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Jan. 22, 2024 - Epoch Times
01:17:41
[Free Episode] Stephanie Winn: The ‘Trans Industry’ is Creating a Sterilized Generation
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We're sterilizing a generation who will not be able to have their own kids.
And we're altering their sexual functioning in a way that's going to make it more difficult for them to have loving relationships.
Stephanie Nguyen is a licensed marriage and family therapist who is currently treating detransitioners and parents with children questioning their gender.
Puberty blockers are not FDA approved for the treatment of a mental health condition.
They're being prescribed off-label for very young children.
And we know for a fact that puberty blockers damage, among other things, brain development, also bone development.
Wynn stars in Affirmation Generation, a new documentary that critically explores the gender-affirming care model, society turning a blind eye to detransitioners, and the for-profit trans industry.
This is American Thought Leaders, and I'm Jan Jekielek.
Stephanie Wynn, such a pleasure to have you on American Thought Leaders.
Thanks for having me.
It's great to be here.
Stephanie, congratulations on this amazing, amazing film, and we're going to talk about that today.
Before we go there, you're a psychotherapist yourself, of course, and you say something in the film that I thought would be a perfect launch point for us.
You say, clinicians, we've been sold a bill of lies.
What are the lies?
Well, for one, we've been lied to that so-called gender-affirming care is an actual model of psychotherapy, like other models, right?
We have many models of psychotherapy, DVT, ACT, CBD, EMDR. These are just...
Some acronyms, but models of psychotherapy generally include ways of conceptualizing and formulating our clients' distress and understanding their presenting problems, and then ways of proceeding with helping treat their distress.
Gender-affirming care is We're actually antithetical to the therapeutic process, which always necessarily includes really getting to know our clients and exploring their life circumstances.
We do, you know, I mentioned this in the film as well, we do a biopsychosocial assessment.
What's happening for them physiologically, environmentally, socially, internally, and in terms of their phases of life.
So normally we have to have room to explore all of these things in order to do our jobs well, but with this so-called gender-affirming model, what we're told to do is not to ask questions, just to affirm, just to agree.
It's a reduction of our role from Curious explorer who uses mirroring and reflection as just one of many tools to somebody who's just relegated to the role of only mirroring and reflecting without probing, questioning, or discernment.
I think when I say that we've been lied to, I think I'm talking about how our generally agreeable and conscientious natures have been exploited by being asked to do something that is actually antithetical to the goals of our profession.
Because therapy is mental health, and mental health is part of health care, part of helping the individual be well.
What is it to be healthy?
Well, it's to have a sense of vitality, capability, being able to do things, being able to have healthy relationships, being able to be physically active and pursue meaningful work.
These are some kind of foundational cornerstones of health, along with, of course, eating well and sleeping well and things like that.
And what therapists are doing who are practicing so-called gender-affirming care, in other words, just agreeing with their clients on this question of gender, is not actually in the service of health.
Because affirmation, social affirmation, is the first step in a process that leads to hormones and surgeries that are experimental and that are very costly to our physical health.
This is one reason that I'm passionate about this issue because, and I'm sure we're going to talk about this more, right, but the threat of suicide is often used to push concerned citizens, especially parents, Into so-called affirmation.
But we know that in the long term, things that increase suicide risk include not having the health and vitality to be physically active, to feel good in your body, to have meaningful relationships.
And I'm sure we'll talk about All of that more.
But basically, we're undermining people's long-term health and well-being.
And when we practice gender-affirming care, we're essentially agreeing with the lie that these vulnerable young people who are in a moment of great distress really, truly have no other ways of coping than to make life-altering decisions with a lot of negative ramifications for their health.
And that's not true.
That's how we've been lied to.
And in the process, We've been lied to about our own capabilities as therapists to support our clients' resilience, and our duty to challenge them when their thought process is not completely sound.
In the film, it's mentioned that lobotomies were one of these Physical interventions, physiological interventions, a very rare situation to try to deal with a mental condition.
And there was this sort of analogy drawn that this gender-affirming care model that leads to these very profound physiological interventions was comparable.
So tell me about that.
Well, it's pretty wild, isn't it, that this is part of our history as Americans, the lobotomy craze of the 1940s.
I mean, that's part of its peak, but it was actually longer than that.
If you think about lobotomies from today's standpoint, it's like, how could we have ever done that?
How could we have ever thought that you should mess with people's brains?
Putting an ice pick through their noses to fix something psychological and yet That that does bear resemblance to what's happening today because it was always experimental It was always nothing but experimental and yet it was being Proposed like it was a legitimate form of treatment and it damaged people Permanently,
you know one parallel I see is that Puberty blockers are not FDA approved for the treatment of a mental health condition.
They're being prescribed off-label for very young children.
And we know for a fact that puberty blockers damage, among other things, brain development.
Also, bone development.
Also, every system of the body.
This is a so-called treatment that is interfering with a young person's development in a profound way.
It's not FDA approved, and yet it's being prescribed outside of clinical trials.
And we're not even tracking what's happening to these kids.
Hello, everyone!
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The magazine is filled with incredible stories of iconic Americans, breathtaking American landscapes and historic architecture, and a celebration of American innovation and enterprise.
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You can check it out at AmericanEssence.com.
So I want to discuss some of the potential harms associated with these interventions, for sure.
They're basically typically billed as not being particularly harmful.
You sent me this report about puberty blockers, which I found frankly shocking.
Before we go there, though, there's this sort of question that's just sort of hanging in the air.
And, you know, these are, in many cases, children or teens who are just discovering themselves.
And they're making these, sometimes prepubescent, right?
And making these profound life decisions that will affect them permanently without Being able to grasp remotely the consequences, you know?
Do you want to have children one day?
I don't know.
There's a million questions I could add to that.
So, how is this even being considered?
Well, that's a great question.
And in our documentary, Lisa Marciano makes that comment, right?
She says that it strikes her as extremely naive of any responsible adults to go along with this child's understanding of who they are and what they're going to want in the future.
I think anyone watching this can think of someone you know who swore up and down they did not want children when they were in their teens or 20s and then a switch flipped at some point, maybe at even 35, where suddenly they wanted children desperately and now they're so grateful that they have them, right?
And if there are healthy people who How are we assuming that young,
vulnerable, mentally unwell, impulsive Angsty teenagers and prepubescent teens could possibly know what they're going to want in the future.
I don't understand how so many people are going along with this and how we're assuming that the better life outcome Is to live in accordance with this magical gender identity and that we know kids are going to be happy with that rather than leaving open the possibility of having a family.
Almost ubiquitously, the gender dysphoria is associated with some other issues, right?
And often those issues just get swept off to the side.
And there's a term that I forget that's mentioned in the film, actually, that describes that.
So I think the term you're looking for is diagnostic overshadowing, right?
It's this idea that when you have various comorbidities, Or potential comorbidities that maybe haven't even been diagnosed or ruled out properly, that the gender dysphoria sort of trumps all of them.
It overshadows all of them.
And there's a dangerous and unfounded presupposition in this gender-affirming model that if you just treat the gender dysphoria by permanently changing the young person's body, all the other issues will go away.
What I see is actually the opposite.
What I see is that youth who have been exposed to this culture and these narratives around gender identity, that culture, much of it online, gives them a language, a framework, a way of thinking about their psychological distress.
And so you'll hear these youth refer to things as my dysphoria, quote-unquote.
And when they say my dysphoria, they could actually be talking about anything.
They could be talking about what, you know, we might be able to actually attribute to PMS or social anxiety or ADHD. And we know there, you know, about 48%, I believe, of the children referred to the Tavistock Gender Identity Clinic, which has now been ordered to shut down, by the way, were autistic.
So there's any number of things it could be referring to, but the language that they have for it is the term dysphoria.
And it's always my dysphoria this, my dysphoria that.
And something I've learned from working with the parents of these youth is that almost any upsetting life situation can serve as a trigger to For a bout of so-called dysphoria.
It could be that they got a bad grade on a test, or their girlfriend dumped them, or they found out that their friends were hanging out behind their back without them.
It could have nothing to do with gender or even sex.
And yet, the language that they have for it is dysphoria, and then they go down kind of this sometimes obsessive-compulsive route where that leads to thinking, now I've got to cut my tits off, right?
It's part of my language, but there's this urgency of, I have this distress, I don't know what to do about it, so I'm going to interpret that it's about my gender because that gives me something to control, that gives me something to plan for, And to look forward to.
And so I'm going to take that next step, whatever that, you know, that next step is, depending on where the child is in their so-called gender journey or the young vulnerable person, maybe not child.
But it's always, well, here's something I can do about it.
I can pursue that next step in passing or in being affirmed or in medicalizing my transition and And that'll alleviate my distress.
These kids and young people aren't being given a proper emotional vocabulary, a way of conceptualizing normal or abnormal psychological difficulties.
So what would you do in this sort of situation where maybe something like this happened?
A child or a young person comes and says, I think I'm a different gender than my birth gender.
Well, so a therapist who ascribes to this belief system basically just has to agree with that and maybe even praise it, let's be honest.
I mean, the attitude that you're kind of taught to have toward these young, vulnerable, confused people is I'm so glad that you told me.
Thank you for trusting me with this wonderful news about your gender identity.
You know, I mean, I'm exaggerating a little bit, but it's that you're supposed to be so warm and welcoming and praise this magical truth that they've just come out with.
Then you ask about who else knows about this and how do you want me to talk about you when your parents are around, which then comes down to the issue of how we're triangulating parents and children.
And just focusing on now that you've discovered this wonderful thing about yourself and found the courage to tell me and trust me with this important fact, How can I support you in your gender journey?
Do you need help coming out to your parents or educating them?
Do you need help socially transitioning at school?
That's sort of the next step that therapists are expected to do in that approach.
I mean, a number of the young people in the film mentioned that first visit or second visit they were already being prescribed drugs of some sort, which is kind of very difficult to fathom.
Right, and the role of the therapist here is interesting because If you look at how mental health clinicians intersect with the medical system, so a therapist like myself, so I'm an LMFT, Licensed Marriage and Family Therapist.
I'm a master's level clinician, which means I have a master's degree in counseling psychology, and then I have Internship hours that I accrued under supervision after that to gain licensure and I passed an exam.
There are other master's level clinicians like LPC, for example, Licensed Professional Counselor.
That's another type of master's level clinician.
So if you look at clinicians who are at the master's level rather than doctors, and you know, when it comes to doctors, you have clinical psychologists, but then you also have psychiatrists who can prescribe.
When you look at master's level clinicians, We have to stay within our bounds with regard to medical advice, right?
So we learn, for example, how to recognize signs that a person might need to work with a doctor on certain issues.
So, for example, there are certain nutrient deficiencies that can cause depression and anxiety.
As a therapist, I can't say, oh, I think you must have low vitamin D levels.
But I could, within my scope of practice, say, You know, we're living here in the Pacific Northwest and it's the winter and many people are low in vitamin D. You're presenting with signs of fatigue, loss of interest, loss of pleasure.
When was the last time you saw your doctor and had some routine labs run?
Maybe there could be vitamin D or another deficiency.
We just want to make sure we're ruling that out, right?
Another thing that I could say within my scope of practice would be, That if someone is presenting for depression but there's a sign that they have maybe sleep apnea, well we know that untreated sleep apnea can make all kinds of mental health conditions worse because your brain's not replenishing at night.
So I would suggest that they work with their doctor on treatment.
So normally we stay within our limits and if a client comes to us saying I want to take medication, For depression or anxiety or ADHD. Well, we can help them process their thoughts and feelings on the pros and cons about that.
We can provide a certain amount of psychoeducation, but mostly we refer out to other professionals.
Now, contrast this with the role of the therapists in the medical system with this gender-affirming care.
Therapists who are practicing this write letters recommending surgery.
And now, under the so-called informed consent model, a therapist's letter is not even required.
I think the letters are pretty useless anyway because anyone who's writing those letters has already been indoctrinated.
So I don't think that There's a proper process of assessing and ruling out who is and isn't a fit for any of these interventions.
But we've been asked to go outside of our limits and recommend that people take these medical steps.
It's confusing.
It's a boundary violation.
You know, the assumption is that the mental state is the correct state and the body is what's wrong.
I've seen this slogan, nobody is born in the wrong body.
I guess that's a response to that.
It would seem to suggest that dendro dysphoria isn't actually a condition.
And can you help me untangle this?
Right, right.
So there's kind of two questions there, the second one being whether gender dysphoria is a diagnosable mental health condition.
But the way you put this initially, I think, is really important to explore, right?
The idea that it's the body that's wrong and the mind is fine.
That seems like An interesting way of defending against shame.
If you look at the fact that so many of the vulnerable young people who are presenting with gender dysphoria are autistic.
Many of them have trauma histories.
They've been bullied.
They've been abandoned.
We know these kids are over-represented in foster care and adoption, right?
So oftentimes there's deep attachment wounds, deep issues with having a loving, stable connection with one's family.
So the natural response to that is shame and inadequacy.
And that shame can be so painful and so overwhelming, it really takes a lot of maturity to learn how to Integrate our shame and tolerate it.
So this idea that there's nothing wrong with me, my identity, my mind, my psyche, it's my body that's wrong, that's why I'm different, it's a really convenient explanation for defending against the shame of, you know, for these kids especially, for example, the ones who've been bullied because they're autistic.
Autistic kids are socially awkward.
They're often bullied.
And they don't understand how to process that.
They don't know why they've been mocked and made fun of, but they sure feel badly about themselves.
So there's already enough shame there.
So it's very tempting to have something that says, oh, this is why I'm different.
This is why I've been made fun of.
And then I don't have to feel that shame.
The idea of therapy, though, proper exploratory therapy or watchful waiting, feels intrusive because if you're walking around with this intolerable level of unprocessed shame, that there's something fundamentally wrong with me, there's something corrupt about me that people just don't like, And I don't know what it is and I don't know how to control it.
The idea that a therapist could see that thing about you is really alarming.
It takes the right sort of situation and the right sort of clinical relationship To help someone who's walking around with that much shame and anxiety understand what therapy could be for them.
But I think a lot of these young people are very guarded against the possibility that anything could be sort of quote-unquote wrong with them.
And they also are resisting the hard and abstract work of self-improvement that comes with the healing process.
So there's often this trauma that's associated with the gender dysphoria.
Is it 100% of the time?
I think it's almost always from what I've been reading.
I don't know the comorbidity rate with a PTSD diagnosis.
Like I said, I know with the Tavistock GIDS program referrals that 48% of those young people had autism.
But I do know that adoption, foster care, and sexual trauma history, as well as homosexuality, we're seeing high rates of those in youth presenting with gender distress.
Clearly you're not a gender-affirming therapist today, but you were at one point.
I came of age at an interesting moment.
I went to grad school from 2010 to 2013, right as this stuff was starting to take hold, but kind of marginally.
And, you know, our class had one social justice warrior, but I'm imagining that grad schools now have, you know, 90% of the people in those classes have the same attitude as that one social justice warrior that did then.
And I don't honestly remember learning about gender dysphoria or the idea of trans in grad school, except we have a psychopathology course where we study the DSM. And like I said, I came of age in an interesting time because when I was in grad school, we were still operating under the DSM-IV, Diagnostic and Statistical Manual of Mental Disorders No.
4, and we were studying the 4, knowing the 5 was about to come out, I believe 2013, the year I graduated, is the same year that the DSM-5 came out.
So I didn't get a lot of exposure to this in grad school.
And then, you know, between when I started practicing in 2013 to now, 10 years later, there's been this exponential rise.
And it wasn't until, I believe, 2017 that I went to a training in so-called gender-affirming care.
And in retrospect, I think it was quite shocking.
But every time I talk about this training that I went to, I just think about how Therapists have this polite, deferential, agreeable nature and we all sit quietly and do as we're told.
And when I think about the company culture and how that can affect how we relate to trainings, I also think that that training was, in retrospect again, a departure from how trainings normally go because it was really led by an activist in disguise telling us this is the model now and you must comply.
And I have a vague recollection of one or two people raising issues and being kind of shut down.
But after that, we are expected to comply.
And there's a lot of pressure.
At the time, I was a younger therapist working for a group practice as opposed to an older, more experienced or more independent therapist like in private practice, which I am now.
I think in company or agency culture, there's a lot of pressure to be Kind, agreeable, conscientious, and you don't want to create problems for anyone, right?
And you don't want to look like you don't know what you're talking about.
And so, even though we were being sold this really radical and, frankly, absurd idea, I don't think anybody wanted to look like they were the bad guy.
And so you kind of go in with this deferential attitude like, well, what I'm being told, it seems counterintuitive, but they must know something I don't know.
And it took me years of going along with it thinking they must know something I don't know until I finally reached the point where I realized I actually know something that's important and now I have something to say.
Was there some defining moment where you thought to yourself, I'm going to change how I treat this?
I wish that I could identify one, but it was such a gradual process for me of working with these trans-identified young people and not seeing them get better and feeling like we couldn't talk about the elephant in the room, feeling deeply conflicted about what I was supposed to be doing.
Because on the one hand, when I worked for that company, there was A slight bit of pressure that if you were a good therapist, you would go to the next level training where they taught you how to write these letters.
Basically rubber stamping people for surgery.
And I always felt like, oh, I should do that, but a part of me didn't want to.
But I think just seeing these young people not getting better and leaving that question in the back of my mind of, is this really...
You know, for the ones who were pursuing surgeries and hormones, is this really it?
Especially when I was seeing other issues, the autism, trauma, eating disorders, homosexuality, you name it.
As much as I had my doubts, I was being sold this story that this is what's going to help these people get better.
And if you're not seeing what's on the other side of that, then you just have to believe it.
But it was when I found out about detransitioners, and my first exposure to detransitioners was finding out that their stories were being suppressed.
That was the first time I heard about them, was when I heard about how trans rights activists were trying to stop 60 Minutes from going through with their story on detransitioners.
And I thought, wait a minute.
I need to hear this side of the story.
And so that's when I started listening to detransitioners and phasing out accepting trans-identified people into my practice as new patients.
So I was wrapping up the work that I was doing with my existing patients and really just keeping the focus on the things that they were there to talk about.
I didn't Question or push back because I thought that that would be too risky to our therapeutic relationships and I researched the issue for about a year or two before I said anything publicly to anybody.
So was one of the reasons why you were afraid to do that, because you often hear this, what's told at least to parents, if you don't affirm your child is going to commit suicide or there's a high likelihood they will commit suicide, presumably therapists learn the same thing.
Yeah, it's such a dangerous myth.
You know, we do see higher rates of suicidal ideation in trans-identified young people, but we really can't separate that out from their comorbidities.
If you look at the comorbidities, depression, anxiety, I haven't mentioned OCD, body dysmorphia, eating disorders, actually, that's a major one that I haven't mentioned yet.
If you look at all the psychiatric comorbidities, the rate of suicidal ideation, as far as I'm aware, amongst trans-identified youth isn't higher than, you know, maybe non-trans-identified young people but who also have those same comorbidities, as far as I'm aware.
But we do have to consider that a lot of these young people are actually being told on the internet and by their peers that they should be threatening suicide to get what they want, that affirmation from their parents, whether it's a binder or puberty blockers or hormones.
So we do see a higher rate in general of suicidal ideation.
However, ideation and behavior are two different things and then suicide attempts or self-injurious behavior and completed suicide are very different.
For every one person that actually completes suicide there are many who attempt and end up in a hospital or not even needing hospitalization depending on the degree of self-injury.
The thing is with teenagers that they can be very impulsive and To put it more casually, they can be dramatic.
They're kind of known for that, right?
But teenagers are actually quite safe in their home environments with their parents because the love that a parent has for their child is one of the most powerful forces that we know as humans.
So when people say your child will commit suicide, I mean, first of all, will?
No.
Might.
Commit?
No.
Attempt.
Not complete.
So when a child expresses any degree of suicidal ideation, appropriate therapy involves really exploring how far they're going down that Train of thought.
Whether they actually have access to any type of, you know, weapon, sharps, pills, a vehicle that they could drive off a cliff, you know, whatever they're thinking and you need to know if they have a specific plan in mind and You need to assess their reasons for wanting to die, but also their reasons for wanting to live.
Usually there's a fair amount of ambivalence, and there's almost always at least one thing that's keeping them going.
Unfortunately for a lot of these trans-identified youth, the thing that's keeping them going is the fantasy, that dangling carrot of, well, if my parents will just defer me and if I can just transition.
But that's socially mediated.
Right?
And if we were to expand it and get them off of that kind of obsessive way of thinking, there's usually something else to live for too.
It could be their cat.
It could be wanting to see their favorite band in concert.
It could be wanting to go to the college that they've dreamed of.
It could be having a crush on someone.
But My point is, just because a teenager expresses having some kind of thoughts of suicide or self-harm doesn't mean that they have a plan, a means, an intention, and it certainly doesn't mean they're unsafe at home.
As therapists, we're all trained to guide parents through this process of how to inspect your child's rooms and remove sharps, lock up sharps and weapons, lock up pills, conduct checks every 15 minutes if you have to.
You know what?
Remove their door if you have to.
I mean, there are things that parents can do to protect their children.
So the threat of suicide has been Grossly distorted.
And people have been backed into a corner and intimidated in a way that's really quite sick.
Because that is truly every parent's worst fear.
And, you know, I happen to know, not professionally, but personally...
A parent who has lost a child to suicide and the fact that people are making light of that by using it in a manipulative way is just it's morally abhorrent My concern is for the long-term suicide risk because like I say adolescents are actually pretty safe as long as they have parents who are not neglectful, right?
We we have Plenty of data on suicidality.
And all therapists are trained to understand some of the basic risk factors and protective factors.
One of the biggest protective factors is responsibility to children or loved ones.
So we're talking about lifespan suicide risk, right?
And if you're a therapist like me and you've been in practice long enough, you've had that experience of actually sitting with someone who's deep in depression and who's actually had fantasies of Driving their car off a cliff.
You know, we've actually had these conversations.
And you ask them, what's kept you here so far?
How come you didn't do that on your way home from work last night?
And if they have kids, it's definitely the first thing out of their mouth.
And if they don't have kids, but they have a husband or wife or somebody that they love, it's like, well, I couldn't do that to my loved ones.
That's always the first thing out of their mouth.
So responsibility to loved ones is a huge protective factor, even for people who are in the worst part of depression.
One of my concerns for why so-called gender-affirming care is so harmful is because it actually takes away that protective factor.
We're sterilizing a generation who will not be able to have their own kids.
And we're altering their sexual functioning in a way that's going to make it more difficult for them to have loving relationships.
So you take away people's ability to have families, to get married, or have a long-term, stable, loving relationship.
You just took away a huge, lifelong protective factor.
Engagement and hobbies is also a big protective factor.
And the ability to do things that make you feel good physically, like sports, dance, exercise, huge protective factor, right?
Helping people exercise again if they're in the depths of depression.
Helping people remember things that they love doing and pick those interests up again.
Well, we're taking those things away potentially as well with so-called gender-affirming care.
Why?
Because puberty blockers create problems with bone density.
So we're inducing osteoporosis, osteopenia.
You know, in our documentary, David, who medically transitioned to living as a woman, I believe in his adulthood, just from estrogen, he didn't take puberty blockers as far as I'm aware.
He developed osteoporosis and osteopenia.
He was walking with a hunch.
So we're actually inducing disabilities.
And that's just the bone stuff, right?
I'm not even talking about blood clots, heart attack, diabetes, and all of the other medical complications.
As a result of these things.
But we're inducing chronic pain.
Chronic pain, major risk factor for suicide.
People who live with chronic pain, disability, or chronic illness are across the lifespan at a much higher rate of risk of suicide.
And again, speaking from experience, I lost someone to suicide and it is speculated That chronic pain and disability was one of the reasons that he felt so hopeless.
And I've also had that clinical experience, talking to people about what makes them feel so desperate that they're thinking about ending it.
Well, when you can't get out of bed not just because you're depressed psychologically but because you're in pain physically and you live with that day in and day out and you can't do the things you might have enjoyed and you can't go out with your friends and you can't work we're also putting people in a situation where their ability to work is going to be impacted because of the increased risk of all these diseases and disabilities Combined
with the problems that we're creating for people cognitively, right?
Because we also know that these drugs affect people cognitively.
Puberty blockers impair brain development, specifically with regard to executive functioning and emotion regulation.
Take that to an extreme.
You're looking at potential for crippling levels of attention deficit and emotion dysregulation.
Borderline personality disorder is the behavioral manifestation of somebody who has extreme chronic issues with emotion regulation.
So when someone can't concentrate Can't function, can't take care of themselves, can't stabilize their emotions, can't deal with life's ups and downs because their brain has been chemically altered during a developmental period.
Yes, you're setting people up for poverty and unemployment, huge risk factors for suicide.
I could go on.
So-called gender-affirming care is full of these risk factors.
The worst nightmare for any parent is, of course, their child committing suicide.
I imagine one of the worst nightmares for a therapist is their patient committing suicide in their care.
I guess the strength of the ideology or the megaphone around the ideology, you know, imagine, I'm just sort of trying to imagine being the person that says, well, I'm not going to affirm.
And then, but what if that actually does happen?
Suddenly now you're, it's clear that you're the villain, right?
Or at least in this thought construct that I just described.
Yes, and you're right that it is—therapists have, I would say, two main worst fears, right?
One of them, you just described the fear that our patient will complete suicide, and the other is more self-centered.
It's that we will suffer attacks against our license.
And potentially lose it.
And I have faced those attacks.
I think one of our kind of flaws of our typical personality profiles therapists is I think we're a little too fear-based sometimes.
I think we work so hard to get our licenses.
I mean we you know sometimes go into hundreds of thousands of dollars of debt for graduate school and then after getting a graduate degree we have to complete thousands of supervised hours and we work so hard to study for this We work so hard to get our licenses and we're just so afraid of losing them, right?
And I think between the fear that someone could make a complaint against your license and the fear that one of your patients could end up hospitalized or dead, those two fears keep us acting from a place of fear and Rather than a place of courage and rather than trusting our intuition and acting on, honestly, what love would compel us to do.
But the thing is that we can ultimately never really control either of those.
And I, again, speaking from personal experience, while I personally have not lost a patient to suicide while they were under my care, while I worked in my first job in the mental health field, a resident who, I was not this person's personal counselor, but I worked at the facility, and my coworker, Who was quite young and vulnerable herself.
She was his primary counselor.
And he died of suicide while we were there.
And so I've seen how this affects people.
And he was not the one we were most worried about.
We had a very high acuity population.
We had people with psychosis, schizophrenia, schizoaffective disorder, complex trauma, personality disorders, people who had been in and out of the streets, in prostitution, on drugs.
I mean, we were working with a very high acuity population.
We had many people we were a lot more worried about than this young man.
But he was the one who took his life during his time, or actually shortly after leaving, I believe.
And we found out about it.
So, you know, you can just never know.
And like I said, I've also lost someone to suicide.
He was a therapist.
He was a brilliant therapist who saved people's marriages, and he died of suicide.
Again, it's speculated that chronic pain and disability was a reason for that.
So you just never know.
And my message to therapists that I want to encourage to be bold on this issue is that, yes, it is scary living with the knowledge that you could face a threat against your license or that a patient of yours could complete suicide.
Just like it's scary having a child and knowing that something bad could happen to your child.
It's a fear that you choose to take on living with every day as part of the package of the responsibility that you've taken on.
But you do it because it's meaningful and ultimately you can never know whether going this way or that way Will make things better or worse?
A lot of parents who are concerned about their trans-identified youth are in a very similar position.
And they ask me questions like this, and it's coming from a place of so much fear and worry for their kid.
They ask me, if I say this, if I do that, do you think that's going to push my child further away?
If I draw a harder boundary and tell them what I really think of all this gender stuff, is that going to push them away?
Am I going to lose my kid?
And the answer is always, maybe so, maybe not.
You know, so ultimately, given that we can never fully predict or control the impact of our actions, we have to choose some kind of guiding value.
And I just don't think fear is a very good guiding value.
I think courage and love are better guiding values.
Also, you did mention that this gender-affirming care doesn't work as a therapy, whereas this watchful waiting, which you referenced briefly, which I'm becoming more familiar with over the last months, is something that actually has been shown to work.
Right.
Yeah.
We don't have evidence that the long-term outcomes for these kids are going to be any better, and gender-affirming care doesn't actually propose any particular approach to therapy itself other than just agreeing with the patient.
Watchful waiting, which you described, is also not particularly an approach to therapy.
It's not a whole therapeutic toolkit.
It's basically just the message that If a kid presents with distress or confusion about their gender or sexual identity as a young person, just don't do anything about it.
Just let them be a kid and give them time.
And chances are they'll grow out of it.
Usually it'll turn out that they're gay.
I mean, at least that's how it was before this became a social contagion.
Back when the rates of gender dysphoria were lower, most of the people who had gender dysphoria in youth were males.
Now the gender ratio is flipped.
And mostly they would turn out to be homosexual.
And puberty was actually the cure.
Just going through the natural process of puberty, the gender dysphoria would desist because the kid Becomes a sexual being as they go through adolescence and as they develop an identity in adulthood.
Hopefully, if they're in a supportive environment, they can come to terms with accepting themselves as potentially a gay or lesbian person or simply a so-called gender non-conforming, you know, a tomboyish girl, for instance.
So watchful waiting is basically just the idea that we don't need to pathologize gender nonconformity or gender atypicality, I think is a more kind of neutral term that Leonard Sachs uses.
I like gender atypicality.
We don't need to pathologize that.
Kids will be kids.
They'll play around with different identities.
You know, kids will believe in all kinds of things.
We as adults just watch and wait.
Well, you watch and wait, but it sounds like you can also try to address some of these other comorbidities, which are basically almost always there.
Exactly, right.
So if you look at gender dysphoria, you know, 20 or 30 years ago before it was a social contagion, some of the reasons that a young person might present with feeling of distress over being a boy or being a girl are Might have to do with their social environment if they're, let's say, they're a gender atypical child in a household that adheres to gender norms.
It's going to be more distressing if you're a girl who wants to play in the mud growing up with a mother who wants to dress you up in pink and tell you how a good girl should act.
That's going to be...
That mismatch with your environment is going to create more distress than that same girl with that tomboyish disposition who wants to play in the mud, whose mom says, yeah, go for it.
Dinner's at six.
So the social environment plays a role.
But yes, in this day and age, increasingly, we see that a variety of mental health conditions are all kind of getting subsumed under this gender dysphoria umbrella.
And we're not looking at what's really going on, why they're feeling so much distress in the first place.
So you mentioned now there's a lot more girls than boys.
I've heard about this rapid onset gender dysphoria and that it almost functions like a social contagion, or at least there's been some papers written on showing that this is a thing.
So how did this exactly happen?
So the term rapid onset gender dysphoria was coined in 2018 by Dr.
Lisa Littman, who's also featured in our film.
She's a physician and a scientist.
And she was noticing the same pattern of just one after the next group of adolescent girls all suddenly declaring that they're boys, typically together.
And so Dr.
Lippman has done some really great work looking at the pattern of these sort of clusters of socially influenced groups.
That study, she talked with parents about their observations, about their children's behavior, and then she also did a study on detransitioners that was illuminating as well.
I'm just remembering something that we talked about very briefly as we were preparing, which is something that I've been interested in, that there is some evidence of a connection between consumption of pornography and gender dysphoria.
Absolutely.
So I'll divide that connection into two broad categories.
So male and female.
And with males, we're looking at an older cohort, typically heterosexual, autogynephialic, meaning attracted to the idea of themselves as a woman.
So that cohort tends to be influenced by certain, how shall we say, like deviant porn that they've gotten into after a process of becoming addicted and needing higher and higher levels of stimulation.
I am more interested, for the sake of our conversation today, in the experiences of these young women, because it's now increasingly prevalent that adolescent girls even, not just boys, are being exposed to pornography not just boys, are being exposed to pornography at very early ages.
And even for the girls who aren't exposed, they are around boys We're looking at that porn and that porn is shaping the boys behavior their expectations of the girls and so girls are either getting exposed directly to these horrifying images of being exploited as Being associated with what it is to be female or they're being mistreated by boys.
For example, I've heard many stories now of girls whose first sexual or romantic experiences were very pornographic in nature because of how the boys that they're interested in have been shaped by porn culture.
So this combination of factors of how porn is directly and indirectly affecting girls is understandably making these girls quite frightened at the idea of being female if if this is what it means if what they're seeing in porn is what it means to be female and so who can blame them for wanting to opt out and say no thanks that's not me and then they have this alternative of the idea of being a boy specifically
for many of these girls the idea of being a gay boy Which is fed into by, I believe, anime and other aspects of online culture that I'm not terribly familiar with.
But, you know, it's like they get this horrifying porn, this degrading, humiliating, gross porn on the one hand that's like, this is what it is to be a female.
Or you could be this sweet...
Anime gay boy who has a love story.
And those love stories, they're being shown with the anime, and I'm sure there's more words for it, and some listeners probably know more about this than me, but there is a whole online culture in which these young people fantasize about these kind of idealized gay boy relationships that are very affectionate.
And romantic and loving, which is what girls have always wanted.
So it seems to these girls like the path to having a safe, affectionate, loving, sweet, innocent relationship lies in being a boy rather than being a girl.
So these days what kind of patients do you work with?
So, I still see ordinary people who aren't particularly concerned with gender over other issues, and I work with couples as well.
But for the people concerned with gender, I work with detransitioners and parents who are worried about their children.
I don't work with gender-questioning youth because I've already faced threats to my license, and it's very easy if I were to work with these youth for them to Google me, become outraged, and submit another complaint to my licensing board.
So I stay out of that, but I work with parents who are concerned about their youth.
So you're working with the parents, not their kids.
Right, so parents who come to me are typically extremely stressed out.
This crisis takes a toll on the whole family, on their sleep, their well-being.
So sometimes we have to talk about self-care.
Also, I want to say that, you know, my background, my professional training is in understanding and working with family systems, looking at how all the parts connect.
And what we see in families with trans-identified youth is that the youth are sometimes what we would call in family systems theory the identified patient, meaning there's a problem in the whole system.
The whole family's not well, but there's one person who manifests that unwellness and typically becomes scapegoated for it.
Um, so sometimes you'll see that the youth presenting with the gender distress is the identified patient in the family, and it's really just a symptom, right?
And so my job is to look at what is it a symptom of?
What is the symptom trying to diagnose the system with?
But since I'm not working with the youth, I'm hearing the parents report, and I'm getting a picture in my mind of, um, and I do have I have some pretty good skills with regard to when someone tells me about someone else who's not present.
I can usually make inferences and I'll sort of say, it sounds like this person might react this way.
Does that sound like them?
And they'll say, yes, that is how that person would react in that situation.
So I've gotten kind of good at I'm consulting about someone who's not present in the room, but these parents tell me what's going on with their children, and I help them identify what it could be a symptom of.
So, for example, in some families, you know, by the time the youth is identifying as trans and the family's getting into conflict over that, it's just the pinnacle of something that's been developing for a long time.
It's sort of, you know, that image of the glacier where there's only this much that's above the water, right?
It's like the part we can see is the trans identification, but there's so much that came before it that might have to do with problems in the marriage, difficulty figuring out how to parent together, maybe unprocessed trauma, dating back generations even potentially, skewed roles in the family.
There are times that these kids are trying to control or alter something in the family system by presenting with this distress.
So I look at what is this diagnosing about the family system, and then I work with the parents on what they can do, right?
So if the parents typically haven't had very good boundaries, then I work with them on boundaries.
I work with them on staying emotionally grounded, but also understanding there's a huge cognitive Piece to our work together because I help them understand Sort of the mentality of a teenager who's been frankly indoctrinated into a cult I provide a lot of psycho education on what these kids are being exposed to and That's another thing.
A lot of these parents, some are in their 30s, but a lot of them are in their 40s and 50s.
They may not have grown up with the internet.
They're certainly not as immersed in it as their teenagers are.
So I'll get parents coming to me saying, my kid said the craziest thing.
Can you believe this?
And then I said, yeah, that's what they all say.
It's a TikTok trend.
You know, it sounds crazy.
But so I'm educating the parents on what their kids are being exposed to, helping them understand what their kids are going through.
And I do that with a lot of compassion.
For the kids, but it doesn't mean that we have to agree with the kids' self-diagnosis or their preferred way of addressing the situation.
You referred to the term gender cult earlier in our conversation.
So how is it a cult?
Oh, boy.
How is it not a cult?
I think would be a shorter list.
I mean, the one thing that cults typically have that the gender cult does not is a single charismatic leader.
But you still do have several charismatic leaders.
There are just many of them, and they're Internet influencers.
You know, the Jeffrey Marshes and the Dylan Mulvaney's.
Of the world and that Addison character, you know, you have these public figures who get a lot of attention.
But in many other ways, I mean, the splitting off of vulnerable, young, naive in many ways, but also very bright in other ways, young people from their families, you know, young people from their families, you know, that is a classic move of cults.
Because if you can drive a wedge between parents and their children, then you have vulnerable people at your disposal who still need love and something to attach to and someone to idealize and something to believe in.
And they'll work very fervently for the cause that you kind of reattach them to.
So the family triangulation is a big one.
I mean, obviously, it's a body modification cult.
That is literally what it is.
And it has this bizarre kind of quasi- or pseudo-religious way of thinking about the world.
There's a lot of magical thinking.
There's a lot of kind of nonsensical ideas that you have to buy into to believe in this stuff.
So, for example, there's an episode of my podcast called The Myth of the Magical Child with Matt Osborne where we talk about how he was raised...
Being told that he was an indigo child and he sees the similarities between the idea of the indigo child and the idea of a trans child because there again there's this departure from reality where the normal laws of human nature don't apply like the idea that a child knows who they are and that what a teenager wants right now is what's always going to be good for them so there's this kind of suspension from disbelief And then if you look at kind of the progression of cults,
too, there's a lot of similarities here as well, where, again, you start off with young, vulnerable people, many of them gifted, quirky, weird people.
And you start off with love bombing them, giving them this idea of belonging and that it's all going to be so great when you join us and it's just literal rainbows and glitter.
I mean, those are the symbols that they use, right?
So first there's this love bombing, this we're your family now and it's all going to be better when you join us and when you take these steps.
But then you progressively have to give up more and more of yourself in order to please them.
There's always that dangling carrot, like I said, of, well, if you're really one of us, then you're going to, you know, of course the first step is social transition, social affirmation, you know, might be things like binding or tucking, puberty blockers, cross-sex hormones, and surgeries.
One after another.
I mean, it's typically not just one surgery.
And the surgeries have a high rate of complication.
So there's always that next step that you are expected to take.
And there's kind of this idea of you're not really one of us.
Like, we love you so much, but also you're not really one of us if you don't Take that next step.
And if you don't fight for our cause, if you don't proselytize our cause, you know, I noticed this back when I was still working with these indoctrinated youth, is that they didn't want to be around what they called cishet people.
They wanted to only be around their kind of people.
And that is just a reflection, again, that they're being progressively cut off from the world, told that the world is unsafe.
That's something that That this has in common with cults as well.
The idea that the world is unsafe, that normal people aren't special, don't get it, and are out to get you.
And you have to, at all times, surround yourself with reminders of what we are about.
So those are just a few of the characteristics that the trans stuff has in common with cults.
I mean, one more that comes to mind, and maybe you can comment on this because you do work with detransitioners, is There's often a high cost of leaving, right?
Absolutely.
So what is the situation?
Well, detransitioners, I admire the courage many of them have, and I know some of them would push back against that, saying, I had no choice.
But they've really had to give up so much, right?
Because when they finally realize that this is not what they thought it was, And that these people don't really love them and that altering their body didn't make them feel better and in many cases it made them feel worse psychologically and physically.
Whenever that all finally breaks down for them...
They have to give up everything that they have built their identity and worldview and sense of self on for the past however many years.
Sometimes it's been their entire adulthood.
Sometimes it was their entire adolescence and adulthood.
So there's a real kind of shattering of the ego and of everything they thought they knew that had to take place, right?
And then to admit that to other people is to not only risk losing friends, but to risk having people Turn against you, telling you that you're bigoted or that you are indoctrinated into a right-wing cult now.
That's one of the things that they believe.
And another thing I've noticed with detransitioners is so much fear and guilt about letting people down, especially, for example, if If they kind of pushed their parents into it, or if they feel like their parents really thought they were doing the right thing, or whatever steps they took in whatever relationships to get people to go along with this.
To walk it back and admit, like, I was wrong and I put you through all that for nothing, I mean, especially if you look at some of the worst-case scenarios, and not to say that all of these have been things I've seen in my office, but things I've heard in different situations, you know, there are people whose parents divorced over this.
You know, what's it like to feel like you're responsible for your parents divorcing because you were so sure that you were trans and you were so adamant that mom who was backing you up was right and dad was the bad guy and when mom decided to divorce dad over this you had mom's back and you thought that was the right choice and now you realize that you were just in a cult the whole time?
And you feel responsible for splitting your parents up?
I mean, there are a lot of situations like that, a lot of variations on that, but I think the guilt over, wow, I did so much to get other people to go along with this.
And then there's employment difficulties as well.
Because people who have to detransition at work, that can be really embarrassing.
And in a number of different ways, right?
So in one of my podcast interviews with a detransitioner in Australia named Oliver Davies, he talks about how he had been using the women's facilities at work.
I think he was in the habit of biking to work and he would like shower when he got there and then he just as he was gradually realizing that this wasn't really him he just kind of you know walked it back like oops you know but but that's relatively mild compared to what some detransitioners go through with their employment situations because you know I've also heard stories for examples of female detransitioners who were in male-dominated professions and I
When they were passing as a male, they were treated one way.
And then when they revert to living as their birth sex, they were treated a different way.
And their experiences of discrimination are in some ways like even more painful than the average woman's experiences of discrimination because they actually knew what it was like to be treated with the assumption that they were competent.
And then years down the line with even more experience under their belt, now they're being treated like they're not competent because they're presenting as their birth sex.
So that can be extremely painful and isolating.
So one of the things that's mentioned in the film is when some of these young people get these very extensive interventions, essentially that puts them on a track to basically be medicalized for life and that there's a kind of a whole budding industry ramping up for this purpose almost.
So tell me about this.
Absolutely.
It is a huge industry that is growing a lot, and it's a big moneymaker for hospitals.
We have, you know, Matt Walsh leaked video from Vanderbilt talking about how much money is in this, and there are some charts in our film that show the exponential rise of the profits in this industry, just along with the exponential rise in the youth presenting with this distress.
It's becoming increasingly difficult to believe that this is all happening organically.
You're right that these trans-identified young people are absolutely being set up to become medical patients for life.
And that can happen in a number of ways, right?
So once someone is on cross-sex hormones, they have to continue taking those hormones.
And if they don't, if they physically, you know, quote-unquote, de-transition, Then they are going to encounter another host of medical problems, and the D-trans young people I've met are dealing with really complex and novel medical situations that a lot of doctors don't know how to treat.
If a trans-identified person has certain body parts removed, then they will always have to be on exogenous hormones.
So for females, a hysterectomy Or for males being castrated, you know, then the body parts that produce hormones naturally are gone.
So they either have to remain on those cross-sex hormones, or if they wish to switch back to their natal sex hormones, they have to take those exogenously as well.
So there's the dependency on the hormones.
There's also the continual pursuit of more and more surgeries in order to so-called pass.
And then there's the medical complications that these hormones and surgeries create.
The increased risk of early Alzheimer's and dementia, even psychosis.
That's with having the uterus removed, right?
Hysterectomies, yes, but also cross-sex hormones have been known to create early dementia in males as well.
So, but like I was talking about before, with the bone loss or failure to develop bone density, the osteoporosis, osteopenia, and all kinds of musculoskeletal issues that can result from poor bone structure, the increased risk of all kinds of cardiovascular and metabolic diseases, even certain types of cancers.
People are going to become sick for life and The young people making these decisions are starting off with young healthy bodies.
I mean, I think most of us, except those who grew up with some kind of disability, most of us can remember how invincible we felt before we'd ever really gone through a major illness or injury.
And by the time you get to be my age or your age, we've been humbled because we've been sick, we've been injured, and we're grateful for our health.
We don't take it for granted.
So I don't think it's a coincidence that this stuff is being marketed to young people Who have no idea what it's actually like to live day in and day out with chronic pain and disability.
This is obviously critical information that both parents and kids should know at the outset of having these discussions and, you know, as I think we've been discussing, they don't often get that information.
I'm reminded of something that you posted.
I think it's in your Twitter handle.
You have kind of three purposes, maybe in life, I don't know, in your practice.
The third one is to promote justice and healing for those who have been harmed by gender-affirming care.
You've converted your practice into doing this.
And you also have this podcast, You Must Be Some Kind of Therapist.
Some really fascinating guests on there.
Tell me a little bit more about what you're doing to facilitate that healing.
So in our film, a therapist named Lisa Marciano describes detransitioners as shadow people.
She talks about how Jung said that the shadow is any part of us that we don't really want to know about.
And she talked about her process of thinking about how detransitioners really hold the shadow for society because society is turning a blind eye.
People who are still bought in To the idea that trans and kids is a good thing, that it's about compassion and justice, don't want to face that shadow of having their faith shattered and realizing that people are actually being hurt by this, right?
So currently, I would say detransitioners are in the shadow, as Lisa Marciano described, of our society.
And really ostracized and outcast and they can't get proper medical care.
One of my main concerns as a mental health professional is how badly my field has betrayed these vulnerable people.
In many cases therapists played a role.
In doing this, we actually pushed people down a path of transition and it's not pretty and a lot of people don't want to talk about it, but what I've learned from listening to detransitioners is that the people who have been medically harmed by this and regret it have sometimes, in some cases, Homicidal levels of rage toward the people who did this to them, including people in my very own profession.
So when I talk about promoting justice and healing for those who've been harmed, sunshine is the best disinfectant.
The first thing we need to do is stop putting them in the shadow and start bringing them out into the light and looking at what people are experiencing and being present with the pain and suffering that we have caused them.
Taking responsibility for that and seeking to earn and be worthy of their trust because right now we're not.
Detransitioners have been medically and mentally harmed by the professionals who are supposed to help them and now they don't trust us and that's our fault.
So we need to earn back their trust, and that is not a process that can be rushed.
One of the first things you learn when you're studying to become a trauma therapist is how sacred trust is, how easily it's disrupted, and what it takes to actually develop that in a healing relationship.
Detransitioners frankly have no reason to trust therapists like me even.
What to speak of therapists who created this mess.
So somehow we need a cultural shift to help society We need to turn the light of day and our compassion and our desire for justice and all of the liberal values that are caught up in this craze.
We need to turn those values toward this new rapidly emerging population of people who are suffering in these profound ways.
And we need to start talking about it and we need to start educating a new generation of professionals to deal with the aftermath as well as making some societal shifts.
For instance, medical care for detransitioners is not properly funded.
I mean, can you believe that in some cases Medicaid Will actually pay for a confused, distressed young woman to amputate her breasts, but they won't pay for reconstruction?
Not that you can ever reconstruct breasts.
You can't restore the breast tissue.
The mammary glands have been removed.
But, you know, if she wants at least something cosmetic to help her feel like she's restoring her dignity, They won't provide that.
The same thing with how, you know, insurance will pay for testosterone, but it won't pay for laser hair removal for females who regret the impact of testosterone on their body.
So we need them to get appropriate medical care.
We need to train medical professionals in how to deal with the novel and complex medical situations that detransitioners find themselves in.
And we need to train therapists in a whole new Well, I think Affirmation Generation is one step in that direction, and I really think it's a film that has the ability to, maybe to anyone with an open mind, to be able to accept its contents.
I think it's beautiful that way.
So congratulations again.
How can someone see it?
Thank you.
So Affirmation Generation can be streamed online at AffirmationGenerationMovie.com.
And we're encouraging people to organize screenings for March 12th, which is D-Trans Awareness Day.
So if you happen to be watching this before March 12th, We encourage you to have some friends or family over into your living room or rent a whole theater if you have access to that or anything in between to share the message that we're trying to spread.
You know, our producers really put a lot of thought into how do we share everything that we've learned in one hour and a half long film and if there's one thing that you could ask someone who's on the fence about this issue to do, what would that thing be?
It's to watch this film.
Well, Stephanie Nguyen, it's such a pleasure to have you on the show.
Thank you.
It's been great being here.
Thank you all for joining Stephanie Nguyen and me on this episode of American Thought Leaders.
I'm your host, Jan Jekielek.
Hello, everyone.
I think we all need a little positivity and inspiration in these turbulent times.
And so I would like to introduce a new art store we've set up in partnership with the NTD International Figure Painting Competition.
Its mission is pure truth, kindness, and beauty.
It's a painting that is peaceful.
There's a lot of beauty in it.
And you forget about whatever you might be worried about.
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