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May 5, 2023 - The Charlie Kirk Show
35:07
The Transgender Truth with Dr. Ray Blanchard
Transcriber: nvidia/parakeet-tdt-0.6b-v2, sat-12l-sm, and large-v3-turbo
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Introducing Dr. Blanchard 00:02:01
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We are here to learn this hour from someone who has been thinking deeply and researching just really intently for decades the trans issue.
And it's a national obsession.
It's a national phenomenon.
I believe it's a social contagion.
And we're here to learn about this from a scientific view.
Dr. Ray Blanchard, Department of Psychiatry, University of Toronto, and also a retired sex researcher.
Dr. Blanchard, welcome to the program.
Nice being here.
Two Types of Transgenders 00:13:36
So, Dr. Blanchard, I have several questions, but I suppose one that I think you could help with as we begin here is that you seem to have you suggest that there are two different types of male to female transgenders.
Can you describe what those types are?
Yes.
The one type, the type that most people think of when they think about gender identity disorders, are you could think of them as extremely effeminate homosexual males who've kind of gone the additional step and have made moves to obtain surgical and hormonal procedures that would allow them to present as the opposite biological sex.
And that is what people think of when they think of transsexuals usually.
The homosexual type of transsexual who is either starts out as an extremely feminine male or an extremely masculine female, and they just go the additional logical step, you might say.
And that kind of makes sense to most people.
The other type, however, which I think accounts for the majority of biological males who are now presenting as women are not homosexual at all.
They start out as boys who are not observably effeminate.
And they usually start out with either cross-dressing in their mother's clothes or sister's clothes or some clothing that they borrow or steal from somewhere, which is accompanied by sexual excitement and masturbation.
I'll tell you what I call these types later, what I call the second type later, but I want to point out this is not just my brainstorm.
Clinicians have been describing these different types of male to female transsexual, well, since the beginning of the 20th century, so over 100 years now.
And I sort of basically gathered up all the previous clinical observations, systematized them, and gave a label to the relevant phenomenon.
What I call this second type of transsexual is their autogynophiles.
I know that word is unfamiliar to people.
It's not hard.
Autogynophile is the person.
Autogynophilia is the condition.
And this is the erotic, this is the refers to men who become sexually aroused at the thought or image of themselves as women.
And that's the second type of transsexual.
Does that also work for women that want to become men, or is that a separate issue?
There certainly are people who want to claim that there is a counterpart in women of autogynophilic male transsexuals.
I personally don't believe it.
But, you know, I'm open to being proven wrong.
I have no aspiration to control this line of research forever until the day I die and have final say on what people can or cannot conclude.
But I personally think that the autogynophilic type of transsexualism doesn't really have an exact counterpart in biological females.
So just curious about this, and I don't know the answer.
You're using the term transsexual, not transgender.
I'm assuming that's intentional.
Can you just tell me, is there a difference or is it just kind of a more of a technical point that isn't that big of a difference?
Well, nowadays, the definition of words changes like once a week.
So who knows what the woke community approve as a terminology for transgender is transsexuals.
Now, I use the word transsexual because I'm old and because nobody can stop me.
And I think we could talk about a spectrum of gender dysphoria.
There is a genuine spectrum of people who have occasional desires to be the opposite sex up to men who are troubled by this periodically until you get to the most extreme form of autogynophilia where people are just obsessing about wanting to be the opposite sex all the time.
So for me, transsexualism is the most extreme degree of gender dysphoria.
So let's define the terms, gender dysphoria.
I got picketed and protested this last semester, doctor, because I said gender dysphoria.
I'm not allowed to say that.
Some people got very angry about that.
How would you define gender dysphoria?
And is it anything new?
I would define it as, of course, this applies to both males and females, the desire to present as the opposite sex, the desire to be regarded by other people as the opposite sex and to be treated by other people as the opposite sex.
And finally, the desire to have some or all of the anatomic features of the opposite sex.
That's gender dysphoria.
And is it, have you has some people think this is a new phenomenon?
However, my understanding is that there's been decades of research on gender dysphoria before this became a national obsession.
Is that correct?
Oh, it's certainly not a new phenomenon.
One of the most important sex researchers of all time, Magnus Hirschfeld, wrote about it in 1910.
I think Klaf Debing had also mentioned a few cases that were obviously in this ballpark earlier than 1910.
One of the first entire books about a post-operative transsexual was published around 1933.
That was the book that the movie, what was it called, The Danish Girl, was based on.
So people have known about this stuff for a long time.
So the amount of young people that are, let's just say, identifying as trans or could be diagnosed with gender dysphoria is increasing.
Do you think that there is a social component to this?
Or I'm asking, is there a way where people that might have a pre a predisposition towards gender dysphoria can be prompted towards that line of thinking?
Or is this a random occurrence?
Or is this just how people naturally are?
Okay.
What I've been talking about up to this point are what we might call the classical syndromes of gender dysphoria slash transsexualism.
That is the homosexual type, which applies to both biological males and biological females, and the autocytophilic type, which applies only to biological males.
The phenomenon you're bringing up, which has been called rapid onset gender dysphoria, and is predominant among teenagers, this is a new thing.
This is a genuinely new thing.
And what I haven't, I've never worked with or done research on this phenomenon of these rapid onset gender dysphoria kids, but I certainly know people who have, such as Lisa Lippman.
And my impression is that these kids are a mixed bag of some who would, who probably are the same type as the classical syndromes of gender dysphoria, plus a bunch of other kids who are a mixture of personality disorders and kids having adjustment disorders to adolescence, a lot of attention seeking,
just a kind of mixed bag of personality disorders and adjustment problems.
This is fascinating.
Rapid onset gender dysphoria.
The community that attacks me, the trans activist community says it's how people naturally are.
You're not allowed to ask that question.
I would beg, I would just challenge it and say there's probably some social elements to this that are nudging people or encouraging people towards identifying towards that.
That's a question.
If there's research to back it up, I'd be curious to have that.
But it certainly seems as if the amount of, just, for example, in America, clinics that offer gender affirming care or what we would call, you know, medical intervention for 12 or 13, 14 year olds, there's hundreds, hundreds of these clinics, and only a couple existed 20 years ago.
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So, doctor, let me put forward a situation that is happening quite a lot.
And I would like your expertise on how you think it should be handled.
Let's say a 14-year-old starts to tell their parents that they're really a girl or they're really a boy.
How should generally, with obvious understanding that there could be elements that need to be discovered in the process of treatment, but generally, how should that be handled?
With hormone blockers, puberty blockers, or is there another proven way to be able to treat 14, 15, and 16-year-olds that might be wrestling with or struggling with gender dysphoria?
Okay, what you've posed are actually two different questions.
What I would do with regard to, let's say, 13 or 14, I think the first line of attack, clinically speaking, is to help a child or adolescent accept their anatomic sex and make a satisfactory adjustment to the body that they were born with.
Only if that is a total failure, should anything else along the lines of transition be considered?
That's my viewpoint.
Not that sex reassignment should be prohibited in all cases.
I think it should be allowed for adults for whom every other form of treatment has proven unusable, useless, ineffective.
But for kids, I think the first line of treatment should be try and adjust to the sex that you are.
And the great majority of them who have cross-gender behavior from early childhood will end up as gay men or lesbian women.
And I think that that outcome can be helped to be an ordinary gay man or lesbian woman as opposed to somebody who is dependent on medicine their whole life.
I think it can be helped by appropriate treatment.
So that's my personal view.
Now, is there rigorous research supporting that?
No, there's no point in my lying.
Everybody else is.
So I'll tell you the truth.
No, I don't think that there is high-quality medical research to show that there are treatments that can be applied that will correct gender identity confusion in children or adolescents and automatically put them on a different path.
I'd like to believe that that's how it works, but I think I'd be lying if I said, oh, yeah, we have all these great studies.
Does the would the people that argue in favor of surgery and hormone blockers for 12, 13, 14 year olds?
Do they have robust research peer-reviewed that supports their position?
Well, peer-reviewed and robust are two different things.
I mean, you can get peer reviewers who are sympathetic to the point that the submitting author wants to make and it'll sail by just fine.
No, there isn't high-quality research.
It's very, very difficult to do high-quality research in this area because, you know, if you don't give the patients what they want or what their parents want, they'll just go someplace else.
That's how it is.
You know, you're not in a situation where you can say, okay, tough for you, but you're going into the control group and this next patient who comes along is going to get early hormones.
You can't do it because they'll just go someplace else.
And so your earlier opinion is basically very heterodox against this idea of gender affirming care.
Do you think that should be the standard operating procedure, if you will, to affirm one's identity?
You've said it, you answered the question earlier, but let me ask it differently.
How is it then without research backing it that that is now the predominant way of treating 14, 15, and 16 year olds with gender dysphoria?
Magnesium Breakthrough Offer 00:02:56
How did that happen?
There are fashions in medicine and fashions in psychiatry as there are fashions in other areas of life.
I mean, people are idealizing medicine if they think that everything that doctors do is based on some firm foundation of clinical research.
Psychiatrists have gone off the deep end before with trendy ideas, like back in the day when, oh, what was it?
Satanic ritual child abuse was all a thing.
You know, this was maybe in the 80s.
I forget the exact dates now, but for a while, you know, satanic ritual child abuse was everywhere.
And there were a number of psychiatrists who bought into this.
You know, just because a bunch of psychiatrists are presently endorsing a particular treatment doesn't really mean that that's the best possible treatment.
Another example would be prefrontal lobotomies, for which the originator, I think, got a Nobel Prize.
Nobody would do it now.
People think of it as horrible and barbaric now.
So, you know, saying, oh, there's medical consensus.
Well, that doesn't really mean all that much necessarily.
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I'm learning a lot, and he is the leader in this field of research.
In fact, that term mentioned earlier, say it three times fast, autogenophilia was, I believe, coined by you.
Is that right, Dr. Blanchard?
Activists Misunderstand Science 00:15:42
You came up with that term.
Is that right?
That's correct.
Autogynophilia.
I'm sorry.
As in gynecology, you know, gynecology.
I'm far from autogynophilia.
I'm far from an academic.
I do ask good questions, but I'm far from an academic.
So let me ask, what would happen if someone diagnosed with that went untreated?
How would that end up?
What would the result of that be?
That's a very good question, because obviously in previous times, a lot of people did go untreated because they saw no options.
I think that probably they just suffered through their lives.
I mean, people, a lot of people have mental disorders that give them significant distress and probably damage their quality of life, damage it beyond what any of us would want to accept for ourselves or our families.
But they don't see an alternative.
So they hang in there and they get to the end of their lives.
However, Sometimes they might, you know, like engage in surreptitious cross-dressing or other surreptitious activities as a kind of as a kind of release.
But I think that they just got through as best they could.
Once it became apparent that, or I shouldn't say once it became apparent, once the culture changed in such a way that it became thinkable for a grown man to leave his wife and children and pursue life as a female, then more of them began thinking about it as a possible alternative for themselves.
And so you started this field, I think, in the 80s or 90s.
Is that correct?
You started to introduce this term.
Is that about right?
I started working in a gender clinic in 1980, and I think I published the word autogonophilia in 1989.
And so at one point, you were part of WPATH, which used to be called something else.
I mentioned this for a reason.
Has the way you've been treated, has it changed in recent years?
Because you've been in this field for quite a long time.
You thought deeply about this.
You have some incredible research.
But I would imagine I'm speculating you are now the recipient of increased hostility.
Is that a fair speculation?
Oh, yeah.
I mean, I have been under, I've been constantly vilified online since 2003 when Mike, a professor at Northwestern named Michael Bailey published a book called The Man Who Would Be Queen, and he based a lot of the book on my work.
He was viciously attacked by trans activists who tried everything to get him fired from his job at Northwestern.
Nothing that bad happened to me, but since that, since the publication of that book, that was when my work got exposed in a major way to trans activists, and they weren't liking it at all.
So as I said, I've been vilified constantly for the past 10 years.
Just to kind of inform our audience, what do they attack you most on?
What are the lines of attack?
I mean, because you just seem so rational and reasonable.
I mean, you're not saying anything radical here.
You're not an activist.
You're a researcher.
What is the nature of the attacks you receive?
Okay.
Yeah, I'm going to answer that question, but I want to back up like three feet and say, what am I not being attacked for?
I never had a blanket opposition to people undergoing hormonal or surgical sex reassignment.
My position 30 years ago and my position now is that surgical and hormonal sex reassignment are the best treatment we have now for carefully selected adult patients for whom all other forms of treatment have been ineffective and who continue to be wretched.
So I'm not being attacked because I opposed gender transition.
I'm being attacked because of what I had to say about the nature of gender dysphoria.
Activists resented two related points that I made and which I believe are absolutely true.
One is that there is more than one type of transsexualism.
Now, this is not an original thought with me.
When I came to the field in 1980, there was a confusing plethora of different classification schemes for gender identity disorders.
What my work consisted of was deciding which of these are basically different syndromes and which are superficial variants of one of the two basic syndromes.
And that's where I got to the idea of in males, the homosexual type and the autogynophilic type.
The trans activists hate, absolutely hate that I made a distinction between different types of transsexual males.
I think, I mean, I'm trying to now get into their heads.
I suspect that among the autogynophiles, there's a lot of envy of the homosexual type because they're more effortlessly feminine and they often pass better.
So I think that's one possible reason why they don't like the distinction being made between homosexual male to females and autogynophilic male to females.
So they hated my typology just because it was a typology.
Related to that is the fact that I said, okay, gender identity disorder is not a sexual preference per se.
Gender identity disorder is not a paraphilia.
It's not a sexual deviation, but it's related to sexual deviations.
Wherever there's a serious gender identity disorder, it's either preceded or accompanied by a sexual deviation, a paraphilia.
So that the one group, the erotic anomaly, let's call it, is homosexuality.
And for the other group, the erotic anomaly is autogynophilia.
And they hated that because they wanted to think of gender identity as something that descends from the heavens, like the grace of God, and not as something that grows out of an erotic preference.
So that's the other reason that they despise me because I said, no, gender dysphoria, transsexualism is not a sexual perversion, but it is a complication or something that develops out of an anomalous erotic preference.
If I were, I would guess the reason why they find that objectionable, and you could correct me, is because then you're implying that treatment, not affirmation, actually is the first line to address it.
Because the trans activists that I've dealt with, they never want, they want complete and total mandatory acceptance and affirmation of their own perception, right?
Where the way that you're articulating it, it could be interpreted by them as saying, well, are you trying to tell me that you're going to want to talk to me about being anatomically consistent with my biological reality?
Is that why they find that so objectionable?
Because it seems like such a technical point, but when you think deeply about it, it's actually a big, big threat.
They could call it conversion therapy or something of the sort.
Am I correct in that regard?
Well, there's multiple factors here.
So it's possible to be correct, but incomplete.
I think that the autogon, first place, the people bitching about autocynophilia are not the homosexual male to females, but the autogynophilic male to females.
And I think there's two reasons why this bothers them.
One is that, you know, it's important to their mental economy to think of themselves as being in some sense really women.
And so they don't want anything said about themselves, which challenges their view of themselves as being in some essential mystical way really women.
You have to remember these guys, some of them, have done some pretty drastic things in pursuit of this idea.
Divorce wives whom they might have still actually loved, risked alienating children, who in many cases do become permanently alienated.
So there's a lot of investment in this idea.
I'm really just like any normal woman.
And normal women don't usually talk about being sexually excited at the mere thought of being a woman.
So then they don't like autogautophilia, number one, because it's inconsistent with their self-concept.
Number two, and I think this is kind of realistic.
You can sell the public on the Cinderella story of transsexualism.
You had this poor, wretched little kid who everybody was mean and blah, blah, blah, blah.
And then they grew up like the ugly duckling or Cinderella and they got to express their true selves.
And all of a sudden, everything was wonderful because they got to be true to themselves.
This is easy to sell to the general public.
It doesn't have any nasty sex in it.
And it's a simple story.
If it weren't a simple story, it wouldn't have been a popular story with children for 200 years.
If you get into autogautophilia and you're not prejudiced against autogautophilic transsexuals, and I'm not, you know, but it's a much more complicated explanation.
You have to explain, well, we have here this phenomenon which starts out looking very much like a paraphilia and is always accompanied by sexual excitement, but somehow over time, it changes its nature and it becomes more like an obsession that is present in the patient, even when the patient isn't sexually excited.
That's hard to explain.
And even I can barely understand it.
So, you know, it's a less desirable way to sell transsexualism to the public than the Cinderella story of now that I'm true to my real self, everything's great.
That's perfectly said because that is the talking point, is that it's true to my real self.
And you're also introducing a variable that, well, you actually, it might not be as much an identity issue as it is, you actually are getting off on potentially sexually the idea of you cross-dressing or wearing female clothing or whatever.
There's so many questions I hear, Doctor.
And do you think some of these people that are suffering from gender dysphoria from your experience, are they sometimes suffering under other mental issues, depression, anxiety, schizophrenia, bipolar disorder?
Or is that those things don't always come in combination together?
Well, I think that, you know, what psychiatrists would call comorbidity, which means the presence of two or more psychiatric conditions at the same time, that applies to all sorts of psychiatric conditions.
Anybody can have more than one psychiatric condition at the same time.
Whether transsexuals have higher rates of other mental disorders, probably that's true among the ROGD adolescents.
And we probably have more data on that than on other classes of patients.
I want to play a piece of tape here from the Boston Children's Hospital and get your reaction, Dr. Blanchard.
Play cut 102, please.
So most of the patients that we have in the GEMS clinic actually know their gender, usually around the age of puberty, but a good portion of children do know as early as seemingly from the womb.
And they will usually express their gender identity as very young children.
Some, as soon as they can talk, they might say phrases such as I'm a girl or I'm a boy or I'm going to be a woman or I'm going to be a mom.
Kids know very, very early.
So in the GEMS clinic, we see a variety of young children all the way down to ages two and three and usually up to the ages of nine.
So doctor, they're arguing that a two or three year old could even potentially have question, you know, be questioning their gender.
Is there any research to support this?
I would say no.
Now, I think I want to make it clear to you that child and adolescent gender disorders are not my specialty.
At the hospital where I worked, there actually were two separate independent gender identity clinics, one for children and adolescents and one for adults.
And they really didn't overlap that much in function.
I worked only with adults.
And so I'm always reluctant to comment in detail on gender identity disorders in children and how they should be treated.
But I will say one thing because it's a general point and it applies perfectly to this business of early transition and early medical procedures for children and adolescents.
Whenever you make a clinical decision, you can make a mistake.
You can make an error.
This is just how life is.
You can make a mistake and not give treatment to a patient who would have benefited from it, or you can give a treatment to a patient who is harmed by the treatment and would have done better without the treatment.
Now, these two kinds of errors are not symmetrical in their negative consequences in terms of children.
If you're confronted with a, let's say, I don't know, 12-year-old and you decide that you're going to argue against them transitioning.
It could be that in reality, to some omniscient observer, to some God of the universe who knows everything, if that patient had been given help in transitioning, they would have done well and everything would have been fine.
So there is that kind of error, but that kind of error can be corrected.
If the patient doesn't transition at 12, well, they can transition at 16 or 18 or 21.
That kind of error can be corrected.
Now let's consider the other kind of error.
You have a 12-year-old whom you put on puberty blockers or for whom you recommend mastectomy or some other surgery at the earliest opportunity.
And there are places that kids can get this quite young.
And it turns out that that was an error in the opposite direction.
This kid would have done better without surgery.
That error cannot be fixed.
It's irreversible.
So irreversible.
So the two kinds of errors, the false positive and the false negative, are not equal with regard to the potential for disastrous consequences.
That's why to me, you don't even have to know anything about gender dysphoric children specifically to be able to say, hmm, what are the kinds of clinical errors we can make here?
And what are the consequences of the two different kinds of clinical errors?
And I think anybody with their head screwed on would say, well, let's make the kind of error that can be corrected later and not the kind of error that is permanent and unfixable.
Irreversible Clinical Errors 00:00:50
I mean, that's just so logical.
And it's just cruel if you're wrong.
I mean, if there's even a small percentage chance that you're wrong, you're doing irreversible damage.
And I mean, I've met these people, doctor, of people that were 12, 13, 14 that were administered these drugs, and now they are 25, 26, 27, and they say, I don't feel the way I did when I was younger.
I've had a change of mind.
And I wish I had breasts.
And I wish I didn't have all these issues with me.
And there's no going back.
It's a very logical response.
We're out of time.
Dr. Blanchard, thank you so much for being generous with your time.
I learned a lot.
Thank you.
Thank you for having me.
Thanks so much for listening, everybody.
Email us your thoughts as always, freedom at charliekirk.com.
Thanks so much for listening and God bless.
For more on many of these stories and news you can trust, go to CharlieKirk.com.
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