could be experiencing "rapid onset gender dysphoria."

Manhattan Institute fellow, Leor Sapir, along with researchers Lisa Littman and Michael Biggs, published a letter to the editor in the academic journal, Archives of Sexual Behavior, last year criticizing research conducted by University of California adolescent psychiatrist Jack Turban. 

Turban published a study in March 2023 based on the data from a 2015 survey called the U.S. Transgender Survey, in which he claims to find evidence against "rapid-onset gender dysphoria" (ROGD), or the idea that adolescents with no history before puberty of gender distress experience gender confusion. 

Turban and his team argued that what appears to parents to be a sudden onset of gender dysphoria or trans identity is really just a late disclosure of a previously formed trans identity and internalized gender issues, which in turn, they believe, disproves the existence of ROGD.  

"The main argument made against ROGD is that when parents say, 'My kid just suddenly came out as trans at age 14, it was out of the blue… activists claim, 'No, no, the kid always knew she was trans, but she just kept it a secret from her parents for many years and just disclosed it when she was 14,'" Sapir told Fox News Digital. 

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"This ties into the other claims about transgender identity being innate, possibly even biological… which in turn justifies the whole medical approach to treating gender-related distress in kids," he added. 

Sapir and his fellow researchers looked at the data Turban analyzed to come up with their hypothesis and believe the study can be refuted, alleging the data actually shows that what he claims – that transgender identity is innate and possibly even biological – is not in fact true. 

Physician and researcher, Lisa Littman, who partnered with Sapir on the letter to the editor addressing Turban's work, issued three hypotheses about ROGD in 2018. 

First, she argued that adolescents and young adults with no childhood history of gender issues developing gender dysphoria or a trans identity was a relatively new phenomenon. Second, she said many trans-identifying teenagers or young adults had gender issues arise in the context of conditions like autism or ongoing mental health issues and use their trans identity as a coping mechanism to make sense of their psychological distress. Third, she argued that gender dysphoria is oftentimes a result of peer pressure or social contagion. 

"I think it's important to understand why the transgender movement is so adamant in rejecting RODG and the reason is that, at least in the United States, there's a lot of importance that activists attach to the idea that being transgender is innate and mutable," Sapir said. "It's something that comes from within you that you have no control over. People are born that way, so to speak, and as you can probably tell, this narrative is essential as a justification for medical transition, especially of minors."

"So, any suggestion that trans identity can be caused by anything other than this kind of immutable essence that we have within us … must be rejected out of hand because it suggests that trans identity is not authentic, but it's a mental shortcut for dealing with other issues," he added. 

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Sapir said that based on research and data from gender clinics in the U.S. and abroad, the clinical presentation of patients with symptoms associated with ROGD often occurs in adolescent females with high rates of mental health problems. 

"That demographic only started to appear on the radar of adolescent medicine and mental health clinics in the late 2000s, and it really picked up in the mid 2010s among teens," he said. "This was a survey of adults conducted in 2015, so the first thing that stuck out to me was this survey is too outdated, how could you possibly use a survey from 2015 of adults to figure out a phenomenon that was just starting to take root among teenagers during those years."

In addition, Sapir explained that in order to participate in the survey, respondents had to currently be "transgender-identified," so anyone who identified as transgender as a teenager, but had desisted by 18 years old was automatically excluded. 

"Even though it's not necessarily inherent to ROGD to desist or detransition, people who identify as transgender out of social pressure … it's certainly conceivable that by the time they reached maturity, they'll no longer do so," he said. 

"People who were in their 40s or 50s in 2015 weren't teenagers when social media came out, when the transgender movement was starting to reach national prominence," he added. 

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While Sapir believes Turban's work is not a good source of accurate information regarding transgender adolescents, he said newspapers and journalists are "constantly amplifying" his opinions, citing him as an expert in their work. He also said activists have ideologically captured many medical journals on the transgender debate. 

"Most of them have been given over to capture by ideologues," he said. "For somebody who doesn't see this up close, who doesn't work in this space and follow this debate and read the literature … that sounds very conspiratorial to say activists have captured all these institutions, but it's true," he said. "If you look at what kind of research gets published, what gets rejected, how broken the peer review process is, the type of mistakes that they allow to get through that process is just astonishing."

He argued that the research is now driven by a narrative that scholars aim to prove and promote. 

"We sent an abridged version of it to the journal that published Turban's paper, the Journal of Adolescent Health, and they just rejected it out of hand," he said. "When our letter came out and I put it on X, I tagged the Journal of Adolescent Health, and they blocked me immediately. It's as if they have moody teenagers running their social media accounts. Just unbelievable."

Tor D. Berg, the managing editor of the Journal of Adolescent Health (JAH), told Fox News Digital that the paper does not comment on rejections or letters to the editor of other journals, but added that "JAH doesn’t use Twitter anymore, so I’m not sure what Leor Sapir is talking about there." 

However, Sapir shared a screenshot from his account that showed he was blocked by the JAH's X account. 

Turban didn't respond to a request for comment.