"Rapid-Onset Gender Dysphoria" Part 2: Panic! At The Endocrinologist.

Thanks to Jules Gill-Peterson (jgillpeterson.com) and Julia Serano (patreon.com/juliaserano) for help researching this episode and Evan Urquhart, Parker Molloy and Katelyn Burns for fact-checking!

Support us:

• Hear bonus episodes on Patreon
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Links!

• Origins of "Social Contagion" and "Rapid Onset Gender Dysphoria"
• The "Rapid Onset Gender Dysphoria" Controversy at AACAP's Annual Meeting
• Methodological Critique Of The Cass Review
• Methodological Critique of Littman (2018) 
• Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria
• A critical commentary on ‘rapid-onset gender dysphoria’.
• Foundations Of The Contemporary Anti-LGBTQ+ Pseudoscience Network
• Rapid-Onset Gender Dysphoria: Parent Reports on 1,655 Possible Cases
• Opinion: England's Anti-Trans Cass Review Is Politics Disguised As Science
• Tavistock v Bell
• Actually Nothing: The Non-Starter Non-Story of the WPATH Files
• As anti-trans legislation proliferates in 2024, community fears erasure from public view
• States Passed a Record Number of Transgender Laws. Here’s What They Say.

Thanks to Doctor Dreamchip for our lovely theme song!

Transcript

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[Maintenance Phase theme]

Aubrey: Yo.

Michael: Dude, smoothies are such bullshit. 

Aubrey: [laughs] Welcome to Mike's hot takes.

Michael: Dude.

Aubrey: What are you talking about, buddy? 

Michael: I've been fucking lied to. Everyone is telling me to drink smoothies. Because I drink too much coffee in the morning, and then I go to the gym, and then I'm dead tired. I'm just a black hole for three hours. 

Aubrey: Yes. 

Michael: And they're like, “Try a smoothie instead of breakfast.” And so, now I'm drinking smoothies and I drink a smoothie, and then 30 minutes later, I'm fucking starving. 

Aubrey: No, smoothies are delicious. 

Michael: Yeah, they're great.

Aubrey: The idea that they're going to stay with you is false. 

Michael: Yeah, we're back to my beefs with soup and salad. It's like, “Why? What's the point of this?” [Aubrey laughs] I want to be done eating. I want to go do things other than eating. 

Aubrey: Do you want to go grab a spoon of peanut butter now? 

Michael: No, I think it's good. Actually, I think I'm at my best when I'm only running on coffee, TUMS, and Wellbutrin. 

Aubrey: I did see a sticker this weekend that just said, “At my best when I'm at my worst.” 

Michael: Oh, that's pretty fun. 

Aubrey: I do feel like that is what you described. 

Michael: Well, maybe we have a tagline. Maybe we have a tagline. Maybe that's it. 

Aubrey: No, I got a tagline for us. Don't worry about it. 

Michael: Oh, you thought about it. You thought about it in advance. 

Aubrey: I thought about it while I was falling asleep, so it might be terrible. 

Michael: All right, give it to me. 

Aubrey: Hi, everybody, and welcome to the SASS report. 

Michael: Wait, what? [laughs]

Aubrey: Are we not talking about the Cass report? 

Michael: Oh, God. [laughs] Jesus Christ. [Aubrey laughs] Okay, no more before you go to bed, Aubrey. No more dream journal fucking taglines.

Aubrey: No more thinking of it in advance. 

Michael: [laughs] Oh, my God. You know what? We're trying. We're doing our best. 

Aubrey: Are we? [Michael laughs] Is that our best?

[laughter]

Michael: I am Michael Hobbs. 

Aubrey: I am Aubrey Gordon. If you would like to support the show, you can do that at patreon.com/maintenancephase, Michael.

Michael: Aubrey.

Aubrey: Today, we're continuing our conversation about rapid-onset gender dysphoria, yes. 

Michael: Yes. So, Aubrey, do you want to recap us on what we learned last episode? 

Aubrey: Rapid-onset gender dysphoria made its way into the news cycle, sounding very legitimate and diagnostic and so on and so forth. But last time, we learned that its origin was in basically transphobic message boards.

Michael: Yes. 

Aubrey: And that the primary storytellers around this were parents who appeared to be having a profoundly transphobic response or at the very least high levels of discomfort. 

Michael: Yes.

Aubrey: With their own kids having come out as trans.

Michael: Yes. Last week's episode was essentially a bizarre human centipede story where there's these parents whose kids come out as trans to them, and they essentially speculate, “Oh, I don't think she's really trans. I think she's being Pied Piper'd by the Internet and her peers and the culture around her.” And so, I'm just going to assume that this is some sort of like fake, temporary thing, and if I resist it long enough, she will drop it. And despite there being essentially no evidence for this, this narrative starts to appear in the mainstream media. Eventually, we have a poster abstract in an academic journal where a researcher named Lisa Littman does what looks like an exploration of this phenomenon, but it's actually just a survey of the same pretty small number of parents. So, that doesn't really tell us anything about the phenomenon itself. It only tells us about the perceptions and beliefs of these parents.

Aubrey: I would be very upset if there was research into gay people, and the way that they got their data was by asking James Dobson.

Michael: [laughs] Yeah.

Aubrey: “Why didn't you ask the gay people who were right there, huh?”

Michael: So, we are now going to delulu back to 2018. This is the first time we get mainstream, “evidence” for rapid-onset gender dysphoria. This is the publication of the full version of that very, very brief study we talked about last episode by Lisa Littman. This is basically just an anonymous survey of a bunch of parents. Lisa Littman posted recruitment advertisements on these three anti-trans websites, asked parents to fill out this survey, and then they filled it out. There's 90 questions. That's it. That's the whole study. 

Aubrey: Got you. 

Michael: So, there's going to be a lot of debate and discourse about this article, which we will get into. But one of the most striking things about going back to the research for this episode is how almost all of the documents that this movement cites as part of its kind of evidence base for this narrative, how just openly low rent and transphobic they are. 

Aubrey: Oh, God. 

Michael: So, we are going to read some excerpts from this study. This is an excerpt from the results section, where she is talking about parents describing the experience of hearing their kids come out to them as trans.

Aubrey: 81% of the parents answered affirmatively that their child's announcement of being transgender came “out of the blue” without significant prior evidence of gender dysphoria. Almost a third of respondents noted that their child did not seem gender dysphoric when they made their announcement. 

Michael: This one's so weird.

Aubrey: Dude. 

Michael: It's like, oh, they didn't seem like they had gender dysphoria when they told me they're trans. 

Aubrey: Did you believe it? 

Michael: [laughs] Yeah, yeah, yeah, yeah. 

Aubrey: Did they really sell it? 

Michael: “I didn't seem gay when I told my parents I was gay.” That's not really for them to decide. 

Aubrey: This goes back to the post that we read last time around, right. Which is just like, “They didn't seem like they were deeply unhappy and tortured by their own body.” We're like, “Whatever it was,” right? 

Michael: Yeah. 

Aubrey: People are looking for a deep sense of suffering. 

Michael: Also, I was lying. I did seem gay when I told my parents I was gay. 

Aubrey: You seemed gay at every moment. 

Michael: I seemed at every moment of my entire life.

Aubrey: Family photo that I've seen. 

[laughter]

Michael: I can hear our parents budding, “And you seemed real gay. You actually did seem super gay.” [Aubrey laughs] All right. 

Aubrey: 69% of respondents believed that their child was using language that they found online when they, “came out.” 

Michael: “Come out,” I had never seen that before I started researching this. 

Aubrey: Oh, man. This was all over our many, many, many anti-LGBT testimonies. 

Michael: Oh, yeah. 

Aubrey: Oh, coming out. 

Michael: Coming out.

Aubrey: Yeah, totally.

Michael: God. 

Aubrey: Of the 51 responses describing reasons why respondents thought their child was reproducing language they found online, the top two reasons were that it didn't sound like their child's voice and that the parent later looked online and recognized the same words and phrases that their child used when they announced a transgender identity. One parent said, “It seemed different from the way she usually talked. I remember thinking it was like hearing someone who had memorized a lot of definitions for a vocabulary test.” Another respondent said, “The email my child sent to me read, like, all the narratives posted online, almost word for word.” 

Michael: The obvious explanation here is that if your parents are conservative or a little bit anti-trans, you're going to google things to say to them for the coming out process. 

Aubrey: Also, maybe that's something you come across in looking to talk to your parents about it. It also might be stuff that you come across in figuring out your own identity stuff.

Michael: Totally. 

Aubrey: There are lots and lots of ways that this could come to be that don't mean, like, “Oh, no, invasion of the body snatchers.”

Michael: I actually think the study is very useful and very interesting because it's a portrait of parental anxieties. 

Aubrey: Yes. 

Michael: It says in these respondent answers, it says, it mirrors language that I found online afterwards. So, it's like their kids come out to them as trans. They then immediately go on the Internet and they're like, “Where's she getting this stuff?” They basically self-radicalize, right? They find these videos, they find Tumblrs, they find other things online, and then they start thinking that their kid is like some sort of automaton. My kid has been taken from me. 

Aubrey: I feel completely hooked on this idea of what does it mean to say something gender dysphorically? 

Michael: Yeah, yeah, yeah, yeah. I know. [laughs]

Aubrey: Oh, yes. That is a statement of gender dysphoria. Got it. 

Michael: She was doing the John Wayne voice the whole time she told us. [Aubrey laughs] Seems a little, she kept saying, pardner. I don't know why she did that. 

Aubrey: Duh-ha, duh-ha.

Michael: So, we're going to read one more excerpt, and this is just unbelievable. Okay. 

Aubrey: Okay. The groups targeted for mocking by the friend groups are often heterosexual people and non-transgender people. Sometimes, animosity was also directed towards males, white people, gay and lesbian, non-transgender people, aromantic and asexual people, and “TERFs.”

[laughter]

Michael: [sighs] Don't respond. Don't respond.

Aubrey: “Me.” The writer of this?

[laughter]

Aubrey: One participant explained, “They are constantly putting down straight white people for being privileged, dumb, and boring.” [laughs 

Michael: Boring. 

Aubrey: Another participant elaborated, “In general, cisgendered people are considered evil and unsupportive regardless of their views on the topic.”

Michael: I fucking love this. Regardless of their actual views. They call you transphobic regardless of what you believe. What do you believe? “My daughter's not trans.”

Aubrey: Definitely. Well…[laughs] To be heterosexual, comfortable with the gender you were assigned at birth, and non-minority places you in the most evil of categories with this group of friends. Statement of opinions by the evil cisgendered population are considered phobic and discriminatory and are generally discounted as unenlightened. Another participant said, “I hear them disparaging heterosexuality, marriage, and nuclear families.”

Michael: What?

Aubrey: Another participant said, “On my daughter's Tumblr blog, she has liked or favorited or reposted disparaging comments about those who aren't transgender or seem to misunderstand the transgender identity.” Boy, if you are digging through your kids Tumblr likes? 

Michael: Dude, that's exactly where my brain went. I was like, this is a level of self-radicalization that is really alarming. 

Aubrey: Yeah. 

Michael: Later in this paper, it says, also as evidence that my daughter's being taken from me or whatever, says “She edited her diary.”

Aubrey: I was just about to make a diary joke about, like, “She thinks I'm invading her privacy, which I wouldn't know if I didn't have to read her diary all the time.”

Michael: Yeah. 

Aubrey: If you're looking for someone who's being radicalized on the Internet, may I introduce you to a mirror? 

Michael: No, The social contagion thing is also fascinating too, right?

Aubrey: Right.

Michael: Because it's clear that these parents are like whipping each other up and they're posting, “Research that shows that trans people don't really have high suicide rates, blah, blah, blah.” Some of these stories from the parents are honestly very sad. It's like these parents who essentially choose online forums over their relationships with their own kids. A lot of them are just not in contact with their kids anymore because they can't handle just saying, “We love you, no matter what.”

Aubrey: I actually think there's something a little bit more insidious even than like, they're positing that all trans identities are fake. That's not what they're positing. They're positing that all trans identities are subject to the approval of cis people. 

Michael: So, this is actually the explicit project of this study. I am going to send you an excerpt from the conclusion. 

Aubrey: The conclusion of this exploratory study is that clinicians need to be very cautious before relying solely on self-report when adolescents and young adults seek social, medical, or surgical transition. Adolescents and young adults are not trained medical professionals [Michael laughs]. When they diagnose their own symptoms based on what they read on the Internet and hear from their friends, it is quite possible for them to reach incorrect conclusions. It is the duty of the clinician, when seeing a new adolescent or young adult patient seeking transition, to perform their own evaluation and differential diagnosis, to determine if the patient is correct or incorrect in their self-assessment of their symptoms and their conviction that they would benefit from transition.

Michael: If a patient is correct or incorrect in their self-assessment.

Aubrey: Oh God.

Michael: It also says, this is a couple paragraphs later. “The patient's history being significantly different than their parents account of the child's history should be seen as a red flag that a more thorough investigation is needed.”

Aubrey: This was an entry point to weakening abortion protections in the US, was parental notification. 

Michael: Yeah. 

Aubrey: And that's essentially what they're advocating here, right? 

Michael: Yeah. 

Aubrey: It's actually good for these kids if you out them to their parents, who they probably haven't told for a fucking reason. 

Michael: There's also the thing that we see in a lot of reactionary movements where the demands of the reactionaries are things that are already in place. They're like, “We think kids should be assessed before they get hormones and surgery.” It's like, “Yes, they are.” The barriers to getting hormones and surgery as a minor are extremely high, and you can't transition without parental permission already.

Aubrey: All of this really hinges on the idea that legal minors who are transgender have an undue amount of social power and influence and need to be checked. 

Michael: Yeah, we're sick of coddling these trans kids as a society. 

Aubrey: Too much. Enough is enough. 

Michael: Okay. But then my favorite thing about this study, not only just how on its face, janky it is, is like essentially every other study of this kind, while trying to generate evidence of rapid-onset gender dysphoria, it ends up generating evidence of the opposite. [Aubrey laughs] So, as one of the questions to these parents, it's like, “When did your kid come out? Did your kid go to a gender clinic? Did your kid change their hairstyle? Blah, blah, blah.” So, there's 256 parents who fill out this survey. Only 11% of their kids ended up getting hormones, 2.7% ended up getting puberty blockers, and 2% ended up having surgery. 

So, if it were the case that people are tricking doctors into giving them this care, if it were the case that doctors themselves were tractor beaming kids through all these medical procedures, we would see way more than 10%, 15% percent of kids getting gender-affirming care. 

Aubrey: I also think this is where the whole endeavor reveals itself to be less about concern and more about concern trolling, right? 

Michael: Yeah, yeah, yeah, yeah. 

Aubrey: It's certainly not about the ins and outs of what health insurance covers-

Michael: Yeah. No one gives a shit.

Aubrey: -or what doctors are permitted to do or any of that kind of stuff. This is all just ways of eating around the edges of a much bigger thing that they're trying to eliminate, which is healthcare for trans people. 

Michael: Yeah. All episodes that we do is an extended subtweet of Brexit. And this is exactly what happened [Aubrey laughs] with Brexit too. They're like, “All we're asking for is, like, a slightly updated arrangement, and then every single time they get what they want, they just push it farther and farther and farther and they've ended up with the hardest imaginable Brexit. And, you can't negotiate with people who are not actually saying things in good faith. They're saying what they know you will agree to, and the minute you agree to it, they'll push you to the next “reasonable ask.” And that's what's happened in the UK. I was going to say something specific, but it's just the UK at this point. [laughs]

Aubrey: Yeah, the whole thing. The whole thing. All of it. 

Michael: So, this article comes out in August of 2018, in November of this year, Lisa Littman, the author of the paper, presents it at the annual meeting of the American Academy of Child and Adolescent Psychiatry. And there’s a description of her presentation which were only reading because I think it’s extremely funny. 

Aubrey: Following Dr. Littman’s presentation, there was no applause. [laughs] Sorry.

Michael: Got her.

Aubrey: Okay. Boop. Following Dr. Littman’s presentation, there was no applause before several audience members launched into questions. Some were more civil than others, but pretty much all were critical. One audience member pointedly asked Dr. Littman what she had previously studied in her research, OB/GYN, public health issues, and whether she has worked with any transgender patients in the past. She has not.

Michael: Narrator voice, narrator voice.

Aubrey: Her. 

[laughter]

Aubrey: Another questioner at the end repeatedly asked her, “Why did you do this study? And what's wrong with taking on a different gender identity?” To which she would only say that, “We should keep open the possibility that there may be social contagion occurring.”

Michael: [laughs] Yeah, I love that the questions are just like, “Why? [Aubrey laughs] Why are you doing this?” [laughs] You are just like sputtering. 

Aubrey: What if it's neutral? But what if it's happening because of social contagion? [Michael laughs] You're just describing like fashion at this point. “Wow. We maybe, why else would people be wearing cargo pants right now?”

Michael: So, I think this is a good summary of the academic response to this. And before you know it, there start to be more formal methodological critiques in various journals. So, the main thing is that Littman is trying to identify a phenomenon among kids that doesn't interview any kids. So, just as a starting point, that is like pretty janky. And then secondly, we've got the parents who were recruited from anti-trans website, so it's not a remotely representative sample. 

Aubrey: Yeah, yeah, yeah. 

Michael: And then it's even worse than that. So, when Littman recruit’s participants, you have to get like a consent form from everybody where it's like, “This is what the study's about. And you like sign it.”

Aubrey: Right.

Michael: And so, in the consent form for this study, participants are told you are being asked to take part in a research study if you have a child who, when they were between the ages of 10 and 21, developed a sudden or rapid-onset of gender dysphoria. This may have occurred in the context of either increased social media Internet use, and/or belonging to a friend group in which one or multiple friends have developed gender dysphoria and come out as transgender during a similar timeframe. So, basically, this is the conclusion of the study being used on the consent form before people fill out the questionnaire. [laughs]

Aubrey: Another way of putting this is, “Did your kid recently come out and have they found community among their peers?”

Michael: So, there's lots of discourse around this. There's open letters, there's petitions, there's lots of debate after this article comes out. And eventually, on March 19, 2019, the journal that published the paper republishes it. So, they issue a statement that says, “Correcting the scientific record on gender incongruence and an apology” where they say, “In discussion with two academic editors, a statistics reviewer and an academic who treats gender incongruence in adolescents, we've reached the conclusion that the study and resultant data reported in the article represent a valid contribution to the scientific literature. However, we have also determined that the study, including its goals, methodology and conclusions, were not adequately framed in the published version and that these needed to be corrected. The changes include revisions of key sections such as title and abstract, which required us to republish the paper. “

This is a pretty big deal and doesn't happen all that often. The changes are so meaningful that they have to change the title and the abstract. 

Aubrey: Yeah. 

Michael: So, the previous title of the paper, the original title, was Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. And the updated title is Parent reports of adolescent and young adults perceived to show signs of a rapid-onset of gender dysphoria.

Aubrey: Yep. 

Michael: What I find so frustrating about this is that Littman herself and a lot of conservatives do like this weird victory lap about this statement. We've reached the conclusion that the study and the resultant data represent a valid contribution to the scientific literature. [Aubrey laughs] Like the thing they say before the but essentially. Because oftentimes what you see in debates about this in reply guy world is that you're like, “Yeah, the study's like discredited.” And then people will be like, “Well, it wasn't retracted.”

Well, okay. [laughs]

Aubrey: This is like a movie poster where the quote from a critic is just like, watchable. 

Michael: Yeah, yeah, yeah, yeah, yeah. 

Aubrey: It is so damned with faint praise. 

Michael: There's also an unbelievably tedious thing where originally, Brown University, where Lisa Littman was employed, puts out a press release saying, “Our researcher has a study that found these things.” And after these major corrections to the paper, Brown then deletes the press release from its website. There's all this outcry. And the president of Brown releases a statement saying, “We respect the academic freedom of everybody who works at Brown. We don't want to spread messages that might cause harm to the transgender community. We're leaving up the study. We are not retracting the study. We're not deleting it from anything. We're just deleting the press release.”

Aubrey: Yeah. 

Michael: Ultimately, I don't know, relatively minor thing, but the right goes ballistic. Ben Shapiro writes a piece for the Daily Wire called, “A Brown University researcher released a study about teens imitating their peers by turning trans. The left went insane. So, Brown caved.”

Aubrey: The left went insane. 

Michael: Quillette has, “As a former Dean of Harvard Medical School, I question Brown's failure to defend Lisa Littman.” They did defend her. 

Aubrey: Yeah. 

Michael: Fox News has, “Brown U censors gender dysphoria study. Worried that findings might invalidate the perspectives of transgender community.” The study, you can go look at the study and read the study. Nothing has been censored. But I think this Brown University little dust up thing is indicative of one of the big shifts that starts happening over the course of the next couple of years after 2019 is that the anti-trans movement starts to become increasingly conspiratorial. This whole narrative, when you think about it already is a conspiracy theory in that it requires you to believe hundreds of doctors are giving these irreversible procedures to kids with no assessment because they're so blinded by their SJW trans ideology that they don't even care. 

Aubrey: Yeah. 

Michael: You're already in a conspiracy mindset and then this whole thing of, “Brown University censored the research and the trans activists are coming after us.” It creates this thing that we see in other conspiracy theories where everything becomes about these meta debates about, like, “You can't even ask the questions anymore.” When you look at anti-trans rhetoric and these organizations of parents or whoever it is, they spend a huge amount of time on, like, “She tried to publish her research, but then it was censored.” Whether or not it was censored is irrelevant to whether or not the narrative holds up on the merits. Like, people's work can be censored for political reasons, but it can also be censored because it's bad. Like, research on flat earth also gets censored. 

Aubrey: Yeah. 

Michael: This actually appears in a later interview with one of the people who is leading this crusade. He says, “Researchers who have touched this topic have been punished for their curiosity. Just ask Lisa Littman, ultimately, her paper on the subject resulted in unnecessary correction by the journal that published it, and the loss of Littman's academic affiliation with Brown University, which prioritized activist outrage over Littman's academic freedom.”

Aubrey: Wait, did she get fired? 

Michael: No, she left.

[laughter]

Michael: She left to go do anti-trans advocacy. All the time, I found her tweet announcing it. She says, “I'm thrilled to announce my excellent colleagues and I are launching a nonprofit research organization to study gender dysphoria. I will be leaving Brown University and appreciate the time I spent there.” If you had good evidence, you would just be telling me the evidence and sending me citations. But the fact that you keep changing the subject to this meta stuff is just, like, a little bit suspicious. 

Aubrey: How has the tenor of a TikTok video where it just cuts into some lady screaming, like, “You're impinging my First Amendment Rights.” And you're like, “We can have a conversation about this,” but I'm guessing there's some other stuff going on here. 

Michael: Or the anti-mask weirdos on, like, planes.

Aubrey: Hitler made them wear masks before. Okay,-

Michael: Yeah, yeah, yeah, yeah.

Aubrey: -great.

Michael: And then the other, I think, very noticeable conspiratorial element among these rapid-onset gender dysphoria boosters is that there's a total refusal to engage with all of the counter evidence. So, in the years after this paper is corrected, there's actual studies, actual surveys of trans kids, that completely fail to confirm this diagnosis. One of the things we noticed in the anti-vax episodes was that, like, “If anti-vax narratives were true, it would actually be very easy to tell.” You would be able to say, like, “Oh, they changed the vaccine schedule in Michigan, and then one year later, there was a massive spike in autism cases.” 

And it's kind of the same thing with rapid-onset gender dysphoria, that if there was this massive wave of kids showing up to gender clinics who a week ago, they saw a transition video, and now they say they're trans or they have a lot of trauma, and they're thinking they're trans is like a coping mechanism or whatever, we would actually see that in the data, and clinicians would see this too and it would show up in studies. 

Aubrey: Yes. 

Michael: So, there's a survey of 173 trans youth across 10 different clinics in Canada that concludes, “Controlling for age and sex assigned at birth, recent gender knowledge was not significantly associated with depressive symptoms, psychological distress, past diagnoses with mental health issues or neurodevelopment disorders, gender dysphoria symptoms, self-harm, pass your suicide attempt, having gender supportive online friends, general support from online friends or transgender friends or transgender support from parents.” We also have much larger surveys. So, in 2023, we get a survey of 27,000 participants where 40% of trans people say that they realized that they were trans in adolescence. It doesn't mean they're bewitched. It doesn't mean they saw it on TikTok. It doesn't mean that they're not trans. It's just a different way of discovering themselves. 

It's just not the case that we have a bunch of kids who are essentially confused, and they see something on the Internet, and the next day they tell their parents, I'm trans, and the next week they tell the doctor, I'm trans. And then the week after that, they're getting surgery. 

Aubrey: I will say, I remember the gender confusion as the lead message sort of era. 

Michael: Yeah. 

Aubrey: One of the reasons that I recall it so vividly is that we had a volunteer leadership summit at one point and a trans woman attended wearing a t-shirt that just said, “I'm not confused, but you seem to be.” [laughs]

Michael: Oh, that's good. That's very good. 

Aubrey: This is all shit that you come to when you're looking for reasons to disbelieve your kid, when they tell you that they are trans, right? That you're like, “Oh, the timing of it is wrong. The onset was too rapid, or I didn't see you.” I didn't observe you as being deeply, deeply unhappy or emotionally distraught about your gender. 

Michael: Yeah. And to me, it's just so telling that it's like the minute somebody asks actual trans people, they're like, “Oh, that's not my experience at all.”

Aubrey: Yeah.

Michael: That probably should just be the end of the debate then, [laughs] rather than asking more people who are not trans kids and would have no way of knowing what the subjective experience of trans adolescents is. 

Aubrey: Yeah. 

Michael: But then in 2023, we get another attempt to prove that rapid-onset gender dysphoria exists. I know this [laughs] one's even worse, but we're not going to spend as much time on it. So, this one is called Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases. So, one of the co-authors of this is someone named J. Michael Bailey, who-- I don't know how else to put this. He's basically just is a disgraced sex researcher. [Aubrey laughs] So, the scandal with him is all around his 2003 book called The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism-

Aubrey: Oh, oh. 

Michael: -where I know-- We're just going to read it. [Aubrey laughs] I was going to try to preface this. I went to his website, and it has an excerpt of his book. 

Aubrey: I just like that we got the belabored side before you even said anything. Like, you couldn't even start a sentence without just being like ugh…

Michael: I thought like, “What can I tell Aubrey about this guy?” But I think I'm doing a show don't tell thing. So, this is--

Aubrey: Got it. 

Michael: -I believe, the first five paragraphs of his book. This is on his website. This is not leaked secret documents. This is something he has put out as, “This is an exemplar of my work.”

Aubrey: The most expert cosmetic salesperson at the local upscale department store is a man. A female friend told me about him, and intrigued I went to see him. He was young, tall, and African-American, and his head was shaven. His fingernails were long and covered with clear nail polish. I watched him as helped a woman choose the right makeup. After he was done with her, I introduced myself. He was slightly taken aback that I, a psychologist, wanted to meet him. What?

Michael: I don't know.

Aubrey: But he also appeared slightly flattered. He told me his name was Edwin. Edwin is a feminine man, one of the most feminine men I have ever met. I do not ask Edwin about his childhood because I do not need to. I already know that Edwin played with dolls and loathed football, that his best friends were girls. There is some chance that if I ever see Edwin again, his name and appearance will be changed to those of a woman. Even for a gay man, Edwin's appearance and manner are exceedingly feminine. He would stand out in a gay bar, but he'd receive little romantic attention there. First of all, how do you know? 

Michael: Yeah. What is this weird dig at Edwin? 

Aubrey: Ugh, God. 

Michael: Yeah. I mean, gay men are misogynistic as fuck on this stuff, but like, when straight people talk about this shit, I'm like, “Take Edwin's name out of your mouth.” 

Aubrey: Also, femmes are getting laid. Don't worry about it. 

Michael: Wait, I have to take off my carpal tunnel splints. Hang on, hang on. Femmes are getting laid. [Aubrey laughs] Femmes.

Aubrey: He is near the boundary of male and female, and someday he may cross it. If he does, one primary motive will be lust. One cannot understand transsexualism without studying transsexual sexuality. Transsexuals lead remarkable sex lives. Those who love men become women to attract them. Jesus Christ.

Michael: Dude. I know. 

Aubrey: Those who love women become the women they love. Although transsexuals are cultural hot commodities right now, writers have either been too shallow or too squeamish to give transsexual sexuality the attention it deserves. No longer. Also, trans writers have not been too shallow or too squeamish to write about transsexuality. That's been happening for a long time. 

Michael: People write about it. Dude, this is the excerpt he put on his own website. 

Aubrey: Jesus fucking hell.

Michael: This is the work that he's proud of.

Aubrey: So, one primary motive for transition is lust [Michael laughs] for the stranger that you fucking met at Sephora.

Michael: Yeah, you got to see this homo working at the mall.

Aubrey: Who, by the way exists at every Sephora. 

[laughter]

Aubrey: What are we doing? 

Michael: J. Michael Bailey is fairly open about the fact that he thinks there's only two kinds of transgender people, and one of them is basically gay dudes. They want to get men and they can't get them as a man, so they become a trans woman so they can get men. And then the other kind of transgender people is autogynephilic transsexuals, people who basically are turned on by the idea of themselves being women. So, basically, they're sex perverts. It gives them a boner to dress up in women's clothes and live as a woman. And they're only doing it for this lifelong fetish. 

Aubrey: This is the buffalo bill of it all, yes? 

Michael: Yes, yes, exactly. And so, I mean, this is the rhetoric that you got in the fucking 50s and 60s. And he's publishing this book in 2003 and he's still saying this shit now. He now has revised this to say that there's three kinds of trans people. And the third one is rapid-onset gender dysphoria. 

Aubrey: This is you are now turning into Brian Cox in succession, looking to anti-trans movements saying, “You are not serious people.”

Michael: Exactly. But then, okay, so the other reason we're talking about J. Michael Bailey is that one of the first steps of researching this guy was to go to his Wikipedia page. And mostly it's a normal Wikipedia page. It has career stuff. It has information about these various scandals. And so, I'm scrolling and scrolling, and then I get to the final section of his Wikipedia page, which is the “fucksaw incident.” 

Aubrey: What? 

Michael: [laughs] And I was like, “Mike, you have 180 pages of notes. Don't open a bunch of other tabs. Don't find out what the fuck, the fucksaw incident was.”

Aubrey: But come on.

Michael: I didn't have the strength. 

Aubrey: You and I know why we do this show. 

Michael: I didn't have the strength.

Aubrey: Finding out about fucksaws-

[laughter]

Aubrey: -is a non-zero factor. 

Michael: Okay. And then all day I'm thinking about it, I'm like, [Aubrey laughs] “What is the fucksaw incident? What is it?”

Aubrey: Also, I would just say anything involving a fucksaw is an incident. 

[laughter]

Michael: It is not like a quiet evening with the fucksaw.

[laughter]

Aubrey: Sunday afternoons. 

[laughter]

Aubrey: Oh, no, Michael. I might be destroyed. 

Michael: Okay. Do you want to know what the fucksaw incident was? 

Aubrey: [laughs] I don't know if I could take it.

Michael: Okay.

Aubrey: Yeah, tell me.

Michael: Okay. So, 2011, he's a teacher at Northeastern, and he teaches about sexuality. He does sexuality classes, and so he's doing an optional lecture on kink, like the kink community. And so, he brings in two kinky people. I thought the fucksaw was going to be a joke name or something that like a student came up with. This is what the kink performers call it. So, it's a saw, like a saw blade that you use for home construction. But if you take off the saw and you put on a dildo, then it's like a dildo going in and out. I'm doing this with my hand right now, but you can't see it. 

Aubrey: Oh, sure. 

Michael: So, it's like a jackhammer. It's like a dildo jackhammer, basically.

Aubrey: Yes. 

Michael: And so, apparently, they're having this class, and they're describing having sex with this woman with the fucksaw. And one of them is like, “You know, we actually have the fucksaw with us right now. [Aubrey laughs] Should we demonstrate this?”

Aubrey: Oh, hello students, I happen to have my fucksaw on me. 

[laughter]

Michael: It's in my civic outside. Give me a second. 

Aubrey: I brought it to school. 

Michael: Then they go out and they get the fucksaw. 

Aubrey: I love this. 

Michael: This man uses the fucksaw on this woman and brings her to numerous orgasms. 

Aubrey: This is made up. 

Michael: This is fucking real. 

Aubrey: This is made up. 

Michael: This becomes a whole big thing. The whole country is clowning on this professor who let this happen, because apparently, they were like, “Is this cool?” And he's like, “Yeah, yeah whatever. We're all adults here.” There's eventually an interview with him in salon where they're like, “What is the deal with this whole outcry?” And he's saying, “It's not a big deal because it's like an optional lecture. All the kids in college are adults.” And he says, “It took no more than 10 minutes of the hour-long presentation. 

[laughter]

Michael: So, it's one fucking sixth of- 

Aubrey: Amazing.

Michael: -of the thing of 10 minutes of this woman just having orgasm after orgasm.

Aubrey: Watching somebody have sex in a lecture hall for 10 minutes is a long amount of time. 

Michael: It sounds so boring honestly, after the first one, [Aubrey laughs] how much fucksaw do we need? So that's J. Michael Bailey.

Aubrey: Jesus, hell bells. 

Michael: That’s our guy. That's our guy. That was a weird a long digression.

Aubrey: About the fucksaw. 

Michael: We're keeping it.

Aubrey: Good. I love that you're like, “This is totally inappropriate for a university.” Let's just dedicate 25 minutes of our podcast to it.

Michael: I want it to be exactly one sixth of our podcast the way that it was one sixth of the lecture. 

Aubrey: Oh, good. [laughs] Good.

Michael: I think that's fair. I want to keep structural integrity. 

Aubrey: How many of the lecture halls full of students are we going to reach on this episode?

Michael: Yeah, yeah, yeah, yeah. So, back to the reason why we're talking about the fucksaw. This 2023 article that is attempting to prove the existence of rapid-onset gender dysphoria. One of the authors is the fucksaw guy, J. Michael Bailey. The other author is a woman named Susana Díaz. And the way that the study comes about is J. Michael Bailey goes to a conference organized by Susana Díaz, and he's talking to her about this website that she founded called Parents of ROGD Kids. She mentions that she has all of this data. She has a survey that she has sent to the users of this site, and that is the basis of this study. So, right off the bat, you can tell that this has exactly the same problems as the previous study. 

This is just essentially a sketchy online survey, and it's recruited parents who already believe in the concept of rapid-onset gender dysphoria. So, of course they're going to report that they've seen it in their kids. That's why they're on this website. But the amazing thing is that both of those factors are even worse in this study. [Aubrey laughs] So, first of all, the data is even sketchier because Susana Diaz is not her real name. J. Michael Bailey says that, like, “Oh, because the trans activists were so mean to Lisa Littman, she has no choice but to use a pseudonym.” He says, “My co-author, Susana Diaz, doesn't go by her real name. I don't even know it despite having met her in person once and spoken with her many times. She uses a pseudonym to protect her family, especially her daughter, whom Susana believes has rapid-onset gender dysphoria. 

Aubrey: Yeah.

Michael: This is just a lady who founded this website and then says that she surveyed people, but there's very little information about the methodology and logistics of the survey. And secondly, this website that she founded, Parents of ROGD Kids, I mean, the previous study also recruited parents from these anti-trans websites. This website makes fourth wave now look like PFLAG. So, if you go to our position, the basic about us statement on their website, it says our position. One, identifying as the opposite gender is not normal.

Aubrey: Oh, good. 

Michael: In most cases, it's a symptom of severe psychological pain or dysfunction or an attempt to resolve some other issue. Two, our children are subjected to strong cultural influences that promote transitioning. Three, the gender affirmative model is a form of conversion therapy. 

Aubrey: What? 

Michael: I know. 

Aubrey: Sorry.

Michael: Dude. This is the rhetorical equivalent of a fucksaw. 

Aubrey: Okay, okay, okay. 

Michael: The word fucksawing us. Not in the good way. [Aubrey laughs] Four, the current standard of care, the gender affirmative model, is unproven. Five, are gender dysphoric children, youth, and adults are being experimented on. Six, the gender affirmative model prolongs suffering and causes further trauma. Seven, professionals who accept an individual self-diagnosis and propose medical intervention are negligent. 

Aubrey: Jesus, Christmas. 

Michael: Eight, medical intervention for gender dysphoria should be a last resort. So, this is very openly anti-trans organization. 

Aubrey: As you know, my brain is broken in such a way that it can only be treated by recreationally watching the Montana Legislature. 

Michael: Yes. 

Aubrey: And this was a huge, huge, huge fight last session. There were people making these sorts of claims about, like, “Kids are being rushed into transition ba, ta, ta, ta, ta,” and the whole time I was watching it, I was like, “In Montana?”

Michael: Yeah, I know. 

Aubrey: In Montana. The places where the moral panic is the strongest are the places where it is also the most disapproved of. It's just real nonsense, and it's a real dead giveaway that people are just turning off their critical thinking brains at all. They're just freaked out, and their hypothalamuses are like, “This is the only part of your brain that works right now.”

Michael: And so-- [laughs] 

Aubrey: [crosstalk]

Michael: So, we're not going to spend as much time on this as we did on the Lisa Littman survey, mostly because this is essentially--

Aubrey: Are we going to spend as much time on it as we did on the fucksaw? 

Michael: [laughs] No.

[laughter]

Michael: Mostly because this is essentially the same thing again, but, even jankier. So, in the consent form it says, “Who should complete the survey?” You should complete the survey if your child, A, had a relatively normal childhood without showing any signs of discomfort with their gender, and B, suddenly, seemingly out of the blue, decided they identified as the opposite gender or some other “gender.”

Aubrey: Boy, gender in scare quotes is a new one for me.

[laughter]

Aubrey: Just like, the whole concept of it. 

Michael: I know. 

Aubrey: I don't fucking know. 

Michael: And then in the recruitment criteria, they say that their respondents are reporting, like, they get a median age of rapid-onset gender dysphoria. And they say that the range is between three to greater than 25 years. So, what child at age three is doing rapid-onset gender dysphoria? [laughs] 

Aubrey: Truly.

Michael: How would you, like, is the three-year-old on TikTok? They say we limited subsequent analyses to parent reports on youths whose gender dysphoria was reported to begin between ages 11 and 21. So, why are you including people over 18? They're not children, then. 

Aubrey: Yeah. 

Michael: Again, this guy is such, just like, so noncredible to me. He says this in interviews afterwards, after this paper gets a lot of criticism. He says, “We identified 1655 cases of rapid-onset gender dysphoria, a significant number for activists to ignore. You didn't identify cases?

Aubrey: Yeah.

Michael: These are not cases. You identified parents. 

Aubrey: Yeah. Also, that whole for activists to ignore. I'm like, A, What are you doing?

Michael: Yeah. 

Aubrey: And B, what else have people been ignoring? Again, this is unlike some grocery stores, you'll never find reds.

Michael: Yeah, yeah, yeah, yeah, yeah. 

Aubrey: You're trying to insinuate that anyone who is supportive of trans people is ignoring data or willfully shutting down some more science-driven conversation. But you're not making the implicit explicit. You're doing these big broad gestures to be like, “You know how they are,” and it's like, “No, you have to tell me how they are.”

Michael: There's then, we're not going to go into it, but there's then a whole tedious debate thing. And this paper is eventually retracted. The reason why it's retracted is because they never got ethics approval. 

Aubrey: Oh, Jesus. Always a good fucking sign. 

Michael: The funny thing is, too, is on the broader and more substantive critiques, he's like, “Well, the limitations section of the paper said these weren't representative,” which I guess, but also, you can't just publish a super shitty study and then limitations be like, “Well, this study is super shitty.”

[laughter]

Michael: So, after this happens, the paper is retracted. You then get another tedious wave of someone published an article that questioned the trans orthodoxy and they were canceled. He writes two different first-person accounts, one of which, for Bari Weiss' website. 

Aubrey: You got to give me a trigger warning before you say.

Michael: I know, I know it's bad. 

Aubrey: Don't say it three times, you know. 

Michael: The headline is, “My research on gender dysphoria was censored, but I won't be.” 

Aubrey: Oh, lord. 

Michael: If rapid-onset gender dysphoria was real, you would be talking about the real evidence for it. You would be pointing us to evidence. You wouldn't be talking about, like, “This guy's paper was retracted. This guy's super jankballs paper was retracted.”

Aubrey: I think part of like, what's at the core of what's happening here is a thing that I thought about a lot as an organizer, which is what happens when people believe that their discomfort has to be resolved in order for other people to do other things with their own lives. Right?

Michael: Yeah, yeah, yeah. 

Aubrey: You feel uncomfortable when a conversation comes up and you're nervous about becoming the new Larry David of your friend group. Like, “Oh, no, you can't say anything, right?”

Michael: Yeah. 

Aubrey: And, meanwhile, people are not getting healthcare that they urgently need. 

Michael: Yeah. Yeah. 

Aubrey: I both have a lot of empathy for folks who feel like change is happening really rapidly, and I'm struggling to keep up with it, and I feel really confused by it and whatever that discomfort becomes the cultural thing that we're responding to instead of, the actual needs of actual trans youth. 

Michael: But you're very clear, and you can just ask them and find out what they are. [laughs] 

Aubrey: Totally. 

Michael: Yeah, yeah, yeah, yeah, yeah.

Aubrey: Totally. 

Michael: So, we have the one Lisa Littman study, which is heavily corrected. We then have this Michael Bailey fucksaw study officially retracted. So, these are the only two pieces of evidence for rapid-onset gender dysphoria. 

Aubrey: Okay. 

Michael: We also accidentally, during this period, get a bunch of evidence against rapid-onset gender dysphoria. I'm stealing this point from Julia Serano, who has pointed this out numerous times, that over the last couple years, the anti-trans movement keeps just declaring victory and saying that they've discovered this smoking gun, that all of their concerns have been proven. And every single time, it ends up proving the opposite. The first one of these alleged smoking guns is a lawsuit from 2020 that's filed in the UK called Tavistock v. Bell. It is filed by two claimants. The first claimant is somebody named Keira Bell, who was a patient at England's only youth gender clinic, which we will talk about in great detail later. 

We're not going to go into too much detail, but I'm just going to read you a couple of choice excerpts from the timeline that is laid out in the discovery facts stage of this lawsuit. So, if you read the decision, these are little sentences that I'm cutting out because they're amidst all of the legalese. It says when she was 15, the first claimant was referred to the Tavistock clinic. That's the gender identity clinic. 

Aubrey: Yeah. 

Michael: She was first seen at the Tavistock Clinic aged 16 and had a number of appointments spread out over one year and nine months. She was referred to another clinic in June 2013 and after three appointments commenced puberty blockers. After commencing testosterone at 17, changes to her body commenced rapidly, and when she was 20, she had a double mastectomy, and then she de-transitions a couple years later. So, just to lay this out really clearly, according to the timeline presented by somebody who claims she was rushed through gender-affirming care, she identifies as trans at 15, she doesn't get her first appointment at the clinic until she's 16 because there's a huge waiting list. She then has a bunch of appointments spread out over one year and nine months before she gets puberty blockers. She then starts testosterone at 17. So, another year goes by and she gets a mastectomy at 20. 

Aubrey: Yeah, five years. Big rush. 

Michael: This also explains why in the lawsuit they mentioned that in the previous year, the clinic only gave puberty blockers to 161 kids, which is minuscule. We're talking about 8 million kids between 10 and 19 in the UK as a whole. And if you compare this to antidepressants, 500,000 kids in the UK are on antidepressants [laughs]. I don't want to cast aspersions on antidepressants or whatever, but it's like you can get antidepressants after one appointment. 

Aubrey: I feel like between this and your last episode saying your therapist called you a nervous wreck-

Michael: Look.

Aubrey: -that you might be telling on yourself more than you mean to.

[laughter]

Aubrey: You can get this shit in one appointment. I don't know if you know that. 

Michael: I was rushed into dealing with my anxiety issues. 

[laughter]

Aubrey: After a scant 40 years. I was rushed into it. 

Michael: It was very funny. He's like, “Yeah, you have a fast talking, urgent, nervous energy. Has anyone ever told you that?” And I was like, “About 1500 people on iTunes.” [Aubrey laughs] You can actually see reviews of my personality. You can get a second and a third and a fourth opinion if you'd like. 

Aubrey: Only every time I talk, which I do for a living. 

Michael: For a living. 

[laughter]

Michael: So, okay. So that is the first claimant. So, someone who was rushed through a five-year process. And then the second claimant, I'm going to send you this excerpt from the lawsuit. 

Aubrey: The second claimant Mrs. A is the mother of a 15-year-old girl who has autism spectrum disorder. The daughter has a history of mental health and behavioral problems. She is desperate to run away from all that made her female and has been referred to child and adolescent mental health services.

Michael: Which is not the gender identity clinic, by the way. This is just like mental health for kids. 

Aubrey: Mrs. A is very concerned that her daughter would be referred to the Tavistock Clinic and prescribed puberty blockers. However, the daughter has not currently been referred to the Tavistock Clinic, and having regard to the defendant's current practice, would not meet the criteria for puberty blockers because her parents would not support that treatment. Mrs. A's interest in this action is therefore largely theoretical. This is so English in the best way. [Michael laughs] That's English. Bless your heart. 

Michael: This is literally just a random person. Her daughter has mental health problems. Okay? We think she might be rushed into medicalization if she was referred to this clinic, but she wasn't. Can you imagine filing a lawsuit against the Sackler’s and be like, “Well, if I was in a motorcycle accident, I would have been prescribed opioids, and then I would have gotten addicted.”

Aubrey: I really like how close we're getting to calling this lawsuit stolen valor. 

[laughter]

Michael: For all the fictional people who really were rushed into treatment, this does a disservice to their sacrifice. 

Aubrey: Yeah, pour one out-

Michael: Yeah. 

Aubrey: -for all the made-up people. 

Michael: This decision in which all of these facts come out actually results in banning puberty blockers for people under 16. The case is later overturned, thankfully, but this actually results in making it much harder for people to get puberty blockers after this. 

Aubrey: Puberty blockers are something that I worked on specifically. 

Michael: Oh, did you? 

Aubrey: Yeah, absolutely. And it fits in a category that almost all transition-related or gender-affirming care fits into, which is, we already provide it to cis people-

Michael: I know.

Aubrey: -we're specifically denying it to trans people because they are trans, right? 

Michael: Yeah. There's this really bizarre talking point going around about puberty blockers for trans kids that they're not reversible. We don't know if they're reversible. And the whole point of puberty blockers is that they're reversible. People take them when they're going through puberty too early, and you take them for a couple years, and then you wait for the appropriate age to go through puberty and you stop taking them and you go through puberty. So, if they weren't reversible, they would not be prescribed to a few thousand cisgender kids a year. Like, the whole point of them is irreversibility. [laughs]

Aubrey: That's why people like them and seek them out. [laughs]

Michael: Okay, so that law suit was the first rake stepping that the anti-trans movement has done, where they're accidentally ginning up more evidence against their entire narrative. The second one is the Missouri Gender Clinic whistleblower. I know that you, as a scholar of my tweets, have probably been following this very closely. 

Aubrey: Here's what comes up when I open up my fucking chrome on my computer is it has a bunch of suggested, like, “Hey, here are places you go often.” And one of them is just Michael Hobbs on Twitter. 

Michael: I feel like what it actually does, it opens up 75 tabs, but they're all just different photos of your dog. 

Aubrey: [laughs] No, that's my phone. [Michael laughs] The new iOS has a thing where you can just rotate through pictures of a person or a thing or whatever. And my phone was immediately like, “You got a lot of pictures of this fucking dog.”

Michael: Siri is like, “Look, I don't usually do this, but tone it down. Look, that's enough.” [Aubrey laughs] So, this woman who was an employee at a gender clinic in St. Louis wrote an article for Bari Weiss' blog called, “I thought I was saving trans kids. Now I'm blowing the whistle.” And this was part of a media rollout that also included a sworn affidavit that she filed with the Missouri attorney general. And in this affidavit and in this article, she basically says that, “Kids were being rushed through processes. They're barely getting seen by psychologists.” And yet the doctors are like, “We think you're trans. Here's some hormones.” But once she files this, once it goes public, people start noticing that she's making some implausible claims in this affidavit as well. 

So, at one point, she says that a kid comes in identifying as a communist attack helicopter, human female, maybe nonbinary, and was put on hormones. And I don't know if you know this, Aubrey, but this thing of, “I'm an attack helicopter.” It's like a really well-known right-wing meme. It's something that right wing people say to basically invalidate trans people. Like, “Oh, you identify as a woman. Well, I identify as an attack helicopter.”

Aubrey: It's all the bumper stickers that say my truck identifies as a Prius or whatever. 

Michael: Yeah, it's the one fucking joke. They only have one fucking joke. And so, this attack helicopter thing strikes people as, like, “Was this maybe someone who was joking or maybe this whistleblower read it on a website and thought it was real or something,” like, something weird is going on but then, to me the far more implausible claim that she makes in this article and in this affidavit, she says the clinic routinely issued puberty blockers or cross sex hormones without parental consent. 

Aubrey: If those kids are under 18 that's extraordinarily unlikely. 

Michael: If this was true. I mean, it's a very risky strategy for this clinic. Because you're opening yourself up to litigation. And there's also the question of insurance and the administration of the American healthcare system that someone is paying for these procedures. And so, the parents are getting a bill from a gender clinic for a shot of puberty blockers every three months, and they're not noticing. And also, their kid is visibly transitioning. [laughs]

Aubrey: Yeah, totally.

Michael: Every single person who works in healthcare is like, “I don't think so.” 

Aubrey: Yeah. 

Michael: As usual, this is something that, of course, there's this big victory lap of like, “You finally have to admit that these clinics are pushing kids through.” But then local reporters start looking around and saying, “Well, okay, this person alleges that a ton of kids are pushed through procedures. Well, let's find some of them.” Let's go talk to people. And so, a local reporter finds almost two dozen parents of kids who were seen at the clinic, and every single one of them says that they don't agree with the characterization of this whistleblower at all. It took a long time, and they were really thoroughly assessed and were happy with the procedures. 

And they even talked to some anti-trans parents who were like, “Yeah, we didn't think that our daughter was trans at all, but we don't think that she was rushed through anything.” We think that they went really, really slow, and eventually she didn't get care, partly because weren't happy with it. [laughs] So, it's like they just can't find anybody. And to this day, as far as I know, not a single individual named person has come forward and said, “Yes, this happened to me at this clinic.” All we've had is numerous people come forward and say, “No, this isn't my experience at all.”

Aubrey: It's really fascinating to me that not really anywhere in the storytelling of this stuff does anyone go, “I think this person might just be really uncomfortable with trans people.”

Michael: Yeah, yeah, yeah, yeah. And as I always say, I'm not going to litigate what is in this person's heart. I'm not going to speculate about their motives or what they really believe or whatever, but in her own affidavit and in this Bari Weiss article, she routinely misgenders kids that come to this clinic. 

Aubrey: Jesus Christ. 

Michael: It's pretty, really, really, really low bar. 

Aubrey: It's also just like a sign of a fucking gremlin of a person. 

Michael: Dude, I know. It's so easy. 

Aubrey: If you introduce yourself to me as Michael. “Hi, my name's Michael.” I wouldn't be like, “Mikey Mdog.”

Michael: What does your birth certificate say? 

Aubrey: You wouldn't do that. That's weird. You're being weird. 

Michael: The third rake stepping. I hadn't even heard of this one before I started researching this episode. But in March of 2023, there was something called the WPATH files. 

Aubrey: Ooh. 

Michael: So, WPATH is the World Professional Association of Transgender Health providers. It's basically like the AAP or the endocrine society or whatever for trans medical providers. And basically, I'm not going to go through the whole fucking 300-page document. But the introduction basically presents it as, we have leaked documents from inside WPATH where they're admitting that they are rushing kids through these procedures. The only problem is, [laughs] first of all, these are not internal WPATH chats. This is not a private forum. [laughs] So, our friend Evan Urquhart has looked into this in more detail and found that this is a professional forum where anybody can pay $225 and [Aubrey laughs] participate in it. It's like a moderated forum for health professionals. 

Aubrey: Oh, no, it's your voter’s pamphlet, where you're like, “Look man for 800 bucks anybody can put a statement in here.”

Michael: And then the other significantly larger problem is that if you actually read the leaked evidence that they amass, it again proves the opposite of what they're saying. So, if you get to the actual leaks, the actual text parts, where they're like, “We got it. This is it.” The first example of this is a doctor in Brazil posts on the form. It's a Reddit thing. He's posting a question. He says, “Look, I've got a patient who identifies as trans, and they're 14 years old, and they want genital surgery. What should I do?” One of the replies is a doctor who says, “I wouldn't do it. Tissue too immature. Dilation routine too critical. Okay, so don't do it.” Another person posts, “We at GS Montreal would not undertake a surgery at 14. Genital surgery is delayed until the patient is 18.” Okay.

Then there's another post which is, like, much longer and more detailed, where it's somebody saying, “Look, in my entire 30-year career, as a gender-affirming care practitioner, I've only done maybe four or six genital surgeries on people under 18, and they were in very specific circumstances. These were basically kids who wanted the surgery before they went off to college, and they wanted it to be in the summer so they could have the recovery time and start fresh in college. But that's something that's done with a tremendous amount of care, and that's not something that we do lightly. And I wouldn't recommend doing this unless you really know the patient and definitely don't do it at 14.” [laughs]

So, someone asked, “Can I do surgery on a young kid?” And everyone was like, “No.” [laughs] And they just present this as if, like, well, we've proven they're giving surgery to young kids. [laughs]

Aubrey: We got them, folks. 

Michael: And also, we have statistics about how many people under 18 get genital surgeries. And it's so close to zero. You might as well fucking round it down to zero. It's like-

Aubrey: Jesus Christ.

Michael: -basically, people are not getting these procedures under 18, so. [laughs]

Aubrey: Michael, I'm so tired. [laughs]

Michael: Dude. It's exhausting. And again, you get this fucking victory lap. 

Aubrey: It just sucks to see all this shit playing out and be like, “Okay, cool. So, this is going to be the fabulously wealthy trans community is going to be fucking spending their money. 

Michael: Yeah, no kidding. Yeah, yeah, yeah, yeah.

Aubrey: And all their fucking advocacy time beating back this fucking bullshit. 

Michael: It's also so frustrating to do this pretty recently after we just did this with the gay marriage debate. 

Aubrey: Fucking honestly.

Michael: It's like, do you really need a trans cousin? Really? We have to start from scratch with this.

Aubrey: That's really sad and frustrating and demoralizing. And the people who are doing it really think that they are bringing up reasonable and good points.

Michael: And they're forcing us to make us to make a series of tedious podcast episodes, talking about fucking methodology again. 

Aubrey: [laughs] Yeah, Michael's being forced constantly. 

Michael: I'm not doing this to win Internet beefs, Aubrey. I'm doing this for science. [Aubrey laughs] But then the thing is that, I mean, this is the really dark part of the episode, so please bear with me. The really sad thing about this is that despite all of this, just years long rake stepping, this strategy is working. So, over the last couple of years, we've seen an unprecedented legislative assault on trans people. 21 states have banned trans kids in sports. Eleven states have banned LGBT content in schools. Six states have banned trans people using the bathroom, they want to use-- Florida just banned gender identity cards. So, if you want to change your driver's license, so it says female. They're not letting you do that anymore, which is like, just an unbelievable dick move. 

Aubrey: It's just so shitty. 

Michael: There's nine states now are legislating pronoun use and are making it illegal for teachers to use kids preferred pronouns if it doesn't match their birth certificate. 

Aubrey: Jesus, God almighty. 

Michael: Do you want to hear the galaxy brain justification for these? 

Aubrey: No. God. What is it, Michael? 

Michael: You say no, but I'm just going to keep going regardless. I was just waiting.

Aubrey: I know that’s our show.

Michael: That's a formality to hear. [laughs]. 

Aubrey: I understand. I'm asking the consent on this show is fake. 

[laughter]

Michael: Look, I'm going. All right, [Aubrey laughs] let me proceed. 

Aubrey: You're like those little windup chattering teeth.

[laughter]

Once he starts, there's no-- You just got to let him fall off the edge of the table or just run out of juice or whatever. 

Michael: So, the justification for banning social transition is that most kids who socially transition go on to puberty blockers, and most kids who go on puberty blockers go on to hormones. But that's an argument that most of the people who socially transitions are trans. And they're actually pretty firm in their identity, relatively young, they know young, but somehow transphobes have galaxy brained themselves into this idea that this is like putting them on a medical pathway and that this is like, bewitching them and keeping them trans against their wishes. And this weird inversion, this DARVO nonsense where it's like, “Well, there's stigma against de-transitioning.

Aubrey: What? 

Michael: So, we have to actually make sure that they feel comfortable de-transitioning. As if parents who are like, “We affirm your trans identity,” but when they say, “Mommy, I'm cis,” they'll be like, “Fuck you.” [laughs] That's why so many cis kids are homeless. It's like, “What the fuck are we talking about.”

Aubrey: Dude? DARVO is such a good analogy for what's happening here. For folks who are unfamiliar, DARVO deny attack, reverse victim and offender, yes. 

Michael: The thing is, I didn't actually know that. I just have a friend named Darvo and she sucks. So, I was just saying this is DARVO shit. That's what I meant.

Aubrey: Okay, okay, okay. It's a lady named Darvo. 

Michael: Yeah. 

[laughter]

Aubrey: The doctor was a woman, you know. 

[laughter]

Michael: Stop making me giggle during dark shit. 

Aubrey: Do you understand my job? [Michael laughs] But I think DARVO is such a good example because honestly part of what people are so whipped up about right now is children, their parents, and their healthcare provider making decisions about what kind of healthcare they ought to access and when. 

Michael: Yeah,

Aubrey: Right. It is such a deep DARVO shit that you're like, sorry a kid in I don't know where, Modesto, California, got some healthcare that they wanted, and you're this bent out of shape about it. 

Michael: So, we're also, of course, seeing this wave of bans on gender-affirming care, and it really is hard to convey how serious these laws are. So, this is from a New York Times article. Last month Florida joined at least four other states that make providing gender-affirming care a felony. Florida's law penalizes doctors who violate the law with up to five years in prison. 

Aubrey: Jesus. Fucking hell, dude. 

Michael: It also changes child custody rules to treat transition care as equivalent to child abuse. 

Aubrey: Yikes. 

Michael: This rapid-onset gender dysphoria narrative is central to the passage of these laws. In Florida, they have a long briefing allegedly studious document that goes along with the law, where they're kind of laying out the evidence base, which refers to Lisa Littman's papers numerous times. 

Aubrey: Jesus Christ. 

Michael: In Georgia, a congressman reads Lisa Littman's study into the record. 

Aubrey: Jesus fucking Christ. 

Michael: I also got obsessed with this evidence brief, frequently asked questions thing that was submitted to the Utah Legislature that has numerous explicit references to rapid-onset gender dysphoria and also includes a bunch of testimonials from de-transitioners. The first one is by somebody named Ashira. And she says, “I was about 17 when I heard the word for transgender. All I did was Google gender therapist in Calgary, and that was how that happened. After three sessions, I got my permission slip or whatever for transitioning medically for hormones. And so, I started in 2013 on testosterone, and it wasn't until 2015 or 2016, actually, that I had any surgery.” And then the link to it is a link to YouTube. And if you watch just a little bit longer after this, the person interviewing her is like, “Oh, so how old were you when you transitioned?” And she's like, “Oh, 23 or 24.”

Aubrey: Fully a legal adult. 

Michael: They also have somebody who in the document, it says “Billy Burley took cross sex hormones and getting surgeries to change his outward appearance after a difficult childhood and being sexually assaulted by his swim coach. He did his best to live as a woman, but ultimately the truth of his biology won out.” So, I followed the link, which goes to a born-again ministry website. He's kind of a little bit vague on the details, but he's like, “I never felt comfortable in my body. And then in college, I fell in love with someone, and then I was denying it. And after five or six years in a failed marriage, I finally decided to transition.” And I'm like, I don't think all this happened before he was 18.

Aubrey: Guys, we have other policy interventions. If someone before 18 has a six-year failed marriage.

Michael: It appears to be in his 30s or his late 20s that he transitioned. 

Aubrey: Boy, oh, boy. 

Michael: The thing that I really want to stress here, and I know I do this on the show all the time, is that this is not normal. Both of us have worked in development and NGO charity world, and if you're talking about a real social problem, you should be able to point to instances of it that everyone agrees are examples. So, if I say that, like, school shootings are a problem in America, if I talk about Uvalde, Texas, the most hardcore far right gun that will be like, “Yep, that's a school shooting.” If we're going to talk about kids being rushed into transition, it's like, “Sorry, your examples need to have kids, and they need to have rushing.” [Aubrey laughs] It's really fucking suspicious that you cannot provide straightforward examples of your own claims, that is not what we see from real movements that are seeking to safeguard women or whatever they say they're trying to do, protect children. That's something we see from anti-vaxxers. 

Aubrey: I also just want folks to flash forward in their brains. “Dear cis listeners, come along with me on a journey.”

Michael: Cisners, Cisteners?

Aubrey: Do you think that 50 years from now, people will be going, “Hey, remember that chapter when we thought some people were transgender and we were all totally wrong?”

Michael: Yeah. Mass psychosis. 

Aubrey: Or do you think we're going to be going, “Hey, look at this additional chapter in the horror show of American history, where we once again decided to scapegoat a group of people who already had very little.” 

Michael: Yeah. 

Aubrey: Even if you don't give a shit about trans people, give a shit about you saving face in a couple decades.

Michael: I love that you're like, we're taking names. [laughs] I just want you to know, the LGBT community sees you, and we have an excel spreadsheet. 

Aubrey: Gay reverse Santa. He keeps the naughty and nice lists.

Michael: Yeah.

Aubrey: Yeah, good. 

Michael: So, these were all of the alleged smoking guns that the anti-trans movement has pointed to as irrefutable proof that kids are being rushed into surgeries and hormones, all of which turned out not to be proof of that and evidence of, in fact, the opposite. The final crescendo, the biggest smoking gun, and the greatest example of this happening is something that happened last month. This is very recent history. In April of 2024, the United Kingdom published something called the Cass review. So, what do you know about the Cass report already, Aubrey? 

Aubrey: First, I'm going to say how I feel about the Cass report, which is-- [slide whistle noise]

Michael: [laughs] Oh, God, I forgot you have your fucking soundboard next to you. 

Aubrey: I found my slide whistle. I hate it. So, here's the situation. What I know about the Cass report is a person who does not treat trans people and does not have expertise in gender-affirming healthcare or related fields, did an audit of the NHS's gender clinic and found a bunch of wild things or made a bunch of claims that have led to a dramatic reduction of the NHS gender-affirming care. Yes. 

Michael: Wait, say the thing about her qualifications one more time, but sound meaner. Sound really, like, put your throat into it. Do it, do it. 

Aubrey: Are you trying to force me to reply guy? 

Michael: No, no. Do it, do it do it. Just make the voice thing. 

Aubrey: Look, all I know is that this lady has no qualifications for treating trans people--

[Mike plays rap airhorn sound effect]

[Aubrey laughs]

Michael: Who also has a soundboard on their phone, Aubrey.

Aubrey: [laughs] You know how I feel about that, Mike? 

[laughter]

Michael: [crosstalk] Do it. 

Aubrey: I started laughing. [Michael laughs] [whistle sound effect] That's how I feel about that one. That's good. 

Michael: You were so hesitant to do the voice. You're like, I don't know if she's good. 

Aubrey: I don't know what's happening here. [mimics rap airhorn sound effect]

Michael: I wanted to say. Say it as If, you know, a rap airhorn is coming. But that would reveal the whole thing. 

Aubrey: Is that an app on your phone? 

Michael: Yes, it is. 

Aubrey: That was something. Goddamnit, Michael. 

Michael: It's in Siri. When Siri suggests app, it's most opened. 

Aubrey: Michael, on this show, we value sound effects, which is why I say, [plays boos sound effect].

Michael: Oh, yeah, yeah, yeah. I know. I knew you'd escalate. I knew you'd take it there. Again, we are giggling about some of the darkest social forces in the world [crosstalk].

Aubrey: Giggle about dark shit. 

Michael: Basically, the Cass review is the entire reason I wanted to do this series of episodes, because over the course of the last decade, effectively every institution in Britain has been captured by this anti-trans movement. This allegedly polite anti-trans movement, especially led by parents. But the same kinds of messages that we started to see on those forums in 2016 are showing up on the BBC. They're showing up in politics. Both the Tories and the Labour Party are echoing this stuff. We see it in the courts, right? that blocks puberty blockers after this case, that was not somebody getting rushed into care right. 

Aubrey: Yeah, yeah, yeah, yeah. 

Michael: And so, this report is yet another, I think, very obvious example of somebody looking around for any excuse to invalidate this kind of care and to completely ignore the underlying facts as they do it. 

Aubrey: Yeah. 

Michael: The number one thing to know is that the Cass report does not provide any new information, with one exception. The vast majority of the report is basically, it's a review. They're putting together all of the existing data. They've commissioned these reviews from the University of York, and it's supposed to be a factual overview of, “What does the data say, what do the records say, etc.” The only piece of new information contained in this report is an audit of England and Wales only gender clinic. So, again, we're looking at the question of whether or not kids are being rushed into care. And so, we have the medical records of every single person who was seen by this gender clinic between 2018 and 2023. This is going to be boring, but I just want to go through it because it's really important to stay grounded in reality, which everyone else seems to refuse to do. 

Aubrey: I love this as a statement from a podcast host. This is going to be boring, but--

[laughter]

Michael: I know. I know I'll do the rap airhorn at 10 second intervals to keep you away. [drums sound effect] [unintelligible 01:14:09] Yeah, fuck off. 

[laughter]

So, they did this audit. So, as their starting point, between 2018 and 2023, this clinic only saw 3306 patients. So, that's 661 patients per year. Over the course of five years, only 892 kids were referred to endocrinology. So, 178 kids per year were even eligible to get puberty blockers or hormones. A 73% of the people who were seen by this clinic got nothing. So, just as a starting point, only 178 kids were referred to endocrinology. Of the kids who were referred to endocrinology, only 145 kids per year got puberty blockers. 97 kids per year got puberty blockers and hormones. So, these are minuscule numbers.

Aubrey: Which isn't, like, good news that not a lot of people are getting care. 

Michael: Yeah, exactly. 

Aubrey: But it is evidence that that sort of inundation just isn't really happening. 

Michael: Yes. 

Aubrey: And even if it was, that the sort of filter function that is built in is doing a pretty rigorous job. 

Michael: I mean, speaking of filtering function, the audit also includes numbers on how many appointments the kids had before they were referred to puberty blockers and hormones. The average kid had 6.7 appointments before a referral. And then the report also knows that the average total appointments is 10 before this court decision. And then after the court decision made it harder, 14 appointments. So, even after they refer to endocrinology, they then have another couple of appointments of gatekeeping. 

Aubrey: I mean, I think this is, again, where anti-trans rhetoric really reveals itself. Which is like, there is not an amount of gatekeeping that makes people feel comfortable. 

Michael: Yes. The last thing that this audit found is that fewer than 10 kids de-transitioned during these five years. So, the anti-trans brain trust loves pointing out. They're like, “Well, they might have aged into the adult clinics, and then they later de-transitioned,” which fair enough, like, we don't have perfect data on this, but a lot of these kids were getting puberty blockers and hormones at 15. And so, what this means is that over the course of the following three years, fewer than 10 of them de-transitioned out of 3300 kids. If we were seeing a mass wave of de-transitioners, we would see some sign of that from kids who were getting hormones at 15. 

But then, to me, the best sign that this is a moral panic document that is the output of a year’s long moral panic that has taken over all these institutions in the UK, is that these are the central findings of this Cass report. To me, this should be like the beginning of the report. There were concerns that kids were being rushed into care, “Hey, we looked into it.” There's really no cause for concern. This audit, all of the data that I have just given you, this is appendix 8-

Aubrey: Oh, no. Come on. 

Michael: -of the CASS report, all of the rest of it is just filibustering. 

Aubrey: Is there any point in this report where they talk about the issues that trans kids face that could be remedied by healthcare. 

Michael: Dude, no. There's a whole thing about context, but at no point does it mention the rise of transphobia in the United Kingdom. The word transphobia only appears three times in the entire document. 

Aubrey: Jesus, hell. 

Michael: We will find out more about the process by which this came about, and I'm very confident that it will look extremely bad. But also, just the text, the straightforward text of the document is just a series of anti-trans talking points. 

Aubrey: Boy, oh boy, oh boy. 

Michael: This is from the introduction to the report written by Dr. Hilary Cass herself.

Aubrey: We have to start from the understanding that this group of children and young people are just that. Children and young people first and foremost, not individuals solely defined by their gender incongruence or gender-related distress. 

Michael: Right. They're not defined by it. 

Aubrey: We have to cut through the noise and polarization to recognize that they need the same standards of high-quality care to meet their needs as any other child or young person. When you talk to these young people and their parents, they want the same things as everyone else. The chance to be heard, respected, and believed, to have their questions answered, and to access help and advice. It is only when they have been on very long waiting lists and sidelined from usual care and local services that they are forced to do their own research and may come to a single medical answer to their problems. 

Michael: They are forced to do their own research and may come to a single medical answer to their problem. 

Aubrey: This is like a slightly more grounded sounding version-

Michael: Yeah, yeah. 

Aubrey: -of the ROGD stuff in general. 

Michael: Yes. 

Aubrey: Hey, guys, let's really empathize with these kids, and then from there, we can understand how wrong they are. 

Michael: Essentially, the only evidence for rapid-onset gender dysphoria at this point is the fact that there were more referrals to gender clinics. Starting in 2014, referrals went up very rapidly. 

Aubrey: Yeah, yeah. 

Michael: Personally, I think this is just very easily explained by the fact that trans people are more visible in society and are less stigmatized than they used to be. I don't see that as, a particularly big mystery, but this is another anti-trans talking point. Over and over again, people just say, “Well, that can't explain it.” So, in the report, it says, “Although it is certainly the case, that there's much greater acceptance of trans-identities, particularly among Generation Z, and this may account for some of the increase in numbers, this is not an adequate explanation for the overall phenomenon. 

Aubrey: Why?

Michael: Yeah, there's no citation given for that. And then it says, “The exponential increase in numbers within a five-year timeframe is very much faster than would be expected for the normal evolution of acceptance of a minority group.” So, our friend, the health nerd, Gideon, he did a whole post about whether or not this is really exponential, but it's, to me, the fact that referrals went from roughly 700 to roughly 2500. Like, if you look at it on a relative scale, it kind of looks like, “Ooh, they tripled in a couple years.” But it's also just a very small number of kids. The fact that we have 1800 extra kids getting referrals over the course of five years is not that weird. And then the other thing that it doesn't mention is that the numbers have leveled off. 

So, since 2018, even before the pandemic, the numbers basically flatlined around 2500. There's some data that makes it look like it's spiking but then the footnotes of the report say that this is likely a duplicate. So, it looks like it's doubling yet again, but it appears that's falsely counted, so it's plateaued. So, again, if we're talking about social contagion, the way that a virus spreads, it would continue going up. So, the other component that we saw in these parental accounts was this idea that they're being influenced by their peers and online.

Aubrey: Sure. The Internet did it. 

Michael: The Internet, the computer. Again, you're going to love this language. I'm sending you an excerpt. 

Aubrey: Gender questioning young people and their parents have spoken to the review about online information that describes normal adolescent discomfort as a possible sign of being trans and that particular influencers have had a substantial impact on their child's beliefs and understanding of their gender. 

Michael: This is the precise sewage that we saw in the Littman study. Kids are having normal teenage issues, and because of the Internet, they think that means they're trans. 

Aubrey: I've never wanted an airhorn app on my phone more. 

[laughter]

Michael: I will send it to you. [Michael laughs]

Aubrey: Peer influence during this stage of life is very powerful, as well as the influence of social media. The review has heard accounts of female students forming intense friendships with other gender questioning or transgender students at school and then identifying as trans themselves. This is someone who doesn't understand what the coming out process is. 

Michael: Yep, they're turning the frogs gay, but the frogs are teenagers, teenage social groups. 

Aubrey: This is totally fucking anecdotal everything. But that could just as easily be trans students seeking out other trans students because they have a sense that they're on the same page in some important way. 

Michael: Yes.

Aubrey: This is like all the fucking gay kids at your school who came out after high school, and you're like, “Yeah, no shit.”

Michael: There's also, man, we can't go into every single one of these. But I was putting these paragraphs in categories, and one of my biggest categories was just like general jankiness. [Aubrey giggles] So, in this section, it says, “Clinicians and parents reported that gay students are still being stigmatized and bullied in school, and there's sometimes a perception that there is less validation for them than for trans pupils.” 

Aubrey: What? Are we doing this shit again?

Michael: This is another bizarre fucking conspiracy theory that transphobes always trot out that gay kids are saying that they're trans because it's easier to be a trans person than a gay person. 

Aubrey: Which is also wild because in our continuing journey to the wayback machine, a very standard response to queer people coming out in the 90s was like, “So you think you're a woman? or so you think you're a man?”

Michael: Yeah, yeah, yeah, yeah.

Aubrey: Dudes, you're just finding reasons not to listen to us. And I wish that you could just get right with that is what's happening within you, right? 

Michael: Yeah.

Aubrey: Because it's real clear from the outside that most transphobes and homophobes don't really deeply know the difference between those two identities. 

Michael: This is also the part where the misogyny at the heart of this also comes out. There's something very weird how this whole movement says that it's like, we're out to protect girls right like, fairness and women's sports and all this kind of stuff. But then the only other piece of evidence for rapid-onset gender dysphoria is there's more kids coming to the clinics, and most of those people are assigned female at birth. That's like, the only other piece of evidence that they can point to. And this report has so much stuff about how, like, girls are mentally unstable.

It says, “Puberty is an intense period of rapid change and can be a difficult process where young people are vulnerable to mental health problems, particularly girls. Girls reported more hours of social media use than boys. 43% of girls used social media for three or more hours per day, compared to 22% of boys. Girls were more likely to have low self-esteem, to have body weight dissatisfaction, to be unhappy with their appearance. Girls were more likely to report fewer hours of sleep than boys, and to report experiencing disrupted sleep more often or most of the time.” Again, it’s not really saying what it means, but it’s like, yeah, girls are like, so I guess, like, sleep deprived and mentally ill that they all think they're trans. 

Aubrey: Girls were more likely to be diagnosed with neurasthenia and hysteria [Michael laughs] Girls were more likely to report a menacing figure hidden in the yellow wallpaper of the room where they're confined. [Michael laughs] What are we doing? I'm hitting my desk. 

Michael: This is another thing that I just don't find all that mysterious. I think the super basic fact is that young girls are allowed to experiment with gender presentation in a way that young boys typically aren't. And so, I think what's happening is that if you're trans and you're assigned female at birth, your parents are going to kind of let you experiment and maybe let you wear boy’s clothes. Whereas if you're assigned male at birth and you're like, “Oh, I want to wear mom's dress or something, or I want to grow my hair long.” Parents are going to be like, “Fuck, no, you don't.”

Aubrey: Most like school dress codes or school uniform codes allow for girls to wear pants, but do not allow for boys to wear skirts. 

Michael: Yeah. 

Aubrey: And in terms of the repercussions, if you are a person who has attended a trans day of remembrance event, you've heard the reading of the names, you have maybe seen photos of people who passed. Those are overwhelmingly trans women, and they are overwhelmingly trans women of color. There's just a lot of garbage. 

Michael: I think it's also important, though, to mention that it's not just trans kids that have it really tough. It's also really tough for their transphobic parents. 

Aubrey: Oh, good. 

Michael: So, this is our next excerpt. 

Aubrey: The review heard concerns from many parents about their child being socially transitioned and affirmed in their expressed gender without parental involvement. 

Michael: I love being socially transitioned. They've been transitioned. 

Aubrey: This was predominantly where an adolescent had, “Come out at school,”

Michael: Quote, unquote?

Aubrey: But expressed concern about how their parents might react. This set up an adversarial position between parent and child where some parents felt, “forced” to affirm their child's assumed identity or risk being painted as transphobic and/or unsupportive. 

Michael: Again, we have this thing where it's like they're going to be called unsupportive just because they don't support their kids. Yep. 

[laughter]

Aubrey: Wow. I didn't think were resorting to name calling, but I guess we are. 

Michael: They're going to call me short just because I'm five foot six. 

Aubrey: Some parents who spoke to the review felt that social transition was of more benefit to their child in terms of its social impact than in helping to manage their gender incongruence. They describe how their children were previously isolated and bullied, but their status amongst peers has improved as a result of “coming out.” 

Michael: This is like straight from transphobic websites. 

Aubrey: Oh, when pro-gay parents get together, they get to be PFLAG and when anti-gay parents get together, we're suddenly bigots. 

Michael: Oh. So, it's okay to be nice to kids, but as soon as you're mean someone called, you mean [Aubrey laughs] really interesting. Hypocrisy much? 

Aubrey: I don't know. I just find this whole thing so sad. 

Michael: And also, I mean, the saddest thing, of course, is this document is an extremely obvious and relatively explicit call to put more barriers in front of kids who identify as trans. It has this proposed restructuring of the NHS to basically put more roadblocks in place so that when kids identify as trans, instead of getting referred directly to the gender identity service, they have to go through psychologists and people who aren't trained in gender dysphoria to make sure to rule out all of these other things and to basically make transition a last resort. So, kids are already, again, 10 to 14 appointments before they get onto puberty blockers. 

Aubrey: That's so long. That's so long. 

Michael: They've already just banned puberty blockers in the UK. And because puberty blockers are considered to be a necessary precursor to getting other forms of gender-affirming care, this basically results in a ban on gender-affirming care as such.

Aubrey: A ban on care for youth, right?

Michael: Yeah. Although there's also plenty of coded stuff in this report about the need for more responsive services for people 17 to 25. 

Aubrey: Yeah, great. Good. 

Michael: I mean, people are going to yell at me for saying this, but this is the very explicit project of this, this entire review. Like, if you actually read it and you engage with what it's saying at every turn it's saying, we need to consider all the options before transition. We need to maybe consider slowing down. Recommendation number two in the report is that hormones should be used with extreme caution. Well, all fucking evidence is that they are. It's 97 kids a year in the entire fucking England and Wales are getting hormones. I would call that extreme caution. 

Aubrey: Yeah. What would extreme caution look like if not that? 

Michael: But again, they're winning. And it appears the NHS is going to be restructured around this “new model” that is just going to make it even harder to get a form of care that is already extremely hard. That's the output of all of this. That's the legacy of the rapid-onset gender dysphoria narrative is no evidence and a huge, what appears to be global at this point, crackdown on kids getting a care for which there's very good evidence that it helps and no evidence that it harms anybody. [Aubrey groans] You need a different soundboard? Where's your soundboard? You need a groaning soundboard. [laughs].

Aubrey: I need a custom. I need a bespoke soundboard. 

Michael: An Aubrey grunt machine. 

Aubrey: If we were going to make a taxonomy of Maintenance Phase episodes, one of them would be the, like, “There's a kernel of truth here, but it's gotten blown out of proportion and people think it's universal” or there'd be another one that's like, “The studies were much more nuanced, but the PR really blew it out of proportion.”

Michael: Yeah.

Aubrey: It's fully made up and originated on the Internet category of our shows is one of the smallest categories. It's like Braggs and this. 

Michael: Yeah, yeah, yeah, yeah.

Aubrey: Like, that is really telling and makes me, again, profoundly upset. 

Michael: [plays airhorn sound effect] [Aubrey laughs] I was waiting for you to use the voice. I mean, I have my thumb on that for six minutes. Give me the voice, woman.

[laughter]

[Maintenance Phase theme]

[Transcript provided by SpeechDocs Podcast Transcription]