The Megyn Kelly Show - 20211025_dr-lisa-littman-on-rapid-onset-gender-dysphoria-th

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Oct. 25, 2021 - The Megyn Kelly Show

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20211025_dr-lisa-littman-on-rapid-onset-gender-dysphoria-th

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Honest Look at Medical Care 00:04:00
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	Welcome to The Megyn Kelly Show, your home for open, honest, and provocative conversations.
	Hey everyone, I'm Megyn Kelly.
	Welcome to The Megyn Kelly Show and happy Monday.
	Oh, we have a great and important show for you today.
	I have been waiting a year to interview this woman.
	Her name is Dr. Lisa Littman.
	And if her name sounds familiar, it's because she has played a big role in one of the most intense national debates the country has seen.
	In recent years, it all started when Dr. Littman began to notice an unusual number of teenagers announcing that they were transgender, in particular, girls announcing that they were now suddenly transgender on a scale that did not make sense statistically.
	It seemed to her like an anomaly.
	So, as a physician and a researcher at Brown University, she decided she would study the issue.
	Well, her research found that children might be transitioning, might be determining, I should say, that they are transgender on the basis of peer or cultural.
	Influence, that this could be a social contagion, if you will.
	What's now known as rapid onset gender dysphoria is a term she coined.
	It's controversial and it appears, at least based on the research that she has done and now some others have taken a look at, as a very real phenomenon, though you'd be hard pressed to find people within the medical community to support that.
	As you can imagine, Dr. Lippmann immediately came under attack.
	Trans activists accused her of bigotry.
	They called her work dangerous.
	This is a woman who's a lifelong liberal, pro LGBTQ, was interviewing parents who were, for the most part, openly very pro LGBTQ.
	Fellow researchers nonetheless accused her of bad or shoddy science.
	And her own university, Brown, bowed to the pressure and retracted a press release touting her study and replaced it with an apology.
	The scientific journal where her research was published pulled it and announced a review at the same time.
	There was a side of the story, however, that was not covered by the press very much.
	And that was that Dr. Lippmann heard from a lot of grateful parents, moms, and dads, thankful that someone was courageous enough to look into what was happening to their sons and daughters.
	And not only that, but people who had considered themselves trans only to realize that they weren't and felt that they were betrayed by a medical community that had pushed them with, quote, affirmative care, also expressing their gratitude to Dr. Lippmann for trying to take an honest look at this.
	She has no agenda.
	Just tried to take an honest look at it.
	This is Dr. Lippmann's first interview since recently leaving Brown University.
	This is also her first interview since publishing a new study involving detransitioners, meaning people who took steps to transition to the opposite gender, but then reversed the process.
	Welcome, Dr. Lisa Lippmann.
	What a pleasure to have you here.
	Well, thank you so much for having me, and thank you for that very, very warm welcome.
	There are some things that you got exactly right that I am a liberal Democrat.
	I am pro LGBT.
	I have people in my family and friends who are lesbian, gay, bisexual.
	I have colleagues.
Diverse Perspectives on Dysphoria 00:15:30
	Who are transgender, my desire to look into this situation was I noticed something that was unusual and I felt that it needed some exploration.
	And coming in with, I wonder what's going on, you know, I felt that there were questions that needed to be asked.
	And so my ulterior motive was trying to understand what was happening that was different than what has been.
	Observed for gender dysphoric young people in the decades previous.
	I mean, I think we all saw it, except you actually did something to try to figure it out, figure out the why behind it.
	And the prevailing line had been well, societies become more tolerant of trans people, thus, the increase in numbers of people, including teenagers, saying that they're trans.
	And you were cognizant of that line in going into your research too.
	You understood that that was sort of the line that a lot of people used.
	Yes, more tolerance will lead to more public identification as trans.
	And we're open minded to that being the explanation.
	Right.
	So, first, I want to say that society becoming more tolerant of people who are transgender, people who are gender dysphoric, people who are lesbian, gay, bisexual, I think that's great.
	Like, that is really, really important.
	Progress that we've had.
	And previously, there was a lot of discrimination and stigma.
	So I would say that is a step in the right direction.
	What happened, what I was seeing in my own small community, some other around the world, clinicians started to see this.
	And these are the specialized gender clinics started to notice this massive change that there was a skyrocketing of teenagers seeking to transition.
	And it was even more pronounced for teenage girls.
	So both.
	Teenage boys and girls went up, more so the girls.
	Previously, I would say as recently as 2012, there wasn't a lot of information even about adolescents.
	There were only two gender clinics in the world who had enough information.
	And so these increases, when I say skyrocketing, you know, what does that really mean?
	So in the United Kingdom, they saw a 45,000% increase in girls'.
	Attending the gender identity development services, 4,300.
	So 4,000, I'm sorry, 4,500% increase.
	And that is huge.
	That's really huge.
	And just to do the math on that, to keep it simple.
	So, whereas there might have been one girl coming in 10 years ago saying, I think I might be, you know, I'm gender dysphoric, you know, just to really dumb it down, like confused about my gender or may identify with the opposite gender.
	Now there's 4,500 girls coming in 10 years later.
	Well, 45,000.
	Is that the rate?
	45.
	Right.
	So the increase is, you know, I tried to drill down because it's hard to kind of what is this?
	So that's a 60% increase per year, you know, over this eight year period.
	You know, so that's so confusing.
	It hurts my head.
	They've gone way up.
	Let's go with that.
	It has gone way up.
	And so some people say, oh, that's just, it's just because of stigma.
	And when you see numbers like that, You know, there's a responsibility to dig a little deeper than just saying, here's one explanation.
	Let's just stop there and stop looking.
	And so some people, I think.
	Can dig in their heels and say, nope, it's just because of this.
	And if you look at other things that you might consider where stigma has decreased and you've seen things increase, we'll talk about left handedness.
	So many years ago, it was strongly discouraged for kids to write with their left hand.
	And when people got over that and were more neutral, the numbers went up.
	And those numbers went up from 3% to 11%.
	And so that's a number of, let's say, 266%, but it was over 50 years.
	So it went up much less and it was over 50 years.
	So I tried to do some calculations and I don't know if this is going to like bore people or not, but just to try and say it in the same language.
	Because if we're talking about 50 years or we're talking about like eight years, you know, so for the girls attending the clinic, that was 60% increase per year.
	And for left handedness, it was 3% per year.
	So, you know, those were really big changes that people were seeing.
	And they were seeing also this because there were so many teen girls, it shifted.
	It shifted to a population that was mostly boys to one that was mostly girls.
	Yeah, let me ask you about that.
	Historically, because when we had Abigail Schreier on the show, who I know interviewed you extensively, she's a wonderful person.
	Everybody should read her book, Irreversible Damage, if you haven't already.
	My gosh, it was life changing for me.
	Just showed me so much and helped me a lot with my friends who have kids who are going through this.
	I've referred everybody to it and to her.
	But she had made the point about traditionally gender dysphoria tended to be a thing with boys or males, not so much girls or females.
	Can you fill that out a little bit for us in terms of how it used to be 25, 30 years ago?
	I think that's really interesting because this is not a new field.
	And we have data from the 1970s and even before that.
	And the typical patient was a middle-aged male, you know, or there might be children that were predominantly male.
	So, so that was a very situate, a very different situation.
	And there's like late onset, which is when people start to have gender dysphoria after puberty versus early onset.
	And so to shift from that to teenagers is huge.
	And so here's an analogy.
	Um, let's pretend that you're a doctor who treats breast cancer.
	And for decades, decades and decades, your patients with breast cancer and All of the patients, all of the practices that we knew of, this was the patient profile was mostly middle aged and older women.
	And so let's say that happened, that was for decades.
	And then in one short period of time, 10 years, all of a sudden, it was mostly teenage boys.
	And it would be irresponsible to just say, business as usual.
	There's nothing to see here.
	Move along.
	Let's just pretend it's exactly the same thing because.
	When the patient profile changes so dramatically, you need to ask, is this the same kind of condition?
	Is this something else?
	Is this going to be helped by what we're doing, by this treatment?
	Or are these patients going to be harmed by it?
	And so when you see huge changes, you have to start asking questions and you have to be open minded to look for the possibility of multiple, multiple factors.
	Because sure, there is decreased stigma, but when you see numbers like 4,500%.
	You need to think about maybe there's something else going on too.
	Right, exactly.
	Because this population does not, so far as we can tell, seem to have been suffering in silence from the beginning of time, just waiting for the door to open socially to this announcement.
	Traditionally, it was more of a male thing, and now it's not as much.
	And that led me to the question of do we know what causes it?
	Because we have transgender people in my family, in particular, two.
	Men who transitioned to female.
	And they both say they knew from the time they were two that they were in what they would say is the wrong body.
	You know, they felt like they were girls, which is, of course, very different from what you've studied in these teenage girls who never showed any signs of being confused about gender at all.
	And then suddenly, you know, hence the sudden onset, the rapid onset piece of it, then suddenly said, I'm trans.
	So when you tell me a two year old is saying, I belong in the opposite body, that tells me it's.
	I don't want to use the term disorder, but it's there's something in the brain that is sending the signal, right?
	That something's wrong, that the body doesn't match up with the identity.
	But what, so how does the medical community describe what's happening in the two year olds?
	Right.
	So this is very, as you know, contentious, controversial.
	So there are a lot of different perspectives about this.
	And so, yes, one thing that people have seen for a long time are.
	That there were young children who had gender dysphoria that was severe.
	They really felt uncomfortable.
	It was obvious to everyone in their family that this child was suffering because they felt that they wanted to be the opposite sex.
	And so early onset gender dysphoria typically starts in childhood.
	And what's really interesting about it is, and this is something that a lot of people don't know, is that.
	Even when it starts in childhood, most of those kids, once they get through adolescence, will not be transgender.
	They will more likely be lesbian, gay, or bisexual, non transgender adults.
	However, some of those kids will continue to feel that disconnect with their biological body.
	And those people are said to persist.
	And those people do get benefit from transition.
	So there's that early onset situation.
	Those are the people that were studied.
	So here we've got people who seem to start their symptoms as teenagers.
	And some of them will say, yes, this is when it started.
	And others will say, well, I felt it all along and I just didn't know what it was.
	Or this is how clinicians will, how it's discussed.
	And what's very different.
	So back in the day, if a teenager came in, especially a teenage female, Who's gender dysphoric, her childhood was remembered by the parents and the child as being very strongly gender dysphoric.
	So you can say that these kids who didn't have observable signs as childhood either they didn't have gender dysphoria back then, or if they had it, it was much milder and different than those earlier cases where it was obvious to everybody.
	And toddlers really can't, are not very good at keeping secrets and lying.
	Like, maybe there are some who can.
	But so, this is one reason why it seems different.
	And so, why do people feel gender dysphoric?
	I think that's the million dollar question because we don't really know.
	And so, there are two.
	Competing models right now.
	And I think that's really the crux of our political debate about the topic is these things.
	Well, and I mean, I can see it, you know, in, and I totally get the debate about the teens and the rapid onset thing.
	I fully get it.
	But, you know, if it's actually happening in a two year old, and I'm not talking about a boy who wants to dress up here or there in a girl's dress or a girl who wants to, like I did, wear nothing but boys' cowboy outfits her entire childhood, that's not gender dysphoria.
	That's just role playing and experimentation and having fun.
	But genuine gender dysphoria, which I do believe exists in a very, very small number of very young kids, they don't know what causes it.
	They don't know, but it doesn't seem like at that age there's any argument it could really be a social contagion of any kind.
	It's something in your brain.
	Do you agree with that?
	Well, I think there are two ways to look at this.
	So there is a more developmental model that says that gender dysphoria and those feelings can emerge from other things that are happening.
	Even in a young child.
	So, a young boy, for example, who likes ballet and is bullied for it, may feel very strongly that he's in the wrong body.
	Things would be easier if he were a girl.
	And, you know, somebody, a teenager who has suffered the trauma of rape, could become gender dysphoric after that.
	Or a teenager who is just realizing that she's same sex attracted and is struggling to accept herself.
	And gender dysphoria may emerge from that.
	And so, in this developmental model, there are a lot of different causes.
	And depending on what the context is, the treatment is different.
	So, multiple causes, multiple treatments.
	But there is an oversimplified model, which I think you alluded to a little bit, where people believe there's one cause and one treatment.
	And the one cause is people believe that there's something called a gender identity, which can either match your body or not match your body.
	And so, this belief system represents somebody's true self and gender dysphoria or trans identification.
	Is due to the one cause that there is a mismatch.
	And in this belief, there's one treatment, which is transition.
	And right.
	As soon as you discover you've got this thing, it's great.
	It's very clear.
	And delay hurts people.
	So these are the two competing thoughts this oversimplified one cause, one treatment, one size fits all kind of approach versus this developmental looking at the big picture about what could be going on with this child.
	And as you would imagine, folks that are in this clinicians that are in this camp.
	Believe in a thorough evaluation to see what else is going on in the child's or the teen's life and to see whether something might be, whether there might be an underlying condition for this.
	And here in America, we're in the second camp.
	Here in America, we're not factoring in what your life experience may have been, what trauma you have been.
	It appears we're more, we're just affirm.
	Aha, you've discovered that you're secretly the opposite sex.
	Affirm, affirm, affirm.
	And here's the pathway to changing your body.
	Should you choose to do so, so that it aligns with that identity.
	Right.
	So, this philosophy has become very popular in the United States, that's for sure.
	And it looks like there's just one belief system because people get very offended by the other thing.
Cautious Approach to Diagnosis 00:03:58
	They're like, how dare you even talk about underlying conditions?
	How dare they not?
	How dare they not?
	Yeah.
	I think that there is an obligation to making sure that people get the appropriate diagnosis.
	The appropriate care and the appropriate treatment.
	But there's some really positive things happening.
	So it may look like it's just like this in the US, but Other countries who have experienced doing gender transition for youth are reevaluating the evidence and saying, wait a second, the evidence is not strong enough to defend doing these very significant interventions with permanent effects on youth.
	So they're taking a more cautious approach.
	So Sweden, Finland, the UK are taking a little bit like, oh, wait a second, we do need to evaluate these kids.
	And in the United States, so this is a surprise and it's I would say it's a little hot off the press.
	Recently, three very highly ranked individuals who work in the field of providing transition, two of them were trans themselves.
	So one is the current, well, one is either the current or incoming president for US Path, and one is the current or incoming president for W Path.
	Both are trans women.
	One's a psychologist, one is a surgeon.
	What does Path stand for?
	Sure.
	So there's an organization called the World Professional Association for Transgender Health.
	Okay.
	And then the U.S. one is basically U.S. instead of world.
	And this is a group of clinicians, individuals, people with family members who really, you know, if you want to talk about, you know, sort of having a position, they're very strongly pro transition and pro quick transition.
	Quick transition.
	So, anyway, so these kind of organizations, there are three people from within the organization that said, wait a second, we have some concerns.
	We are concerned that we're seeing kids not get better from just transitioning.
	We're concerned that one of them, I think it was an interview with Abigail Schreier, said, I'm concerned about what I would say was sloppy care.
	Now, personally, I would call it ideologically motivated care because it's That's what it seemed to me.
	But this person who is a trans person themselves said, I am concerned.
	And although they don't like the term rapid onset gender dysphoria or like the term social contagion, they did say, look, teenagers are influenced by their peers.
	And we can see this in a lot of things.
	We can see this with depressive symptoms, we can see it with eating disorders.
	Why should this be any different?
	Right, right.
	So, why is this the one area in which they would be uninfluenceable?
	Right?
	That doesn't make any sense.
	Absolutely.
	Absolutely.
	And so you can't take the person out of themselves.
	You are an adolescent, you are a human being.
	And then the other person from WPATH, who's been very highly regarded, has been in this field for years, did an interview and she said, I am really concerned that people are using the suicide narrative to manipulate parents and children into transitioning because we don't know whether transition will increase suicide.
	Will decrease suicide or fail to change it.
	And so it's irresponsible to take this as a threat, you know, and push people either towards a treatment or away from a treatment.
	So we need to really be careful that people are not using this statistic to scare parents into treatment.
Contagious Beliefs and Coping 00:16:04
	That's great news.
	The trans activist community has been wielding that threat, you know, to parents who say, you know, my kid, I don't think my kid actually is trans.
	I think my kid kind of glommed onto this.
	In the midst of a social trauma, or we can get into all the reasons why they do.
	And the response to the parent can't just be if you don't affirm, they're going to kill themselves, because that's quite a heavy burden to put on parents.
	And it shouldn't be used as a sword against parents who are genuinely searching for true diagnoses of their kids.
	Wait, let me pause you there because I want to squeeze in a quick break.
	There's so much more to go over, including what the typical profile of a kid who might be subject to rapid onset gender dysphoria looks like.
	And she's got some red flags and some sort of warning signs for parents who might be concerned, and we'll pick it up there next.
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	Here with me today, Dr. Lisa Littman.
	This is her first interview since recently leaving Brown University, which I inaccurately stated before had pulled her article.
	They never actually pulled the article, they never actually pulled the study, they just made you sort of redo it, even though it had already been peer reviewed.
	We'll get to that.
	So, you decide to take a look at all this.
	And early onset gender dysphoria, we knew about that, wasn't a particular shock.
	But this sort of rapid onset amongst teen girls was a new phenomenon, and you took a hard look at it.
	And you surveyed, as I understand it, about 256 parents.
	You recruited them through websites where parents had been discussing sudden gender transitions.
	I mean, obviously, you went to the parents who'd been expressing this, it happened in their families.
	And An important point to this story is your doing that is not an unusual methodology in conducting research.
	Why it's not?
	I mean, because the critics will later say, you went to the Klan to find out whether Black people are good.
	You're like, whoa, whoa, whoa, wait.
	That's not what happened.
	Right, exactly.
	So before we get to that, and I do want to talk about it, I just want to, I just want to point out just a couple of things because we talk about trans activists, and I want to be really clear that this perspective activists don't speak for the entire transgender community.
	Oh, trust me.
	I say that about three times a show whenever we're doing a trans show.
	Okay.
	So maybe, you know, pro transition activists or, you know, so it's really there's a broad range of experiences, and I know transgender people who were helped by transition who are very concerned about this issue.
	Yes.
	So, yeah, so I don't want to be.
	You know, painting with too broad a cloth there.
	And one thing that if you don't say or if I don't say, it'll come up, but rapid onset gender dysphoria is not a formal diagnosis.
	And that was one thing that when PLOS One asked me to revise the paper, They asked me to emphasize that it is not a formal diagnosis at this time.
	And just to make it super clear, and they wanted me to emphasize that this was a parent report study.
	The information was taken from parents, which, you know, it was already in the title and in the method section and throughout the paper.
	But they wanted more emphasis on that.
	So, anyway, so those are the two things that I just wanted to say.
	But about the research, yes, it is not unusual to gather information.
	In research by asking parents about their children.
	There's a whole body of literature.
	And even though there is some literature that supports social transition, which the folks who are upset about my research are very supportive of that research, use parent reports.
	And so, what's really interesting is I didn't create or invent any of the methods I use in the research.
	These have been used for decades and they haven't caused any kind of outrage until now.
	So, I think part of what's happening is that people really feel very strongly about their beliefs and what they believe is best.
	And if the research is consistent with what they want to believe, then it's all fine and good.
	But if it challenges it, then there needs to be an attack.
	And if that attack needs to be the methods or something else, because when you have research using exactly the same methods and one has one conclusion, one has another conclusion, And folks are saying, well, this is fine and a good study and robust, and this is trash.
	You know, you kind of have to think, like, what is going on here?
	Okay.
	So, take us to the bottom line of what you found after doing the study with 256 parents.
	What was your conclusion?
	So, my conclusion is that parents gave very detailed and thoughtful information about their kids, and they are worried about their kids' mental health, and they saw a lot of behaviors that were And some of these behaviors support that social influence could be possible.
	And so, between the behaviors, such as groups mocking people who aren't transgender, and behaviors with, you know, really being very positive about it.
	And I'll tell you one story that's really compelling, but also these clusters, they describe these friend groups where 50% or more of the friend group became transgender identified.
	But there's one story that really drives home this issue about kids influencing kids.
	There were two cases, unrelated, where these kids were with their peer groups at school and came to the conclusion that they were transgender.
	The kids, both of them, actually spent a summer away, just in a different environment, made new friends, had romantic relationships.
	And while they were away, they concluded that they really weren't transgender after all.
	And these kids, were.
	When they came back, were terrified to face their peer group and asked their parents to help them transfer high schools so that they wouldn't face these kids, because they were concerned that these kids wouldn't understand, they would mock them, they would treat them like a traitor.
	And both of these families were able to relocate and help the and the kid transfer high schools and was thriving.
	So I think that speaks about that.
	There is, kids are influenced by their peers and again, this is a first descriptive study, so this is not, You know, conclusively proving anything.
	This is just raising hypotheses.
	And then the other interesting thing that came out of this is well, maybe this process might be like a maladaptive coping mechanism.
	So, like the way anorexia, people are suffering and then they come to the idea that the reason that they're suffering is because they're too fat and the solution is to lose weight.
	And so, we know that that doesn't solve problems of depression and anxiety and can cause new problems, but this is.
	You know, it's a coping mechanism for pain, but it has other consequences.
	So the stories are people that had, you know, mental health issues and trauma.
	And it just was, it painted a picture that this is possible and more research is needed.
	And it's, I don't know, I mean, this is my own commentary, not yours, but I don't think it's any accident that it arises at a time when it's considered sort of.
	Uncool to just be a straight, possibly white, possibly male, whatever kid doesn't, whatever.
	It's not that sexy for the young girls who I don't know if there's been a breakdown in race, but like people need a card to play in today's day and age to be told that they matter.
	And this is a card.
	And it gets affirmed in the same way any other sort of minority identification or quote, victim identification would be rewarded.
	And so the kids who might not have that.
	Previously, or might not feel that they belong to a group that supports them previously.
	This is an entry into being special, feeling connected, feeling more popular, and maybe having some of your idiosyncrasies explained away in a way that's more acceptable.
	That's my own addition.
	Yeah.
	I mean, I think it's, well, I know it's hard to be a teenager, and it's even harder to be a teenager right now.
	And things are very polarized now.
	I mean, heck, when I was a kid, You could get up to the point of college and really not know about politics.
	And I mean, and smart kids, not just, you know, because it wasn't in everybody's face all the time.
	And so we've become very polarized.
	And although in some circles, you know, kids may be really, you know, supported for being LGBT, there are other circles where they're going to be bullied for it.
	So, I mean, it depends where you are.
	And so the way I would look at it, In terms of different perspectives, we've got and how we deal with, you know, everybody is different.
	There are all kinds of differences, but we can start out with discrimination and stigma and move to tolerance and support.
	And then maybe as an unintended consequence, maybe sort of glorifying.
	And so I think the most important thing is that we've moved from discrimination and stigma to support.
	And that's a beautiful thing that we are.
	You know, tolerant, more tolerant, and more supportive of LGBT individuals.
	I think as we're trying to navigate this, you know, whether we're making it, you know, sort of a little bit more glamorous or making anything more glamorous, I don't want to pick on this.
	I mean, this is, you know, there are a lot of things like this, but I think we're sort of grappling with where should we be.
	And so the answer is yes, we should be in this tolerance and support, but we don't want to pressure people.
	Into needing to identify a certain way.
	Nor do we want to celebrate something that may not be real and may have real downsides physically, mentally, and emotionally, you know, as we're seeing some of these detransitioners come out and talk about.
	You know, it's anorexia isn't the perfect.
	Analogy, but it's got some parallels in that you would never put an anorexic on the school stage and give her snaps when you're looking at a clearly skinny girl and say, You say you're fat?
	You are fat.
	Yes, go ahead, keep dieting.
	You wouldn't do that.
	You wouldn't celebrate it or make her feel like she'd now joined some sort of cool clique that was going to be profiled in magazines in a way that was laudatory.
	This is something Abigail Schreier's been saying.
	And if you have genuine gender dysphoria, that's one thing.
	But if you're glomming onto this, whether you know it or not, because you want, You don't want to be a lesbian.
	You don't want to be something that you consider not special.
	This is deeply problematic.
	The road towards transitioning medically and otherwise is fraught with peril, fraught with a lot of peril.
	So, to me, it's all part of the abuse by our medical community of these kids who, after one expression of, I might have this problem, get affirmed, affirmed, affirmed, all the way to top surgery and beyond.
	Without anybody taking the time to really understand what's going on.
	So let me ask you this because you say in the study, the overall finding that I read, this is from you, among the young people who were reported on, 83% of whom were designated female at birth, more than one third had friendship groups in which 50% or more of the youths began to identify as transgender in a similar timeframe.
	So do you think, you know, in the same way people used to think, well, don't hang out with that kid because he's gay and I don't want you to be gay, you know, like back in the sort of dark ages of our country.
	Being gay is not contagious.
	Being lesbian is not contagious.
	I don't want to say being trans is contagious, but there is an element of like if you see your daughter hanging out in a group of four kids and three out of four are trans, you might posit her odds go up of saying she's going, of her saying she's trans.
	Right.
	I think we get caught up in the language a little bit because are trans or are not trans.
	I think that's, you know, it's a very definite thing.
	I think what we're talking about is gender dysphoria.
	And so we should be thinking about this as, you know, sort of the feelings around not being comfortable with your body.
	And so, no, you know, it's first of all, sexual orientation and gender dysphoria are very different things.
	So it's important that this is very different.
	So people will oversimplify the topic and say, oh, she's saying that, you know, your friends or the internet is going to make you trans, right?
	And that is not at all what I'm saying.
	What I'm saying is that.
	It's plausible that a set of beliefs can be shared from person to person and in groups that are beliefs like vague symptoms should be interpreted as gender dysphoria and proof of being transgender.
	Beliefs around the only way to feel better is transition, and the beliefs that anyone who disagrees with you is abusive, transphobic, or something like that.
	And it's those sets of beliefs, in my opinion, that can definitely be shared person to person.
	But could lead a vulnerable kid to come to the conclusion that they are transgender and that they need transition, especially the shutting down, the idea that we should be exploring.
	We should be talking about and looking at what else is going on.
Invalidating Underlying Disorders 00:14:34
	You found that 62.5% of those identifying as trans or expressing gender dysphoria, 62.5%, Had been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to onset.
	That's a big percentage.
	What kinds of mental health disorders or neurodevelopmental disabilities?
	Yeah, so the things that were common are depression, anxiety, ADHD, and autism.
	So those are psychological and neurodevelopmental.
	And so what was reported is that these were kids who had these diagnoses before they became gender dysphoric.
	And people would say, well, how do you really know when they become gender dysphoric?
	Because maybe they didn't tell you.
	So, in my study with the detransitioners, people reported on their own experiences and they found, you know, they reported that they had these diagnoses before they became gender dysphoric.
	So, I think just what we're seeing from that is at baseline, these kids had some vulnerabilities.
	And again, there's a real separation between whether we're allowed to talk about underlying conditions or not.
	So, in this, in the gender affirmative, Pro transition mindset, the context isn't important.
	And so, if there are psychological issues, they believe that it could be secondary to the gender dysphoria, like the discomfort makes them, you know, makes them depressed or anxious, or from poor treatment, you know, discrimination, all of those things will lead to depression.
	And they believe that if there are psychological issues, it's not likely to be an underlying disorder.
	And somehow that's taken to We're not allowed to talk about underlying disorders.
	So, in this broader developmental perspective, like, yes, it's possible that people could be depressed or anxious because of poor treatment and discrimination, and it could be completely unrelated, but it could also be the underlying cause for their gender dysphoria.
	And there's no research that says it can't be that, but it's really been a shift in our conversation that it's become taboo to talk about that.
	Well, that's the problem.
	It's not just a taboo by the media people or sort of what we call the woke scolds.
	It's the medical community.
	The medical community is now trying to shut down discussions like that.
	And you were chastised, I know.
	I want to get into the crazy statement, the apology from Bess H. Marcus, the Brown University School of Public Health, that was your school, Dean, who the addendum she sort of put onto, like your article talking about what its problems were, I thought were.
	Were nuts.
	I mean, she talked about how, look, the conclusions of the study could be used to discredit efforts to support transgender youth and invalidate the perspectives of members of the transgender community.
	Could be used to discredit efforts to support?
	Well, is it factual or isn't?
	I mean, like, that's the question, not how someone's going to use it.
	That's not relevant at all, how someone's going to use or misuse the facts that you landed on.
	It could be used to invalidate a transgender person's.
	Perspective?
	Well, too bad.
	If it tends to invalidate them, then that's your judgment.
	But you don't not publish it or get criticized for doing a study because it could be used in one of the following ways that someone might find hurtful.
	Well, I think there's a little issue.
	Like, yes, we should be sensitive and kind and care about all people, especially people who are marginalized.
	But I think this is a A misconception that people having one experience with gender dysphoria shouldn't be used to invalidate people with other experiences.
	I mean, I think.
	I think maybe that's what they're getting at.
	And so, at no point did I say that this applies to every person with gender dysphoria.
	Right.
	You know, this is, this may be a very tiny population.
	It might be a medium sized population.
	We don't know yet.
	But that doesn't mean that there aren't people who really suffer from gender dysphoria and are helped by transition.
	And, you know, that it shouldn't invalidate someone who had early onset gender dysphoria and was helped by transition that somebody else had gender dysphoria that resolved.
	Or that somebody else transitioned and was harmed by it.
	Like it's all part of the puzzle and it's all part of our understanding.
	And, you know, having that information about different types and different outcomes that improves healthcare for people who are transgender or for any person who is considering transition.
	Like if you go to the doctor for, let's say, a knee replacement surgery, you don't want your doctor to say, everybody does great, no one has any problems.
	You don't want them to say, I mean, if that's not true, you don't want an overly sunny expectation, and you don't want an overly negative.
	Like, you want accurate information of what are the range of outcomes that people have.
	And so, shutting down that conversation really seems like that could hurt people, you know, to not know that.
	And so, in particular, our children.
	I mean, it's not just grown adults making informed decisions, we're talking about kids as young as 12.
	And in some cases, even younger.
	Even here in the United States, there are reports of 13 year old girls getting double mastectomies.
	That's madness.
	That's abuse.
	And more and more, the rights are being taken away from parents to weigh in on this at all.
	We're going to talk about that and about Dr. Lippmann's newest research on detransitioners.
	Again, people who transitioned and then decided to transition back in just a minute.
	Also, from your study, the following 41% of kids had expressed a non heterosexual orientation beforehand.
	And while you accurately point out that sexual orientation is not the same thing as your gender identification, in other words, you can be a woman who transitions to male and still be attracted to men as you were as a woman.
	They don't necessarily go hand in hand.
	Transitioning in one lane doesn't mean you transition in the other.
	What you found is that there's a high percentage of these kids in the rapid onset field who thought they were lesbian.
	And this is almost seen by some as a modern day form of conversion therapy where rather than saying, I'm a lesbian, they say, I'm just, I'm not even a woman.
	I'm good.
	I'm straight, but I'm a guy.
	Yeah, exactly.
	So here's the thing I think the elephant in the room on this topic is homophobia, that people really are.
	Having a difficult time accepting themselves as lesbian, gay, or bisexual.
	And that's what we're hearing from detransitioners.
	Many of them feel that why they felt gender dysphoric was, in retrospect, having a really hard time accepting themselves and just not wanting to be lesbian, gay, or bisexual.
	And so helping young people accept themselves, like that's really important to help these young LGB people.
	To be comfortable in their own skin and not feel that they need to transition.
	The other issue, so, yes, some people say that, are worried that this is kind of like.
	Gay conversion therapy.
	And I try to.
	It's like it's self imposed, self imposed, right?
	By the internet or by the peer group.
	Sorry, we're keeping it tight today because we got all these commercial breaks we need to get in.
	But so I'm going to pause it there again and get right back because there's so much more to go over, including the backlash you got and then the detransition study that you're doing, which doesn't have the one thing that you were criticized for the first time around, which is just reliance on parents.
	Now you went right to the sources and have firsthand data, which we'll see if that silences the critics, Lisa.
	Anyway, stand by and we'll get right back to our conversation with Dr. Lisa Littman right here.
	Before we move on from the original study, I've got to ask you about the social media input because it looks like, according to your analysis, 86.7% of parents reported that, along with the rapid onset of the gender dysphoria, their child either had an increase in social media slash internet use or belonged to a friend group in which one or multiple friends became transgender identified or both.
	But social media use, and Abigail talked to us about this.
	Hours spent on YouTube, on Reddit, on Tumblr.
	This was a common thread in these young people.
	Yes, that's correct.
	And so this was several years ago.
	Right now, it would be hard to find a teenager that doesn't spend hours a day on social media.
	So this was a couple of years ago.
	But what parents noticed that they were getting really pulled into Certain types of social media, things on social media that, you know, the YouTube videos, Tumblr.
	And so I asked a lot of questions about that because when I was preparing to do my study, I looked at the social media content that was about this issue and it was quite alarming.
	So what I saw was that teenagers, maybe on Reddit, were saying, you know, I have these feelings.
	Never fit in, I feel lonely.
	Does that mean I'm trans?
	And the answer is almost always yes.
	So these vague feelings, common, you know, very common experiences, that means you're trans.
	I saw these in group, out group dynamics on social media where people were being very positive when anyone came out, but they were really very derogatory towards anybody who was not trans.
	And so that looked a lot like what happens in social settings around.
	Individuals with eating disorders.
	And then there were also tips and tricks on how to trick, you know, how to deceive your parents into getting hormones and how to misrepresent your history to the doctor on how to get hormones.
	And so I asked those questions of the parents, and the parents, you know, said, yes, my kids have been exposed to, and they checked, you know, how to tell your transgender that if you wait to transition, you will regret it, that if your parents say no, that means they're transphobic, you know.
	If you want hormones, you should lie to your doctor just to get them faster.
	And so a lot of people said, well, how do the parents know what the kids were exposed to or what advice?
	And people gave really detailed answers about their kids printed it out and showed them, or they saw their kids sharing this information with other people.
	Or, you know, there was one kid who desisted, came through the other side and said to his parents, Yeah, this is, I learned this from these online sites.
	So, I do think so.
	Yet another reason to be monitoring what your kids are doing on the internet.
	There are so many apps now that you can use to sort of keep an eye on what your children are doing.
	It's not.
	I mean, I guess technically it's an invasion of privacy, but it's also very consistent with your parental responsibilities to keep them safe.
	So, any random stranger can have access to your kid now on the internet.
	And the messaging is really messed up, not just on this issue.
	So, if you feel bad about it, get over it.
	Okay, so you publish a study.
	You say, these are some things I looked at.
	Here are some things that we should have further study on.
	And all hell breaks loose.
	You're called a bigot by some of these pro transition trans activists.
	It's really kind of insane.
	Brown University, people wanted the affiliation between them and you to be removed from the article.
	Brown, to its credit, declined to do that.
	But the magazine's editor apologized for not having provided better context for the research, promised additional review.
	By the way, it had already been peer reviewed by two independent academics and one academic editor.
	The medical community comes out.
	I mean, Psychology Today published an open letter from transgender allies calling your work methodologically flawed, unethical for relying on parent reports.
	American Psychological Association, American Psychiatric Association co signed a statement with other medical groups.
	This is not a diagnosis to be used.
	The term is likely to stigmatize rapid onset of gender dysphoria.
	It's likely to cause harm to transgender people.
	It lacks empirical evidence.
	On and on it goes.
	I mentioned the one person, Diane Aronsaft, a prominent child gender psychologist, who told The Economist that this is akin to, quote, recruiting from the Klan or alt right sites to demonstrate that blacks really were an inferior race.
	Your use of parents.
	To speak about what their children are doing.
	I mean, this makes it sound like you were like Lisa Lippmann, turf.
	Let's get them.
	Trans people are bad.
	We have to stop.
	The opposite.
	Anybody who's listened to this interview for the past 65 minutes knows you're cautious.
	You are balanced.
	You are quick to make the other side's argument, to point out the weaknesses in your own side argument.
	What was this like for you personally and professionally to have the knives out for you in this way?
	Well, in a word, it was very stressful and it was unexpected.
Faculty Reactions and Support 00:05:25
	I did not expect this kind of backlash because I was taking a very measured approach.
	Everywhere in medicine, we're concerned about we don't want to undertreat people, but we also don't want to overtreat people.
	And, you know, asking questions and knowing what's going on is really important.
	So the question, like, how did I manage this?
	Yeah, it was stressful.
	So there were a couple things that, A couple of ways that I responded.
	One is I remembered that I am speaking for people to help them.
	You know, there are people who don't have a voice who are being harmed by this particular way of not evaluating people before providing hormones and surgeries.
	So people are being harmed, and a lot of people can't speak about it because they've got a family member who's involved or because they're afraid of losing their job.
	And so I felt that I was in a position that I had to speak out for these people, and I was grateful that I could.
	The other thing is, so some of the things people said were just really bizarre and very extreme.
	And so I remembered the people who were saying that, oh, she's the worst, or even saying she's a hero.
	These are people who don't know me.
	Like they're working on limited information.
	The people in my family, my friends, I have a group of people who love me and know me.
	But most of this is by strangers who are really reacting by whether they like the findings or don't like the findings.
	And the third thing is just remembering that people.
	You know, in terms of the methodological issues, is that a lot of people are using a double standard.
	There's something called isolated calls for rigor, where, you know, we all want to be right.
	We all want to be confirmed in what we believe.
	We're human beings, right?
	So we're going to look for information that confirms that we're right, and we're going to be a little more negative about information that challenges our beliefs or says that we're wrong.
	And there's something called isolated calls for rigor, in which The proof you demand for something that challenges your beliefs is much higher than what you would demand for something that is along, you know, that actually is within your beliefs.
	So, yeah, so that's how I saw, you know, there's this method, this methodology, you know, fine in this other study, but horrible in mine, you know, right?
	Unless your name is Lisa Ledman, you got to disregard it.
	So, what, so yeah, so take a breath.
	They made you basically.
	Do it again and take another look at it.
	And they stood there, they're really everything held up.
	All of your conclusions held up.
	They put a bunch of sort of cautionary language on there, like, well, she went to the parents and didn't know that.
	But the study held up second time around.
	But I wondered whether there was fallout for you on campus with other colleagues, you know, with students.
	How did that go?
	Okay.
	So, so first it was the actually the results stood, but the conclusions changed because they were.
	You know, they had much more of a framing around the parent report.
	So, that was sort of the changes in the paper.
	So, on campus, I'm glad you asked that because I do want to clarify that my position at Brown, I was affiliated as an assistant professor of the practice.
	And so, that's like an adjunct professor.
	So, I was not teaching courses.
	I was not, you know, on campus very often.
	So, my direct interactions with people, it was not what You know, what you would just automatically assume.
	You know, I would say that my relationships did become fraught.
	So, when I started with my affiliation in January of 2018, I was very open about my research.
	So, my research started before I got to Brown.
	And so, when I was affiliated with Brown, I said, This is what I'm working on.
	This is my research.
	Every faculty meeting I went to, when people introduced themselves, I would say, I'm working on, you know, gender dysphoria, adolescence, social influence, the transition.
	So, there was nothing, you know, Nothing that wasn't open.
	It was when, so my paper got published, and then it was with the pushback that things became very uncomfortable and fraught.
	So what I heard was people were, you know, that the leadership was getting complaints from students and alum, but I know that they were also getting positive things from students and alum because people CC'd me.
	And same thing with, you know, faculty members.
	And so, and, but I was, what I like to say is that there was, Loud outrage and quiet support.
	So, this was on social media, people were furious.
	But personally, I was getting emails from a couple of students, people from the LGBT community, other faculty members, professors that I knew saying, I really support what you're doing.
Framed Experiences and Truths 00:10:41
	I think this is really important.
	And I heard from a lot of clinicians saying, I'm seeing this in my practice.
	This is not what I've seen before.
	Thank you for looking into this.
	And I'm really, you know, I'm really sorry about all the, you know, all the things that are going on.
	All the targeting.
	It's not just like people are looking at you saying, Methodologically flawed, and it's a crappy study.
	They're saying bigot.
	It's like, well, they take it next level, like, whoa, okay, it's all the personal attacks.
	I should mention that the former dean of Harvard Medical School supported you, and that was good.
	Said, we need more studies on possibilities and causes.
	That makes sense.
	That's sense, Jeffrey Flyer.
	What's needed is a campaign to mobilize the academic community to protect our ability to conduct and communicate such research, whether or not our methods and conclusions provoke controversy or even.
	Outrage.
	So good for him.
	So then you decide to do another study, which I love because you're clearly not easily deterred out of the frying pan and into the fire.
	And this one is on.
	It's important.
	It is important.
	And this one's on detransitioners, which is also controversial.
	Some in the sort of transgender activist community say, what?
	That this isn't.
	Do they say it's not real or do they say you just shouldn't talk about the detransitioners because it's somehow dangerous?
	No, there are a couple.
	Right, there's a couple things.
	So there was like, they don't exist, was the first thing.
	And then, oh, the numbers are too small to even matter.
	Or if people detransition, it's only because of discrimination.
	And, you know, no one regrets transition.
	And so these are ways that there's been pushback against it.
	And I think that the experiences of detransitioners, again, there are some that are happy with their transitions and they detransition because they were discriminated against.
	But there are people who were harmed by their transition.
	And they feel it was a mistake and they regret that their doctors didn't ask them questions about why they felt that way.
	And it's an inconvenient truth.
	Like their existence and their voices really raise questions about that there are many different experiences from people with gender dysphoria and there are many different experiences from transition.
	And you can't have this oversimplified view that one cause, one treatment, everybody benefits.
	And if you delay it, you're going to harm.
	Like it's so.
	You know, there's no time to evaluate why someone feels that way.
	So it's really, I think that's the crux of the pushback is that these inconvenient truths about these people who exist, you know, raises questions about is it wise to just oversimplify and just go straightforward and transition just if people, just based on self diagnosis instead of doing an evaluation?
	All right, right.
	We're letting prepubescent kids make these calls.
	It's kind of insane.
	And Abigail's pointed out, That since your original study, the American Medical Association, the American College of Physicians, American Academy of Pediatrics, American Psychological Association, and Pediatric Endocrine Society have all endorsed gender affirming care as the standard for treating patients who self identify as transgender or having gender dysphoria.
	The American Psychological Association's guidelines, what that means, in other words, for affirming care is care that is supportive of the identity.
	And they said specifically, and I'm quoting, psychologists are encouraged to adapt or modify their understanding of gender.
	Broadening the range of variation viewed as healthy and normative.
	So make no mistake about it.
	If you bring your child to a physician, to a pediatrician, to a psychologist, the standard of care for that doctor is to affirm, period, to affirm your child's gender dysphoria as being real and their identity as trans.
	And that may not actually be the correct diagnosis in your child's case.
	And the detransitioners, in a way, prove it.
	Right.
	And I think that's why there's so much pushback against them, which I think is so unfortunate.
	Because they are real people.
	They have feelings, they have experiences, and their experiences matter.
	And to be told, you know, to be shut down is really a problem.
	And I've been so surprised by how many medical communities have really come on board with this.
	And I think there are two main things.
	One is this is promoted as the kind, tolerant thing to do.
	And believe me, like being kind and being tolerant is.
	Awesome.
	Like, this is great.
	Who wouldn't want to be kind and tolerant?
	So, it's framed that way.
	But in the same way, is it kind to not do an evaluation and find out why somebody is suffering?
	So, it's framed that way.
	And the other thing is, the science is not settled.
	There's really been an exaggeration of certainty about the belief in these interventions.
	So, these interventions were only tested on kids with.
	Early onset severe gender dysphoria.
	Like these are the main studies that justify it.
	And so, and these kids that actually were included in these trials, they also were psychologically stable.
	So, this is very different than the population who's seeking care now, who didn't have a, many of them didn't have a history.
	And even some of the main researchers and clinicians from those first studies are saying, you know, the kids without a history.
	And the kids with psychological issues, they weren't part of our studies.
	We don't know.
	We don't know if their gender dysphoria is going to be temporary.
	We don't know if it's going to be long term.
	We don't know if these interventions are going to hurt or help them.
	But there's been this exaggeration of certainty.
	So when people do the analysis of how strong the evidence is, and when you look at these interventions for teenagers, it is of low and very low quality.
	This is what happens when you look at the research.
	However, the discourse is this is life saving.
	This is evidence based.
	And so, this disconnect is really, I think, a problem.
	And I think part of it is everybody needs to read past the abstract.
	People need to read the whole articles from the source and check the references to make sure that the references really support what people are saying.
	And what's crazy is we're going to go, those numbers you gave at the beginning that we struggle with 4,500, you know, the times 4,500 in the UK and times 1,000 here in the United States.
	They're going to be higher, higher, and higher, and higher because now, this is according to your detransition study 71% of the respondents reported that prior to transition, they thought transitioning was my only option to feel better.
	And that 65% said they thought transitioning would eliminate my gender dysphoria.
	And they detransitioned when they came to realize that wasn't true.
	So, more and more kids are going to do it because the messaging, All around them, at least here in the States, but also in places abroad, is yes, you have this.
	Yes, transitioning is the option to solve it.
	Right, right.
	And I think what's going on is people are getting just a small sliver of the information that they need to make an informed choice.
	And so I think we're going to continue to see.
	So we don't know the numbers of detransitioners.
	It's very, very hard to find the numbers because, one, they don't.
	Uh, you know, very few of them will return to the clinics to say, Hey, I'm unhappy with my care.
	That's like those two kids didn't want to go back to the same high school and face the other and the people who helped you transition at the clinic.
	You don't want to go back to them either.
	I get it, that's why the numbers are a lot of shame, there's a lot of embarrassment.
	They're you know, they're worried that they're going to be pressured to transition, they think it's not going to help anything.
	I mean.
	There are a number of reasons why you wouldn't go back.
	So, the doctors who are doing this are not seeing many of the patients who actually detransition.
	So, they think, wow, everything's going great, where they should be looking in their loss to follow up, people that just don't come back.
	Another reason that it's hard to track this down is that many of them don't continue to identify as trans.
	So, in my study, 61% return to identifying with their birth sex, 8% continue to identify as trans, and 14% Identified as non binary.
	So, a lot of the studies that are saying that they're looking for detransitioners are actually looking just in trans communities.
	And so, there's another paper that came out right before mine.
	And the detransitioners in that study talked about how once they said they were detransitioning, they were generally ostracized from LGBT communities.
	So, really, like you really have to look where you expect to see them.
	And I think, so, we've got a lot going on.
	Culturally, these messages like this is the only thing that can help you.
	But we also have, as you mentioned, this really dramatic change in approaches from approaches that relied on thorough evaluations and, let's say, used judicious medical and surgical interventions to approaches with minimized or eliminated evaluation and very liberal use of medical and surgical transition.
	And so that shift.
	As well as this cultural shift, we may wind up.
	This could be an unintended consequence of all of those changes.
	Think about this in a world in which the data show between 61% and 98% of those who say they have gender dysphoria will get past it if just left alone.
	The vast, vast majority of boys and girls saying that they think they have gender dysphoria, they think they're trans, will grow out of it if left alone.
	Do we have an entire medical community that has settled on affirm, affirm, affirm, affirm, and remove parents from the equation, which is happening more and more for kids as young as 12, 13, 14?
Pressure from Doctors and Trauma 00:10:09
	Let me squeeze in a quick break.
	That's where we'll pick it up because there was a shocking article out about kids as young as 14 in Germany.
	There was a bill that was proposed to remove parents from that equation, and it's already happened in several countries overseas.
	We're going to talk more with Dr. Lippmann about that.
	So, Lisa, as you know, 60 Minutes did an in depth Report on detransitioners, something that you just released your report on as a scientist.
	And they had testimonials that were disturbing, no question.
	And one young woman in particular, her name is Grace Lidinsky Smith, who talked about how in her early 20s she was depressed and so on and searched the internet for answers and saw people being so happy and excited about transitioning to the other gender that she decided to go for it.
	And then she said that in the course of one year, One year, she both transitioned, including surgery, and detransitioned.
	Here's a little bit of Grace on 60.
	In her early 20s, Grace Ladinsky Smith was seriously depressed and developed gender dysphoria.
	She began searching for answers in transgender communities on the internet.
	And when I saw them being so happy and excited about doing this wonderful transformative process to really become their true selves, it was like, have i considered that this could be my situation too grace says she found a gender therapist on the internet and told her i'm thinking of transitioning because she was over eighteen and didn't need parental consent she says she merely signed an informed consent form at a clinic And got hormone shots.
	Just four months after she started testosterone, she says she was approved for a mastectomy, what's called top surgery, that she told us was traumatic.
	I started to have a really disturbing sense that, like, a part of my body was missing, almost a ghost limb feeling about being like, there's something that should be there.
	And the feeling really surprised me, but it was really hard to deny.
	And so she detransitioned by going off testosterone.
	Later in the same report, they featured a young man named Garrett from Baton Rouge who said he went from taking hormones to getting his testicles removed in the course of three months.
	He then got a breast augmentation and said instead of feeling more like himself, as the promises are made online, you're going to feel like yourself once you do all this, he felt worse.
	And it's not uncommon at all for these young people who transition to feel worse once they transition and indeed to feel suicidal.
	I think it's heartbreaking that some of these young people didn't get the evaluation, the support, the kind of mental health services that they needed, and instead were really rushed to medical transition and surgery.
	And as you mentioned, mastectomy and testicle removal, like that's permanent.
	You really can't change that.
	And I think it was really brave for 60 Minutes to do that because they got a lot of pushback.
	And so I think there's a harm in doing just this one sided perspective that everybody is helped and no one is harmed.
	Because I know people who have been helped by transition, and I know people who have been harmed by transition.
	And these are both very, you know, it's important to understand the full range.
	And I believe that the doctors who are very gung ho, I mean, to push for a mastectomy in three months or a testicle removal in three months.
	They really believe that that is the answer, and that's what's going to help people.
	I have talked to doctors who are very pro transition.
	And, you know, I've been in a situation where I was the one in the room saying, but wait a second, but what if it's something else?
	But wait a second, what if the parents are right and this is not in their child's best interest?
	And I was, you know, I got the side eye.
	Like this was not a welcome thing.
	But, you know, I think the reason they do it is that they are convinced that this is what people need and this is what's going to help them.
	And there's a real, You know, maybe there seems to be a lot of effort in not hearing the stories that would challenge what some people are hurt.
	So I saw, I listened to your interview on Savage Minds, which was terrific.
	And one of the girls that you discussed had said she decided to transition and then detransition.
	And she realized that she was never transgender.
	She just had, I think she had seen her mother.
	Sexually assaulted or raped, and had convinced herself that if she were a man, she could either prevent it or it wouldn't happen to her.
	I mean, it was a great example to me of how trauma gives your brain a reset that it doesn't need.
	It pushes it in the wrong direction about what the solution is.
	Right.
	So that was a clinical case that was written about in the literature.
	And I think it really goes right back to the, you know, this model of there are many causes for this distress and there are many.
	Treatments.
	And so the psychologist that took care of this young child, she, I believe, had witnessed her mother being murdered.
	And she developed a sense that if she had been a boy, she could have protected her and could have prevented it.
	And so I think this is heartbreaking.
	And if you don't ask, if you just say, oh, you're right, you really are a boy, you're going to miss a lot of diagnosis.
	You're going to have missed diagnosis, you're going to have delayed diagnosis, and you're going to give people the wrong treatment.
	And I think that's where we need to get back to basics.
	You know?
	So, two things on that.
	One, it reminds me of the discussion we kicked it off with about the two year old.
	You know, who knows?
	Maybe there was trauma in the first two years that pushes a child, you know, as young as that to start thinking about this, even if it's not conscious.
	Maybe, you know, as opposed to being a biological thing, you know, that you're born with.
	Who knows?
	The point is, we don't know the answers to these things.
	But the other thing I was going to say is, oh, gosh, I can't remember the second thread.
	Oh, I know.
	Yes.
	Because you wrote about how the, Most of these kids, not only did they not get alternatives when they went to seek medical care or counseling or whatever, but the vast majority of detransitioners you spoke with said they felt that they were underserved by the doctors they spoke with, that the downsides of this were not adequately discussed, and the positives of this were grossly overstated.
	Right.
	And so, one thing to remember is my study is a convenience sample.
	So, it's not a representative of all people who detransition.
	There has not ever been a study that's nationally, you know, a representative study.
	But in terms of talking about the people in this study, that more than half felt that the evaluation they got was not adequate before they transitioned.
	More than half of them felt that their clinician didn't really explore whether there could be something else like a mental health condition or trauma that was why they wanted to transition.
	And I asked people, and again, I get accused of being just one sided.
	I gave options so that people could say, yes, it was accurate or no, it wasn't, you know, in terms of the counseling they got.
	So there were options the counseling was accurate.
	My doctor was not positive enough about the benefits or was too positive about the benefits or not negative enough about the risks or too negative about the risks.
	So people really did get the range of responses that they could pick.
	So it wasn't just, here's what I'm thinking it is.
	I really, Wanted to be brought in.
	Actually, in creating the survey, I worked with 2D transitioners.
	So we really worked to make sure that the questions really encompassed a wide variety of experiences.
	And so, regarding the counseling, about a quarter felt that it was accurate, but maybe a little less than half felt that it was too positive about the benefits.
	So that's something that deserves investigation.
	We need to see whether or not people are getting accurate.
	I mean, could it be that these people had a negative experience with?
	Detransition so they might remember it, you know, differently.
	Sure, but we need to look into it.
	The other thing is that some of these people said that they felt pressured by their doctors to transition.
	And so, that's so I'd like to, yeah, I'd like to give you a couple of quotes because, you know, they said it in their own words that, um, where did I put that?
	Um, you know, you look for it, you look for it, and I just want to squeeze this one stat in from your study 58% said.
	They believe their dysphoria, their gender dysphoria, was caused by trauma.
	58% believe it was caused by a trauma or a mental health condition previous, not by.
	You know, I genuinely am gender dysphoric.
	And these people are getting surgeries, surgeries now based on the medical community's desire to be woke, to be affirming without questioning, and so on.
	Go ahead with your stats or your quotes.
	Okay.
	I'm going to give you the quotes, but I do want to say about woke.
	So I think the idea of woke is a good idea, like to be aware of injustice and to really look at the possibilities of people being treated unfairly.
Researchers Must Speak Up 00:09:01
	But I think that in practice, it's gotten very rigid.
	And very narrow.
	And I think that's the problem.
	But here are the quotes from people who said that they felt pressured.
	Quote, my gender therapist acted like it, transition was a panacea for everything.
	My doctor pushed drugs and surgery at every visit.
	So this was people who really did feel pressured by their doctors.
	Again, we don't know how many, but I mean, I think those are strong words.
	And in the meantime, There was an article recently by two German professors who were taking a look at what's happening in Europe.
	In Germany, there was a bill that was just submitted.
	It did not pass, but it would have let children as young as 14 be able to decide for themselves whether to take hormones and undergo surgery.
	Age 14, you could bypass your parents altogether.
	You would just need a green light from the courts, which are not as discerning as we would like because we've got all these doctors who are like, Go for it, go for it, go for it.
	So that was rejected in Germany, but they write that other European countries have already passed similar legislation, including Malta, Ireland, Norway, and Spain.
	So we're putting these decisions in the hands of kids who we won't even let buy a cigarette, buy a glass of wine, or in this case, drive.
	We recognize their brains are not fully developed enough to get behind the wheel of a car.
	Never mind, start cutting off their body parts.
	Right.
	And so I think the people who are in this really feel that.
	Gender is an exception to everything.
	So, what we know about teenagers, teenagers go through phases.
	It's part of their job.
	They're trying to figure out who they are.
	And they don't necessarily know what they're going to want in the long term.
	And so, there's this approach, this whole affirmative approach pro transition rests on a couple of assumptions.
	And one of which is teenagers are always right.
	And what they want in the short term is going to be what they want.
	You know, what is best for their health and well being in the long term.
	And so I think if you're resting on a teenager is always right and a parent is always wrong, if there's disagreement, I think you're on pretty shaky ground.
	And that doesn't mean don't listen to teenagers and don't listen to parents.
	Like I think this is a, you know, this is a big deal.
	Surgery is a big deal.
	Hormones with permanent consequences are a big deal.
	And we should be getting information from a variety of sources to Figure out whether this is the best thing.
	Is this going to help this person or is it going to harm them?
	Because we've seen both.
	And, you know, did the detransitioners?
	Did they talk to you at all about what they would do if they had a child who, you know, said, oh, suddenly, you know, suddenly, oh, I think I'm trans?
	Right.
	So I did try to explore that in my survey and I didn't really analyze it because I think a lot of.
	The detransitioners were young adults who weren't parents.
	I mean, in retrospect, I was looking for some information, but I, and maybe this should be explored further.
	I did hear from detransitioners who do wish that people had asked questions and had asked why they felt this way.
	And like, maybe somebody should have asked me whether this was my discomfort about being a lesbian and not being able to accept myself.
	So there, there were.
	Or my awkwardness with my teenage pubescent body, which we all go through only in today's day and age.
	Are they telling you that might be gender dysphoria as opposed to that's your humanity?
	Right.
	I think we should be addressing, you know, puberty a little different.
	Like, so I really think we should be having a lot of conversations with our kids when they're young.
	And when they really care what we think, I think that's a great time to talk about this and give them a heads up about adolescence before it hits them.
	You know, to say, look, people feel uncomfortable, but most people feel uncomfortable.
	And what's really weird about adolescence is you might think you're the only one that feels that uncomfortable, but that's not true.
	And, you know, and normalize it.
	Like everyone you know who's older than you, your grandparents, your aunts and uncles, they've been through adolescence.
	All of your little cousins, you know, they haven't been through adolescence, but this is a life stage that people go through.
	You know, people are often uncomfortable.
	They have a lot of feelings, you know, and they're growing and they're changing.
	And sometimes they might be, you know, disagreeing with their parents and things like that.
	And this is part of this growth process.
	And just to kind of give them a heads up so that it's not, so that they're not susceptible to somebody saying, oh, you don't like how your body's changing.
	That means you're trans.
	Right, right.
	Right.
	When you start to grow breasts, they don't look good and you're not used to having them.
	And it's like, what the hell is going on down there?
	That doesn't mean you're trans.
	It's like your body's changing.
	And at the same time, you're getting acne and you're gaining weight and you're already on an awkward phase where you want to belong and you probably don't feel like you do.
	And parents need to be really explicit in today's day and age about how we all went through that.
	That's life, that's childhood, teenage, adolescence, all of it.
	And always, you know, it's, yeah, go on.
	Yeah, well, let me ask you this.
	So I see the medical community as a massive problem in all of this.
	The media, of course, social media, huge.
	The trans activists who are pro transition, deeply problematic because they run around calling everybody a bigot.
	And that silences people.
	The 60 Minutes people had a quote from a doctor in there saying, I'm very scared to speak up.
	So is everyone.
	We're afraid of not being seen as affirming or being seen as bigoted and so on.
	So, what would you say?
	Like, who are the most important people we need to start being pro all points of view, studies, questions, in depth probing before we just knee jerk surgery hormones?
	Who do we most need to get on the side of reason?
	I think we need a lot of people on the side of reason.
	You know, and again, transphobia, like it's a real problem.
	There are people who have ill will towards trans people and there is discrimination.
	But there's a problem when you start calling everything transphobia, if it's even asking questions about underlying conditions or doing a thorough evaluation.
	And when you start calling asking questions or understanding different types of gender dysphoria and looking at all the outcomes transphobia, one, You completely weaken the word.
	And I think we need that word to be specific to what transphobia is, which is harmful and discrimination.
	But it also shuts down this conversation that we should be having to help solve problems.
	And so we need clinicians speaking up.
	We need clinicians who are in the field speaking up.
	We need researchers speaking up.
	We need detransitioners speaking up.
	And we need trans people and LGB people speaking up.
	And actually, they have started.
	There are, you know, it's hard to call.
	People who are trans, transphobic.
	And so this, unfortunately, this happens.
	So there is a group of trans individuals that started an organization.
	Called Gender Dysphoria Alliance, you know, created and run by trans people who are saying that we need to know about the different kinds of gender dysphoria because this helps us understand ourselves.
	We need to acknowledge biological sex.
	We need to use evidence.
	We need to be aware of detransitioners and support them.
	And so this is coming from individuals who are trans.
	And it's just boggles my mind that they're being called transphobic.
	So there are trans people who are organizing.
	And there are lesbian, gay, and bisexual people organizing and saying, hey, this whole practice of calling everything, transitioning everybody, this is hurting our youth.
	Like, this is a lot of people who are lesbian, gay, bisexual felt very gender dysphoric as kids or gender stereotype non conforming.
	So they feel that these youth are being sort of pushed down a path that really isn't right for them, that's being medicalized.
	And they, you know, so, so yeah, so I think the LGBT population.
	Great if the people who are standing up and more of that and detransitions.
	I think it's unfortunate that if you say it, you're going to get attacked.
	So, I mean, that's America.
	You know, you get used to it.
	But I like what you said.
	It weakens the word and we need that word.
	I like that.
	I'm going to use that again in the future.
	I do want to ask you, I'm going to bring in callers.
	And I love that you're willing to stay and take some calls because our phone lines are lighting up.
Parental Voice in Decisions 00:05:35
	But can I just ask you quickly?
	And I know you don't really want to get into this, but I've got to just ask you, did they push you out of Brown?
	Do you feel like your relationship with them ended because of all of this?
	I think it's really complicated.
	And definitely the decision not to remain at Brown was Brown's decision and not my decision.
	But it's really, it's really, yeah, so it's kind of hard to talk about.
	I do have a consulting job that I lost over this, and that is much more clear cut because people submitted the paperwork to renew my contract.
	Pro transition activists wrote a letter saying, you need to fire her, even though my work there had nothing to do with gender dysphoria.
	And then the leadership decided not to renew my contract.
	So, that is, I mean, you know, an unfortunate, very clear line of what happened, you know, as opposed to things that Brown were brought and, you know, being unwelcome in certain, you know, contexts.
	So, yeah.
	Their loss.
	I'm going to try to get some callers in now, starting with Heather in Florida.
	Heather, what's your question?
	First of all, I just wanted to say, Dr. Littman, you.
	Have given me such a beacon of light because my daughter's been dealing with this for the past two years.
	I'm sorry, I'm emotional.
	And I've always been made to feel like I'm the enemy of it because I question them wanting to push giving testosterone and pushing transitioning.
	And I just was wondering is there any place that you could send me?
	I know that I was trying to listen online, but any place that you could send me to get more information about how, as a parent, I can have a voice in my own child's medical procedures or not procedures that would take place?
	Because it Kind of feels kind of hopeless as a parent watching it happen.
	Sorry.
	Yeah.
	Yeah.
	So I understand how hard this is because, I mean, parents love their kids and they want what's best.
	And to be made to feel like, you know, these very normal things of parenting, like protecting them, is now demonized.
	So there are some resources.
	There's a great podcast called Gender A Wider Lens that is by Sasha Ayad and Stella O'Malley.
	And so they take a deep look at this topic.
	And if you look at Sasha Ayad, Sasha's website and videos, she really gives some really great educational materials.
	And then there are some support networks.
	I hear from parents all the time.
	Parents email me.
	So if you want to send me a message through my website, you know, I try to connect parents with some resources depending on what they're looking for.
	Heather, have you read Abigail Schreier's book?
	I have not, no.
	You got to read her book because Dr. Lippmann is not really as much about the prescription, but Abigail is.
	And she's got action points at the back of that book that a parent can do.
	If their child starts going through this, I'll get them.
	I mean, just a couple off the top of my head, like get them off the internet, take them out of town, go to a new town, the two of you, the three of you, or the two of you are taking a three month vacation together and get her away from people who are influencing her if you don't think this is real for her.
	And Abigail's much more articulate and helpful on it.
	But I can hear how stressful this has been for you.
	It just breaks your heart because, you know, for me, I have no problem with.
	Her identity and her, what she's walking through.
	But it makes me so angry to see a medical community not really care to get to know if there is, you know, a mental health issue, which even my daughter herself said, and it was always pushed from the very beginning.
	The only answer is to affirm it and let's start talking about, you know, giving you testosterone and talk about surgery.
	And it's heartbreaking, you know?
	Is there a medical group, Dr. Littman?
	Like, is there a medical group that talks sense as opposed to one of these doctors that's just going to say, yes, yes, yes?
	Yeah, so there are a couple of places of people who are starting to raise questions.
	There's an organization called the Society for Evidence Based Gender Medicine, so SEGM.
	And so this organization is very concerned about whether the evidence base is high enough to justify these specific interventions.
	So that is a good place.
	I mean, that's not a place for referrals, like to find clinicians.
	I mean, it's really, it's It's really hard.
	I would recommend the Inspired Teen Therapy website.
	It's crazy.
	I'm not really sure.
	It's very, very hard.
	Even the fact that you're searching for it, that just underscores our whole discussion today beautifully.
	Lisa Lippmann, you're a brave woman.
	I think I speak on behalf of my viewers and I say we're grateful to have you.
	Heather, so much love to you.
	Thank you both.
	And Dr. Lippmann will continue to follow everything that you write.
	Tomorrow, don't miss the show.
	John McWhorter, the brilliant John McWhorter, is here.
	Check us out at youtube.comslash Megan Kelly to watch the show.
	Thanks for listening to The Megan Kelly Show.
	No BS, no agenda, and no fear.

Chapters

00:00:00 Honest Look at Medical Care
00:04:00 Diverse Perspectives on Dysphoria
00:19:31 Cautious Approach to Diagnosis
00:23:30 Contagious Beliefs and Coping
00:39:34 Invalidating Underlying Disorders
00:54:09 Faculty Reactions and Support
00:59:34 Framed Experiences and Truths
01:10:15 Pressure from Doctors and Trauma
01:20:24 Researchers Must Speak Up
01:29:26 Parental Voice in Decisions