You Must Be Some Kind of Therapist

Swell AI Transcript: 118. Tamara Pietzke FINAL.mp3
Tamara Pietzke:
I talked to my colleagues and my boss and I said, you know, at what point do we not just, like, affirm whatever somebody is saying they identify as? Their response from my team was that it's not a problem. If the client doesn't think it's a problem, then we basically champion them for knowing who they are and we just, like, support them in that. It's not impacting their functioning. It's not an issue. Just move on to talk about something else. And I was like, that doesn't sit right with me. Like, I don't feel like that's true. I think that if somebody is so wounded by life that they can't even identify as human anymore, then we need to give some attention to that.

Stephanie Winn: You must be some kind of therapist. Today, I have the pleasure of speaking with Tamara Pitsky. You might be familiar with her Free Press article in which she blew the whistle on gender affirming care in Washington back in February. She's done a few interviews since then. Tamara is a mental health therapist, specifically a licensed clinical social worker in the state of Washington. and although she had no idea what she was getting herself into as someone who's not particularly political, she stepped into a scandal earlier this year by raising concerns about what the heck is going on in the mental health field when it comes to this expectation that therapists should do nothing but rubber stamp people's gender identities and recommend that they get on hormones and surgeries. So Tamara is another brave whistleblower I'm happy to feature here. Those of you who are long-term listeners know that I'm not exactly the sort of podcaster who jumps on stories when they're hot and fresh, but I do love to speak to whistleblowers a few months or even years later, just to find out how it's going and talk about their reflections on the issue. So I'm really glad to finally be able to sit down with Tamara today. Tamara, welcome. Thanks for joining me. Thank you so much for having me. It's good to be here. easy for you to take this risk with your career being a whistleblower in a blue state, that you're a single mom, you have a family to feed, but that you just felt like you had to speak out about the injustice that you were seeing. So for anyone who hasn't heard your story, let's sort of do a recap of these events that unfolded over the past year or so.

Tamara Pietzke: Sure. So I think that the first thing that happened was when I had my client come in and say that they identified as a wounded male dog, it was a 16 year old. And after that, that was back in like about a year ago, a year, March of last March of 23. And so after that, I talked to my colleagues and my boss and I said, you know, at what point do we not just like affirm whatever somebody is saying they identify as. And the response from my team was that that's not a problem. If the client doesn't think it's a problem, then we basically champion them for knowing who they are. And we just like support them in that. If it's not impacting their functioning, it's not an issue. Just move on to talk about something else." And I was like, that doesn't sit right with me. Like, I don't feel like that's true. I think that if somebody is so wounded by life that they can't even identify as human anymore, then we need to give some attention to that. But I didn't do anything with that information. I just kind of like sat with it, let it sit in the back of my mind. And then September, this past September, we were informed that we were going to have a mandatory gender affirming care training. And I had some concerns about the wording. Like I didn't even know what gender affirming care meant. Like I had not heard those three words together. I assumed I knew what it meant, but I had to do research. Like I was concerned because they said it was a mandatory meeting, which our meetings up until that point hadn't usually been, they were like optional. And so this was like, the meeting was happening right after Labor Day. And so I spent that whole weekend just doing research after the kids went to bed. And I was trying to figure out like, what is real here? Like, are my concerns about this training that we have to go to valid? Like, and I sent out a bunch of emails, anyone that I saw who wrote an article about their concerns about this, anyone that was like an organization, I was like, please tell me if I'm right here, because I'm not going to go to this training and sit through something that is gonna like where they're demanding that we do things that are going to hurt our clients. I'm going to tell them I'm not going to go but if I tell them that because it's mandatory I'll probably lose my job and so I want to make sure that I'm not wrong. And so I sent out this email and somebody responded and was like, if you don't go, they're going to just render you irrelevant. Like you have more power if you go. And if you ask these questions, you're not wrong. And so I went to the meeting and I asked some basic questions like about why we're just, you know, moving through moving forward with gender affirming care when other countries are pulling back and saying, you know, maybe this isn't the right approach. Like, why are we suddenly like, speeding full steam ahead, mandating this of our clinicians. And I was met with just so much hostility. My colleague said, keep politics out of this. That I didn't even understand what that meant at the time. I was like, what do you mean politics? I didn't say anything about like the president. Like I didn't know what they were talking about. And they said, you are doing harm to people. You're like violating the oath to do no harm. Just you're part of the problem. You need to check your biases. The host of the meeting basically told me, you know, we're not going to take time to have these conversations. So you need to basically just stop talking. And so after the meeting, I was so upset. I couldn't even work that day. I just like. called in sick and I was like, so distraught. And then my boss reached out to me and was like, you know, that wasn't the right time or place to ask those questions. And I was so mad about that because I was like, okay, I had 122 of my colleagues at that meeting. When would be the right time and place to ask these questions when nobody else could possibly be aware that there's another side of the story that you're not telling us? Like behind closed doors where you can like silence me and shush me and make me go away. Like, I don't think I did anything inappropriate. You guys just don't like what I'm saying. And so after that, I continued to ask some questions just in like a more appropriate format, like via email with my boss and the person who orchestrated the meeting. And they were like, I need you to understand, my boss never responded, really. But the meeting, the meeting host was like, I need you to understand, like, we're not going to agree on this. Like, you're basically you're wrong. There's no reason why somebody's mental health would impact their gender identity. This is multi cares. This is best practice. This is a multi care standard. I need you to be really clear about that. And then I had a 13-year-old client, mostly, like, extensive trauma history on the spectrum. Like, in our sessions, they would just, like, rock back and forth, barely even communicating verbally, just, like, scrolling on their phone, showing me, like, just really violent animes-type stuff. I had only met with them three times, and I saw on their-on their-on their chart that they had an upcoming gender clinic appointment, and so I asked them about that, and they didn't even know that they had one. I was like, how are you feeling about your upcoming appointment? And they said, you know, they didn't know. And so I kind of was just like monitoring that. And then after their first appointment with the gender clinic, dad asked me for a letter, basically, he said, you know, and I looked at the note, and it was like, in order to start testosterone, get a letter from your therapist, if your therapist isn't a gender affirming therapist, make sure you see somebody who is because a non gender affirming therapist can cause damage and harm to you. So I was like, I'm not going to write this child who I'm, first of all, they're 13. Second of all, they have so much else going on here. I'm not going to write them a letter to start testosterone. And so that I, again, thinking that I had like, just the perfect example of why we shouldn't just be rubber stamping everyone who comes through, my boss contacted the meeting leader and was like, hey, this person's wanting testosterone. And in my silly little brain, I thought they'd be like, well, Tamara, use your judgment. Of course, we don't always want to start kids on hormone therapy. But they didn't say that. They said that I have to do it. And when I pushed back, my boss came to me at one point and was like, I want you to know this has gone above me. The person who did the, who led the meeting has reported you to risk management. And so the client is going to be taken from you and given to somebody who will write that letter. And so I was like, well, that feels crappy. Like I care about this person. you know, my client, but then I also thought, okay, well now I can talk to risk management and maybe we can finally get somewhere on this issue. And so I met with risk management multiple times, had them go through the client's whole chart, wrote this big extensive letter about why, even according to SOC 8, like this client should not be started on testosterone or anything else. And risk management still decided that I was the risk and that I was basically incompetent as a, you know, gender distress, gender dysphoria clinician. And at that point, I was looking for other work. I was like, I can't work for an organization or a company that I don't respect. And then you got another job. I did. And then I got another job three weeks, two weeks before the article came out. And then my third week there, the article came out and completely blindsided me. My boss at that place called me at like seven o'clock that night and was like, you know, you're just not the right fit for this position and didn't really give any additional reason. And so I lost that job.

Stephanie Winn: And now you are a single mom building a private practice from scratch.

Tamara Pietzke: I am. Yeah. I'm grateful to be able to provide care the way I think is best and meet the needs of the community. But it's been really hard to, you know, to just, um, build that caseload and, um, connect with teenagers who maybe, um, want a more affirming therapist. You know, I think that word is being skewed. I definitely consider myself affirming in the sense that I don't want anyone to feel judged or come walk away from an interaction with me feeling like, I'm trying to change them. That's not my approach at all. But I don't think we should be fast-tracking kids to medicalization. Yeah.

Stephanie Winn: It's very disturbing that the minds of young people are essentially being poisoned to make them closed off to help. Right? That they're being fed these lies about, like you said, a non-gender-affirming therapist can cause damage and harm to you. So they have this really narrow set of expectations about what help is supposed to look like. And that help looks a lot like permissive parenting, but at the level of a therapist instead of the level of the parent, rather than authoritative parenting. We know that part of the responsibility of a parent is to give children what they need, not necessarily what they want, to give them boundaries. But there's sort of this expectation that if I want candy and ice cream in video games, you give me candy and ice cream in video games. And same thing with the gender stuff. These kids are, they're asking for boundaries, and you picked up on that in your countertransference when you describe this interaction with the child who said, I identify as a wounded male dog. You felt that sort of cry for help in that. Now, going back to that moment, you know, it's like the kid uttered the magic words, I identify as. If you use that phrase, or if you say anything about the word gender identity, or gender identity, you know, anytime those words get uttered, a switch gets flipped, and a young person is now, they've entered a machine that is designed to carry them through this process, like a conveyor belt. And some young people say those phrases knowing that because of what they've learned online, and they think that this is what they want, and it's, again, it's this is how to ask for the candy and the ice cream and the video games. But some of them don't. Some of them don't know that their choice of language is opening up a whole world of possibilities and closing down a whole other world of possibilities for what help might look like. And so when you were recounting this moment, and I've heard you describe this on other interviews you've done, I identify as a wounded male dog. It makes me think how different would that young person's life have been if instead of saying, I identify as, they had said, sometimes I feel like I'm a wounded male dog.

Tamara Pietzke: My approach to that would have been entirely different. I would have wanted to know what that meant. But when you say identify as, it's like, I guess you don't touch that because you could lose your job or your license, you know?

Stephanie Winn: And part of what makes me so angry about the way the system is set up right now is that young people are saying all these things that are ripe for symbolic exploration. Now, sometimes they're saying them because they They're coming from somewhere, right? Like, when you describe a phrase like, I identify as a wounded male dog, very similar to, but in completely different meaning from, I feel sometimes like a wounded male dog. But all these phrases, you know, phrases like the idea of being born in the wrong body, well, that's an unfalsifiable metaphysical claim. Gosh, it's symbolically meaningful, though. I think a lot of these young people, they're just consuming so much online propaganda, if you will, that if you were to prod at that, you wouldn't get anywhere. But I think for some other young people, that even if it is coming through peer and media influence, There's still something there for them, sort of like how, I don't know about you, but when I was a teenager, song lyrics were very meaningful for me, right? So that artist was putting something into words that I related to or felt, so then you kind of latch on to these things that other people say. And then you're like, I'm trying to get at a part of my own experience this way. And all of these things are so right for symbolic exploration for those clients who have the, you know, enough sort of insight to go there, which, you know, and you've seen some of the clients who don't, some of the ones who are autistic, nonverbal, just really lacking in insight, but therapists are blocked from being able to go there symbolically and explore what that might mean to them. And it feels like we're ignoring people's cries for help, ignoring their symbolic attempts at self-expression.

Tamara Pietzke: Yeah, and what about the poor parents who are like, my kid is in distress, they are identifying as another gender or whatever, however they identify, and they think, I finally found a therapist who can like kind of weed through this with us and figure out like, is this true? And then the therapists are told, basically, like, if the client is saying this, then gender affirming care is suicide prevention. So we're telling the parents, like, we're not doing any sort of like, I don't know, is this, you know, does this child, is this child's dysphoria gonna last into adulthood? Is it just something they're going through right now as a teenager? Because teenagers experience a lot of different, you know, they're navigating figuring out who they are instead of like we're not able to actually help. We're just saying like, okay, so this child is saying that this is what they are. And if we don't do this, then we're putting them at increased risk for suicide. Like that is so abusive to the parent too, to be like, well, if we don't do this, your kid might kill themselves. Like that's horrible. And that's the, that's the mentality that we're feeding people and kids. Like I had a child come to me and say that I tried to like talk with him about my approach on this. And I'm like, so you care more about my physical health and my mental health. You want me just to kill myself? And I'm like, that's not like, they are being fed this like script where If you, if the adults in your life don't allow you to do this, then you might die. And if somebody told me that at 16, if somebody said not to trivialize this, but to use the example of like sweets or whatever, if somebody was like, yeah, if you don't get that donut, then you can tell your parents that you're going to kill yourself because they just took whatever joy from you. Like that's, I would be like, sure. Yeah. Let's absolutely run with this because I'm being told that I'm at increased risk for suicide. If I'm not getting this thing that I think that I need, you know? Um, I just feel like. And I tried to explain to the kid, I'm like, I absolutely care if you feel like you want to do something to hurt yourself. But that is a different conversation. Like that is. I want to help you so that you feel life is going to throw lots of curveballs at you. I don't want suicide to ever become an option for you again in the future. Let's figure out why it is that that's an option for you right now. Let's treat that as something separate than the gender dysphoria and gender distress. Not to say that the gender distress isn't causing you a lot of suffering, because it obviously is, but let's make sure that we can help you feel Like, when hard things happen in the future, your brain doesn't automatically default to that being an option again. You know?

Stephanie Winn: Exactly.

Tamara Pietzke: Right?

Stephanie Winn: We're not allowed to do that. is more along the lines of what you described, that their brain goes there, suicide is an option, or whether this is more of an interpersonal manipulation, frankly, that if I don't get what I want from someone else, I can always threaten suicide like taking that person hostage by using their worst fear against them. Either way, yeah, let's distinguish that form of mental distress or that form of interpersonal problem But let's unpack this, because I've unpacked this in a few different places, but every now and then I get a new request, like, can you explain this a little bit more clearly, Stephanie? And so I'm really glad that you brought this up, Tamara, because I think as two therapists who've both been trained in so-called gender-affirming care and ended up blowing the whistle on it, I think we're in a good position to unpack this. So step one, here's where I want to start. Suicide ends a life. And so if our concern is bringing down suicide risk and suicide rates overall, which is definitely part of the professional responsibility of every mental health professional, then we need to consider lifetime suicide risk. And we now have studies showing that the lifetime suicide risk of people who go through with these drugs and surgeries is, one recent study found, about 12 times higher And I'm happy to explain, maybe I will in a little bit, all the reasons why at least how I'm able to put two and two together saying here's everything we know about suicide risk factors and protective factors and now let's overlap that with what we know about so-called gender-affirming care and figure out why the suicide rate is higher in this population. So I'm happy to unpack that, but I just want to say as sort of a guiding principle that I think we need to consider the impact of our actions on a person's lifetime suicide risk. And it seems to me incredibly foolish to say I'm worried that a 13, 14, 15, 16-year-old is going to do something to harm themselves during this time in life that, yes, they're impulsive, but also they're under their parents' watch. That is a really safe place to be. Living with people who love you and want to protect you is a really safe place to be. And to say, I'm so worried about this person who has the safety net, doing something impulsive now, that I'm going to risk what their future looks like 10 or 20 years from now when they don't have that safety net, when they aren't living with their parents anymore, that for me is incredibly foolish. Plus the way people talk about this, the way therapists talk about this to the parents, and to the youth in front of the parents, or to the parents in front of the youth, in a way that implies that, A, the youth have no agency, like, oh, suicide is just gonna come take them over, you know, like, what? Like, suicide is just a demon that possesses your body and makes you do things? Or does the youth have agency here? And then does the parent have agency? Because as professionals, you and I have, I'm sure, both been to plenty of trainings on dealing with suicide risk. And we know where to draw the lines, you know, how to assess the severity, the level of intent, whether there's a plan, whether there's access to means, whether there's anything contributing to an excessive sense of urgency for that person right now, whether there are any things that could increase their impulsivity, like alcohol use, right? We're trained to assess all those things and to know when do we say, I don't know if you're safe, I think you need to go to the hospital, versus when do we work with that individual or work with the family say here's how we can keep you safe at home, and here's, you know, where we draw the line where now you need to go to the hospital. So when a person has these active, engaged parents, and they're a teenager, You know, there's very few things most parents wouldn't be willing to do to keep their kids safe in that situation. So it's this way of, oh, your kid's just gonna kill themselves, as if the kid has no agency, as if the parent has no agency to say, not on my watch, not under my roof, no, I'm here, right? Yeah. I just wanted to give you an opportunity to respond to that.

Tamara Pietzke: Yeah, I mean, it's true, and I feel like… whether they're using that, well, I'm just going to kill myself then as a manipulative tactic, or whether or not that's a thought that they have in the back of their mind as like an option. I do think you're right in the sense that like, I mean, in a lot of senses, but that we, they're in the safest place right now and they're under their parents' roof to build those like distress tolerance and coping skills so that if they struggle with this in the future, if they end up medicalizing and then, you know, regretting it or struggling with their mental health down the road, because we never actually dealt with any of the underlying issues when they first came in, then they have those skills, you know, hopefully, you know, I feel like, yeah, let's, let's do therapy with them while they're under their parents' roof, where their parent can keep them safe, can keep an eye on them. Let's help them eliminate suicide as an option so that when they're an adult, hopefully they can re, reflect back on what they learned, you know, when they were in a safer, under-the-prints room.

Stephanie Winn: If you're looking for a simple way to take better care of yourself, check out Organifi. I start every day with a glass of their original green juice powder mixed with water. It contains moringa, ashwagandha, chlorella, spirulina, matcha, wheatgrass, beets, turmeric, mint, lemon, and coconut water. 100% organic, with no added sugar. It's the best tasting superfood supplement I've ever tried, it's super easy to make, and it makes me feel good. Organifi also makes several other delicious and nutritious superfood blends such as red juice, immune support, protein powders, a golden milk mix, and even superfood hot cocoa. Check out the collection at Organifi.com slash Sumtherapist. That's O-R-G-A-N-I-F-I dot com slash Sumtherapist. And use code SUMTHERAPIST to take 20% off your order. I'm going to push back on this idea that, I mean, because I like it in theory, the idea that even if a person chooses to medicalize, that there are things that can be done with exploratory therapy where that person doesn't just consider suicide an option. I do want to say though, if a person is already, you know, demonstrating very low distress tolerance, about psychological distress in the absence of any, you know, physical pain, injury or anything like this, right? And then you add the serious health problems that can happen after months or years of medicalization. I mean, that's just a whole new level of challenge. And also, I think, you know, it's like they have to use the suicide argument in the gender affirming care world. Because we know that these medical procedures are life-shortening. And so, you know, like, I have a friend who's going through cancer treatment right now, and she is not somebody who normally would choose to put a lot of chemicals into her body. She's pretty natural in her lifestyle, but she's going through chemotherapy because the alternative might be death. Right? Like, you really have to weigh, like, If the alternative is death, then yeah, I'd rather, you know, put poison into my body and shorten my lifespan but at least give myself a future because that's the path of least harm. So with all this gender affirming stuff, I think they have to put it that way. They have to frame it like the alternative is death in order to justify that they're actually shortening people's lives.

Tamara Pietzke: Yeah, let me clarify. I don't think what I meant was that if we can do therapy with them when they're teenagers, and they're under their parents roof, if we can like prevent them from medicalizing, then we're helping them we're dealing with the underlying issues, the anxiety, the depression, we're building those coping skills that is hopefully this distress tolerance skills, and we're setting them up for more success as adults. If they as adults choose to still, you know, transition, then hopefully, some of those well first of all hopefully their brains are more developed than if they had it transitioned as teenagers or young people and but hopefully the skills that we provided them with as a teenager will help in some aspect but I guess the goal or the dream would be for them not to feel like they need to transition because we're able to do good therapy with them when they were young and under their parents' roof and they were more safe from the option of suicide because they had somebody keeping an eye on them, you know?

Stephanie Winn: Yeah, and where you're coming from makes sense to anyone who's familiar with the actual research and who has that mindset of let's protect people's health and well-being. Let's always choose the least invasive options. But it's like there's this kind of glaze that comes over people who are indoctrinated into the gender stuff. And you were met with some stuff that was really shocking to you in terms of the ways your colleagues responded. And something I've heard you say on a previous podcast reminds me of something I've heard myself say a lot, which is that one of the most shocking things to me is that See, when I first learned about detransitioners, when I first learned that there are people who claim to be harmed by this was 2020, you know, fully at least three years after I'd been taught the gender affirming model. And for me, the moment I learned anyone is being harmed by this, I felt like I need to learn everything I can. I need to I need to pause on working in this way. And and I went down that rabbit hole. And to this day, the most shocking thing is that there are therapists who don't have that reaction like you and I both did.

Tamara Pietzke: Yeah, it is shocking to me. And then I think, what is that? Is it this cult mentality? Is it that you're just trusting that the higher, the people above you are making the right decisions and you're just not looking into it yourself? What is that? I can't understand that really. Why are you not exercising any critical thinking skills? I just In my experience, the higher-up people aren't necessarily trustworthy or motivated by doing what's best for the client. So we have to use our own brains to ask ourselves, like, what is happening here?

Stephanie Winn: Can we actually speculate? Because I'd love to know. Because I mean, I hear you saying, I don't know. Like, it could be this. It could be that. But I want to kind of speculate into that further, because it's such an interesting phenomenon, what happens when these people who, you know, they've gotten into a career because they love caring for and helping people. generally pretty empathetic and open-minded, pretty kind and understanding. Maybe some of them, you know, if they do marriage and family therapy like I do, maybe some of what they do is help people hear each other over difficult subjects, right? So this unlikely population therapist becomes nasty and closed-minded when it comes to, you know, the type of concerns that you've raised. So I guess I've had one idea come to me recently that I think some of it has to do with tribalism, and that they've been taught that there are these bad people out there who oppose transgender rights. Let's say it's being framed that way. I have a whole spiel on what transgender rights even means, like what rights do trans people have that the rest of us don't have? Anyway, you hear what I'm saying. But they've been told that they're these bad people, right? And in their mind, there's this whole demonized other category of people. And then someone like you, who they had in the good people camp in their minds, becomes that voice saying something that triggers an association with what the bad people ostensibly are saying. And then it's like, I just imagine their amygdalas are firing like crazy, like it's like some kind of chain reaction kicks off in them of fear and anger where they're like, oh my goodness, this person I trusted, this person I thought was one of the good people is actually one of the bad people, almost like they just discovered that they let the Trojan horse into their town or something. And now it's like, You know, everything is firing on all cylinders and they're like, how do I get the bad person out of my good people group? You know what I mean? Sure, yeah.

Tamara Pietzke: Yeah, I think that's an interesting, and probably, I mean, I think that makes a lot of sense. When I've asked this question to other people, they've said, for them to hear you, for them to give any weight to what you're saying, they'd have to admit within themselves that they might have done something that harmed people. Totally. And they can't handle that thought, and so it's easier for them to villainize you. I understand less the, like, angry i hate you for speaking out against this because i think that even if i hadn't been in this position that i'm in now like if one of my colleagues who i trusted was like i have some concerns about this i'd be like let's have a conversation like absolutely i want to know what your concerns are i understand more the gray area because again i'm trying to imagine myself like if I didn't know anything about this world, or even just the me of like a year ago, right? I didn't know anything about this world. I had this mentality of like, okay, there's these people over here who feel very strongly about this. And then there's these people over here who feel very strongly about this. And I don't know enough to know like why this group over here can feel so strongly and this group over here can feel so strongly and how they're not… One of them has to be right, right? Like, I don't know why how they can be on opposite sides of the argument and so convinced of their rightness. And so I feel like I'll just sit somewhere in the middle and believe that maybe sometimes this is okay for people to do, and maybe sometimes it is harmful to them, and hopefully the powers that be will figure out how to decide which children should be medicalized and which children shouldn't. I can see myself, if I didn't know anything, being like it's more comfortable to be in the gray where like they care a lot but they care a lot too and I think everyone cares about people's well-being and so let's just like let people do what they're gonna do and I just think it's more comfortable sometimes for people just to be like, I don't know, let everyone just make their own decisions, you know, and just kind of like keep their themselves out of it. But when you're a therapist, when you're being asked to write, not even asked, told that you have to write letters or you're going to lose your job or your license, then you have to ask yourself like, what is happening here? What am I doing? Am I, and I remember the thought that like really got me, motivated me in the beginning was like, I can't look at my 13 year old client in the eyes today and know that I am writing a letter where potentially the them of five or 10 years from now is going to look back and say, why did my therapist let me do that? Why did they not ask any questions? Why did they look at me and smile and nod and go along with everything I was saying? Like I can't as a caring person live with myself. If I am setting my clients up for a future where they're struggling with cancer, bone density issues, or infertility, or any of the other things that we know are associated with these early medicalizing

Stephanie Winn: you know, processes. That position that you described of the sort of, let's say, the humble moderate, right? The person who sees that there are people on both sides fired up, knows that they don't have all the answers. And there's an assuming of goodwill, too, that I appreciate about that position, which is, because I noticed the way you framed it was, they care a lot, and they care a lot. But that's not how most people in this argument are framing it. They're not saying, I see how much you care about this. And that was one of the things that you've expressed being really shocked by, is that your colleagues couldn't at least acknowledge, I see where you're coming from, or let me take a look at that, or I understand you're trying to protect people. It was that the moment you questioned any of this, you are now bringing politics into the workplace, which you didn't know you were doing. That's like, they're the radicals. And you're doing great harm to people, right? They love that idea of harm. So now that you're in private practice, I imagine that you have parents seeking you out, wanting you to work with their young people. But you've said that there have been some difficulties with this since you are Googleable as a whistleblower, even though your stance is a lot gentler, more middle of the road than people like me, who I say that I You know, I've basically boldly declared my stance. I don't think there's ever a time that doctors should take healthy people and make them sicker. I don't care what age. Like, that's my stance. You've come forth in such a gentle way, a moderate way that makes space for other opinions. You clearly come across with a lot of intellectual humility. And yeah, it sounds like from your experiences so far, ever since you became a whistleblower, that there are young people who just wouldn't be willing to talk to you. They have certain expectations of what a therapist is supposed to do. And can you describe, obviously within the limits of protecting patient confidentiality, but can you describe some of the obstacles that you've encountered or trends you've noticed?

Tamara Pietzke: Yeah. So I have had a number of parents reach out to me and they're like, I'm so glad I found you. My child is struggling with this issue. It's so hard to find a therapist who's not just going to rush to affirm them. And sometimes I feel like if the kid in question is still just trying to like figure out who they are and is just like, this is just a thought in the back of their mind and then they're willing to see me. They're willing to like, just kind of like, yeah, let's just like explore this together. I'm not in any hurry to like medicalize, but it's the kids who are like, I want a letter right now. I want to start, you know, testosterone or estrogen or whatever right now, those children do not want to see me. I met with somebody and they cried the whole way through our appointment, you know? Like I thought, well, yeah, I get that they're angry at me, but certainly we can like have some sort of back and forth dialogue here and they can see that like, I care, like I care about them. Like I'm still just really like living my way through this and learning so much as I go, because I'm just so naive. Like I really thought like, but they'll see that I care. And that's not how it played out, you know? And I talked with Sasha Ayyad about this actually, and she's like, you have to see it as like a religious experience. If somebody told you Jesus never walked on water and you're a Christian, are you gonna hear that? Or are you just gonna stick with this belief that you have so innately inside of you that like, yeah, but he did, you know? You're not gonna be able to say anything to convince these captured children that like, You're not the enemy. And so that's been really hard because I desperately want to help them. I hear when they talk to me that there's so much else causing them pain and distress. And I remember asking that client that I just mentioned, the one who like cried through the whole session and never saw me after that. Like angry cried, not sad cried, mad at me cried. I said, what is it that you want from a therapist? Like what ideally Are you looking for? And they said, you got someone to write this letter for me, someone to help my parents get on board with the letter. Like that's what they want. They don't want there. Then you're not asking for therapy, right? Like you're asking for someone to help facilitate the product process to medicalization. Like that's not, I am not a good therapist. If that's all that I do for a client, you know? So it's been hard. It's been hard to like know how to help people. It's been hard to know how to help parents. And it's been hard to know how to help teenagers who are just so It's like talking to a wall. It's not like talking to a person anymore. I thought certainly we can connect and it's just, it wasn't that way.

Stephanie Winn: Yeah, it requires, I think, a combination of ego strength and humility to be able to be vulnerable with a mental health professional. You know, to come feeling distress and knowing this person has tools for helping people like me when we're in distress, even when we don't fully understand how we got here or how to get out of this, that's a really vulnerable thing to do. And I'm sure you've had many wonderful experiences, as have I, in the role of therapist with people who did have the ego strength and the humility to come to us saying, I don't know what my problem is. I know I have a problem and will you help me? You know, that's a really, really brave thing to do. But I think the problem that you're pointing out is that these young people have a huge set of expectations built up already. They have a strong, compelling story that they're very bought into about why they feel the way they feel and what is going to help them. And so they come saying, whether or not they've verbalized those, the message that their behavior is sending is, I know exactly what I need, and what you, Tamara, are and are not capable of, right? It's like, there's no receptivity there, there's no, maybe this is like a wise, compassionate person who can see something that's in my blind spot, and that it would actually really help me to look at that blind spot. Maybe I would get new insight. There's none of that, right? There's like, your job is to do this, which is actually, when you think about it, is a really cynical worldview, right? That everything, because if I'm, you know, 13 and I'm thinking this way, like, I certainly, there's very little I know about life. There are very few skills I have, right? And to think like, this is the be all end all. If I don't get this testosterone, there's no point. And it's like, in one simple statement, that a youth might make to you, that it's like, there's so much to unpack there.

Tamara Pietzke: It's like, before, MultiCare wouldn't let me unpack it, and now the clients themselves often seem to be incapable of going there, you know? But just again, like, I don't know. Let's just let their brains mature and develop. Let's just create this, like, safety net, this bubble for them to just figure out who they are. I just wish that, like, medicalizing before 25 was not even an option, so that these kids could stop thinking that if they say this or if they do this, then then… then they'll be able to transition. Like what if they just knew that like, okay, I can't drive till I'm 16. I can't potentially transition to 125 when my brain's fully developed. Right? Like if they just knew that, then we have this like time to kind of work with them and then no one has to be the enemy. Like I don't have to be the enemy about whether or not I'm going to write a letter for them because that's not even a topic of conversation. Like, I don't know. That's just me dreaming of like a world where we can actually help these kids, you know?

Stephanie Winn: So I've been thinking, I've been working on this course that addresses the psychology of this issue. And I've been thinking about something pretty related to what you just said. I've been looking at, you know, various psychological phenomena like the sunk cost fallacy, the hot cold empathy gap, all these things as they pertain to ROGD youth. So I think that, are you familiar with the phrase the hot cold empathy gap? No. Okay. So there's this episode of Hidden Brain Podcast that explains it really well. I think the episode is called In the Heat of the Moment. It's like maybe from six years ago or so. But it's basically that not only are we bad at predicting how other people will act in various high stakes situations, we are actually pretty bad at predicting how we ourselves will behave in a situation in which our heart is racing. So that's why it's called The Hot Cold because we're in a cold or cool, calm, and collected state of mind. And we imagine what we would do if we were in a situation that triggers the fight, flight, or freeze response. And so a classic example is that a majority of women surveyed said that if they were sexually harassed at a job interview, they would speak up. And then it turns out, in a study where they had participants unknowingly were actually sexually harassed at a job interview, and this was the study, and none of them spoke up. They all froze. Right? So that's kind of like a classic example. And so I think between that and the sunk cost fallacy, you know, the idea that when we've invested a certain amount of time, money, energy, hope, and especially something as precious as one's sense of identity, if we've invested a certain amount in something, we will keep fighting to try to make it work and to defend it even long past the point that it's become clear that we're essentially throwing good money after bad. So I think with all these things, even this idea, and you don't have to agree with me, and I'm not trying to openly challenge you or criticize your ideas. I'm just showing a different side of the story that even if there were that barrier at where nobody could do anything medical till 25, it's not like there's zero harm in a young person going from age 16 to 24, spending all those developmental years reinforcing those neural pathways by, you know, iterations of thousands if not millions of thoughts, feelings, and actions on repeat, reinforcing the sense that I need to be seen as the opposite sex in order to be happy, this is who I am, like, Yeah, the neuroplasticity of that time in life is pretty powerful. And so I'm sort of combining a lot of ideas here. And I probably sound all over the map. But I think that even with that boundary in place, there's still harm in social transition. And there's still harm in there being a world where therapists aren't allowed to do their job, a world where

Tamara Pietzke: Yeah, I don't disagree at all. Not at all. I think that that absolutely needs to be in place. But yes, I think that social transitioning for kids to like, just like hyper focus on, I'm this opposite and this other gender or I'm this or I'm that, I do think there's definitely harm in there. I think there's a social contagion piece. I think that we need to monitor what kids are seeing on their phones, because if all they're watching is stuff that's reinforcing that, then that's not doing any help, or that's not helping them at all. But as a therapist, I'm like, man, if I could do therapy with If they would just be like, okay, yeah, let's talk about these other things going on. But they won't even talk about them because all they see is that they're having this gender distress and they need a solution for that. So if I could be like, okay, yeah, I hear that. Let's set that aside for just a minute. Let's just set it aside for a minute. Not that it doesn't matter, but let's look at this other stuff here that's going on. Because we can't really do anything about that until you're 25 anyway, right? I think it would just be so helpful to be able to do therapy with them, because right now we can't. As soon as somebody comes in and says, I identify as a different gender or whatever, like, well, we don't do therapy with them anymore, right? Because anything that you do or anything you ask can be seen as like, what is the word?

Stephanie Winn: Conversion therapy. Yes. That's what I've been accused of.

Tamara Pietzke: Conversion therapy. Yes. And you're like, but no, I'm just trying to ask like, hey, you are 16 and you have your whole life ahead of you. Why do you feel like a dog? Like, I need to know. And why a wounded male dog? Like, let's explore that a little bit. Like, I very much want to know. But if you ask that, then they can say you're not being affirming, you know?

Stephanie Winn: Well, on that note, I think a direct quote, if I if I have this straight that was used against you is there's no reason why someone's mental health would impact their gender identity. So that's this that comes back to this unfalsifiable belief that there is this thing, this sort of independent, ineffable thing called a gender identity, and that there's just no correlation between a person's, you know, magical insights into who they really are, and the things that have happened in their life. And if someone gets the gender bug, if it occurs to them that they might be trans, then that's just a fact about who they are.

Tamara Pietzke: What about the fact that 80-85% of young people who are allowed to progress through puberty normally often resolve their dysphoria, end up being gay oftentimes? What about that? Why are we not allowing—if there's no way for us to No, who is going to be the 15% or whatever that's going to persist into adulthood with this? If we have no way of knowing that when they're teenagers, why are we not just creating the safe space for them to figure that out, to go through puberty normally, and then either decide that this is something that they're going to persist in or not? Like 80 to 85%, right? That's the statistic.

Stephanie Winn: Well, and I think it's even worse than that, because I don't remember what year that study was from. I know what you're talking about. And I think that was from a time when it wasn't this massive widespread social contagion, there wasn't 30% of a generation identifying this way. And it was mostly the people who had gender dysphoria, where were the gender atypical gay kids, or the proto gay kids, the kids who would grow up to discover they were gay. And so yeah, I think the statistic match that time. But now, with the social incentives and disincentives that this younger generation is facing, there are all these kids who are actually, by nature, pretty gender-typical, by nature heterosexual, and they're getting swept up in it too because the last thing they want to be is cis, so I think it's even worse, you know? I think, like… Maybe.

Tamara Pietzke: Do you think it's, like, they find a group that… Because oftentimes there's an ADHD or autism component, right? Do you think it's that they find these people who accept them and are also, you know, struggling maybe with their gender or their identity? And then they just, like, it's a social contagion piece because they found a group that, like, accepts them that they feel like they fit in with, and then they all sort of, like, struggle with this thing together.

Stephanie Winn: You know, I… I think it's even worse than that. Really? I'm just, I'm so skeptical of everything at this point. I mean, the idea of acceptance. Here's… I think it's the idea of acceptance. Right, I think it's more like it is, you know, the relationship between that and true acceptance is like the relationship between genuine love and love bombing. Right? It's the Trump card. It's the, now you have to accept me. And it's the fact that with a lot of these kids being on the spectrum, they can't read social cues. And given what I do, so I mean, now all I do is I do consulting with ROGD parents. And a lot of the parents of autistic boys specifically, I notice a lot in those stories, that the boys are so unaware of people's social cues that they really, really cannot tell the difference between people liking them and thinking that they're pretty and seeing them as girls versus people just being polite. I've heard some incredibly naive statements like, you know, a boy with autism saying, well, now that I've grown out my hair and legally changed my name, everybody will see me as a girl. It's like, No, like, you know, like, so I think it's this, like, it's more like the love bombing version of acceptance. Sure. It's the fantasy of acceptance. It's being rewarded for something. It's having a trump card. It's feeling powerful. It's going from the underdog. I mean, like, I'm thinking about, like, I was a punk kid and I remember, like, going from being, like, nervous, shy, awkward, geeky kid who'd been bullied to having this overnight transformation and entering, I think it was ninth grade, with my Operation Ivy t-shirt and my short spiky blue hair. I remember that when you feel powerful, you're like, screw you, world. You can't touch me. It's ironic that there's this huge social justice belief system associated with this stuff. One of the things that people who are into social justice are most fascinated by is the notion of power. Here with all these young people, I think there's a fascination with power. I think they're learning just how powerful they can be. I mean, you know about how adolescence is the second rapprochement, right? The echo of the developmental stage of toddlerhood, and it's like, let me see what I can get away with. Let me see how far I can push, but they're calling out for boundaries. It's a lot.

Tamara Pietzke: It's like, what do we do? Where do we go from here? How are we going to fix this? people have asked me that, and I'm like, I'm still living my way through this, like, I'm still figuring it out as I go and trying to, like, understand, like, how we even got here in the first place. I wish that I had an answer. I wish that I could be like, well, this is what needs to happen, but I just, I don't know.

Stephanie Winn: Like, how do we undo the damage that's been done? I think a lot of young people are just gonna have to get through this phase of life unprotected, because all the people who are trying to protect them, our hands are tied. And some of the time, our hands are tied because of belief systems adopted by the young people. Like you said, like there are young people who you are there, you are a diamond in the rough, you are like one of a handful of people in the state of Washington who's actually safe enough to refer these young people to for counseling. But they have unfortunately, already been fed so much, frankly, propaganda that tells them that someone like you I mean, it's ironic because you're so soft spoken and you have such a gentle, sweet face. I'm sure you're not accustomed to people being threatened by you.

Tamara Pietzke: No, not at all. Very confusing notion.

Stephanie Winn: Like, I at least have, like, a resting bitch face, so I'm accustomed to people being, like, intimidated or threatened by me, so that, like, when this happened, I was like, yeah, what else is new? But, like, you look like you couldn't harm a fly, and this is all very, I mean, you didn't even know how political this was when you stepped into it. You didn't know that you were going to be labeled, like, a far-right MAGA extremist for saying these things, and so. No.

Tamara Pietzke: And I wouldn't have done anything different anyway. The more that I realize how corrupt the system is and how they're working to silence people with concerns, the more I feel like I need to scream about this issue. Because I really thought people were just trying to do the best that they could. And that at some point, a person would hear me. Risk management or my boss or somebody would hear me and we'd be able to have a conversation about this. I was so naive. I really thought. I just had missed all the years before of therapists navigating the same road where they were like, no, no one's gonna listen to you. Like, I was not aware of that.

Stephanie Winn: You know, I remember when I was going through it back in 2022, when I was under investigation for my board, I had a similar fantasy. Like, I had a fantasy of at least some kind of climactic moment where I got to sit across from a table with my board members and, like, have a conversation. But everything was either a phone call, I had two phone calls with the investigator, or it was over email. It was all very depersonalized. I never had an interaction with any licensed mental health professional on the board. Look, I'm not complaining because the board let me go. They found no evidence of wrongdoing. I have faced no disciplinary action. For me, the writing was on the wall. I saw it, like, I walked away from that, on the one hand, grateful for it to be over and for me to walk away with my license intact, but I think I also felt like this is only gonna get worse. I'm only going to become more outspoken on this issue. And you know, every time someone like you comes forward with a story where you said the most innocuous thing, and you were really, you were giving them every opportunity to prove that they even lived on the same planet as you did, right? You're like, so wait, just to be clear, right? Like you gave them every opportunity and they were like, no, no, no, no, no, no, we rubber stamp people through a process of medicalization. That's what we do here. You know, you're like, do I need to like, get my ears checked? So after going I mean, so it's like every time I hear one of these stories, it's like, this is a war. And so for me, I think I needed to prove to myself that I would be okay if I lost my license. And so that's part of what's driven my continuing with the podcast and stuff. It's like, well, then I need enough people who know and respect where I'm coming from that I'll have some kind of safety net if this continues, but it has taken away my ability to just be like an anonymous therapist. So have you been grappling with like how to, I mean, since you're pretty new to private practice, like how to market and position yourself? Yeah, absolutely.

Tamara Pietzke: So I am like, do I go to pediatrician offices? Because, like, where are they going to stand on this issue? Like, are they going to see me as the enemy? I mean, I just don't, you just don't know, you know, like, and I don't, I love working with people who want me to help them, whether the issue is gender distress or something else, like, I don't want to… I feel like oftentimes people reach out to me because they see me on podcasts or something, and so then I'm working with a lot of, like, teenagers who are reluctant to see me. And I am happy to still see them if they want the help, because I know, like… I… I know that they're safe with me, that I will do therapy with them. I… really wanna help them, but, like… Am I just gonna become this person who… work specifically with this issue because a lot of other people in this state. I just feel like I don't think I'm making sense because I'm trying to word it in a way that's not going to make me sound. I want to still do therapy with all issues. Depression, anxiety, trauma, all the things. I love that I've been in this world of getting to have a voice against this issue and provide a safe place for kids to be, to get treatment, whether they're experiencing gender stress or something else. But when I market myself, are people going to be like, Oh, hey, that's that whistleblower person. We're not going to like hand out her flyer to these people because that's all she does is like tell kids they can't transition or something. You know, like, I don't want that to just be. I don't want my clientele to just be children who are okay with seeing me, but who are experiencing gender distress.

Stephanie Winn: Well, yeah. I mean, I really hope that it ultimately pays off and works out for you because I think that as much as there are people who would reject you because of this, there are also people who would specifically seek you out. I mean, do you do couples counseling? I hope so. Do I do what? Couples counseling?

Tamara Pietzke: I do, yeah, couples, family, whatever, yeah.

Stephanie Winn: I mean, there are, I'm sure, people looking for individual therapy, couples counseling, you know, things who have just lost so much respect for the mental health profession over what we've done, like how egregiously we have failed on this issue. And then they find themselves in these situations where they're like, I probably really need to go to therapy, or we probably really need marriage counseling, but I have so little trust in this profession." And then just the fact that you have called out the insanity on this issue means that you are one of the trustworthy people.

Tamara Pietzke: Yeah, I did actually have one – now that you say that, I did have somebody reach out to me and they said, I'm not – I saw you on this podcast, I'm not struggling with gender or anything, but like, I trust you more because of what I've heard you saying, like, I know that you're going to do good work and that, and I want to see you. And I'm so grateful for, for that, for the ability to be like, some of us are still asking these critical thinking questions, you know? It just is infuriating to me because I'm like, even if I was wrong about this issue, which I am not, I'm screaming, like, I think we're hurting kids. Why would a good person not be like, let's talk more about that? Like, if you're so quick to be like, No, you're transphobic or you're this or you're that, then you have something to hide or protect. We're not having a dialogue anymore. Even if I was wrong, if I thought kids were being harmed, I should be screaming it until somebody heard me, right? Like, does that make sense?

Stephanie Winn: Yeah, I know, it's just shocking that it's so hard to get someone's attention on… Okay, here's an example. If my fiancé was driving, And I said, stop! He would slam on the brakes. Because he trusts me enough, right? Like, what, is there an animal on the road or something? Like… And you would think that they're just amongst adults in general, that there would be enough of an ethos of trust that if any adult who hasn't disproven themselves by, I don't know, like having a criminal record, you know, aside from a handful of like criminals and creeps, You know, the rest of us, like, that there should be a license to say, I'm worried a child is being harmed, and that other adults would say, what's happening, right? It's just like this basic ethos, whether or not you yourself are a parent or work with kids in any capacity, like, it's just part of the ethos of adulthood that, like, you look out for children.

Tamara Pietzke: Sure, if you say somebody's drowning in that lake, do you just not jump in? What do you do? If you're saying somebody's in danger, why do you just ignore that? Or why do you not at least say, let's see if there's actually anyone in the lake? Look, let's have a conversation about this.

Stephanie Winn: It is one of the most damning things, and you described you know, in your previous interviews where you shared more in-depth what happened in your previous workplace. It was, you know, the fact that your former boss said, I don't have time to read that article. You know, it's things like this that all these people have gotten swept up in it.

Tamara Pietzke: Yeah, I had somebody say that what it's going to take is these kids who are medically transitioning right now, detransitioning in the future, and that is, like, before anything changes. And that thought is so sad. We're just sacrificing a generation of children. Like, that's so sad.

Stephanie Winn: I love sleep. Sound sleep is a crucial foundation of good mental and physical health, from mood and concentration to metabolism and cellular repair. And I sleep very well thanks to my Eight Sleep Pod Pro Cover. My side of the bed is programmed to be warm when I get in and cool down to a neutral temperature in the middle of the night so I don't wake up overheated like I used to. How would you customize your bed temperature? Visit 8sleep.com and use promo code SUMTHERAPIST to take up to $200 off your purchase. Even if they're already running another sale, this code will get you an additional $50 off. 8sleep currently ships not only within the USA, but also to Canada, the UK, select countries in the European Union, and Australia. Thanks for considering purchases that support the show. Well, and Lisa Littman study found that three quarters of D transitioners did not inform their former doctors. So how many therapists have rubber stamped people and not even heard back from those same people down the line? I have a template. It's in my my usual Lincoln bio, which I'm not sure is in the show notes. It's my like, if you follow me on social media, Anyway, it's bio.site slash sometherapist. I believe that there's a shortcut in there. If not, it's on my blog at sometherapist.com slash read. But there's a template I have for filing a complaint against the gender-affirming therapist who harmed you for detransitioners. And I was very glad to know, because I feel like a lot of people don't know how to navigate the system. And then we have abuses of the system, like trans rights activists coming after me a couple years ago. I'm sure they're still filing. I'm sure every now and then some new trans rights activist discovers me for the first time and decides to send a complaint to my board. And I don't know if my board at this point is like, oh, another anonymous online trans rights activist filing a complaint about Stephanie Wynn. We can go ahead and disregard this. We've already been through this with her. I don't know how often that happens. But, you know, you have people who will abuse the system to stop people like you and I from speaking out. So I felt like it was important to say, hey, if the system exists to protect people, let's use it for its intended purposes. And two can play at that game, right? Like there's, there's no reason. I mean, and I know that there's a lot of so called gender affirming therapists who their heart was in the right place, and I don't want them all to necessarily suffer. I'm not trying to punish them, but I think we need to use the system and that there's nothing more powerful than someone who has been harmed as a patient saying, I was harmed, and this shouldn't have happened. And I think You know, before we started recording, I told you some sort of inside information that I won't share in detail here, but I have reason to believe that some people in positions of power within licensing boards and the lawyers that advise them and so on know that this is all headed for some massive train wreck. And so it's like, I think that every detransitioner who's willing to Yes, it's great when they file lawsuits. And we have like a dozen or so of those in North America right now, between the US and Canada, maybe Mexico. But lawsuits are, you know, there's a very small minority of people who are going to work up the courage and find the resources to hire a law firm. I think a much lower hanging piece of fruit for people who were harmed is to complain to licensing boards. And I will even go so far as to say, for those who are listening, you don't just have to be a detransitioner to use a licensing board to complain about gender affirming therapy. If you are a parent who felt like a therapist harmed your relationship with your child, or harmed your child, you have every right to use the system. And you are protected in that system. If you go through the system and its board complaint process, your privacy is protected, the board can't… They can't do anything to punish you as a consumer for appealing to them for help. Like, you're really protected as a consumer by going to a licensing board, so people might as well, like, you've been dragged through it, I've been dragged through it, lots of other therapists who have blown the whistle or sounded the alarm about this issue have been dragged through the licensing board process, so you know what? I think our colleagues should have to feel some of what we felt. Again, I'm not trying to punish them, but I'm trying to say we need this to be a fair fight. And right now, those of us who are on this side of the issue saying, hey, we think there's something wrong here are being unfairly punished, and it's very disproportionate. And meanwhile, there are lists on the internet of hundreds of therapists who have Signed an agreement saying I will affirm people. I will write letters on the first visit. No questions asked So who's holding them accountable? I think people should be filing complaints about that and there's no reason why they can't use the system well, I think you've said some very wise words on previous podcasts saying like That you are you're scared and you're sad and you're having all the feelings but you're not sorry for what you've done And I thought that was a really powerful distinction

Tamara Pietzke: Yeah, not at all. I remember somebody said, was it worth it? And I was like, I don't even know how to answer that question. If I saw a burning building and somebody was screaming in there, and I ran in, whether I could save the person or not, whether or not I ended up getting burned in the process, the question isn't, was it worth it? You do the thing that needs to be done to save the people who are in danger. That wasn't a thought. You just do the thing that is right to do. I don't know. And I don't know why… I don't think I'm an exceptional person, so I don't know why I have that mentality and so many other therapists don't. If kids are being harmed, why do we not ask these questions? Like, yes, this road has been scary. Yes, I've lost things. Yes, there's been there's so much that has been hard about this. I don't regret any of it, even if the state was to take my license, I would say I did the right thing and I am going to let the world know how corrupt the system is because that is that is that's wrong. It's just wrong. So I just feel like I and I think that for my kids to I'm like, when I think when I feel guilty about the ways that I've impacted my ability to provide for them. I think if my kids were 37 years old or 20 years old, and they're like, mom, I think something is happening at work. That's wrong. I don't feel good about it. I would say you do whatever you need to do to make sure that you're airing your concerns. And if the powers that be try to silence you, then you can talk to me because we need to figure out why that is. Like there might be something else going on. Like you always, always, always do what you feel is right. You know, even if, even if. There's repercussions or consequences for that. Always do what you think is right.

Stephanie Winn: That's awesome to hear. And you've been able to think through all of that as somebody with, you know, limited resources and a certain set of obligations and responsibilities. You don't have to share, of course, anything like that you don't want to share with the public. But I'm just curious if you have like a backup plan or how you've been able to sort of

Tamara Pietzke: Reassure yourself that you have options Yeah, so I know I I'm very grateful like when I first when this when I first lost my job, I was like even if I have to like lose my house and move back in with my dad like I still did the right thing. Like I, but I'm very grateful that I have been connected with the LGBT courage coalition and they set up a give, send, go for me. And that money is like saving my butt right now. I'm so grateful to everyone who's donated because it's how I'm making ends meet and taking care of my family. Like I. was getting unemployment and now the state's coming after me for that so I might have to pay back thousands of dollars like it's just been such a headache and so having that give send go money and just knowing that like okay we can keep a roof over our heads while I continue to build up this my caseload with my clients like it's been incredibly helpful. And I know that any other potential whistleblowers whistleblowers out there with the LGBT courage coalition is in place to support them. So I would suggest reaching out to them. That's awesome. There is there's a safety net of people willing to help.

Stephanie Winn: Yeah. And that was started by Jamie Reid. And she's she was on a previous episode of this podcast. And I hope to have her back. Maybe we could even do like a group episode with you and her, like a Whistleblowers episode. Yeah, that would be awesome. Well, you know, I hope that your private practice thrives. I know you never set out to be in this particular position or even to specialize in this issue. And I can relate to that. I ended up becoming very specialized in this issue. But by nature, I'm a generalist. And, you know, I also saw a wide range of people with a wide range of issues for a long time. But I think for lots of people, lots of just fair-minded, clear-headed people will, you know, not necessarily need therapy for anything related to gender, but just know that you are one of the trustworthy therapists out there in Washington State. And I have, as of today, made sure to add you to my own private little referral list, so if I ever get an email, someone looking for a therapist in Washington, you're on that list. And I'll be happy to introduce you to some friends there as well. So yeah, is there anything else that you wanted to say or follow up on from before?

Tamara Pietzke: I don't think so. Thank you so much for having me, though. It means a lot to connect with other like-minded therapists and just know that, like, I don't know, I just came back from the therapy first retreat and it was so good to be face-to-face with other therapists. I was like, these people are so smart and they have such big hearts. And so I just take so much courage from knowing that there are other really intelligent people who are fighting this fight and caring very deeply about this issue. We're not going to give up, you know?

Stephanie Winn: Yeah, that's great. So we'll have your new private practice counseling website in the show notes. We'll also have your GiveSendGo and the free press article. Anything else you wanted to share about where people could find you? Well, no, I think that sums it up. OK, great. Well, thank you so much. It's been a pleasure. Thank you so much. I hope you enjoyed this episode of You Must Be Some Kind of Therapist podcast. To check out my book recommendations, articles, wellness products, guest episodes on other podcasts, consulting services, and lots more, visit sometherapist.com. or follow me on Twitter or Instagram at sometherapist. If you'd like to go deeper, join my community at somekindoftherapist.locals.com. Members can dialogue with other listeners, post questions for upcoming podcast guests to respond to, or ask questions for me to respond to in exclusive members-only Q&A live streams. To learn more about the gender crisis, watch our film, No Way Back, The Reality of Gender-Affirming Care, at nowaybackfilm.com. Special thanks to Joey Pecoraro for our theme song, Half Awake. If you appreciate this podcast and want more people to find it, kindly take a moment to rate, review, like, comment, and share on your platforms of choice. Of course, just because I am some therapist doesn't mean I'm your therapist. This podcast is not a substitute for medical advice. If you need help, ask your doctor or browse your local therapists online. And whatever you do next, please take care of yourself. Eat well, sleep well, move your body, get outside, and tell someone you love them. You're worth it.