You Must Be Some Kind of Therapist

Swell AI Transcript: 161. Glenna Goldis.mp3
Glenna Goldis:
I think this is a neutrally worded document and the ethics chapter is, you know, it finds that it's unethical. So people will say it's not neutral. But I don't know how you could lay out all these ethical principles and then just walk away and not connect the dots for the reader. So I think it's done very well. And it also uses some language from consumer protection law and talks about kind of the argument in favor of giving the patient whatever they want and the theory of patient autonomy. And it chops that down. since we need to have like a larger ethical framework than that. At some point it refers to the practice of gender medicine. And by the way, this would seem to apply to adult gender medicine too, although it doesn't say this, but it refers to the field as the crude responsibility abdicating ethos of medical consumerism. Caveat emptor. Buyer beware. That's brutal. I mean, we've all been calling this medical consumerism, but now it's in a report and is totally accurate.

: You must be some kind of therapist.

Stephanie Winn: Today I have the pleasure of welcoming back to the show Glenna Goldis. She is a lawyer in New York with extensive experience in government, fraud investigations, and domestic violence advocacy. She publishes Bad Facts, a newsletter about the movement for trans rights, so-called trans rights we should say, And you might have previously heard her on episode 148 of my podcast, which was called, Executive Orders Decoded, Attorney Glenna Goldis Explains Impacts on American Families. So I don't know how many more times I have to interview her before we can call her our resident legal expert, but it's starting to feel that way. I'm just really glad that Glenna was able to hop on a call so quickly after I learned about this recent Health and Human Services review. And so Glenna is here with her legal expertise to fill me in and fill in all of our listeners on what exactly this review is and is not and what it means for our country moving forward. So Glenna, so good to have you back.

Glenna Goldis: Thanks for having me.

Stephanie Winn: Yeah, thank you for joining us. So, you know, probably like many other people out there, I have a hard time keeping up with the news. Life gets busy and then, you know, you're just getting these little snapshots. You see headlines, you see social media posts, but you don't take the time to look into things. And so I know that there are things moving quickly in our country and abroad when it comes to, you know, events related to the whole gender madness. And one of these recent events is the Health and Human Services Review. I haven't had a chance to look at it. So as I've been saying in my other recent episodes, I'm kind of going in blind along with any listeners who are as naive as I am about this. And so some of my questions might seem like dumb questions, but I hope that that'll just make it more relatable for people who get easily confused by this stuff like I sometimes do. So let's just kind of start from square one. Please tell us what is the recent Health and Human Services Review?

Glenna Goldis: When President Trump came into office in January, he pretty quickly issued some executive orders related to gender, and one of them related to gender medicine for people under age 19. And that, among other things, he ordered a review by the Department of Health and Human Services, of the evidence base for this practice. So this has been a highly fraught question for years, of course. What is the evidence? Is it sufficient to be taking such extreme steps about children? So we knew this was coming. We knew that Health and Human Services was going to issue something about the evidence base. There was a 90-day deadline. So that is very short in government time. Things tend to move slowly in government. but they got it done. So last week it came out. I think they had to extend the deadline a couple of days, which is fine by me. It's still very impressive speed. And this document is, again, we didn't know exactly what it would be. It turned out to be very expansive. So it addresses the evidence for the benefits, which are supposed to be psychological. It also addresses the evidence for harms caused by gender medicine. And that is something that has been really lacking in this field. And part of the reason it's lacking is because they don't study it very much. And the people who did this review, they said, no, even though there aren't that many studies, we're going to jump into it as much as we can. And we think there are some inferences we can draw about how this is affecting people, kids. So we have chapters on that. There's a chapter on ethics. There's a chapter on psychotherapy. It's a very expansive document. It also covers the history of gender medicine. There's a lot on that. It discusses the discourse around it and why, you know, questions like, how come all the professional societies support this? And what does it mean that almost all the professional societies for doctors and for mental health professionals support it? It gets into all of that. So it's much more than just medicine or science, although it does cover a lot of that as well.

Stephanie Winn: Well, with that overview of what it addresses, I'm so curious what specifically it says on each of those. So you said it starts with the evidence of both the so-called benefits and the harms. And as you point out, the claims of the benefits are supposedly psychological ones. This is where I feel like it has been my place to be one of the people commenting on this as someone with expertise in psychology. And that's why I've joined the discussion, right? Because exactly that, I'm like, wait a minute, we're doing permanent bodily damage to people in the name of psychological benefit? What's the evidence base, right? And what does common sense say? So I'm so curious, what does the report say about the so-called evidence of psychological benefits? Let's start there.

Glenna Goldis: share world finds. And this is no surprise because there have been previous systematic reviews on the subject. And so it finds that the evidence is shaky at best, that there could be any benefit points in both directions. And even the evidence that supposedly does support that point is either low quality or very low quality, according to kind of a standardized way of understanding and analyzing studies. So that's not a surprise, and they don't mince words about that, but they go through, they cover different systematic reviews that are already discussed in the past, such as the Cast Review from the United Kingdom. So that's where it lands there. And it does not give an inch to the kind of anecdotal reports that you would see in the Cast Review or other places. So that's been kind of, you know, it's kind of a stain on the Cast Review that even though she couldn't find any evidence, like scientific, high quality evidence to support the idea of benefits, that report from the UK still had this language in there like, oh, but it's really great for some people. Like, why? How do you know that? And so the great thing about the HHS review is it doesn't do that. It doesn't pander to the people who say, hey, I'm really happy and I use the drug. You know, it kind of stops that cold.

Stephanie Winn: Does it mention anything about the placebo effect?

Glenna Goldis: Yeah, yeah, I believe it does. It does talk about placebo effects. It's really a thorough document in that sense.

Stephanie Winn: That's awesome because, I mean, when it comes to so-called psychological benefit, we're gonna have to parse that out, right? Like you say, people anecdotally saying that they feel better, well, it's like, okay, well, maybe you spent the last five or 10 years telling yourself thousands of times over that the only way you're ever gonna feel good is if you receive these so-called treatments and if people see you a certain way. And so, of course, when those things happen, there's this temporary so-called euphoria that's not necessarily robust evidence of psychological long-term benefit, right? So I'm really glad that it mentions the placebo. I don't want to misrepresent. It doesn't go deep into placebo.

Glenna Goldis: I mean, what you're saying is super important. It almost doesn't need to because it finds that any so-called evidence supporting the idea of this being awesome is just not, I mean, it's not there and it's not high quality. So it doesn't even need to go into placebo. It does talk about gender euphoria in a different chapter. I think it was the ethics chapter. And there's a lot of quotations from people like Florence Ashley. Maybe we can get to that. So it talks to gender euphoria. A very even tone, I would say. But just the fact that it's putting it out there is very satisfying.

Stephanie Winn: I'm actually, I'm fine skipping ahead. I mean, I think we'll still go in order. But like, what does it say? And I don't remember who Florence Ashley is. Is that a trans activist?

Glenna Goldis: Yeah, yeah. I think technically a lawyer, but it's somehow like a bioethicist. But somebody who's very, like a trans-identified man who publishes very loopy things, but in academic journals. And a big topic of Mr. Ashley would be gender euphoria. And it's nice to have that in a report like this because normies don't understand what we're dealing with here, that people are actually saying the goal of this medicine is gender euphoria. And this report is very straight-faced, but if you look at the footnotes, it has these notes like, It just explains gender euphoria more, and it says gender euphoria supposedly can only be achieved by trans people and not by cis people, because it can only be an effect of gender medicine, but not an effect of just being a person with a gender. I don't know. It dives into things in a very straight-faced way, but it should.

Stephanie Winn: Well, when you take these made-up concepts like gender euphoria, it is highly debatable. I've seen some ridiculous arguments from the trans activist side that actually so-called cis people do experience gender euphoria. You know if I as a woman supposedly experience this thing called gender euphoria when I shave my legs and put on a pretty dress And go for a walk in a field full of flowers If that's if that's what you want to call the happiness. I'm experiencing in that moment then You know should should taxpayers pay for me to have laser hair removal on those legs or I mean, you know Where do we draw the line and in what other field of medicine is any type of so-called euphoria the goal? And you mentioned that it talks about psychology, right? According to psychology, euphoria is by definition a temporary state. It's not something that can be sustained.

Glenna Goldis: Yeah, and you're right to say that some writers say that we can achieve euphoria, and the report notes this. It says, the definition of gender euphoria offered by Ashley and Ellis entails that no one who does not experience incongruence can experience gender euphoria. According to other writers, however, gender euphoria is, quote, quite common among trans and cis folks alike. And there's more citations. And it says that researchers recently have developed a scale intended to measure gender euphoria. And indeed they have. And I'm glad this is on the public record now that everybody knows there's a gender euphoria scale.

Stephanie Winn: Oh, do we know what's what are the questions on the gender euphoria scale?

Glenna Goldis: We will have to look that up. They should have added that as an appendix.

Stephanie Winn: OK, that'd be interesting. Maybe if we have time at the end to go through the gender euphoria scale and quiz ourselves. So let's see. So going through, I also wanted to know in the psychological benefits and harms section, if it talked about suicide.

Glenna Goldis: It does go into the suicide myth. It does address all of that. So yeah, and that's again, that's something that's already been on the record. The other side has even conceded it. And so this report does what it should. It goes through and explains where that came from and why it's not accurate.

Stephanie Winn: Feels like we're just inches away toward having meaningful change in public policy downstream of that because, I mean, the suicide myth, as you call it, has been used to disastrous effect.

Glenna Goldis: Yeah, absolutely. I mean, it's the number one reason why people agree to transition their kids is because they're afraid of suicide. Well, we can get to this, but we have all these wonderful things in the report. The question is, will Americans learn about it? So far, it's not looking great, but still hopeful in terms of the media getting the message out properly.

Stephanie Winn: So I happen to have the fortune of being a podcast host who's connected to people like you, so I don't have to do my own research. I can ask Glenna Goldis for an interview, right? And then all my listeners also get the benefit of not having to have that legal expertise or even read the document themselves. Now, granted, there's going to be things lost in translation. It's always a game of telephone when you're having a person interpret a document, but I trust that you'll do a pretty good job, you know, as far as these things are concerned, and that we will all be a little bit more informed than we were before. But for the average, yeah, for the average individual who doesn't know how to find someone like you or listen to a podcast like this, I can imagine that, you know, this is not the sort of thing they would study. How dense is this document? What's the size of it?

Glenna Goldis: So the size of it, it looks big at first. It's like over 400 pages. A lot of that is appendices and bibliography. So it's still long. It's like 200-something pages without that. But it's accessible. I think it's readable. So I think that an average person, if they're motivated, can pick it up. They can definitely read the executive summary at the beginning. And if they're somebody like, for example, a parent whose kid wants to transition, so they're very interested in the subject, then yeah, they can absolutely pick this up without specialized knowledge, without a medical degree, and understand exactly what it's saying.

Stephanie Winn: I'm imagining the average person could also do something that I also could have done in preparation for this interview, but like I said, didn't because I'm flying by the seat of my pants right now. But I'm gearing up for five weeks away from work, so I'm just really compressing a lot of stuff into a short time period. You know, the other thing you can do is just download the PDF of the document and upload it to your artificial intelligence engine of choice and interview the AI. You know, if you're good at writing prompts, right, you know, to remove the moralizing and the psychofancy and all that kind of stuff, just try to get the substance. Alright, so moving on, so what else should we know about what is covered in the evidence of benefits and harms section? Because I think you said the evidence of benefits, the benefits have been asserted to be psychological ones, but the evidence of harms obviously goes beyond psychological harm.

Glenna Goldis: Yeah, so the physical harm section is, I think it's really advanced for the whole, whatever you want to call it, gender critical cause, because it does walk through all the different, not all, it doesn't catch all of them. And I think that maybe because there's just not studies on all of them, but it goes through all things like what happens to your organs when you're on testosterone and what happens to you know, the risk of stroke for the boys on estrogen and all the uncertainties around puberty blockers. And it goes a little bit beyond the studies to say, well, we can use our, you know, these are experts in medicine or biology, and they say, well, we know how the body works. We can kind of hypothesize about what might be going on physically if you use puberty blockers. They point out the research that has not been done on the harms. For example, no animal research has been done. Why not? And this goes into the ethics again, but it's, you know, they're saying we should be researching the harms on animals before we research them on children.

Stephanie Winn: That's just, it's shocking because isn't it the case with any other type of medicine that animal studies come before human studies? And we just skipped past animal studies, skipped past, you know, randomized, controlled, double blind, or whatever the gold standard is, because we can't always do it that way, right? You're going to know if you got the testosterone or not. But, you know, we skipped past the experimentation on humans being done within the confines of studies, which honestly would obviously raise a lot of ethical issues, and we skipped straight to just giving drugs to kids like candy. That's so interesting. I actually never thought of that before. I never thought of, hmm, do we have studies on rats or monkeys?

Glenna Goldis: No, and what's really harsh about it is that where this originated with those Dutch researchers in the 1980s, at least one of them actually had a lab with rats for this purpose, for experimenting. I think she's an endocrinologist, and so she had rats at her disposal who she could have fed the opposite sex hormones to, or the puberty blockers to, I guess. And they didn't.

Stephanie Winn: Yeah, I'm so glad that they allowed people with knowledge in relevant adjacent domains to weigh in and, you know, speculate and draw analogies. And that is what you have to do, at least as a starting point, right? It's not necessarily enough, depending on what exactly we're researching, but That's what I've done when it comes to the psychology stuff, right? Once I gave myself the freedom to think clearly about this issue instead of being indoctrinated around this issue, I thought, well, duh, look at what I learned in all my trainings on suicide risk and prevention. I learned that responsibility towards loved ones is a major protective factor, but so-called gender-affirming care sterilizes people so they can't have children and also makes them a lot less likely to have successful long-term relationships. That's taking away a major protective factor. And I just did that for like 10 or 20 other things. And I'm like, oh, actually, we already have all the information we need to draw some pretty concerning conclusions here.

Glenna Goldis: Yeah, and it also draws from adjacent fields. So they use the S word, steroids, for testosterone. They say, look, we have studies already on steroid misuse. So we know some of the consequences of that. And it should be similar when you're calling it medicine.

Stephanie Winn: That's excellent. OK, so evidence of benefits and harms. You also said that there's a chapter on ethics. What was the tone or the gist of that?

Glenna Goldis: Well, the gist of it is, Pediatric gender medicine is unethical. And it's kind of funny to read it, because in the very beginning of the report, in the foreword, it says, this document does not provide policy recommendations. It's not a clinical practice guideline. And I think that's kind of the press around it. And that's not true. And I love this report, so it's not a criticism. But it has an ethics chapter that says, let me see if I get the exact line. It is not ethical to subject adolescents to hormonal and surgical interventions used in pediatric medical transition. So we're not making any recommendations, but we are calling it unethical. And they say that's because of what they learned in the earlier chapters that you know, there's not a favorable risk-benefit profile for the studied intervention. So it's expected to hurt you, and there's like no basis for thinking it will help you. Therefore, it's unethical. So that, I mean, that's the money quote, but it actually has, there's so much in this ethics chapter. So throughout, it really emphasizes the importance of using accurate language. And again, this separates it from so much that has come before, including the CAST review. It doesn't use incendiary language like, you know, people have accused the president of doing. It uses accurate language, which of course will be interpreted as offensive by some people, but by my lights, it is as neutral as you can possibly be. It even discusses the language choices in a chapter, in an early chapter, so it kind of shows its thinking, like, this is why we chose the language we did, this is why we think it's the most accurate way to discuss it. And then you really understand why when you get to the ethics chapter, because they're saying that it's unethical to mislead a patient about what a treatment is and about what their condition is and about whether sex can change. I was really excited about this because I have been thinking about language for a long time from a legal perspective. And I've been thinking, you know, if a doctor is calling a patient a boy and she's actually a girl, if a doctor is using he, him pronouns for the patient who is a girl, then that's just basic consumer deception. That's, you know, deceiving them about what's going on and about what their condition is. So I didn't even get to medical ethics, just thinking of it in terms of like the doctor being a business, which technically could be under consumer protection law. And the patient as a consumer is just thinking, well, this is, we call this consumer fraud when you mislead them like that. And it could also be insurance fraud, which has been discussed a lot lately, where they report to the insurance company that the person is the wrong sex. So it was insurance fraud, consumer deception. And then when they say that in court, I was thinking it's perjury. We're all so used to it, so nobody's gotten in trouble for it yet. But you refer to a girl, you say that a girl is a boy. It's not true. And you know it's not true. And you're doing it to mislead everybody about what's going on here with the medical treatment to make it seem like it's a sex change when it's not. So all of that, I was thinking these are major legal problems. The HHS review is not a legal document. It doesn't make a legal argument. But it is so parallel to that in terms of just saying what I just said, but in terms of medical ethics. It is unethical to tell your patient that she's a boy when she's a girl. And so we have some quotes here. It says, You know, the clinicians routinely employ euphemistic and morally loaded language, which can mislead or unduly influence patients and their guardians. So that's great to have it out there. And there are a few other points as well, where it says that the language itself is misleading and therefore unethical. And that is so basic to the practice, right? Like you can't even practice gender medicine if you're not going to use the words. Because like the words themselves, that is the transition, right? It's all, we're in this postmodern universe where everything is constructed by words. So this is just, I mean, right off the bat, they're cutting this thing off the knees by taking away the words and saying, you can't use those words, they're unethical. So that is huge. And I can't wait to see how the TRAs respond to that if they ever do. Maybe they won't. I mean, it's amazing the media hasn't covered that, because this is the foundation of gender medicine, and it's something that we, just as regular Americans, have been subjected to. Like, you have to use the misleading language. And now the federal government is saying, actually, that's unethical. That's a major violation of medical ethics that's just being… pushed out into the world. So that's just been like this sleeper point that hasn't showed up in the media, but it's actually gigantic. And like I said, it has legal implications too. I mean, not that a lawyer would literally argue based on this report, but like it should inspire people to think along these lines and it should kind of soften the ground for legal arguments to be made in court. This is not a crazy idea. This is endorsed by the HHS.

Stephanie Winn: And that really also connects to the issue of the ethics of social transition, because you said that the report deems it unethical to medically transition minors. But social transition, as we know, as we've discussed on this podcast, is not benign itself, right? It does psychological damage, and it increases the likelihood of that person medicalizing, whether they wait till they're 18 or not. is almost irrelevant as far as I'm concerned, because there's nothing magical that happens when a person turns 18, even when a person turns 25. You know, people like to think, oh, when your brain is fully matured, okay, but what if you spent the 10 years leading up to that point reinforcing the neural pathways associated with so-called gender dysphoria, dissociation, body hatred, wishful thinking, right? Like, if that's how you're spending your formative years, your brain is not just gonna magically be healed and mature and snap out of it when you're 25. That's why social transition is harmful. So I think what you're saying about misleading patients kind of connects to that. Another thing I would point out is that patients have been grossly misled with regard to treatment options and prognosis. And that's what really gets to me is like that patients are being lied to about the likelihood of desistance and detransition. Patients are being lied to about the types of therapies available. They're being told that, you know, colleagues, let's say, you know, not quite people like me, because now I'm this like public figure and it's changed my career trajectory, but the sorts of people who listen to this podcast and work in the field of psychotherapy, you know, are exactly the sorts of people who are most ethically you know, in the best position to provide ethical psychotherapy, but minors being misled to think that those are so-called conversion therapists, that they're going to be subjected to some sort of psychological torture by seeing someone who just wants to help them. So I feel like that's a huge area where patients have been misled.

Glenna Goldis: Yeah, and you practically quoted from the report. It says, medical providers have a professional duty to apprise their patients of their conditions and the treatment options in language that is accurate, ethically neutral, and in no way misleading.

Stephanie Winn: And it's so hard to be neutral about this stuff. And this is one area where I probably have a debate with a lot of more middle-of-the-road therapists. So, I mean, I've heard this said, for instance, for people who don't quite see the whole situation in as extreme of a light that I see. Because I see it as, like, iceberg right ahead, like, 911, danger, danger, danger. Like, that's how I see this whole gender situation. And for people who don't feel that way, I've heard claims like, well, when I have a trans patient, I just, you know, help them explore how they feel about their gender identity, and some choose to go on with transition, and some choose not to, and I don't see what the problem is. Right? They talk about it like that. And it's like, well, how are you supposed to treat those two options as if they're equally good outcomes? That's what I hear when people say neutrality about this issue. That's what I, I hear. And I'm not sure everyone actually means that, but that's the thing that worries me because I'm like, those two options are not comparable. Like one is going to shorten their lifespan potentially by decades, you know, like, and one's not. So how are we supposed to treat them? Like, you know, they're equally good outcomes.

Glenna Goldis: So I have to confess, as a non-therapist, I get very confused about this question of, like, how much therapists can kind of stack the deck or steer or, like… Because, like, you're not supposed to, right? But… I don't know. I don't get it, honestly.

Stephanie Winn: Yeah. I mean… In the role of therapist, we're constantly making choices. You know? Um… and granted a lot of what we're doing is listening and reflecting and you know there's a certain amount you could say of validation that I don't really like that term but like there's a certain amount of Hmm, mirroring, I would say perhaps that a patient is going to need to feel a healthy sense of rapport with their therapist. And depending on the patient's personality, expectations, relationship patterns, they could need substantially more than the average person. Or they could come in, again, with those expectations for what therapy is supposed to look like. And a therapist is constantly making choices you know, when do I just reflect this patient? I'm mirroring them so they can understand their own perspective better. And when do I need to bring myself into the room and show that, you know, just because I'm happy to hold up a mirror to what your thought process is does not mean that I agree with your thought process. You know, maybe there's a moment for me to challenge your thought process or at least differentiate that, you know, just because I'm here for you, it doesn't mean that I see the world the exact same way you do. That can be very threatening to some patients, depending on their expectations. Yeah, I mean, what goes on behind closed doors, you know, is a mystery even to those of us in the field. You know, we don't know what's happening in someone else's office or telehealth office, if you will. But I think there's a pretty broad range between the therapists who are totally in camp affirmation, which includes, you know, calling your patient, not only calling your patient what they want to be called, but reflecting them in a way that encourages them down that path. And I have had some examples, some interviews on this show, like really egregious examples. The most egregious example that's coming to mind is like Brian, I'm trying to remember his last name. He might not have used a last name on this show. It was way back. It was like a couple of years ago. I interviewed a detrans man named Brian and the therapist he saw was like really pushing him down that path. But then, I mean, I think therapists who are a little too laid back and go with the flow about all this can also inadvertently do harm by sort of, you know, maybe unconsciously, unintentionally colluding with the patient, that this is just this idea of their gender identity is just this true fact about who that person is. and it has nothing to do with why they're in therapy. And it just needs to be taken at face value. And I remember the cognitive dissonance I felt as a therapist when I was expected to just act like it is a fact that this is a trans man in the same way that I would act like it's a fact that this is, let's say, a Black man in my office. You know, if it's a Black man in my office, that is a demographic, unchangeable fact about a human being that doesn't tell me anything necessarily about who he is, why he's here, what he means for me. You know, and and that same like matter of fact attitude about someone's demographics, I think, is expected. It's expected that therapists have that attitude about a statement that a person is trans rather than seeing that, you know, in the case of this trans man, I just made up that this is a female. at war with her biology, scapegoating her sex. Her choice to scapegoat her sex could have everything to do with the things that she's here to talk about, relationship issues, whatever it might be. So sorry, that's a little bit of a tangent. But I'm here to interview you, though.

Glenna Goldis: Well, we're going to come back to that probably when we get to the therapy chapter. But we're going to hang on to ethics because it's just such a breakthrough here. So I think this is a neutrally worded document, and the ethics chapter is, you know, it finds that it's unethical, so people will say it's not neutral. But I don't know how you could lay out all these ethical principles and then just walk away and not, like, connect the dots for the reader. So I think it's done very well. And it also uses some language from, again, my favorite consumer protection law. It refers to you know, and talks about kind of the argument in favor of giving the patient whatever they want, and how like the theory of patient autonomy, and it chops that down. So it's great. It says, you know, it says we need to have like a larger ethical framework than that. And at some point, it refers to the practice of gender medicine. And by the way, This would seem to apply to adult gender medicine too, although it doesn't say this, but it refers to the field as the crude, responsibility-abdicating ethos of medical consumerism. Caveat emptor. Buyer beware. Yeah, that's brutal. I mean, we've all been calling this medical consumerism, but now it's in a report and is totally accurate. And I don't think it's a leap. I don't think it's kind of stretching. I think that's exactly what's going on is medical consumerism. And that is the view that's being pushed by the other side. And what's interesting is one of the many interesting things is that kind of denigrating caveat emptor and denigrating the idea of giving the client what they want, and holding the physician, who again is a business, holding them to a high standard that's more than just giving people what they want, but actually exercising judgment and taking responsibility. That is all very liberal in its perspective, right? Because conservatives are always saying, like, they say personal responsibility. When they're in office, they kind of pull back on consumer protection efforts. In the context of children, they would say, well, the parents can decide. That's the conservative paradigm. So people are accusing this document of being political, like, you know, Republican. And in so many ways, it's liberal. It's what the liberals in the gender critical space have been saying. you know, using these consumer protection analogies and talking about gay people, by the way, even though he talks about therapy, it's just it's not conservative.

Stephanie Winn: It takes a certain level of intelligence to be able to see that, Glenna. You know, I think there's there are a lot of really, you know, black and white thinkers out there. And if you come out opposed to any of this gender stuff, then you're, according to their definition, conservative. Right. It's just never mind how you got there.

null: Right?

Stephanie Winn: Yeah, medical consumerism is a really good term. I'm going to have to incorporate that into my vocabulary.

Glenna Goldis: Yeah, Corey Cohen has been using that for a while. He might have been like the, yeah, in the 2010s he was calling it that.

Stephanie Winn: That's awesome. You know, I saw, again, I didn't take the time to look into it, but as I was scrolling through Axe recently, I saw that Mia Hughes and Peter Boghossian debated each other over the issue of patient autonomy. And I saw Peter posted that he said, I lost which was great to see, because I think I know where each of them stand, and I think I'm with Mia on this issue. I don't know how familiar you are, Glenna, or how familiar our listeners are with where Mia Hughes stands versus where Peter Boghossian stands. I've interviewed both of them in the past, but I think Peter is more in that kind of libertarian camp on this issue. I know he works closely with Travis Brown, who I've interviewed pretty recently. And Travis, I mean, he's doing a documentary on this issue called Uncomfortable Truths About Trans. I was in it. I interviewed him something like 10 episodes ago or so. But even Travis, even as a filmmaker who's doing a documentary on this, he still has that libertarian stance of like patient autonomy, right? So, I think Travis and Peter are more aligned in that libertarian view while having a lot of ethical concerns about this stuff. I think, again, without knowing what she says, I think Mia's brilliant, and I think she would probably say something along the lines of my view on this, which is that this isn't about individual liberties. This is about what physicians, medical professionals who are regulated and who have obligations to patients, what they are allowed to do to people. Because you want to hack your own body up as a non-doctor. There's only so much self-harm you can perform on yourself before you're in the ER. Knock yourself out. It is supposed, you know, one could argue it is your God-given freedom to self-mutilate. There, of course, are questions downstream about what are others' responsibilities when they see you doing that to yourself. But this isn't about self-mutilation. This is about doctors mutilating patients. So, yeah, I'm, at some point, I need to look into Mia and Peter's debate. You didn't happen to see that one, did you?

Glenna Goldis: I did not see it, but I think I would be with you on that. Doctors are licensed by the state. Everything they do carries the imprimatur of the state. So it kind of implies that there's a medical benefit to what they're doing, which is baked into just them existing and being doctors and holding these licenses. People get the impression that what they're doing is somehow helpful.

Stephanie Winn: Oh God, and there's so much authority in that, especially for these impressionable young people. And it's not just under 19s, because the HHS report considers minors to be under 19, right? But it's not just them. It's 19, 20, 21, 22. These are the ages of the children of the parents I talk to. these youth put so much trust in doctors as authority figures. It's like part of that adolescent rebellion pushing away your parents, minimizing how much they know, but then there's kind of a transferring of authority and almost in some ways like omnipotence and omniscience. It's almost like has a godlike quality that gets transferred on to institutions and professionals who, I mean, that's gotta be so intimidating to like a 20 year old to see how much education a doctor has and how much they put themselves through. So, I mean, their opinion is like indistinguishable from God's at that point. And I just talk about the ethics and the psychotherapy thing. That's something we're not talking about enough is like, the significance of the authority that these professionals hold, especially in the eyes of young people who don't have the life experience.

Glenna Goldis: Yeah. And at this point, I'm concerned about adults as well, of any age. I think because I'm part of this population, lesbians, where lesbians at all ages are transitioning. And there's just so much to get my head around there. But I mean, part of the issue is, yeah, that they think, how bad can it be if doctors are recommending it?

Stephanie Winn: I don't imagine you happened to see my detrans grandma interview.

Glenna Goldis: I haven't watched it. Is she a lesbian?

Stephanie Winn: She's a lesbian who went through the trans stuff after menopause.

Glenna Goldis: Physically, that must be really hard, right?

Stephanie Winn: I know, we were talking about, it was wild. I was like, so just to be clear, I mean, just to give you a snapshot of where we went in that conversation, there was a point at which I was like, so just to be clear, as a lesbian, after the age of 50, you were considering prostituting yourself out to men because testosterone was affecting your sex drive in a way you'd never experienced before. Just be clear, that's what you're saying? She's like, yep, that is what I'm saying. That was wild.

Glenna Goldis: Yeah, because they target us. Anybody who is naturally gender nonconforming, which is basically euphemism for gay, gay people are inherently gender nonconforming, we're told that this is what makes you happy. Remember, we're talking about gender euphoria. It's this crazy pitch. I mean, homophobia is one issue, but even setting that aside, it's just like, imagine people are coming after you all the time saying, here's this great product that you can use, and it will give you euphoria. and everybody will love you more and you'll escape from misogyny and whatever else in all your life maybe you haven't fit in or whatever. You're part of this community that kind of exalts trans people above lesbians who can move up a rung. There's like everything. And so, yeah, I see myself as part of the population that's being targeted by these disgusting cretins at all ages, but especially… It's got to be so hard.

Stephanie Winn: Like between that and the men who call themselves lesbians, it's got to be so hard to be a lesbian right now.

Glenna Goldis: Luckily, I never run into the man in real life. I just see him on the internet and get to… It's hard because a lot of my normie friends, they'll get on board with banning it for under 18, or at least being very skeptical of this for under 18. That's the easy part. But once it comes to finding out that their favorite trans-identified celebrity is actually a pervert, Like, that's where they think I'm insane, and that's like where you get into very stigmatized territory, you know? And that's where I'm angry, because like you say, these guys are calling themselves lesbians.

Stephanie Winn: You're like, remember when lesbians were skeptical of the intentions of men? Do you guys remember that time?

Glenna Goldis: I could go on and on about the history here of, yeah, a lot of lesbians have always been in favor of this and suckered into it, and a lot have been against it. We have been targeted for trickery more than anybody else, like those men specifically target lesbians with their manipulative tactics more so than straight women, more so than anybody else.

Stephanie Winn: Like as a population, personally, but like that sounds like an interesting conversation. Almost like makes me think I should do like a lesbian panel because you're you seem young, but you know, a lot of stuff about things that maybe even happened before you existed. I have another interview coming up soon with another one of these much older detrans lesbians, and I don't know her story yet. So that ought to be interesting as well.

Glenna Goldis: Yeah, those are really interesting stories. And they're just stories of predation. That's, again, consumer protection. It's just like powerful entities going after a certain vulnerable population.

Stephanie Winn: In that interview I did with Gina, the detrans grandma, it's like, I mean, she's such an open book. And Some people think that the interview sounded like therapy. I'll just remind, like, I don't do therapy on this show. That would be majorly unethical. Like, these are not my patients. These are just people I'm talking to as someone who's habituated to thinking like a therapist. And, you know, and if someone's going to be open and vulnerable with me, like Gina, I'm just going to go right there because I sense an open door and I'm a curious person. So, yeah, that might have sounded a little bit like therapy when Gina and I talked. But I mean, we unpacked what it was really about for her. I remember there was a moment in that conversation where I just connected two different things that she said, and basically what it translated to was, in order to have sex, I have to not care. And that was something she got from sexual trauma. And, you know, it was men don't care. Men are for not caring. Women are for loving. If I wanna have sex, I have to not care. Like, that was the message at the core of the trans identity. And it's like, the idea that we don't just like stop and question that, right?

Glenna Goldis: That's such an interesting point about her, the way she's using men. So I guess even before she transitioned and used the testosterone, was she using men that way? Sort of?

Stephanie Winn: No, she was. She was. I mean, now people, people are either going to feel like this is a recap or maybe they want to go and want to go and listen to this episode is a really good episode with Gina. I liked it a lot. My producer liked it, too. You know, but she was just. she had a hard time with women. She had some trauma early on that and some shyness and awkwardness that made it really hard for her to have the kinds of experiences with women that she craved deep down. And so there were a few times in her life where she had really powerful feelings for someone and that would trigger the sense of I need to be a man, like I need to be a man in order to be with her was the feeling that would come up for her.

Glenna Goldis: Okay, I definitely have to watch that episode.

Stephanie Winn: Yeah, she's got an interesting story, for sure. And a great sense of humor about it. Anyway, back to today's conversation. So, medical consumerism, patient autonomy. You said there was a chapter on ethics, a chapter on psychotherapy, a chapter on history. What did you want to say about any of that? Many of you listening to this show are concerned about an adolescent or young adult you care about who's caught up in the gender insanity and therefore at risk of medical self-destruction. I developed ROGD Repair as a resource for parents just like you. It's a self-paced online course and community that will teach you the psychology concept and communication tools the families I've consulted with have found most helpful in understanding and getting through to their children, even when they're adults. Visit ROGDRepair.com to learn more about the program and use promo code SomeTherapist2025 at checkout to take 50% off your first month. That's ROGDRepair.com.

Glenna Goldis: Well, one of my favorite themes in this that came up in a couple of chapters is gay people. So it did not shy away from the issue that one of the cohorts throughout history who has been targeted is gays. And in fact, at the beginning, this was It's just a fundamentally homophobic practice. And driven by homophobia, it became popular because of homophobia. It attracted so many patients because they were victims of homophobia. I think it's still fundamentally a homophobic practice. Like I say, it targets people who are naturally gender nonconforming. So we have had trouble getting people to talk about that publicly in the media, among conservatives, among liberals. Everybody has their own interest in kind of suppressing or feeling awkward about this topic. But this review goes there. And one reason why, by the way, is that it's hard to find studies on it, right? And it's hard to pin down what sexual orientation is. I mean, there's actually pretty good science on this, and I've written about it, but it's… underdeveloped enough that people on both the left and the right kind of challenge the notion that sexual orientation is innate. And if you can't prove it's innate, then a lot of people who are very scientifically minded will say, well, I'm not going to touch it because I don't really know. And we can't prove it's a factor here, even though we all know that it is. Anyway, this HHS review is not shy about talking about gay people. So And it does that in a couple of ways. One is the history. I talked about George Jorgensen, who became Christine Jorgensen, so that is the first American to get a genital surgery to, like, quote-unquote, change sex in the early 1950s. He has to go to Europe to get it. And he, of course, he didn't identify as gay, and you can't prove that a dead person is gay. But the report just says, look, he's, like, it just lines up some biographical facts and some things that he said. And so, you know, this is a gay guy. And so that is just so refreshing to see that. And it talks about how so many, it says like basically all of the women back then and I think most of the men were gay. And kind of connects the dots on how you can tell they were gay. Women were talking about how they want to marry their best friend and that was their motivation. So it's all laid out there. And it's just very gratifying to see that when so often that has been swept under the rug. And then all of a sudden this front and center in the history section and very early chapter of this. And then later in the ethics chapter, it talks about how the ratio, or it's not really a ratio, but they say gay patients are way overrepresented among trans-identified people, especially in the young. And there are some studies about that. For example, in the Dutch protocol, almost all those kids expressed that they were attracted to the same sex. So, you know, you have some data points like that, and then you have reporting, such as Hannah Barnes, about all the homophobia that has sprang up, and maybe there's even been a resurgence of homophobia, at least in the UK, based on her reporting. So, kind of connecting all these dots, and says that this is an ethical problem, the fact that gay people are overrepresented. And that was so satisfying to me, because I have been going around challenging people about this subject because I think a lot, even in the gender critical world, even people who are relatively sophisticated, they kind of take it for granted that gay people are transing and they don't automatically see that as bad. It just seems like intuitively correct that most of these people would be gay or there'd be a lot of overlap or something. And so, and of course, if you, but if you think that is causing physical harm, which it is, that's an objective fact, then that is really bad. That is being disproportionately inflicted on a minority group that has historically been harmed, especially by the medical establishment. And in this case, we're talking about children. So all of that is like horrible, but it's been hard to get people to zero in on that and for it to click for them, because they just seem to like intuitively accept the idea that gay people are the ones caught up in this. And the report isolates that and catches it and says, no, it's bad. We have to focus on it. So, you know, there's a line here that says that it raises serious justice related concerns that LGB patients are overrepresented. And it's just like a simple line, but it's just, you know, it's got that moral clarity to it, which again, doesn't not to say Republicans are homophobic, but historically you haven't seen, you know, that's associated with the left, but of course the left has not been standing up for gays at all the past 20 years. Yeah, seeing that in the review is just so satisfying, and especially of me, because I write about this topic a lot, and I have some essays specifically on the subject of why are so many gays being trans, and why are therapists transing away the gay? Whenever I write about it, I'm always kind of frantically drawing from 12 different sources to piece together my argument that gay people are overrepresented. Now I can just cite HHS. The federal government acknowledges this. It acknowledges that it's a fact, and it acknowledges that it's an ethical problem. It's such a relief. It's like a psychic relief for me that I can just cite one source. I probably will continue to ramble on and cite all kinds of things. But they did that, and they cite good sources. For example, Hannah Barnes, who I mentioned from the UK, they cite her reporting. It's interesting because her own country, the Cast Review, did not cite her reporting, even though she was writing about them, the system they were analyzing. They just didn't use her work. But then in America, we did use her work.

Stephanie Winn: USA number one. A couple of points to add on the gay people subject. I mean, so one is, as I discussed with Gina in that recent episode, Cross-sex hormones can change people's sexuality, right? Like Gina was a lesbian who was attracted to men for the first time in her life when she started testosterone. And now more than ever, I hear young people who are just so confused about their sexual orientation, who really don't know. Especially with the young men, adding in porn really confuses them because then they're ought to going to feel like fetish kind of bleeds into a fetish about being with a man even if they were previously attracted to women. So this stuff just gets so convoluted. We know more straight kids are getting caught up in this now than they were 10 years ago. But I also hear some really interesting comments that trans-identified kids say. I hear them through their parents who come and consult with me. And the overall picture I get from reading between the lines of what a lot of these young people are expressing is that it feels really vulnerable. and uncool to just be a lesbian or you know and yeah or sometimes just be a gay guy because but it's usually lesbians that uh the parents i'm talking to i'd say there's a lot of boys now um i feel like it's like 50 50 boys and girls now compared to where it was five years ago but like it's it's really it's it's the young lesbians that it just feels like being a man, the idea of being a man or boys is like cool, tough, shield they can hide behind. But when people try to give them the message that, you know, it's okay to just be a girl, you can be any kind of girl, you can be a lesbian, like you can be a tomboy. When people give girls those messages, I feel like they're missing the point. Because the girls are like, no, but that's not what I want. That's not cool. That's vulnerable. That's like just putting myself out there as this weak little uncool being for the whole world to judge. It's much cooler to be a trans man because then I have this shield to hide behind. So I just feel like there's really a lot going on there.

Glenna Goldis: So the lesbian thing, I mean, there's always been a stigma attached even just to the word. And there's kind of been understood among lesbians. And you can I've had a post on this where all lesbians when they're young go through a phase of really hating the word lesbian. Even if they admit they're attracted to girls. It's just like, but I'm not a lesbian. I'm queer or whatever. I don't do labels. When I was young, it was like, we don't do labels. Sure. So it's like almost this primitive hatred of the word. Like it feels like it's coming from some like, lizard part of your brain. And in a sane world, adults would tell the girls, well, like, you are a lesbian, so, like, accept it. But now they're being told, and Laura Edwards-Leaper is an example of this, or is in my Laura Edwards-Leaper post. There are all these therapists saying, oh, well, if you don't like the word lesbian, because all that matters in the world are words, that means, like, let's find a word that you feel better about, and then that's what you are. And so that word is, like, a trans man or whatever. And it's just so idiotic from the point of view, like if you knew, if I read like a lesbian 101 talk to therapists, I'd be like, look, all your young patients are going to like really hate the word lesbian. Like that's just how it is. It doesn't mean they're not lesbians, but I don't even know if people take like a lesbian 101 course. If they do, it's all about like fetishistic men who call themselves lesbians.

Stephanie Winn: A lesbian 101 course, what would be included in a lesbian 101 course?

Glenna Goldis: So it would be the word lesbian, all the young people hate the word lesbian. It would be that a lot of them all hate each other. And that is also not an indication that they are not lesbians. It is completely natural and pretty much proves they are lesbians because they're like oversensitive on that topic. Just have to talk about how how lonely and isolating it is if you're a kid. It would talk about how few people are lesbians because it's very obnoxious having to pretend that all these fluid girls who are going to end up with boyfriends are somehow your kin. So the numbers thing would be a huge point to raise.

Stephanie Winn: That is a real issue, by the way. I mean, talk about the things that are difficult about being a lesbian right now. Let's add to the list, right? So you mentioned all the women are transing, including the older ones. You've got men claiming to be one of you. And then you've got the straight or bi-ish or bi-curious girls. And this is where words like queer aren't doing actual gay people any favors because it gives this illusion that there's so many people in your dating pool and really like… That girl might wanna snuggle you and call you her bestie or make out with you at a party when she's drunk in front of other people, but she's gonna have a boyfriend, right? These poor young girls who don't know the difference.

Glenna Goldis: Yeah. Yeah. I mean, for me, like, the hardest part of coming out was not being attracted to girls. It was not being attracted to guys. Like, I had a lot of trouble admitting that to myself because it just, like, that's the harder piece. That's where you're like, my life is going to be different. You know, I don't have the option of a husband. And so, like, that's a unique experience. I don't like how it just gets blurred into the so-called queer experiences, though. Like, oh, we're all minorities together. It's just psychologically, it's really hard not to be attracted to boys when you're a teenager.

Stephanie Winn: Yeah. And that is that is a distinction amongst girls. There are girls attracted to boys. There are girls attracted to girls. There are girls attracted to both. There are girls who are still figuring it out. It is a unique experience to only be attracted to girls. It's different from the experience of girls who might have some feelings for girls, but might ultimately settle into heterosexual relationships.

Glenna Goldis: Yeah, and then you add into that, like, there's clearly a biological component. And, you know, we see the patterns of the children. Pre-pubescent kids have those, like, opposite-sex play patterns. I was one of those. Luckily, I grew up in a place where that did not matter, but I was totally into all the boy toys. I would play with boys just because I liked swords, whatever. And so there's this kind of profile of a lesbian that you could isolate if you were being honest about who a lesbian is. And, you know, we may find it easier to connect with each other, or it's kind of, like, nice to be around people who just have that natural, even if it's kind of superficial, that natural thing, but then you're kind of being told that, no, you have to hang out with the men who identify as lesbians, and, you know, your world gets, you're not allowed to just sit there and say, like, I want to talk to the other dykey, whatever, like, not into men kind of women.

Stephanie Winn: Yeah, gosh, I mean even as a as a straight woman, it's so awkward being in situations where I'm expected to pretend that I see a man as a woman like I went to a makeup store the other day and there was a trans identified male working there and I had to spend like five or ten minutes interacting with him and I was perfectly pleasant much to the dismay of people who hate watch my show. I am actually like not a terrible person when I'm interacting with like people in service, but I'm not terrible to people in general. I deeply feel sorry. I deeply feel sorry for all these people, because I know how hard life is going to be for them. But still, I would rather interact with a woman when I'm going makeup shopping. And this guy, he kept calling me girl in that way that gay men call women girls. And I was just like, are you a gay man? Or are you, like, just really, really pretending? Because, like, he read to me as straight and deluding himself and, like, really playing up this whole, oh, girl thing. Because I study this issue so intensely. And, I mean, I talk to so many people about the trans-identified people in their lives that I have these, like, profiles and, you know, maybe I'm jumping to conclusions, but I'm like, I'm pretty sure this guy is straight. And this is actually not his real personality at all. And I feel so awkward having this interaction, but I've got to get through it. And that's in a situation where nothing more is expected of me. I'm just being a customer, you know? But to, like, be a lesbian and be told, this is your community. These are your people. These are people who share your experiences. That's got to be so hard.

Glenna Goldis: Yeah, it's awkward. Or the opposite, like meeting somebody. It's been a while since I went to an LGBT thing, but maybe like a year and a half ago or two years ago. you know, interacting with women who were identifying as male. And so talking to someone who, I think she's a lesbian, I think that's like, just like a beard. And she's, you know, six inches shorter than me, but I'm sort of almost like, I think there's sort of an instinct where like, a man is a lot shorter than you, you don't want to like emphasize it. And so then I'm like, well, here, I've got this woman who's like six inches shorter than me, which is pretty unusual for a man. And I don't know, it's like, what's the polite, it's, And the whole time, it's like, this is disappointing, because if she were just accepting herself as a lesbian, then maybe we would have a nice conversation that wasn't laden with all these…

Stephanie Winn: Yeah, I mean, I hear a lot of people struggling with the sense like we want to have compassion for these people who are confused and suffering and they're in a cult and their lives are going to be hard and they're going to be really medically suffering. We want to have compassion for them. At the same time, there is some level on which it feels like a betrayal. Like, these women who are choosing to call themselves men, like, they're opting out of the hardships that they see as coming with being a woman or coming with being a lesbian. And it's like, so you think that the rest of us deserve the things that you're trying to opt out of? Or, like, what's the logic here?

Glenna Goldis: Yeah. Like, they have a gender identity. And this goes back to what we were saying before about, like, the kids, the position they're in. It's like they're choosing a sex. Like, you and I didn't choose to be women. We never went through that thought process. But if you're confronted with that and you have to choose, then yes, offensive that they don't choose women. Because we almost feel like we chose even though we didn't. Choice should not be brought into this conversation about sex.

Stephanie Winn: But once it is brought in, it's… No, I mean, I had such a hard time with puberty. And I wouldn't, like, if you'd asked that part of me, like, I mean, because it gets into the idea that you can choose what kind of body you have. And like, for the most part, no, you can't. You can't choose your genetics. You can choose some lifestyle factors that influence how healthy you can be within a certain range. You can choose some factors about how you groom and present yourself. But like, I have a certain body shape that was given to me genetically. I wouldn't have chosen that when I was a teen girl growing up in the 90s exposed to 90s diet culture and body messaging. You think I would have chose this particular shape? No, it was a lot to adjust to the body that I was given. Yeah. Anyway, I'm going to try to bring it back to what I'm enjoying. I'm enjoying riffing with you. And I hope listeners are enjoying this conversation. But back to the report. Anything else you wanted to say about because you were talking about the it's commentary on gay people, which is not limited to a particular chapter. It's kind of throughout. There's also a chapter on ethics and a chapter on psychotherapy. Was there anything more that you want to say about any of those pieces?

Glenna Goldis: Yeah, I think we should talk about the therapy chapter because this is the one, you know, I have a very positive view of most of this report and I think it's like it's basically an idealistic project and it's like exactly what government should be doing is just like rapidly pulling together all this information and giving it to us in the most neutral way. The therapies section I had a little bit of a problem with. I'll also preface by saying that this, I don't believe this is a final draft that we're looking at. The press release says that they're sending it out for peer review, which implies that they're open to changing it. And so I'm hopeful that whatever criticisms we have and others have, that they'll just be fixed later on. That's how I come at this. So the therapy chapter comes in, it's the second to last chapter, so it's pretty much the last chapter before the wrap-up. And so it's got that special place. And it was the first time, you know, I've read it like consecutively, it was like the first time where I felt like, oh, this is kind of reaching for a predetermined conclusion, which was like, we have another idea besides gender medicine to help these kids, and it's therapy. And it doesn't, it's not able to make that case. I don't think, it doesn't, they kind of just vaguely say that therapy is good. in general. And so if it's good in general, then it'll probably be good for gender dysphoria, too. And it throws out some examples of comorbidities with gender medicine, like, for example, eating disorders, depression. Like, we know how to treat that with psychotherapy. Therefore, we should be able to help these kids with gender dysphoria as well with therapy. But there's a really big blind spot here. Even if you accept all that, there's a really big blind spot, and that is gay kids. So this report was really good about gay kids earlier on, but then in this chapter, it totally forgets about them, doesn't mention them as a patient cohort. And that is really important because the mental health profession has harmed gay kids with gender medicine. And not only has it done that, but it has not had any alternate program for gay kids. So I've been asking around about this for a while, and there's not like a set program or playbook for helping a kid with internalized homophobia. In fact, the mental health profession removed that as a diagnosis from the DSM in 2013, I believe it was. So they're acting as though it's not even a problem. You can't be diagnosed with it. And it was just brought out of the conversation. You can be diagnosed with gender identity disorder. I mean, not gender dysphoria now, you know, if you're gender nonconforming, but you cannot be diagnosed with anything related to homosexuality. And that was sold very fraudulently as a good thing for gay people because, oh, we're de-stigmatizing it, or we're saying that there's something wrong with being gay. But that's just completely misleading, and that was a lie, because there are mental health conditions caused by or correlated with being gay. And gay patients deserve to have therapists who are able to diagnose those, because if it's not even diagnosable, then there's a fear that it will fall through the cracks. And in fact, what has happened when you look at guidelines since then, so in 2015, the American Psychological Association put out its guidelines on transgender and nonconforming people, the TGNC guidelines, and that book talks about internalized homophobia, but using different words. So it says, you know, if you have a patient who thinks that they're gay and they feel a discordance between their sex assigned at birth and their romantic attractions, well, you should talk to them about gender identity because they might have a gender identity problem. They might be trans, so give them information about trans. So if you take what I just said and you translate it into English, it's saying if you have a gay patient who is experiencing internalized homophobia, they don't want to be gay, Tell them that they're trans. Encourage them to be trans. It even says they might be wrong about sexual orientation, or they might be grasping for that label because they don't know the true label of trans, so you need to explain that to them. And then there's more to it, too. It's a horrible guideline, and it's still operative if you are looking to say, what does the American Psychological Association say about helping gender nonconforming people? Oh, it says to trans them. It says if you have this gay patient in front of you, you should trans them. And it's an atrocity. It's an abomination. It's just sitting there on the Internet. It's like the official policy of the American Psychological Association. One of the authors is Laura Edwards Leeper, who is the queen of trans and gay kids. And it's laying out there right in plain sight. So it's really dangerous for the government to be saying, send your gender dysphoric kids to therapy because a big segment of those are gay kids, possibly with internalized homophobia, and you are throwing them to the wolves. The psychological profession, I mean, a lot of individual therapists, of course, are good. they're not systematically producing good therapists on the subject of gay. They're systematically producing bad therapists because the only guidelines out there are, you know, these 2015 ones and, you know, you have this DSM that doesn't have any diagnosis for it. You have some gobbledygook in 2021 which lumps lesbians in with guys who call themselves lesbians. Like, you just should not be throwing gay kids to the… I mean, and it's a horrible thing to say because… And, of course, there are individual therapists who would be very good if you're confident about that going in, if you know who you're dealing with. But you should not just open the phone book and choose a random therapist for a gay kid because they're not trained in it. Phone book. Okay, definitely don't use a phone book.

Stephanie Winn: It's just funny because I don't know how old you actually are, but you don't look a day over 30, but you're talking like a 60 year old.

Glenna Goldis: No, I'm 40 actually.

Stephanie Winn: really so so my family did have a phone book growing up but it has been a while yeah okay i remember the phone yeah i'm also 40. yeah so sometimes i listen to my voice and and i think i sound 14. it's quite embarrassing yeah i gotta work on that too i worry that that's why people think i'm young or some my

Glenna Goldis: some kind of emotional immaturity. But anyway, what is the quote here for the the money quote on therapy? It says, psychotherapy generally promotes improved mental health and psychosocial functioning and carries little risk. That's not even true. And setting aside the gay stuff, Abigail Schreier published a book last year called Bad Therapy, Why the Kids Aren't Growing Up. And it was very well received in gender critical circles. So whoever this author of the chapter is must have heard of that book. And they're just saying, nope, there's no such thing as iatrogenic harm. Send everyone to therapy.

Stephanie Winn: So who's in charge of this document? And then who's in charge of that chapter?

Glenna Goldis: OK, so let's get into this. The most prominent criticism of this document so far from the TRAs and the media, meaning the trans rights activists, is that we don't know the names of the authors. Right now, at this moment, they have not been revealed. And HHS says the reason for that is because it's sending the document out for peer review. And so I don't know, I'm not familiar with scientific peer review conventions, but HHS says, like, this is how you do it. And it makes sense, logically. Like, why would you want people judging the document based on its authors? They should be judging it by the content. So what's implied there is that we are going to find out the authors once the peer review process is complete. But we don't know now. So I'm very curious, and I have my theories.

Stephanie Winn: Well, I have a bad habit of biting off more than I can chew. I get ideas and I just grow them or I just say yes to things, so I'm probably going to regret this. But if any listeners want to volunteer me to help with the psychotherapy chapter, I have opinions.

Glenna Goldis: Yeah, well, this chapter… I didn't recognize any of the authorities cited as being gender critical. There might have been some that I just didn't recognize, but the ones that they're quoting, people like Stephen Levine and Ken Zucker and Laura Edwards Leeper. So none of those three are gender critical. They all use language like sex assigned at birth. They've invested their careers in gender medicine. To some extent, they're still practicing it. I think Levine says he stopped transing kids, but then he's testified he's had this complicated role in the lawsuits about the bans against the practice. Ken Zucker, proudly trans and kids still as far as I can tell. He's definitely on the record still, you know, being in favor of that. And Laura Edwards Leeper also in favor of trans and kids she's fighting against, she submitted an amicus brief to the Supreme Court. opposed to Tennessee's ban on trans and kids. So these people are all being cited as authorities in the therapy chapter. And remember, other chapters of this document say that doctors who, or therapists, who use language like gender identity or using the wrong pronouns, they're being misleading to the point of being unethical. And yet they're being quoted in this later chapter as authorities on therapy.

Stephanie Winn: Well, why don't you guys at the Department of Health and Human Services talk to people like me, okay? There are voices. I might not have a doctorate, but I would love to weigh in and I'm well connected to a lot of very thoughtful professionals in the field. You don't need to go to people like Laura Edwards-Seeper for this. I think it's funny that like Laura Edwards Leeper, Marcy Bowers, and like one other, I forget who, but they've been, you know, every now and then they'll say something that like gives some weak concession of like, yeah, maybe gender affirming care is not the right thing to do in like 100% of cases. Maybe we've gone a little too far here or there. They'll say something like that. And then people who are desperate will latch onto that and be like, look what Marcy Powers said. Look what Laura Edwards Leeper said. And it's like, we can do better. not to like toot my own horn too much, but I was like, I was like, this is bullshit. This is ridiculous. This is a major ethics breach. I even said in my interview with Ryan Rogers recently, um, which was on his podcast, reality therapy, but we're going to borrow it for this podcast to fill in some content this summer while I'm on vacation. Anyway, I said to him, I was like, gender affirming care is worse than sexually abusing a client in psychotherapy because you know, if you, A therapist who has sex with a patient at least leaves that patient's genitals intact at the end of it, like they walk away with psychological damage, you know, but a therapist who affirms a patient's gender identity, like their genitals are not intact, like that is sexual abuse, you know. So there are professionals like me who, I mean, I got to the point where I was like, I can either try to keep practicing psychotherapy within this crazy landscape where I can just fully lean in to like, okay, I guess I'm a public figure who does coaching now. I still have a therapy license, but it's so crazy to even try to practice in this climate right now. I really feel for all my friends and colleagues who are trying to walk that fine line. So yeah, there are some of us who are just completely honest about how insane this whole thing is, and we would love to talk to you at the Department of Health and Human Services. Absolutely love to talk in August or later of this year because I'm taking some time off this summer.

Glenna Goldis: Yeah, I hope that, I don't know what the peer review process will look like, but in any case, I hope the word gets to the people or maybe they just kind of reconsider how they wrote this and think, you know, this chapter doesn't fit in as well. They may be, there's been an argument that the therapy chapter doesn't even belong there. So Jennifer Block did some reporting on, you know, questions about that. It kind of sticks out from the report as being less, well, it doesn't. I guess there there kind of is no research on whether therapy can treat gender dysphoria specifically because it's been like practically banned, Erika?

Stephanie Winn: I'm like, so many misconceptions to clear up. I mean, we can't talk about the subject without. Sorry. Sorry. Go ahead, Glenna.

Glenna Goldis: I just add the parts of the therapy chapter are OK. They're talking about things like how this is not conversion therapy. So it's just like basic background on the subject.

Stephanie Winn: Yeah, but I mean, like, you can't really talk about the subject without talking about what is going on in the field right now, like the cultural climate of the field of psychotherapy, the fact that it's gone off the rails woke. And then all the thoughtful, good professionals are either giving up and retiring early or going to coaching or something like that, or just super careful about how they practice because they want to keep their practice. They want to keep their license. And they don't want a lot of drama. And they have a family to feed. So I know people who will not see patients under the age of 25. I know people who screen their clients very carefully. If you're going to get your hands dirty, people at the HHS, if you are going to get your hands dirty at all with the subject of psychotherapy, talk to someone who knows what's going on in the field right now, like the cultural climate, the myths that we're up against, the conversion therapy laws in every state. We need to map this shit out because Yes, therapy can help these kids, but we have to talk about what's going to get in the way of that. And the overly litigious climate, the kids' expectations about therapy, the secondary gain and cluster B issues, I mean, this is all part of the picture, people. Yeah, I have opinions on separate report that.

Glenna Goldis: Yeah, I think it kind of doesn't fit in this report. You can't just have like one simple chapter about therapy within a medical report on gender.

Stephanie Winn: See, I disagree. I mean, I haven't read this, so it's bold of me to disagree. But I'm also like it is our fault. Like it's our profession's fault. Like like you said at the beginning, like the justification for doing this to people is a psychological one. And therapists are signing off on this. So if you're going to tout it as a mental health treatment, you'd need that voice from the mental health community, in my opinion.

Glenna Goldis: Yeah, I mean, and that original justification was more explicitly anti-gay at the beginning. It was like, well, this gay guy's got a horrible life because he's gay, so we're going to fix him. And so then the question is like, well, how are the therapists justifying it nowadays? Because they don't come out and say that. It would get very long. I shouldn't say it wouldn't fit thematically. It doesn't fit physically. There's just too much to say. Because again, I remember I'm 60 years old and I only do things on paper.

Stephanie Winn: It's good to know another person my age who also looks and sounds young.

Glenna Goldis: Yeah, we can go trick people. I got carded the other day, by the way. You got carded? Why? What were you trying to do?

Stephanie Winn: Yeah. Were you trying to go to a bar? I was buying port at Trader Joe's for cooking.

Glenna Goldis: Well, maybe you were the youngest person who ever bought port there, so they got confused.

Stephanie Winn: Are you saying port is an old person's drink? I have no idea. I mean, maybe it is. I don't know. When I think port, I think of like grandpa by the fire. Well, the reason I got port instead of wine, I was like port versus cooking, like wine goes bad and I hardly ever drink. So like have a bottle of port, doesn't go bad. And then no, it's like, it's in my experience, it doesn't, I don't know. Cause you open, you get like a big, you know, 32 ounce bottle of port and it lasts like two years if you're me. I don't think it goes bad. Please tell me people, am I poisoning myself? It doesn't taste bad. Well, geez. Okay. Have we covered everything? I feel like we keep getting derailed, but it's, you know, I think this is one of the benefits of having someone back for a second or a third time as we, we start getting a little bit more buddy buddy and, and, and then we can get loopy together.

Glenna Goldis: I probably said too much about the therapy section. I just want to see it brought up to the par of the rest of the report. Now I want to read it. Yeah, yeah, definitely. And this is pure speculation, but I wonder if it's included, or at least the kind of recommendation aspect is included, because they don't want to leave without giving an answer of how to help these kids. You know, there's like a human impulse. You have to give some kind of answer. And it's a political impulse as well.

Stephanie Winn: Yeah. And I mean, it's like, yes. And right. Like there need like the answer is cultural change is a big part of the answer. And telling the truth. About what so-called gender dysphoria is and is not. Or what it can be. I mean, it's a huge range of what it can be, depending on the person.

Glenna Goldis: But also, maybe you just don't answer that question in this report. Maybe you just have to, like, exercise that painful self-control to say, like, no, I'm going to release a report into the world that just describes the problem and doesn't provide the entire answer. I think that's so hard to do, but it might be the correct thing to do in this instance.

Stephanie Winn: Well, I think you bring up a good point there, Glenna, because sometimes there is this kind of attitude that we encounter, which is like, you're not allowed to talk about a problem unless you're ready to propose a solution. And I think you're right. Maybe we need to be able to talk about problems without having it all figured out ourselves already.

Glenna Goldis: Yeah, especially because this report emphasizes how it's all about the evidence, and we truthfully don't have scientific evidence. We have some anecdotes, but we don't have scientific evidence about how to bring a kid out of quote-unquote gender dysphoria.

Stephanie Winn: I do think it's largely a cultural problem. And I think that's where you and I are kind of touching different sides of the elephant, so to speak, because you're coming at it as a lesbian and seeing the disproportionate impact on gay people. And that's a very real thing. And I'm coming at it as a parent coach who talks to parents of, yes, gays and lesbians, but also a lot of straight kids and many kids who were gender typical for their age up until a certain point. And, you know, so I'm seeing it from a different angle, and I think of it as largely a cultural issue. And I think it's less of a cultural issue for the more kind of classic profile that you describe of the gender dysphoric gay kid, because there is that gender atypicality in their early play, their preferences and mannerisms. And then you combine that with the bullying and the message that there's something different about you, ha ha, right? That profile of, you know, a certain set of pathways that lead towards a trans identity, I think, calls for a different type of response, perhaps, than the things I'm seeing, where it's straight kids caught up in a cult. It's not all straight kids, but it's a lot of them, right? And it's the identity stuff. It's the social justice. stuff. It's the pure stuff. That, I think, calls for a cultural change. And I don't know how we recommend that in a health and human services document.

Glenna Goldis: Yeah. Yeah, exactly. So, yeah, I think it would be strong if they just said, this report is about the problem and not the solution. And we can solve the physical problem by just stop doing this, then poof, physical problems are gone.

Stephanie Winn: Right, I mean, yeah, if the practice was stopped tomorrow across the board, and if they somehow managed to crack down on services like Plume and Planned Parenthood and Gender GP in the UK, all these just drugs on demand things, and there's a black market, right? I know I talked to a parent recently who was petrified to death because their kid got hormones on the black market. And they were like, for all I knew, you were actually taking something laced with fentanyl, right? Like you could have died. So I mean, but if somehow there was a massive crackdown. on all of this, and the access to the drugs and the surgeries, then there would be a ripple effect downstream of that. Of course, there's people who are going to react a certain way, like go at it even harder, demand it. It's a human rights issue. Go underground, create whatever they have to do to stay high on their supply. I don't know, it kind of reminds me of something you said our first time around, which was that there is something powerful about the authorities, the powers that be in our own government saying that this is wrong. Even though for some people it just feeds into their existing narrative about the evil nature of the people in charge.

Glenna Goldis: Yeah. So that's one of the questions about this report is, well, nobody's going to pay attention to it who wasn't already paying attention because blah, blah, blah. And I think there's a certain percentage of the population in which, yeah, they're not going to like it. They're not going to read it. But there are a lot in this. I live in New York. I live in Brooklyn. I'm surrounded by liberals. And they are not rock solid in support of pediatric gender medicine. So I think there are a lot of people who might be curious about this, might be a little bit worried. Maybe they're liberal, but then a kid they know transitions and they become scared. And they will open up this PDF. And when they do, it will be a wonderful thing because they will see this professional, yes, neutral document full of facts and figures and serious citations and rigorous analysis. It has all the indicia of just a serious document. It doesn't feel political. And so I think for all those types of people who just have a little bit of curiosity, this could change their mind. Now, we have a problem with the media not amplifying it the right way. You know, the coverage has been very shallow so far. The guys on the other side are just doing their usual. We know they're not going to be moved. But I think that it will have persuasive effect. And it will also be very useful for professionals who work in the policy space, even for people who work within the Trump administration, this will be a very useful document. Because right now, I think people look at it in our circles and we say, oh, the Trump administration, they drafted those wonderful executive orders, so they really understand this issue, like they're on it. And the truth is, yeah, they have some lawyers who are on it who understand it really well. But it takes more than a few very busy lawyers to carry out the agenda that's necessary here. And so you have all these dozens, hundreds of people maybe pulled in to working on this project of rooting gender out of our society. in the federal government, and they're new to the issue. And like, how do you explain this issue to somebody who's brand new, who's got like this big job to do? Well, a couple of weeks ago, that was very difficult, but today you hand them this report. They can just start reading and they will have a very strong understanding of the issue by the time they're done even with the executive summary. So I think this will be very helpful just within the federal government. People in state governments will also be reading it if they're in quote unquote red states that are doing the right thing. we're going to see a higher quality of work product from all of these bureaucrats.

Stephanie Winn: So what do you think is downstream of this? Now that this exists in the world, what is possible or what could happen next?

Glenna Goldis: Well, I mean, it's not so it's not a magic bullet. It'll be great for educating people who need to be educated within the government. Clinicians, hopefully, although I don't even know at this point what clinicians are. I mean, some of them will be good and they'll read it. It's a So it'll be helpful in all these incremental ways. It'll be easier for the government to work on lawsuits, because they've got all the information in one place, and private parties as well. I think once the authors are revealed, they'll become these sought-after expert witnesses, and so that will just make it a little bit easier on the litigation front. And parents, of course, if their kids are going through this, they will now have this authoritative document to pick up. And maybe you have a parent who was very anti-Trump yesterday, but today their kid comes home and says she's a boy, and suddenly they're a little bit desperate for information, and they'll see what this PDF is all about. So you'll have good information all pulled together in one place circulating around society. The last people to read it will be the New York Times. I don't know. Hopefully this will put some pressure on things in the media. Like if one media outlet starts reporting on it well, then it's kind of like, well, what's wrong with the other ones? So you have like a ripple effect of higher quality media coverage, but have to expect that to be slow given how things have gone so far.

Stephanie Winn: So where we started off, I reminded listeners that I've interviewed before on the executive orders, and then you gave them the context that this is the result of one of those executive orders. The executive order demanded that this document be created, and now it's been created. It's still being revised. I guess I'm wondering, zooming out, looking at the status of the executive orders and everything downstream of them and where it seems like things are headed. Where are we? I'm a little disoriented because it feels like there's so much of the effects of the previous administration and so much of the cultural stuff is still in place, even though there has been this drastic change in terms of who's in charge and what the rules are. I mean, I'm still hearing stories of things that have not been miraculously universally put to an end by these orders. I'm still hearing about schools transing kids behind their parents' backs, CPS overreaching, to say the least. I'm still hearing these stories. Where are we? And how far do you think we can get in the next couple years?

Glenna Goldis: That's a great question, because as you noted, we're losing a lot of lawsuits. So I think you're kind of referring to those secret school transition lawsuits. There have been several losses at the appellate level recently, and now the lawyers are seeking to either get further. Some of them might be headed to the Supreme Court soon. That is the aim. But other categories we've been losing, too, like free speech lawsuits and one of the gender medicine trials that we won in Ohio that we lost on appeal. So there are losses all throughout the country on all different sorts of lawsuits. And then, of course, the cultural side of things doesn't feel like it's shifted for a lot of us. On the medical side, we were very hopeful with the executive orders, because a lot of hospitals at the outset folded. But then there were some skirmishes in court, and things started to go better for the hospitals. And then we saw them start up again. And so I think Trump will definitely be able to take some of their funding. And he's starting to. And he's starting to cut the really obvious grants, where he definitely has authority to do so. But then there's more. We're not sure whether he'll be able to just cut everything that needs to be cut in order to really disincentivize the practice. That's kind of an open question right now. So in Title IX, the law is really good on Title IX for us. But schools are defying the federal government. So the federal government has to use all these resources now to enforce the law, even though the law is so obvious. And it's going to have to fight it all the way to the Supreme Court, just even though it's so obvious that we're going to win eventually. So yeah, we're in a very messy place. I guess I don't have a satisfying answer. I think it'll just be incremental. We're hoping for some good decisions out of the Supreme Court in June, but they're not decisions that will answer all the big questions. Not at all. They'll be incremental wins. We're hoping that in the Tennessee case about their pediatric gender medicine ban, we're hoping for a favorable decision. But all that will mean is not an automatic, yes, all these bans are constitutional. It'll be, Yes, it shouldn't be too hard for the states to defend their bans. The standard for them to defend them will be relatively low. And now the litigation will continue. And even though the ACLU will probably lose, they're going to keep fighting and just dragging this out. So that will be one decision from the Supreme Court. We might get another decision saying that parents have a religious right to opt their kids out of LGBTQ instruction. That's, like, good. I mean, that'd be good any port in a storm in terms of, like, rights for parents. But it's also going to be like this, have this religious inflection. It's going to be kind of more complicated to carry out than it seems at first glance. So I don't see any big, exciting wins. I think I was a little bit euphoric when I spoke to you last time. Like, somebody commented to me afterward. Like, somebody watched it maybe a month after it first aired, and they were like, do you still feel that way? Are you? So I think right now I'm not feeling euphoric or I don't feel as though like victory is tomorrow just because we got an awesome report. I just feel like we're on a good trajectory and it's getting harder for the other side to maintain their position and we just have to keep showing up. I mean like personally what I I mean, this isn't even my day job, so I don't even know. But my attitude is just like, we all just keep showing up, like you and me and everybody who's just kind of out in public being a gender critical person. And we keep showing up with our heads held high and showing that it's a normal position to hold. There are more and more of us every single day. And that should have the effect, among all these many other things going on, should have the effect of opening up the discourse. Because we've known all along that the more facts get out there spoken in public, the faster we win. It's all about getting facts out there. And that's why I like what this report is just one more mechanism for getting reality out into the open. It's not perfect. It won't get the media coverage it deserves. But it is pushing facts out into the light.

Stephanie Winn: Well, it's always refreshing to have a perspective with expertise so different from my own. And legal stuff, a lot of it comes down to facts and logic. And that is kind of a welcoming counterbalance to the things I think about the most, which are more psychology and culture. And I think you sound optimistic. And I sometimes feel, I mean, maybe less optimistic than you were a couple months ago. I sometimes feel… discouraged I think because I spend so much time thinking about the psychological factors that prevent people from admitting to themselves and to others that they were wrong. I think that's where I tend to feel stuck and hence where my recent joke about declaring June humility month comes in, going out in the streets with signs saying, we're so sorry, we were terribly wrong about gender affirmation, please forgive us. You're welcome to change your mind as well. I'm thinking about what is that cultural shift that needs to happen to counterbalance some of those psychological forces because when your identity is built on a sense that you're a good person and that you're on the right side of history, it's It's a lot to give up that smugness, really, and to take a sobering look at what you've actually participated in, which is quite different from what it claims to be. I think that's going to be hard for a lot of people.

Glenna Goldis: I think the answer might be that they get to keep fighting, but they're fighting over smaller and more pathetic scraps. So for the last couple of years, they've been fighting over these big things like, you know, these, like we're saying, the Tennessee's ban on gender medicine. Like, that's like a big thing to be fighting for the right. They're making constitutional arguments, like the right for a child to receive these interventions, a giant question. I think they're slowly starting to lose those. The tide's going to turn. And they've also been arguing, you know, for boys and girls sports, they're going to lose all those. They're going to keep having battles, but they're going to be battles like, I should have the right to talk about being trans. Like it's going to turn into a free speech thing for them. And they'll still feel like they're fighting the big fight, but the fight will be a more conventional American argument of like, hey, I have a wacky belief system and I want the right to say it out loud and not get fired or whatever. So they'll be fighting like, you know, like they'll really be on the back foot. I hope you're right.

Stephanie Winn: I wouldn't mind. I wouldn't mind that. And I mean, thinking like art of war strategy wise, that's kind of it's a it's a brilliant strategy, right? If you can sort of contain your opposition to where they still feel like they're channeling their desire to fight you, but they're channeling it within this you know, tiny little pig pen. You're like, okay, you can stay there. Yes, fight for your right to declare your identity. No one's stopping you. We just don't agree, right? Like… All right. Well, Glenna, I think that's a good place to wrap things up. Thank you so much. Really a pleasure interviewing you. Thank you so much for sharing your expertise. Tell us again where people can find you.

Glenna Goldis: My sub stack is called Bad Facts and I'm also on X under my name, Glenna Goldis.

Stephanie Winn: All right, Glenna, thank you so much. Take care.

Glenna Goldis: Thank you.

Stephanie Winn: Thank you for listening to You Must Be Some Kind of Therapist. If you enjoyed this episode, kindly take a moment to rate, review, share or comment on it using your platform of choice. And of course, please remember, podcasts are not therapy, and I'm not your therapist. Special thanks to Joey Pecoraro for this awesome theme song, Half Awake, and to Pods by Nick for production. For help navigating the impact of the gender craze on your family, be sure to check out my program for parents, ROGD Repair. Any resource you heard mentioned on this show, plus how to get in touch with me, can all be found in the notes and links below. Rain or shine, I hope you will step outside to breathe the air today. In the words of Max Ehrman, with all its sham, drudgery, and broken dreams, it is still a beautiful world.