118. “Gender Affirming” Therapy: Unpacking the Lies, with Whistleblower Tamara Pietzke, LCSW

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In this episode, I sit down with Tamara Pietzke, a mental health therapist best known for having blown the whistle on gender affirming care this past February in a Free Press article. What has she been up to since then?

We discuss the complexities of therapists being pressured to rubber stamp gender identities and recommend medical interventions. Tamara shares her experiences challenging the status quo and the backlash she faced for questioning the rush to affirm identities.

We explore the ethical dilemmas therapists face when young clients demand immediate medicalization, and confront the myths surrounding suicide risk and prevention in the transgender population. How do we navigate the fine line between supporting individuals in the moment and ensuring their long-term well-being? The conversation touches on the hot-cold empathy gap, the sunk cost fallacy, and the conveyor-belt nature of the gender industry, shedding light on the challenges of helping vulnerable youth in today's society.

Join us as we unravel the layers of social contagion, neuroplasticity, and the impact of social transitioning on young minds. Can therapy provide a safe space for exploration beyond immediate demands for medical interventions? Tune in to discover how therapists like Tamara navigate the delicate balance of protecting the holistic health of their clients.

Tamara is a mental health therapist (licensed independent clinical social worker) and has been a therapist for twelve years. She has worked a number of places, but most recently was working at Multicare, one of the state's largest hospital systems, for the past six years. When she raised concerns about the shift towards mandated "gender affirming care," she was bullied and dismissed. She stopped working there January of 2024, a couple weeks before her whistleblowing article came out in the Free Press. From Multicare, she went to another practice, but they let her go after three weeks, the same week the article came out, simply saying she wasn't "the right fit for the position." She has since been working on building a private practice. Meanwhile, the state is now investigating her license on account of not being "gender affirming.”


00:00 Start
[00:01:10] Gender affirming care concerns
[00:07:11] Gender-affirming therapy for teenagers.
[00:12:25] Symbolic exploration of identity.
[00:14:25] Gender identity exploration challenges.
[00:17:48] Suicide risk and gender-affirming care.
[00:20:51] Teenagers and parental involvement.
[00:27:02] Therapists' reaction to detransitioners.
[00:29:10] Therapists' reaction to differing views.
[00:31:27] The gray area in ethics.
[00:36:59] Challenges in therapy practice.
[00:40:21] The hot cold empathy gap.
[00:44:05] Conversion therapy and gender identity.
[00:45:05] Gender dysphoria and identity confusion.
[00:48:57] Power dynamics in adolescence.
[00:53:35] Navigating marketing in therapy.
[00:59:10] Ethics of helping endangered children.
[00:59:29] Detransitioning concerns in youth.
[01:05:03] Ethics in Therapy
[01:08:28] Whistleblowers and support network.
[01:10:50] Gender crisis.

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Show notes & transcript provided with the help of SwellAI.

Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.

Watch NO WAY BACK: The Reality of Gender-Affirming Care (our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration.

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118. “Gender Affirming” Therapy: Unpacking the Lies, with Whistleblower Tamara Pietzke, LCSW
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