You Must Be Some Kind of Therapist

200. Ben Ryan
===

[00:00:00] Ben: Study path was not on trial at all. And their standard of care, their guidelines weren't really referred to specifically very often. And were essentially largely put aside. So people who think that this entire trial or trials like these are gonna be taking on the whole system, [00:00:15] are gonna be in for disappointment because in fact, what they mostly do is they say, here's the benchmark, did you meet it?

[00:00:21] Ben: So whether you agree with the benchmark or not, or whether you agree with the types of practice that now are widely accepted, at least by a lot of physicians, even if you don't agree [00:00:30] with them, did they even meet that standard? So you talk to some lawyers behind these cases and a lot of them are conservative and they really believe this entire pediatric medicine field to be blown off the map.

[00:00:39] Ben: They'll say like, despite the fact that we think the WPAs guidelines are bunk, you didn't even meet them. [00:00:45] And that's why we're doing you,

[00:00:48] SKOT: you must be some kind of therapist

[00:00:54] Stephanie: today. My guest is Benjamin Ryan. He's an independent reporter who has been covering pediatric gender medicine [00:01:00] for the past three years for including on his substack, ben ryan.substack.com. He writes for publications such as the New York Times NBC News and the New York Sun, and covered the DETRANSITION trial for the free press.

[00:01:14] Stephanie: Today we're going to [00:01:15] talk about the historic variant versus Einhorn case, the first case in the world of a Detransition lawsuit succeeding. Uh, which Ben Ryan was the only pers, he was the only journalist [00:01:30] present for the whole trial, so he is got this right.

[00:01:31] Ben: There was one other guy there for part of the time, so, yeah.

[00:01:35] Stephanie: Well, uh, welcome to the show, Ben. Good to have you.

[00:01:38] Ben: Thanks for having me, Stephanie.

[00:01:40] Stephanie: So, uh, I offered a little civil transparent dialogue upfront because I know we have [00:01:45] different policies about how we communicate, and as longtime listeners of this show know, I do not insist on having everything in common with my guests.

[00:01:53] Stephanie: That would be boring, and frankly, I would have no guests because there's nobody I agree with everything on.

[00:01:58] Ben: Yeah.

[00:01:59] Stephanie: So, uh, we do [00:02:00] civil discourse here. I personally use biologically accurate pronouns because I don't believe in gender ideology at all. Ben, what would you like to say about your personal stance on those issues?

[00:02:09] Ben: In this case, it doesn't really matter because. In the trial, it was a little complicated because the plaintiff [00:02:15] identifies as a woman now, but there were periods of time when she identified used they, them or he, him and or the different names. So sometimes they would be switching names and pronouns, but in general, the overall be overarching narrative, they use she her pronouns.

[00:02:28] Ben: But I tend to use [00:02:30] people's preferred pronouns. I think maybe an exception would be if there were someone convicted of a sex crime or something. In that case I'd be like, you know, fine. But another case I try to be respectful of how people wanna be presented, that kind of thing.

[00:02:42] Stephanie: Okay. And you know, I've been following your work for a while and I know [00:02:45] you're, um, kind of a polarizing figure amongst the gender critical community because you are a journalist too, is you, you kind of defined what your role is and I think you're a little too woke for the gender critical people and too gender grateful for the woke people.

[00:02:57] Stephanie: So, yes.

[00:02:59] Ben: [00:03:00] Yeah. I mean, I try to. Go down the middle just intellectually from a place of circumspection and nobody's neutral. We all have our biases, and there is what you choose to say. What you just don't, you don't choose to say that can reveal a certain bias, certain focus, but [00:03:15] I, I do my best to withdraw myself from the story as much as possible.

[00:03:19] Ben: Um, try to be respectful. Just say what happened without being inflammatory, that kind of thing. So, which isn't just say necessarily that being gender critical or woke is by definition inflammatory, but I, I just try to [00:03:30] peel away from those polarities and just helps that people will take me outta the story and listen to what this story actually is.

[00:03:37] Stephanie: I respect people, people,

[00:03:38] Ben: hopefully it's not about me, you know?

[00:03:41] Stephanie: I respect people who have principles that they can clearly articulate and [00:03:45] try to stick to. And I've been following your work because it's too important. Um, I know some people on my gender critical side of the issue really don't like you, and you've blocked them for being rude to you.

[00:03:54] Stephanie: Moving

[00:03:55] Ben: rude. If they're, if they're not civil, unlike, you're outta here. I don't need this anymore. You [00:04:00] know? So,

[00:04:00] Stephanie: but here's the thing. You have this in important role in. Doing your due diligence as a reporter on this trial, which somehow has not made it big yet, but it's a really big deal.

[00:04:14] Ben: [00:04:15] Well, the reason why there were only two journalists there is you had to have clued in.

[00:04:19] Ben: So somebody told me about it long in advance. So, and I was the only one who knew about it. They could have chosen other, tell other people they didn't. And so it was just sitting there, some files, you know, buried within some government [00:04:30] website. So I have all the case files, but then the judge, for whatever reason, put them under seal when he started the case.

[00:04:35] Ben: And then he's kept all the transcripts from the trial under seal as well. So there's no other way for the information to get out. Um, and the only reason there was another journalist there for part of the time is 'cause [00:04:45] I foolishly for my own purposes, uh, you know, undermined my own purposes. I was tweeting about it and he followed the bride crumbs and showed up and I was so irritated still, you know, just being competitive or whatever, but.

[00:04:55] Ben: That's, that's why it happened. It's not a conspiracy of, of any kind of omission [00:05:00] that there were, weren't other journal journalists there. But, you know, there is the question of like, okay, well why am I only hearing from like right-wing podcasts who want me to go on this week and tell them what happened?

[00:05:10] Ben: You know, why, why is the mainstream media not digesting my piece? They might, you know, my [00:05:15] pre-press article only right now when we're speaking, came out a few hours ago. So we'll see. But you know, that's a general trend. You see where the, the right wing media is very eager to report on this, especially if there's a big headlines that they see is at least salacious.

[00:05:29] Ben: Uh, whereas, [00:05:30] you know, the other side is much more cautious, shall we say.

[00:05:32] Stephanie: So this case sort of snuck up on people like all of a sudden. The Fox versus variant case. We hear about this victory. We didn't hear much leading into it. And as you mentioned in your free press article, there are [00:05:45] almost 30 detransition lawsuits.

[00:05:47] Stephanie: This is the first to achieve a victory. Some have met statute of limitation issues, but why is there such a difference between the, the Fox variance case, oh, excuse me, [00:06:00] the Fox variant case. And the more high profile lawsuits that we've all heard about, like Chloe Cole,

[00:06:05] Ben: the main difference is the, this personality and the desires of a plaintiff.

[00:06:10] Ben: She did not wanna make a big thing of this. She's not political. I think it made for a much easier and [00:06:15] cleaner case for her in court. She couldn't be accused of being some political pun that never came up. There were no politics in the case, you know, whereas Chloe, you know, a lover or hater has made a, a great spectacle of her case.

[00:06:27] Ben: You know, they've decided to go all in on [00:06:30] publicity. That's basically her job. You know, she's supported by, you know, some sort of conservative organizations, that sort of thing. So that, that's really, it was really about what the plaintiff wanted, and I'm sure. Conversations with her lawyer of what would be a good strategy and that kind of thing.

[00:06:43] Ben: But, you know, on the stand she made [00:06:45] very clear that she was unhappy about publicity and that sort of thing. And, and, you know, unhappy didn't refer to me in particular, but I was the only, only two week journalist there that she was unhappy about breast being there. So I think she just prefers her privacy

[00:06:58] Stephanie: and That's very understandable.

[00:06:59] Stephanie: She's [00:07:00] lost so much at an early age. I, yeah, a lot to put on time to move forward now,

[00:07:04] Ben: you know, and she's 22 years old and just coming into her own a lot of what the case is about. It was her trying to find herself. You know, I'm in my late forties at this point. I'm, I'm used to being attacked [00:07:15] online. It's extremely scary, you know.

[00:07:17] Ben: I think when you have some experience with it, you know, like, you know, it passes, there's a bloom for a day or two, and then they find something else to talk about. Um, but you know, when you're in the middle of it, that could be really distressing to say the least. Um, especially, you know, [00:07:30] she's, you know, trying to be an actress.

[00:07:31] Ben: So thinking about her name going forward, I'm sure that that's typical too. Think about, you know, having it be associated with something that, you know, you wouldn't want linked to your acting career necessarily.

[00:07:41] Stephanie: So I'm gonna share with our listeners part of why this is so [00:07:45] close to home for me. Uh, you know, I've been part of the gender critical online community for five, six years now, and we've all been looking forward to the first Detransition victory in court, and now we have it.

[00:07:59] Stephanie: [00:08:00] And not only did she win the case, but the psychologist who signed off on her mastectomy was found by the jury to be 70% responsible. And as I looked into this further, I learned [00:08:15] that that psychologist, Kenneth Einhorn. Actually works for the company that bought out the company I used to work for. So Life Stance Health is a national conglomerate that's been going around buying [00:08:30] out these smaller group practices.

[00:08:32] Stephanie: And that happened to the practice I used to work for before I went into private practice life bought out Western, like maybe within a year of my leaving Western. And life stands also bought [00:08:45] out Carmel Psychological Associates, which is where Kenneth Einhorn was working when he treated Fox Variant and signed off on her mastectomy, which she came to regret.

[00:08:55] Stephanie: So this feels incredibly close to home for me.

[00:08:58] Ben: Right. And you and I were talking about this just before [00:09:00] we started taping, is that his actual practice, the company itself really didn't come up. There were no specifics during the trial about his company. It was just sort of a larger shell in which he worked.

[00:09:10] Ben: It was all about his doings.

[00:09:12] Stephanie: And I have some thoughts on that as a therapist who has worked [00:09:15] in a group practice. Um, but I'll save those thoughts for lo long. I'll save those thoughts for later in the conversation. Right now. I'd like to dive into the case and just have you tell our listeners, especially those who haven't heard [00:09:30] of this before, uh, what the variant versus Einhorn case was and what the results were and some, some about the process as well.

[00:09:38] Ben: The Fox variant right now, she's 22 years old. She lives in the White Plains or Westchester County area, which is about 45 [00:09:45] minutes north of New York City, and she had a really difficult childhood, you know, a lot of different emotional problems, difficulty finding a school environment that worked for her very complex educational needs.

[00:09:55] Ben: She was diagnosed with autism. Her parents had a very difficult and protracted custody [00:10:00] battle over her. It started when she was seven years old. She was estranged from her father. Ultimately, she had a major meltdown with her first period, which happened when she was about 12. And so then she started seeing a psychologist, Kenneth Einhorn, when she was 14 [00:10:15] in 2017, and towards the 2000 end of 2018.

[00:10:19] Ben: She's about 15 and a half years old. She started to mention that she might be having thoughts about her gender, might wanna change her name to something kind of androgynous. And then in quick succession between December, 2018, [00:10:30] January, 2019, she got a breast binder. She cut her hair short, she changed her name to a more masculine name, Rowan, and then she started coming out publicly at school.

[00:10:39] Ben: So January, 2019. That's the beginning of the real public phase of this rapid fire social transition. [00:10:45] Two months after that March, 2019, she first mentions to Einhorn that she thinks she might wanna have top surgery, she might wanna have a double mastectomy, and something that in the case, the plaintiff's attorney, Adam Deutch, who's a local white lane's personal injury [00:11:00] attorney, really harped on, was that his case note from that first meeting in, in the middle of March of 2019 was not, you know, we talked about top surgery and explored it or whatever was something about taking action of looking into how to get [00:11:15] top surgery.

[00:11:16] Ben: So that was a real indictment on, on Einhorn of this idea of why didn't you explore and talk about, and even question it, not say I'm an authority figure, therefore you should not do it. You know, very well. Obviously that's not a way that, [00:11:30] uh, psychology tends to work unless it's, I'm gonna go out and murder somebody, you know.

[00:11:34] Ben: Um, so after that march into October. October Einhorn writes a letter of referral to a plastic surgeon, and then [00:11:45] two months after that, the plastic surgeon, after having two meetings with. Uh, with, with Arian, he removes her breasts. So the letter itself, that was real clincher in the case as well. It was pretty flawed.

[00:11:57] Ben: There were errors in it. There were errors of [00:12:00] admission. And also, for example, he said, oh, she's doing what well and better with her anxiety as evidenced by her school attendance. The thing is, she was always in and outta different schools and she'd been in one program the previous school year, but he had just noted the previous months in his case notes [00:12:15] that she wasn't in regular schooling in the fall of 2019.

[00:12:17] Ben: So that was wrong. He left out diagnoses she had, which, which Deutsche argued were not under control. That was never quite established whether they were or weren't. But he argued that and critically and oddly, the [00:12:30] diagnosis of gender dysphoria, which is pretty widely accepted, is the requirement for having top surgery, for top surgery is essentially a treatment for that condition.

[00:12:39] Ben: That diagnosis was not in the letter. Oddly, he wrote Body dysmorphic disorder. [00:12:45] He claimed in a deposition, and this part didn't come up in the trial was for insurance purposes, which doesn't make any sense to me because gender dysphoria is often covered by insurance for these types of surgery. Whereas body dysmorphic disorder as anyone, as you well know, is a contraindication for plastic surgery.[00:13:00]

[00:13:00] Ben: For people who don't know body dysmorphic disorder, do you wanna define it?

[00:13:03] Stephanie: Sure. And. I'll define it with this caveat that I believe the DSM is a very political document. It's, I

[00:13:12] SKOT: agree.

[00:13:13] Stephanie: Pharmaceutical industry, it's [00:13:15] affected by culture. So personally, I think of gender dysphoria as a bogus diagnosis that points to a combination of things, which oftentimes there's a ton of overlap with body dysmorphic disorder, uh, which [00:13:30] has to do with a, an obsessive misperception of, and discomfort with the appearance and form of one's body.

[00:13:38] Stephanie: Um, you know, where do you draw the lines between something like that? Gender dysphoria, obsessive compulsive disorder. Go ahead, Ben.

[00:13:44] Ben: This was a real [00:13:45] dispute between the expert witnesses as well, whether those two things are totally distinct or whether they can or might overlap and, and if they did overlap in this case.

[00:13:54] Ben: So this. Lauren Shechter. He is the head of the Gender Affirming Surgery [00:14:00] Program at Rush University in Chicago. He's the president elect of the World Professional Association for Transgender Health, or WFF, the very influential it, I call it quasi activist medical organization. He testified on behalf of the plaintiff, which has [00:14:15] really surprised a lot of people because they're saying, wait a minute, the W GAAP guy was testifying on behalf of the plaintiff.

[00:14:20] Ben: But what he said was he was looking at the case file and all the depositions trying to find inculpatory evidence. He didn't use that word. Um, mind you about [00:14:30] Dr. Chin, he couldn't find in the end, he, he decided that Dr. Chin, in particular, was very much at fault. He was there to judge Chin's performance 'cause he was a plastic surgeon.

[00:14:37] Ben: Um, but what he said about the letter Dr. Schechter, was that, to your point. It's very concerning. If you're [00:14:45] suggesting that somebody has body disor disorder about the specific body part that you wanna operate on, that, that is a major red flag. He called a a stop sign. He said, he said that Dr. Chen absolutely was required under the standard of care or his [00:15:00] practice to have called Dr.

[00:15:01] Ben: Einhard to say, what's up with this? Let's clarify this. What did you mean? But Dr. Chin was very defensive and said, no, there were all these other. Inferences in there, uh, you know, suggestions that she did have gender dysphoria [00:15:15] because there were several different points he made. See, he's saying this, this, this, and this.

[00:15:18] Ben: Those all define gender dysphoria. Therefore, it was fine for me to assume that she did and to go ahead with the surgery, but neither Dr. Chin nor Dr. E nor despite seeing her for several years, ever wrote gender [00:15:30] dysphoria anywhere in any of their case notes. Dr. Chen wrote breast hypertrophy in his notes, which speaks to a larger theme that we see in gender medicine where doctors and psychologists, their psychiatrists will put in diagnosis [00:15:45] code such as say, endocrine dis disorder, not otherwise specified as opposed to gender dysphoria to try to get insurance coverage or maybe.

[00:15:52] Ben: You know, allegedly in some cases to get around laws that ban these types of treatments. Um, but the breast hypertrophy is used for, [00:16:00] to justify a breast reduction for somebody, you know, who has breasts that are too large for whatever reason. You know, and they may have back pain or maybe it's cosmetic to justify that surgery.

[00:16:09] Ben: So, you know, maybe if Dr. Chen had called Dr. Einhorn and Squared, wait, this question. Oh, I meant her [00:16:15] dysphoria. That would've cleared it up. But also the big question was also then might they have had some more in depth discussions of her problems, whether she was ready for this. And crucially what kind of expertise Dr.

[00:16:25] Ben: Einhorn actually had in this field because Dr. Dr. Chen never asked and [00:16:30] Dr never offered what sort of experience or expertise he had in caring for these types of patients.

[00:16:35] Stephanie: Alright, I'm gonna give some comments. First of all, uh, Dr. Ahan Heim and I talked about this diagnosis of breast [00:16:45] hypertrophy that has been used in medical billing fraud to, uh.

[00:16:50] Stephanie: To cover a completely different procedure, right? There's a difference between a breast reduction and a breast removal. Uh, so a breast reduction preserves, [00:17:00] mammary glands, for instance, uh, and breast removal does not. Um, but Dr. Heim explains in that interview why we see this, uh, medical billing fraud happening to, um, cover treatment, especially for minors.

[00:17:14] Stephanie: And, uh, [00:17:15] related interview refer listeners to, as well as the one I had around the same time with Dr. Travis Morrell. Um, second of all, I wanna just give my commentary on how absurd it is that, that this, uh, so-called standard or [00:17:30] guideline exists anywhere that if the patient has what a clinician labels body dysmorphic disorder, that that should be a red flag.

[00:17:41] Stephanie: If they have what is labeled gender [00:17:45] dysphoria, that should be a green flag. Queer is, no, I'm expressing my own opinion. You don't have to agree with me, but my opinion, which I'm expressing on my show, is that that is ridiculous. And [00:18:00] yet it's so interesting that the fact that WA makes that distinction resulted in what the president of WA, the the WHO

[00:18:09] Ben: President elect, I think he starts at the end of the year, their two year terms.

[00:18:12] Ben: So he would start, I think in November, if I'm not [00:18:15] mistaken.

[00:18:15] Stephanie: Okay. But president elect of WA testified on behalf of the plaintiff in this case. And that is just such a double edged sword because you know, one of the questions I saw coming in for you, and I might be kind of jumping ahead of myself [00:18:30] here, but when I posted on X, Hey, I'm interviewing Ben Ryan about this article, what questions do you guys have?

[00:18:35] Stephanie: This was one of the issues that people brought up. Like does the case. Make it look like WPATH guidelines are bogus in the first place, or does it [00:18:45] make it look like WPATH guidelines weren't followed?

[00:18:47] Ben: Well, importantly, that wasn't really up for question. So it was very interesting because at the time, WPATH guidelines, they were in their seventh edition, I think it came out in 2012, right now it that's in the eighth edition, came [00:19:00] out in 2022.

[00:19:01] Ben: So we're referring to an antiquated edition in the first place. But both the defendants were very eager to say that. They said that the WPATH guidelines were not the standard of care. And I'm gonna have to say also for those of you who know [00:19:15] what the actual TFL of the WPATH guidelines are, they're confusingly called the standards of care.

[00:19:20] Ben: So the plaintiff's attorney very cleverly never told the jury this until later on for fear of confusing them. But the judge, at one point he made, he was kind of a [00:19:30] funny guy. We're all going to lunch, and he is like, this is so crazy and annoying that they called this document the standards of care. What were they thinking?

[00:19:36] Ben: So in any case, they both said the WPATH guide, I'll just call them guidelines, tried not to confuse people. Were not the legal then [00:19:45] standard of care because the question for the case itself was, did you deviate from the standard of care or what a reasonable physician or psychologists would do in the circumstances?

[00:19:56] Ben: So in that sense, WPATH was not on trial at [00:20:00] all and there are standard of care with the Big S, big C, uh, their guidelines were weren't really referred to specifically very often. And were essentially largely put aside. So people who think that this entire trial or trials like these are gonna be taking on the [00:20:15] whole system, are gonna be in for a disappointment because in fact what they mostly do is they say, here's the benchmark.

[00:20:22] Ben: Did you meet it? So whether you agree with the benchmark or not, or whether you agree with the types of practices that now are widely accepted, [00:20:30] at least by a lot of physicians, even if you don't agree with them, did they even meet that standard? So you talk to some lawyers behind these cases, and a lot of them are conservatives and they really believe this entire pediatric medicine field to be blown off the map.

[00:20:42] Ben: You know, they'll say like, despite the fact that we [00:20:45] think the WPAs guidelines are bunk, you didn't even meet them and that's why we're suing you.

[00:20:51] Stephanie: Yeah. Gosh, I have so many thoughts and feelings, I can't tell what's what. I really feel

[00:20:58] Ben: One thing I wanna add though, go interrupt. Sorry. [00:21:00] Mm-hmm. However, I just said there is a caveat.

[00:21:02] Ben: So Chloe Cole, the most famous Destro listener and Kayla Love dah, represented by the same firm. Their cases do add in addition to what I said, they, they also add, and we think WPATH is balk. I don't know how well that'll [00:21:15] work in a medical malpractice case. We'll see that's more ambitious. But I've counted 28 of these cases, including the, the, uh, Varian v Einhorn and let's see, that would make 24 of them seem to be more straight medical male practice cases that don't [00:21:30] go after the system.

[00:21:31] Ben: There are two additional that are civil rights cases that interestingly accused L-G-B-T-Q community clinics of violating the civil rights of gay men for not discerning that they had internal internalized homophobia and misinterpreting that they were transgender and had gender dysphoria, and [00:21:45] then putting them through a vaginoplasty and other transition treatments.

[00:21:48] Ben: So those are also very interesting and ambitious cases. We'll see how they, they fair.

[00:21:53] Stephanie: Very interesting. So I wonder about the strategic choice to [00:22:00] downplay the role of wpath. And there's so many layers to this. So one, there's the, the, um, manipulation of words that Wpath essentially does whatever it wants, calls the guidelines they [00:22:15] come up with, which are not rooted in sites.

[00:22:17] Stephanie: They call them the standards of care, not to be confused with the legal definition of standards of care,

[00:22:24] Ben: except that it is very confusing. Yes.

[00:22:27] Stephanie: Yeah. It's, it's very, I mean, it's like, it's like, [00:22:30] you know, I mean, and here's where I'm expressing my opinion, which may vary from yours, Benjamin, but my belief is like, just because a person identifies as something doesn't make them that.

[00:22:41] Stephanie: But the transgender ideology is founded on this idea that [00:22:45] you can identify as whatever you want. So WPATH identifies as leading experts. They identify as creating what they think are the standards of care. They identify whatever they want. Uh, it doesn't mean that what they say is true, it's [00:23:00] just manipulation of language.

[00:23:01] Stephanie: So I think it's very interesting that this case made a distinction between the classic definition of standards of care. What would a, what were considered the best practices for someone in this profession, treating someone with this [00:23:15] issue in terms of how to proceed? They're differentiating that from the WPATH standards of care, but also kind of downplaying wpath.

[00:23:23] Ben: Well, it was a defense strategy that they were downplaying it because you know what the plaintiff attorney is gonna try to get them to do and did in many cases, is [00:23:30] going to say. Are these the standards of care? And then let's say they say yes, therefore we agree that because you already agreed that you did X, Y, and Z, you deviated from the standards of care.

[00:23:39] Ben: If they're just gonna say there are no standards, when what they said explicitly, both the defendants, they said [00:23:45] there is no standard of care period in this field because it's so for mastectomies, for minors, because it's so new and experimental. So that, I mean, that seemed like a defense strategy. I don't know necessarily that they believe all of those strings of words together, but it made it [00:24:00] harder to pin them on actually doing anything.

[00:24:02] Ben: The one really concrete thing that they actually said, both of them, was that they thought that gender identity should be stable for at least six months prior to surgery. And they ultimately learned because, [00:24:15] so Einhorn. Realized the limitations of his experience and recommended to his patient and her mother that they go seek specialist care from this place called the Pride Center in Albany.

[00:24:25] Ben: It was two hour drive away and she saw them twice. But while she was there, she was [00:24:30] apparently more comfortable being frank about her inner feelings and her ambivalence. She said she was lost. She said she wasn't sure about her gender identity. And then crucially, she said that she felt fresher to settle on a gender identity by the people around her.

[00:24:44] Ben: And then she was [00:24:45] afraid of telling this to her mother. So Einhorn never asked for the notes from those sessions. He never learned this, and therefore, Dr. Chin never learned it. And Dr. Chin said, had he known this hap, it happened only four and a half months prior to the surgery that she told the Pride Center this, that he wouldn't have done this surgery.[00:25:00]

[00:25:00] Ben: That said the, uh. The jury wasn't convinced about the sticker line of attack, and they said it didn't lead to her injury, but it, it was a, a major focus of the trial. And there were a couple cases like this where Chin was very happy to throw [00:25:15] Einhard under the bus. And just to say, I didn't know it was his responsibility to tell him.

[00:25:19] Ben: And I, you know, I was, it was an incumbent upon me to find out this information. He was supposed to offer it. So, whereas Einhorn didn't try to throw chin under the bus at all, and he, he might've, but he didn't. [00:25:30]

[00:25:30] Stephanie: So tell us about some of the more disturbing things that were revealed about Einhorn's treatment.

[00:25:37] Stephanie: Ovarian.

[00:25:37] Ben: Well, her mother, Claire Deacon, she's a practical care nurse, which means that she cares for chronically ill people in their homes. And they were always [00:25:45] trying to pin her of having this great medical experience, therefore, she could discern left from right when it came to the care of her daughter.

[00:25:51] Ben: And she was saying like, no, I don't have a lot experience in navigating the care system because I work in people's homes. In any case, you know, she would get on the stand. She was very demure, [00:26:00] quiet. Sort teary-eyed, upset. You know, it's hard to be on the stand and be scrutinized like that. But when she remembered in vivid detail Einhorn, how she characterized as browbeat her into consenting to the surgery she didn't want for her child with threats of [00:26:15] suicide because she was unleashed, her voice got much louder and she would reenact these scenarios where, where one in particular he said to her, she quoted, you're not a reality mom, where he was saying to her, almost yelling, she said that she needed to come into his [00:26:30] sense of seeing and the way he saw things and say that she was going to probably kill herself if she didn't have this surgery.

[00:26:36] Ben: So the idea was that he coerced her into consenting with this constant threat that her child was in very high likelihood of surgery. But then Dr. [00:26:45] Schachter

[00:26:45] Stephanie: of ER, you mean?

[00:26:46] Ben: Yes.

[00:26:47] Stephanie: The child. High likelihood Of Suicide.

[00:26:49] Ben: Of suicide. Yes. So, Dr. Shater comes in and says. Mastectomies are not a treatment of prevention for suicide, period.

[00:26:56] Ben: So that's just wiped that off the bat. And you know, you [00:27:00] didn't go into greater detail. You kind of didn't have to. But the reality is that research, at least into cross-ex hormones, there's one study that's ever looked at this directly. It was about all this nationalized health data in Finland and they didn't find that there there was any independent, statistically [00:27:15] significant association between having taken prostates

[00:27:18] SKOT: hormones and not, and suicide death.

[00:27:21] Ben: And they, they were able to compare this between youth who had gone to a gender clinic and compared to age match controls in Finland. So, and indeed young [00:27:30] people with gender dysphoria have a higher risk of suicide, but it's still a very rare outcome. So you'll see that these, these practitioners like Joanne Olson Kennedy is a very famous.

[00:27:41] Ben: Gen care provider for California, you know, would routinely tell her [00:27:45] parents that they were wary, would you rather have a live son or a dead daughter? But there's no science to back this and it really implies that your chances are like one in two or something as opposed to it being still a rare outcome.

[00:27:58] Ben: And what the finished study found was [00:28:00] that they were using, having been to a gender clinic as a proxy for gender dysphoria or transgender identity. And then they used specialist psychiatric appointments as a proxy for severe mental illness because inland seeing a specialist psychiatrist means you have a very severe mental illness.

[00:28:14] Ben: And they [00:28:15] found that suicide, elevated suicide death rate was only independently associated with seeing the special psychiatrist and not independently associated with with going gone to the general clinic. And there's been a lot of debate of whether they're sort of like controlling out, you know, they're controlling for [00:28:30] something they're actually looking for in that.

[00:28:31] Ben: And I think those are worthy debates, but nevertheless, the only study to even try to look at this couldn't find evidence to support, uh, what these claims.

[00:28:41] Stephanie: Well, that matches what we know from other sources as well about [00:28:45] suicide risk and transgender identity, which is that it's pretty much matched with the comorbidity level and.

[00:28:52] Stephanie: That for those who medicalize, the rate goes up over time and, and we, we can see why, because of the [00:29:00] complications, even if there's no subjective report of regret, there are, uh, lifestyle complications that take away a person's coping and protective factors. Now, you said something in your article about the timing of when suicidal [00:29:15] ideation actually emerges in the clinical record, and I thought this was quite significant.

[00:29:19] Stephanie: Could you go over that piece?

[00:29:20] Ben: So Fox variant and this, the specifics of this didn't entirely come up in the case, but they were in the deposition where her mother. Said in her deposition a couple years ago was that [00:29:30] Fox would often threaten to kill herself about all sorts of things. This was a frequent theme with her daughter and this clearly, she was a very caring and devoted mother.

[00:29:37] Ben: So this is not to say that she didn't care, but she didn't take it seriously enough to think she was really going to do it. However, when Einhorn [00:29:45] came in and he said that she would, then she felt compelled to take it seriously. He was an expert. He was a grownup.

[00:29:51] Stephanie: Is it true, maybe I'm misremembering your article.

[00:29:53] Stephanie: I thought that I read that Einhorn didn't document the patient expressing tooth methyl Venetian [00:30:00] and to help after these conversations where he used that as to As a threat to her mother.

[00:30:05] Ben: Yes. So I know him testified that in fact he did not believe that Arian was at a serious risk of suicide attempt before the surgery, despite the fact that [00:30:15] constantly telling her mother that she was at very high risk of suicide.

[00:30:18] Ben: And you know, he in lots of ways is saying of why he wrote his notes the way he did. And it was only to jog my memory and that kind of thing. But. When pressed, he did say that if something was very [00:30:30] important, you know, it was incumbent if wanted him to write it down. And he never noted any suicidal ideations prior to the surgery.

[00:30:37] Ben: Not that she didn't have them, but it suggested that they weren't serious enough. To warrant a note, the first time he ever noted [00:30:45] suicidality was after the surgery, and her mother says that she got worse after the surgery, and it wasn't until after the surgery that she started self-harm that she started cutting herself.

[00:30:53] Stephanie: 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, [00:31:00] 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 [00:31:15] tools.

[00:31:15] Stephanie: The families I've consulted with have found most helpful in understanding and getting through to their children even when they're adults. Visit r gd repair.com to learn more about the program and use promo code some [00:31:30] therapist 2025 at checkout to take 50% off your first month. That's ROGD repair.com. I need to speak here as a clinician who's worked for a group practice similar to the one he worked for, [00:31:45] um, there's an obligation to to assess, um, suicide risk factors from day one with any patient seeking treatment.

[00:31:54] Stephanie: And, you know, and sometimes that's just as straightforward as patient reports having [00:32:00] never had. Any suicidal, Asian whatsoever. And so we can just kind of skip over that because it's, you know, they're here for a family conflict or they're here for anxiety or something like that. Right. Sometimes it's very brief.

[00:32:11] Stephanie: Um, but if there's any indication that there's been, [00:32:15] you know, any passive or historical or mild suicidal ideation, there is a certain kind of due diligence that the clinician is expected to do and to document. So it seems very outside of the ordinary for [00:32:30] suicide to have come up so much in the conversations with the mom, but not be documented at all.

[00:32:34] Stephanie: That's. I mean, talk about standards of care that's not standard of care.

[00:32:38] Ben: And you know, of course you know there are different tiers of suicide risk. You know, are you just thinking about it abstractly? Do [00:32:45] you have a plan? Have you gotten implements with which you're going to carry out the plan? That sort of thing.

[00:32:49] Ben: You know, that level of risk of how much do we need to hospitalize you? That kind of thing. So, you know, tho those. Various tiers certainly came up in the trial, um, from [00:33:00] various experts and from the defendants.

[00:33:01] Stephanie: So what else was really striking about this case? You were there for the whole thing.

[00:33:05] Ben: I do think that the plaintiff's attorney did quite a good job.

[00:33:08] Ben: His summation was pretty devastating because he hung. The defendants on their own words [00:33:15] and on their expert witnesses own words. So, you know, one by one he was able to get people to admit they deviated from the standard of care or get their expert witnesses to say so. And there was one in particular where, you know, it was a question of was [00:33:30] Chin, you know, somehow obligated to have gotten the information about this patient that she had waffled in the past on her gender identity should he have reached out and tried to obtain more information.

[00:33:42] Ben: And Joseph STI has a similar [00:33:45] job at Penn Medicine to Joseph Sheer. So they were pretty equivalent in that regard. They both very well experienced, although St. Letti didn't have the kind of direct, um, academic experience in gender affirming medicines, it's called that Shater dead. [00:34:00] You know, sir Letti, he does these kind of surgeries all the time.

[00:34:02] Ben: He is, he's done like a hundred, uh, vasectomy overwhelmingly on minors in the last few years. But, you know, he was rather dismissive of whether it really mattered. This relevant information about her waffling and her gender identity, [00:34:15] whether that was crucial to the dis decision factor of going ahead with the surgery.

[00:34:20] Ben: And I thought this made a really interesting distinction because it was clear. Frankly that he took less seriously a psychological issue that contributed to a surgery than he [00:34:30] did to a a per a medical one per se. And the way that Deutche, the plaintiff's attorney got this out of him, he said, okay, well let's say, let's say there's a cardiologist, specialist and he's seen one of your patients and something came up that he discovered that they have a risk factor [00:34:45] that might be important for whether or not you decide to do a surgery that's re, re related to cardiology.

[00:34:51] Ben: And you don't know about it, but you go ahead with the surgery, you know, was. That information not being passed to you, a violation of the standard of care. And you know, he [00:35:00] crumbled under it and said yes. And therefore, Deutsch, the plaintiff's attorney, said, you would agree that in the similar circumstances in this incumbent information for you to know about gender dysphoria and about the stability of this person's gender identity would be similar.

[00:35:14] Ben: [00:35:15] And, and he ultimately said yes. And I thought that spoke to the fact that something that went un unmentioned in the case that in nowhere else in medicine currently, do doctors change the body to treat the mind. You know, lobotomy people did that. But especially on children, [00:35:30] this is a totally unique ethical.

[00:35:34] Ben: Minefield essentially that they're in. And that's often not acknowledged. And that really spoke. And again, this wasn't addressed explicitly in the trial to the difficulty of having a psychologist [00:35:45] having to communicate with a plastic surgeon and vice versa, or they don't communicate in this case. And trying to bridge those divides.

[00:35:52] Ben: And it doesn't work very well because in some ways the psychologist is being asked to act like a surgeon and approved surgeries [00:36:00] in a certain way. And vice versa, a plastic surgeon is having to think like a psychologist and ask those kind of questions. And of course, plastic surgeons, you know, they may be more used to this than, let's say just a general surgeon.

[00:36:12] Ben: 'cause they have to ask questions that would, for example, figure out if [00:36:15] someone had body dysmorphic disorder and then she reject 'em as a patient. But in this case, this system, which was an ad hoc system, just sort of thrown together by these people, sort of random associations with one another, the communication.

[00:36:28] Ben: It sort of broke down or didn't [00:36:30] happen and that hurt the patient.

[00:36:32] Stephanie: Well, I hope I followed along with most of that. You do talk quite quickly. Sure. But, but I think, you know, you really brought it home there at the end. And this is the crux of the issue that myself and so many other gender [00:36:45] critical people and conservative therapists are saying that how on earth is it a mental health professional's job to recommend that a person modify their body?

[00:36:54] Stephanie: This is completely unprecedented. And maybe it would be one thing if there [00:37:00] was a robust evidence base that the long-term psychiatric outcomes for people who did have body modifications were positive. But what, in fact, the long-term outcomes show are increased rates of suicide and increased rates of psychiatric drug use following these [00:37:15] procedures.

[00:37:15] Stephanie: So there's really no precedent for making that judgment call whatsoever. And I remember when I was first put in a position as a therapist to, um. To refer people to other therapists that were [00:37:30] trained to write these letters. And, and I, I wanna talk about that now because I wanna talk about the group practice element and, uh, totally welcome you, Ben, to either, you know, fill in where you have information that would help or to [00:37:45] remain completely agnostic if I'm speaking to something that you don't wanna express opinion on.

[00:37:49] Stephanie: But I, I wanna voice this for my listeners, especially those in the helping professions and, and those who have loved ones dealing with this issue. Um, [00:38:00] which is that, you know, he did work for a group practice, and as you said, that's really been downplayed. And I couldn't exactly figure out the timeline because the practice that he worked for.

[00:38:13] Stephanie: At the time was called [00:38:15] Carmel Psychological Associates, but it got bought out by Life Stance Health, which as I understand, is not run by therapists. It's run by people in the business of making money. And I would, I [00:38:30] would imagine that, you know, a, a company like Life stance, which is just trying to run the business side of psychotherapy ba uh, businesses around the country would love to just stay out of something like this.[00:38:45]

[00:38:45] Stephanie: But I, I think that this is forcing them into the spotlight. I understand that, you know, Einhorn took the blame himself and did not, you know, particularly refer to any. Let's say colleagues that [00:39:00] he consulted with, or trainings that he attended or company policies. But those are all the surrounding elements of any therapist working in a group practice.

[00:39:11] Stephanie: And when it comes to the idea of a standard of care, [00:39:15] while the standard of care more generally in psychotherapy, not pertaining to gender dysphoria in particular, is that when you're up against the limits of your knowledge base, you consult a colleague, you attend a training, or you refer to an [00:39:30] expert and.

[00:39:31] Stephanie: I'm not sure if he did any of that. I'm hearing that he referred to the pseudo expert at the gender clinic, and that's what so many naive professionals do, including ones on the much more conservative side of this issue who just don't know better. [00:39:45] Those who are, you know, cautious and wanna say, well, I, this isn't my area of expertise.

[00:39:49] Stephanie: Maybe you should go to talk to those gender experts over there. And the left hand doesn't know what the right hand's doing. 'cause those gender experts over there are gonna tell every single person that walks through their door, if you're having any doubts, yes, it means you're trans. [00:40:00] So that's what he did.

[00:40:01] Stephanie: He referred her to a place where she went twice and somehow expressed more doubts in that setting than in the clinical setting. But I'm wondering about what was the environment? This is before, um, COVID era lockdown. So, uh, therapy was in [00:40:15] person, correct.

[00:40:16] Ben: Yeah, eventually

[00:40:17] Stephanie: building

[00:40:18] Ben: COVID happened and they stayed together and, and so there was a talk about them being on Zoom and that sort of thing.

[00:40:22] Ben: But

[00:40:22] Stephanie: Okay.

[00:40:23] Ben: Afterwards, obviously

[00:40:24] Stephanie: I remember what that was like working in a building with colleagues next door. I remember the weekly meetings I [00:40:30] remember, you know, the fact that you're supposed to kind of network and find out like who's good at what and therefore if you have a patient struggling with this thing that's at the edge of your knowledge base, who do you go talk to about that?

[00:40:40] Stephanie: And I am really wondering about that side of things. [00:40:45] Now, a lot of therapists are in private practice these days. It's kind of easier than ever doing things on Zoom. You don't have to pay for your own space to work in. But it leaves me wondering, because I think companies like Life Stance are the ones that are going to have to be [00:41:00] looking at cases like this and deciding what their company policies are.

[00:41:03] Stephanie: We had company policies at Western. We had a training that I went to Circa 2017, which I talked about many times on the show. Um. Still don't know who did the training. It [00:41:15] might've been Laura Edwards Leaper for all I know. I don't remember. But, um, but this was where we were first introduced to a lot of what's considered the, you know, sort of the WPATH standard of care, which isn't really the standard of care.

[00:41:28] Stephanie: This is where I was first [00:41:30] introduced to the dead daughter of living son narrative. And I remember company policy like rapidly trying to keep up with the changing times at the same time as we had conservative leadership that is clearly had some doubts about it. I remember all of that going on. It was [00:41:45] happening in a social.

[00:41:48] Stephanie: Context, and I'm wondering about the role of that social context in this case. I feel like it's been really downplayed.

[00:41:53] Ben: Well, it didn't come up, so I have no answers to those questions whatsoever. The only thing that came up was just how those [00:42:00] two businesses changed hands, you know, when they bought out Carmel.

[00:42:03] Ben: But no, we never heard about any company policies, any of his colleagues, nothing like that. In fact, the jury faulted him for not ensuring that Arian and her mother stuck with [00:42:15] specialized trans care. So, you know, again, to the point of this trial, they weren't there to say, you know, they weren't there to agree with you in particular to say that no child should receive these types of interventions, but rather that there is a standard of care in which they do and they were not followed.

[00:42:29] Ben: And in fact, [00:42:30] you know, one could argue, and it that seemed to be the case, that had she stuck with the specialized transcare, that she might've felt more comfortable to explore herself more than it was happening with Einhorn and then might've come to the resolution that she didn't want her knee [00:42:45] surgery.

[00:42:45] Ben: So, you know, we'll never know. But that was at least in, in theory, what might've happened as evidenced by her being pretty candid right off the bat with the Pride Center in a way that it seems that she had not been with Einhorn. And you know, I think [00:43:00] there's a certain like emotional sunk cost you can imagine where even if you haven't engaged in any changes to your body, you've nevertheless told something about yourself.

[00:43:09] Ben: I mean, I remember being a kid and that was, you know, I had like sulk or something and I kind of. God done sulking, [00:43:15] but like I've committed to it. I'm embarrassed. 'cause if I stop, all of a sudden they'll realize it was inauthentic. You know? And I think that that. In a much more magnified orders of magnitude, greater extent in these kind of cases is what it's [00:43:30] like when you've gone around telling everyone what your name is, you've gotten upset with them if they misgender you.

[00:43:35] Ben: And if you go back and say, actually I was mistaken. They'll be like, why did you get so mad at me? You know, so I'm gonna go back and revise all those times that you indicted me and forgive [00:43:45] myself, retro attractively. So I think perhaps one could theorize at least if that kind of sun class was going on with her mother and with Einhorn, where once she'd driven or, or ridden that train down that path, I kept using a train metaphor.

[00:43:57] Ben: It was driving it. And during the [00:44:00] trial, um, that it's, it's a little hard to turn back. Because you kinda have to go back on your word in a way.

[00:44:06] Stephanie: Well, you're getting into my territory now, Benjamin, talking about the, uh, you know, the sunk cost and the fragile adolescent ego. And that's all the kind of stuff that I teach parents about in [00:44:15] my course, ROGD repair.

[00:44:16] Stephanie: Uh, I, I teach parents how to anticipate those kind of reactions, plan for them, plan their approach differently to help their adolescent save face and not end up feeling like they have to dig their heels in because of [00:44:30] their immaturity. Um, but I think you raised a really important point here, which is how would this case have gone any differently if she had seen a so-called gender specialist?

[00:44:41] Stephanie: Because I'm hearing that there's kind of a narrative, some, somewhere [00:44:45] surrounding this case. I'm not sure if it's your narrative, someone else's narrative, but there is one narrative that says, well, maybe. If she had seen people who truly specialized in gender care, she would've had more room to express her doubts and wouldn't have committed to this.

[00:44:58] Stephanie: But I find that really [00:45:00] hard to believe because it's the people who work in the gender clinics and the people who specialize in gender care that are the diehard true believers. And they believe in things like I shouldn't, for instance. And if you think you're trans, it means you're trans. So I'm [00:45:15] curious, Benjamin did that, did the, how would this have gone differently than come up in court?

[00:45:20] Ben: Oh, yes. So it was widely accepted and no one really differed with this. This idea, Dr. Chin had said, said there was only maybe a one to 4% regret rate with [00:45:30] surgery. And Dr. Einhorn had said that 94% of people who transition stick with it. I don't agree with at, at least I know that those figures aren't reliable, at the very least.

[00:45:40] Ben: So you can't hang your hat on that. I don't know where they got those numbers. There was, I. [00:45:45] Point where the defense attorneys thought that they knew where the numbers came from, and they made reference to a study that I then looked up and said, sure enough, it's from 2022. So no, that's not where the numbers came from in 2019, but that's just presumed that that is a fact, that there's [00:46:00] very low regret rate.

[00:46:01] Ben: And that's whats believed the plaintiff's attorney. So in his closing summation, what he said was that the reason why nobody regrets anything in these other clinics that are highly resourced and everybody's communicating very well [00:46:15] is, is because they're following the standard of care. And in this case, they weren't.

[00:46:19] Ben: So, I mean, I don't think that that's the sound argument at all myself. You know, I can say that certainly there's no science to back that up necessarily. And to your point. Okay. Well, let's take a look at the, at the [00:46:30] diehards of the people who have run US Path or run wpath, Joanna Olson Kennedy, who has led the charge to disparage assessments to say that they're worthless, they're counterproductive, that they're stigmatizing.

[00:46:41] Ben: There's a lawsuit against her, which was filed in December of [00:46:45] 2024 by Clementine Green that said, this girl, she just similarly, she's 12 years old, she just started, started thinking about her gender recently. She walks into Joanna Olson Kennedy's office. She's a pediatrician. Mind you, she's not a mental health professional, and without doing any [00:47:00] biopsychosocial assessment as.

[00:47:02] Ben: Recommended by wpath, you know, which she was the, the president of a US path the last couple of years he didn't do any assessment and gave her puberty blockers, his prescription on the first visit. And then she gave her testosterone. She was 13, signed off on her [00:47:15] mastectomy, and she was 14. So this is one of the biggest leaders in the field.

[00:47:19] Ben: And one could say that, you know, there's a similar pattern here that's engaging in it, at it, in it a little bit differently, let's say. But if you dropped the same patient in the [00:47:30] office of Joanne Olson Kennedy, you know, who's to say that she would've done anything different or that she might've actually done it even faster for all we know.

[00:47:37] Ben: Right. Just wanna say though, that, um, so did not want testosterone. Ironer talked about that with her and there was sort of [00:47:45] debate, you know, MS test, testosterone required before mastectomy. No, it isn't. Okay, fine. So that element was not a part of the case. She didn't take any purity blockers or testosterone.

[00:47:54] Ben: She didn't want to. And then some people said, well, maybe that's indicative that she's really not meant to go through it, medical [00:48:00] transition if she doesn't wanna really commit to it. And Ihorn was saying to her, not necessarily about you should to take testosterone, but he was encouraging her to commit.

[00:48:08] Ben: To her gender identity and, and to do so as a way of convincing her mother and, and owning her gender identity, [00:48:15] using words like that. And so he was really indicted by, in particular Erica Anderson, who, the transgender woman and the former head of US path, who's become a real skeptic and a dissident out of the WPATH system.

[00:48:27] Ben: She's a psychologist and she testified, you know, really [00:48:30] questioned, well, if she doesn't wanna take testosterone, maybe this isn't right for her.

[00:48:34] Stephanie: It seems like there's a big difference between that sentiment coming from Erica Anderson of all people who I have honestly, very little respect for personally.

[00:48:44] Stephanie: Um, [00:48:45] but that and the, the mainstream sentiment amongst gender, ideologues, wpath, and all of that, which is this infinite range of gender expression and that you can, you can be non-binary. You can be anywhere on the spectrum. There's 82 different genders. Right. And, and, [00:49:00] and that you don't. Have to do one to do the other.

[00:49:03] Stephanie: And in fact, now they're making custom genitalia. Why should it look like male or female? Maybe it should look like a flower. I mean, that is part of gender ideology too. So for them to someone like Erica Anderson [00:49:15] and, and Wpath to turn around and say that someone not going full bore trans mask, you know, the testosterone and the top surgery and the masculinization, uh, and like for someone to say that someone not being fully.

[00:49:29] Stephanie: On [00:49:30] that path means that maybe this isn't right for them. Feels kind of like a change in narrative that just happens to protect them at the, at the moment.

[00:49:39] Ben: I mean, it definitely has a change in narrative because the studies that have largely established this field were based on a binary [00:49:45] sense of sex and gender.

[00:49:46] Ben: So you transitioned from one to the other, and now kids are starting to identify as non-binary and gender fluid. And so some of them have been in these studies, and you see that in the Christina Olson study and she is out of, uh, Princeton, that a certain percentage [00:50:00] of them, Jesse Single, wrote about this for the economists and on his substack.

[00:50:02] Ben: I highly recommend those pieces and switched non-binary. And so that came up in this trial, the idea that his defense, when they were trying to argue that she hadn't. Been [00:50:15] unstable in her trans identity. All that mattered was that she never said she wanted to be a woman or wanted to keep her breasts. So, so long as she was on a spectrum that didn't include being a woman.

[00:50:25] Ben: Therefore, she was stable in her gender identity. Didn't matter if his non-binary or [00:50:30] what pronoun she used. Therefore, you know, she passed this six month threshold and therefore was fine for boost surgery. And I, I do wanna say that. Okay, so let's just say what you're saying here. So long as somebody is stable for six months in their gender identity, they can have the surgery as a [00:50:45] minor.

[00:50:45] Ben: And there was a lot of talk of, ooh, it took her three years to say that she regretted the surgery. And that's a long time. So therefore, since it was a long period of time afterwards, the surgeon did his job. So what you're saying is you're arguing that under tort law, so [00:51:00] long as there's a window just like this, you know, and it starts here at the beginning of this year, and on the sixth month marks, you had the surgery and then let's say through the end of the year after that, or maybe the middle of the year after that.

[00:51:10] Ben: She still felt that way. So long as that period exists, the [00:51:15] surgeon is indemnified, you know, and we're talking about a teenager. We're talking about a teenager, and as we all know it, teenagers switch in and out of identities and what they wanna do with their life. And now that we're dressed, that kind of thing.

[00:51:25] Ben: So. Is that a way to look at adolescents when we [00:51:30] talk about concretizing, these identity shifts? And I thought, I mean, they ultimately, the argument didn't seem to work, but they were indeed making that argument very clearly. Um. No one ever stopped, stepped out of it. To say, that's kind of crazy to [00:51:45] say that only six months is required because all the, the plaintiff's attorney needed was just one benchmark to say that they didn't meet, you didn't need to see that.

[00:51:53] Ben: The benchmark itself was crazy, but just that it existed so they could hang them on it.

[00:51:56] Stephanie: Yeah. I mean that there's multiple layers of crazy here. One is, as [00:52:00] you're saying that that six months as a teenager of hating a certain body part, again, what's the distinction between that and body dysmorphic disorder?

[00:52:09] Stephanie: Who knows? But okay, but six months is enough to justify removing that body part for life and never [00:52:15] being able to get it back. That's ridiculous. But then the fact that they tried to twist that and make it sound like, well, there was a six month period in which she did not actively affirm that she loved her body just the way it was.[00:52:30]

[00:52:30] Stephanie: It's like, have you met, have you met teenage girls? Have you ever met a teenage girl before? That is absolutely bonkers.

[00:52:37] Ben: And she testified to that effect, this idea that after she had her first period, she only ever had two periods. I, it was a little clear to me why she never [00:52:45] had another one if they put her on birth control.

[00:52:46] Ben: 'cause it was all this talk about they didn't, she didn't like medications, but in any case, she went into Sterex after the, you know, the sign of womanhood and then she's going into adolescence. And so it was a question of. Is that because you [00:53:00] are or should be male, that should grow up into a young man, or because you are afraid of womanhood.

[00:53:05] Ben: And she was clear in her testimony that she was extremely uncomfortable with being sexualized the male gaze. What that means, you know, when you're coming into your own. I haven't had an [00:53:15] experience that as like being a gay man all of a sudden, like, you know, you turn a date and you're like, I'm a sex object.

[00:53:20] Ben: Oh my God, that's a transition. You know, a different kind of one. So, you know, that was certainly a key part of the case.

[00:53:28] Stephanie: And again, it's like [00:53:30] all of these things that are just such normal struggles for adolescent girls being pathologized as an indicator that they're not meant to be girls, rather than just providing these girls, uh, alternative, you know, more accurate and helpful narratives.

[00:53:44] Stephanie: I wanted to [00:53:45] ask you some questions based on your article and some questions based on what people wanna ask you on x if there's time. So we should probably at least get to sort of the resolution of the trial. Anything else you wanna say about the trial itself before we move on to those questions?

[00:53:57] Ben: Well, one thing, I talked to Carlene Grable, I, I [00:54:00] might be butchering her name a little bit, but she's, uh, an academic in Australia and she's written some papers about the impact of having these mastectomies for young women and how devastating it can be when they change their minds about it.

[00:54:12] Ben: And one thing she said to me was, you know, this [00:54:15] young woman, she was 16 at the time. She very well could have 30 years ahead of her, during which she could be fertile and give birth, you know, and everybody's asking her on the stand, you know, do you wanna have kids? She's like, I don't know, I'm 22. But, you know, just in my own life, so I had [00:54:30] cancer when I started, when I was 43, had surgery, and then I had a recurrence that meant I had to have, um, chemotherapy.

[00:54:37] Ben: You know, I'm 43 years old, I've never wanted kids. But it's this question of do you wanna preserve your fertility? And I did it, it's very embarrassing for men, [00:54:45] let me just say, can't just take a needle and pull, fix out. Um, but you know, it's also very expensive. But I just said to myself, I still don't know.

[00:54:53] Ben: I'm 43 years old, so I spent thousands of dollars to phrase that stuff for the next 10 years. Um, you know, I'm looking as the [00:55:00] 16-year-old girls making this decision. So that, that to me, puts a real personal layer on this.

[00:55:05] Stephanie: And again, I would point to the question, what evidence do we have that teenagers. Are able to accurately predict whether they [00:55:15] will want children.

[00:55:15] Stephanie: There's, there's just no evidence for that. And somehow when gender comes into the picture, it's like we all lose our common sense. And, and we think that, oh, well there's this third category of person and called trans, and a completely different set of rules applies to them. They're not human like the rest of [00:55:30] us, and subject to making mistakes.

[00:55:32] Ben: So ultimately the jury was presented with, I think, 21 questions. Some of them were dependent on one another, and here is how they answered. So did Dr. Einhorn depart from the good and accepted standards of [00:55:45] psychological care in his discussions with the plaintiff about his, her gender identity? They said yes, and that was unanimous, all six of them.

[00:55:52] Ben: And they said that his departure from that standard indeed was the substantial factor in causing her injuries and pain and [00:56:00] suffering. So I'll, I'll abbreviate. The sort of lengthy sentences in the rest of this. So they did, he depart from the standard of care by not ensuring that she received that specialized transgender medical support.

[00:56:11] Ben: Before Ray, he wrote the letter, they said yes, but it wasn't [00:56:15] unanimous, which meant that only five of them voted for it. But they said that that wasn't substantial factor in causing her injury, which meant that four or fewer of them voted yes, or none of them voted yes, or it was not unanimous. So it was somewhere between like one and four.

[00:56:29] Ben: Next, did [00:56:30] Dr. Einhorn depart from the center of care by not obtaining the notes from the price center? They said yes unanimously, but that they said that that wasn't a, a substantial factor in causing her injury. Oh, correction. Sorry. It was unanimous that previous one about [00:56:45] her causing her injury. The next question is, did Einhorn depart from the standards of care by not ensuring that Fox received specialized transgender care support?

[00:56:55] Ben: They said yes. That wasn't unanimous. So meant that five of them voted, but they said that [00:57:00] no, that was not a substantial factor in causing her injury, and that was unanimous vote. So next, did he depart from the standard of care by not obtaining the notes from the Pride center? They said yes unanimously, but they said no unanimously, that it [00:57:15] was not a substantial factor in causing her injury.

[00:57:18] Ben: And then did he depart from standard of care by writing the letter on the day that he did. And in October, 2019, they said yes, not unanimously. And that it was a substantial factor causing her injury? They said [00:57:30] yes unanimously. Next. Did he depart by writing the letter on the day that he did? Yes, unanimously.

[00:57:38] Ben: And was that a substantial factor causing injury? Yes, unanimously. Did he depart by not collaborating with Dr. Chin? [00:57:45] Yes. Unanimously it caused her injury? Unanimously, yes. Did he depart by not discussing the potential? Psychological risks of top surgery. No. Unanimously. So that struck that one out. Did he depart the standard by not [00:58:00] notifying Dr.

[00:58:00] Ben: Chen, that the, the father or the estranged father of Fox variant did not consent to the top surgery? No, not unanimously. Did Dr. Chen depart from the good and acceptance accepted standards of care for [00:58:15] surgery by not communicating directly with Dr. Einhard prior to surgery? Yes. Unanimously. Was that a substantial factor in causing an injury?

[00:58:23] Ben: Yes. Unanimously. Therefore, the fact that he didn't call Einhorn sunk him, then Dr. Chin, did he [00:58:30] depart from the standard of care by performing top surgery on the day that he did in mid, mid-December, I suppose later. Yes. Unanimously and yes, uh, unanimously that caused her injury. And lastly, um, this. Question was reversed before he [00:58:45] obtained consent on behalf of Vox Vian prior to surgery.

[00:58:48] Ben: Did he provide her with appropriate information? Yes. Unanimously. That was said

[00:58:53] Stephanie: interesting. I was most struck by, um, the fact that they said no [00:59:00] to the question of whether the psychologist departed from the standards of care by not discussing the psychological risks of surgery.

[00:59:11] Ben: Indeed, it's possible. What they were saying is that there was an [00:59:15] argument between the lawyers that so long as somebody provided discussion about the psychological risks of surgery, it didn't matter who did it.

[00:59:25] Ben: They could complimentarily have provided all of this informed consent as long as you [00:59:30] got it somehow that was fine. It's possible that they believed that Dr. Chin kind of covered it and that was okay. So I'm not really sure their reasoning

[00:59:40] Stephanie: Interesting.

[00:59:41] Ben: Yeah. Well, you know, he did talk about [00:59:45] various psychological indications, but I think the implication from Deutsch, the plaintiff's attorney, was that he didn't go into enough depth about potential re risks and really, you know, grind into it and say, are you sure you're not gonna regret this?

[00:59:58] Ben: You know, this might not be [01:00:00] a panacea, this might not solve your problems the way you think. It depended on like, the level of death that he was getting into. I think maybe they said, well, okay, he only went two feet deep as opposed to four, but we think that was okay. I don't know. It's, it's not impossible to [01:00:15] know because I did ask the jurors, they're filing out, they've been there three weeks, they wanna get out there.

[01:00:19] Ben: Everybody you wanna talk to the press? And they were just like, they didn't even say no, they just didn't answer. I'm like, okay. So no. So I never got to talk to them.

[01:00:27] Stephanie: The impression I got from reading your article in the [01:00:30] Free press and from speaking with you today is that the psychologist position towards Fox Vian and her mother was very much, this is going to make you feel better.

[01:00:41] Stephanie: This is right.

[01:00:43] Ben: In many ways, [01:00:45] you know, he would refer to all these different DONA domains, your feelings about your body, your ability to relate to other people, and your depression, anxiety. This is going to help. I don't think he. Went to the level of panacea saying you will never have any problems again.

[01:00:59] Ben: [01:01:00] But he would say like, as you know, once we have this surgery, this problem will be better. You'll see. And she really bought into that, you know, and two things are merging here. Kid comes in with an idea and the adult is affirming it. And so the question was, [01:01:15] was it his responsibility not to merge with her so intensely?

[01:01:20] Ben: And she really said, yes. I looked up to him, yes, I saw him as an authority figure. Yes, he gave me tasks at approval, and Einhorn made a big mistake on the stand. [01:01:30] So when prompted by Deutsch, who asked Einhorn on the stand, whether he needed to have chosen his words wisely, his ecologist essentially put into playing language.

[01:01:38] Ben: The very argument against him that the crux of the case, he said, quote. A lot of times in therapy, kids have plans that [01:01:45] maybe are not in their best interest, and you have to be careful to make sure that you're not just giving tacit approval. So, so there you had it. I mean, he spilled out the case against him very neatly.

[01:01:55] Stephanie: Yeah. And as a therapist, I can remember so many moments in my [01:02:00] career now, not so many. I can remember a few moments. I don't wanna overestimate that, where a, a patient said to me something about like, I took your advice. I did blah, blah, blah, blah, blah. And I [01:02:15] remember thinking I, that wasn't my advice. We talked about that.

[01:02:19] Stephanie: And I used therapeutic techniques like reflective listening to help you in your thought process, right? Like, I am amplifying and reflecting the [01:02:30] patient's perspective so they can hear themselves. And that doesn't necessarily mean, I'm saying, I personally, Stephanie Wynn, think that this is a good idea and it's what you should do with my therapeutic stamp of approval.

[01:02:42] Stephanie: You know, and, and, and, but the way that [01:02:45] patients took it, you know, so, and I understand that even with people a lot more mature. Than a 16-year-old. And then it's, it's that much trickier with teenagers add in the fact that this girl was estranged from her father and the both the therapist and the [01:03:00] surgeon were men and she was getting that attention from them.

[01:03:03] Stephanie: And you know, hearing that shift about how she presented as more certain about the gender in therapy with her therapist and then less certain when she went to the gender clinic, which is kind of not what you'd expect. [01:03:15] That makes me wonder, and it's just a speculation, but it makes me wonder how much it was her experience that.

[01:03:23] Stephanie: Clinging rigidly to this. I'm this special trans kid with gender dysphoria, and you have to, you know, help me [01:03:30] convince my mom to get surgery. Like how much clinging to that in her transference and her therapeutic relationship with a therapist was, uh, something she'd learned would get attention from him.

[01:03:42] Stephanie: That maybe, maybe she worried that if she didn't have [01:03:45] this problem or if she didn't express it this way, that he might not have felt, uh, that fond special attention that he was giving her. And I have no way of knowing. But there's all kinds of things that can happen in the therapeutic relationship.

[01:03:57] Ben: I think that nuance didn't come up [01:04:00] specifically, but that she did indeed look up to him.

[01:04:01] Ben: And then, you know, and not at all saying that, you know, there's, you have any problems in being a therapist, but I, it must be sort of difficult what you're saying. You ask yourself. Even though I know I'm practicing all of these methods to, to not not give TA [01:04:15] approval, is there some way in which I nevertheless am being perceived that way?

[01:04:18] Ben: So I, I'd wonder, you know, how difficult is that for you to try to tease that out? And I have that as a reporter. Well, I never told you what my political stance was on anything. I'm like, oh, we can tell by the way the words you choose and the things you do, and [01:04:30] also do not say, for example, what you choose to, to highlight.

[01:04:33] Ben: So in the trial, one example that Deutsche gave was, let's say your patient wants to go rob a bank. He says, I'm thinking Rob a bank, you know, at first you're not gonna say, don't rob a bank. You're gonna say, [01:04:45] why would you like to rob a bank, you know, has to do with your finances. You discuss that. What are the pros and cons of all being a bank?

[01:04:51] Ben: You know, and then let's say, you know, you're getting to a point your client saying, I'm gonna rob a bank on Tuesday at four, and I have a gun. You know, that's different.

[01:04:58] Stephanie: I'm thinking also about the [01:05:00] therapist's counter transference, the therapist's perception of the patient. And when you described to me Benjamin, how the therapist seemed to speak with such conviction about this is gonna solve your problems and your whole life is gonna get better.

[01:05:12] Stephanie: I mean, of course it sounds like wildly irresponsible to do [01:05:15] that, but it makes me wonder too, like, what was the therapist feeling toward the patient? Because we have our own feelings as therapists, we can get quite frustrated with our patients. We can feel helpless, especially when a patient is someone who feels very [01:05:30] helpless and vulnerable.

[01:05:31] Stephanie: It's easy for us to get pulled in and for us to also feel helpless and vulnerable, especially if we end up kind of getting unconsciously into dynamic where we're the expert or we're the problem solver or we're the one who's supposed to make it all better and then we, we don't make it [01:05:45] better. And their distress triggers something in us.

[01:05:47] Stephanie: Like I, I wonder how much he was clinging to this external idealized gender care as like, oh, that'll make the patient better. 'cause I can't make the patient better. 'cause I'm feeling out of control [01:06:00] about how helpless I feel to help her. Or I just wonder what was going on.

[01:06:04] Ben: Yeah. That element didn't really come up.

[01:06:07] Ben: And I saw Freudian analyst for six and a half years, 850 times. So I know that's controversial. It worked for me. I don't know if it was a [01:06:15] causal effect, but I am better now than before. So, but there was this period where he's just like, basically that I didn't have very strong transference and like, wasn't like in love with him or obsessed with him.

[01:06:24] Ben: And I was like, you're fine, you know, and this is like a problem.

[01:06:28] Stephanie: So, and I remember

[01:06:29] Ben: Wednesday. [01:06:30] Flipping outta me 'cause I would not stop complaining about certain friends of mine that were annoying me. And he like just, he finally got lost it one day. Uh, in any case, so back to the subject hand, so it, it's unclear.

[01:06:41] Ben: So, but I think was clearly established was that iron horn was [01:06:45] out of his death and, you know, he made it very clear that it was emotionally devastating for him to be there on the stand and to have these mother, his mother and daughter to be that angry with him. And his demeanor throughout the entire trial was.

[01:06:57] Ben: He was just stricken and they'd be talking about him, [01:07:00] lambasting him for all these mistakes he made and the consequences to this young woman's entire life. His face would be red. He'd be staring, you know, either straight down or sort of at this downward angle, his hands in his lap, you know, almost as if he were praying, you [01:07:15] know, in sort of rueful rumination and regret.

[01:07:18] Ben: Um, and there was this very key moment where the mother gets off the stand after, you know, devastating testimony about what this man, you know, had done to her family or her words. Um, she [01:07:30] walked up. And she walked over to where he was sitting in the seating area and glared at him as if just sudden just daggers through his body with a rage at this man.

[01:07:40] Ben: And he quite literally could not face her. And during a lot of the testimony, he wasn't looking at the [01:07:45] stand, which was just right off of a, maybe a 15 degree angle away from his center eye line. He would look straight ahead or down. Um, he quite literally couldn't face them, whereas Chin was very elegant and, and sort of imperious and unflappable, you know, and despite the [01:08:00] fact that I, that Deutsche is six foot seven and this big attack dog still managed to peer down his nose.

[01:08:07] Ben: At Dets under cross examination by sort of catching in on things that he was doing that were wrong or that he was meandering or stumbling or [01:08:15] something. And so, you know, he came in, he went to Harvard. He was the top 10% of his class. He trained in Vanderbilt and I think it was Yale. He did training again, NYU, and at University of Washington, they were all the best programs.

[01:08:27] Ben: This guy was like the top notch, you [01:08:30] know? And I. I just personally would argue that it was not in his best interest to dress as elegantly as he did, uh, because it made him come across as sort of this elitist and move removed from reality if nothing else. Whereas [01:08:45] EOR was quite sort of, he looked like the absent-minded professor.

[01:08:47] Ben: He was wearing one of those jackets with a patches on the elbows one day, and he wore like these sort of work boots as opposed to dress shoes. So I thought it, their sartorial choices were an experiment in contrast as well as their [01:09:00] personality. But I was sitting right behind Chen during the verdict, and then Einhard was always right off to my left and.

[01:09:07] Ben: By that point, this was no surprise. For one thing, a jury had asked a question about an hour prior about the precise allocations [01:09:15] of, or the amounts they might give for the award. So we already knew that she had won. So this wasn't a crashing surprise at that exact moment. But, you know, chin looked sort of still unflappable.

[01:09:25] Ben: And the thing is, there's reputational damage and now his name is being put [01:09:30] in all these articles and the way you're gonna Google him for at least quite some time, it'll probably come up. But I, you know, their insurance faced for it. And he was only ultimately 30% responsible for the ultimate award. Um, you know, his idea that he was 30% responsible [01:09:45] for the damages, therefore that he pays 30% of the $2 million and it's his insurance company.

[01:09:50] Ben: So, you know, not like they don't shell out for it, but you know, I think especially for Einhorn, it, it was clear that he found this deeply chasing chaning and [01:10:00] humiliating. And he, speaking of regret, he looked very regretful. He. Say, so this is my observation, my opinion, just from observing him. Um, and I, it was also awkward 'cause I'm trying not to become a part of the trial, but, you know, [01:10:15] some, an object being observed has changed by the fact that you're observing it.

[01:10:18] Ben: That old saying, and, you know, I could, I would imagine that he could tell that I kept looking over and being like, is he doing anything that I might, I'm gonna take note of and that my doing so might make him behave in a certain way. So that was a bit of an awkward [01:10:30] dynamic.

[01:10:30] Stephanie: It's interesting because I'm hearing from you that he felt humiliated and maybe,

[01:10:37] Ben: evidently I would say evidently, and I, I don't know that he expressed deep regret about facing a family that [01:10:45] was very angry with him and he had treated her for, you know, about three and a half years.

[01:10:49] Ben: So they had a very intimate relationship. So, you know, speaking of transference, that, you know, he made clear that that was very painful.

[01:10:57] Stephanie: Yeah, it makes me wonder about the [01:11:00] tension between his actual feelings and his defense strategy, because yes, if he felt anything, like you imagine he felt, his personal inclination might have been to say, you're right, I'm sorry, I'm guilty.

[01:11:13] Stephanie: What's my punishment? But [01:11:15] I wonder if that would've had legal repercussions for him that were like, 'cause I mean, a lot of people in the gender critical community, as I'm sure you're well aware, want people to lose their licenses and want people to go to prison. And that was not on trial. Nobody lost their license [01:11:30] here.

[01:11:30] Stephanie: Nobody was facing jail time. This was about a financial punishment. You're saying it's being covered by their, um, malpractice insurance. But I, I wonder like if, if he felt some moral tension between expressing his true [01:11:45] feelings of humiliation and remorse, um, and the fact that he kind of still needs to preserve his, uh, livelihood.

[01:11:53] Ben: One can speculate, I would imagine so, but again. This is me just as an armchair lawyer and that would be a bad [01:12:00] defense strategy if you said yes, I feel terrible, I messed up. Um, that's a great way to lose a lawsuit, so.

[01:12:07] Stephanie: Right, right. Wow. Okay. Well, do you have time for some questions from X? Are you a therapist and needed continuing [01:12:15] education that's not over the top woke?

[01:12:17] Stephanie: Check out my colleague Lisa Mustard's pod courses. All of her pod courses are approved by the National Board for Certified Counselors. Right now, Lisa is offering my listeners an incredible deal. Get all 27 POD [01:12:30] courses. For only $44 that could meet almost all of your continuing education needs for the year.

[01:12:36] Stephanie: Visit lisa mustard.com/pod courses and use code some therapist to take $5 off of her [01:12:45] $49 pod course bundle. Again, use code some therapist@lisamustard.com slash pod courses. I'll include that link and coupon in the show notes for your convenience. Alright, now back to the show. Question from Dr. Travis Morell, who I mentioned [01:13:00] earlier, has been on this show and I would recommend that episode to anyone who missed it.

[01:13:04] Stephanie: So he asks, is this malpractice because of cutting off breasts of a teen or malpractice because of some technicality, like not putting something on the printed informed consent? And if [01:13:15] the latter, is it something likely to apply to many, many cases, say a myths? A mistruth like the suicide lie?

[01:13:22] Ben: Well, I mean, to the first question, it's the latter.

[01:13:24] Ben: You know, we're not asking whether you should, in any case, remove somebody's breasts for gender dysphoria, but [01:13:30] if this case, the standards of care weren't followed. So, you know, I've talked to psychologists, you know, Eric Anderson for one, and Laura Edwards sleeper, you mentioned an Aman, and they're all people who are leadership in wpath who have been dissident and critics of it from within, [01:13:45] saying that, that ultimately this field has become sloppy to use Erica Anderson's very famous words from an interview with Al Schreyer in 2021.

[01:13:53] Ben: So they say that, you know, hopefully this will lead to more cautious practices, more intense assessments, you know, [01:14:00] more careful exploration with kids about their gender identity. But it's not going to, you know, undo the entire field per se, unless that's through, you know, extremely expensive malpractice premiums and fear of reputational damage.

[01:14:11] Ben: And nobody wants to practice within this kind of a minefield, but it's [01:14:15] not going to make invalid. The WPATH guidelines, let's just say,

[01:14:20] Stephanie: although the WPATH guidelines weren't that much of a help here, like they didn't,

[01:14:25] Ben: they were

[01:14:25] Stephanie: just anyone.

[01:14:27] Ben: Yeah, I mean, they were kind of a non presence. [01:14:30] They were in the air, but also they weren't admitted into evidence either.

[01:14:34] Ben: So that was tricky whenever they were trying to ask about it, that there would be lots of injections that we could sustained, um, because the standards of care, big s, big C from [01:14:45] wpath weren't actually as a part of the evidence. So they, they couldn't be that specific about the words in them either.

[01:14:51] Stephanie: Okay. I have a good question from Jonathan Cogburn, who's also been on my show.

[01:14:55] Stephanie: He says, out of the other current open lawsuits, which one do [01:15:00] you Ben, expect to be helped the most by the Arian case, if at all?

[01:15:04] Ben: A, a lot of them run into statute of limitation problems, so that's really the barrier. They can be very strict in certain states. And so the Joanna Olson Kennedy one, [01:15:15] Clementine Breen, she filed her lawsuit very promptly.

[01:15:17] Ben: She started to detransition, she was 19. She filed when she was 20, I believe. And. I don't know the exact specifics of the, the law in California, but whatever the case is, the judge [01:15:30] decided that the clock started when she was 13, when she started testosterone at the date of injury, not at the date of realizing the injury or like a certain period of time after turning 18.

[01:15:39] Ben: So she had long since run out, I guess it was two or three years after age 13 before by [01:15:45] the time she filed. So there's that problem. Um, it's hard to say. I think, you know, ev all juries are gonna be different, but I think that that lawyers will certainly look at this as a roadmap of type of, of strategies to look into where, you know, are they meeting the standard of care?

[01:15:59] Ben: How do you [01:16:00] define it? So it, it's really hard to say, um, but they're pretty similar. So I think that it's, if nothing else, it's going to embolden other lawyers to maybe enter the space to feel a bit more confident. You know, what's really happened is we have these diehards who [01:16:15] have filed these initial cases.

[01:16:16] Ben: For the most part, I don't include Adam Deutsch. In this case, you know, he's just a personal injury attorney in White Plains. Um, so not specialized in this type of, of lawsuit per se. Whereas, you know, we have Campbell, Miller Payne. So there [01:16:30] are these four white shoe lawyers, they all that together they started a law firm for the only purpose of defending, of going after people on behalf of Detransition.

[01:16:41] Ben: So they're really leading the charge in that regard and they're kind of [01:16:45] testing the waters. And there, there are some other places, um, that are doing this as well. Different law firms, but other law firms might be looking at this and saying, is this something that we wanna risk all that time and money?

[01:16:58] Ben: And if they see that there's a promise [01:17:00] there, then they might be more interested in getting in. But then we might see some more frankly, unscrupulous cases by some the ambulance chaser types in that case that maybe the cases aren't as strong and they're just looking for money. But this case in particular, V Variant was much [01:17:15] cleaner.

[01:17:15] Ben: There weren't politics involved. No one could accuse her of being some sort of black Republican party. Publicans politics never came up. Whether, I think Chloe Cole's case is gonna be a lot harder 'cause they're gonna be going after her. Aren't you just doing this for political reasons? [01:17:30] You're doing this for fame, you're doing this for money, you're given 4,000 interviews we can hang you on.

[01:17:34] Ben: Whereas for Fox Variant there were exactly no interviews. You know, she'd never spoken about this publicly. That makes it a lot easier for her lawyer. Uh, whereas somebody was posting on acts today [01:17:45] about something that Joanna Olson Kennedy had said. Um, I, no, I can't remember what it was. Um, but she, she said something where, you know, someone had said like, things your lawyer are wr are really angry that you said in public, you know, or Oh, I would think it [01:18:00] was when that line from, I think it was from Jesse Singles piece in the, the Atlantic in 2018, you know, where she was downplaying assessments and saying she didn't think they were worth anything.

[01:18:09] Ben: You know, so this, those. Harder cases, I think are, are gonna be able to draw [01:18:15] in, you know, publicity, past publicity in the ways that this case absolutely could not.

[01:18:19] Stephanie: Okay. In that same post, Jonathan also asks, which cases do you think have the best chances of success?

[01:18:26] Ben: I think that's impossible to say. Just period.

[01:18:28] Ben: I mean, you know, they're all, [01:18:30] they're all taking a risk.

[01:18:32] Stephanie: Okay. Here's one you've already answered from my friend Julia Mason. Did a WPATH associated surgeon testify against the plastic surgeon, or in support?

[01:18:40] Ben: Mm-hmm. Yeah. Yeah, it was, it was flipped. The guy who was testifying on [01:18:45] behalf of the defense wasn't involved in wpath and he, his authority was undermined by his lack of experience with WPATH and with publishing academically in this field.

[01:18:54] Stephanie: Epistemic asks, what arguments did the jury seem to find most compelling? [01:19:00] What mistakes may have been made by the legal teams? Was any significant evidence excluded for legal reasons?

[01:19:06] Ben: Significant evidence? Uh, well, I guess. Centers of care. You know, I think it, I thought it was strange that they didn't talk about what you'd seen [01:19:15] in, in the deposition about the difference that the mother made between what she saw is.

[01:19:21] Ben: Sort of like less serious threats of suicide from her daughter being thrown around and that of what she heard from Einhorn. So strangely enough that everyone ever made that distinction, [01:19:30] it's possible they just forgot. But it's also possible that for some reason they weren't allowed to go on that avenue.

[01:19:35] Ben: I'm not sure. Uh, you know, it's hard to know. You know, we read out all the jury questions so we know how the answer, we don't really know why. Um, they were totally impassive, like the only [01:19:45] read I got from any of them was that the woman who I knew would be the four woman, she looked like this the entire time she was listening.

[01:19:51] Ben: And she wasn't just a, a opposed either, and you could tell she really wanted to be fair. Like I, I just read that on her face so clearly. And there [01:20:00] was this other woman who just wanted to dodge, had her hair on her face. She was half asleep the whole time. And everybody else, I couldn't tell it all. So, you know, who knows?

[01:20:08] Ben: There, there were, they'll be crying, you know, there are some jokes every now and then laugh, but like nothing big, you know, got no read on them.

[01:20:14] Stephanie: [01:20:15] Well, that actually connects to our next question from Anon mom. Was there a moment in the trial when Ben felt the jury had been won over to the young woman's side?

[01:20:23] SKOT: You couldn't tell.

[01:20:24] Ben: I can tell you that the mother's testimony was devastated me. I even like, like, like tearing up. [01:20:30] Like I, I, I was like a wreck. Uh, and I was trying to keep myself composed 'cause there were so few people in the court and the judge was kind of after me to make sure I, I didn't do anything that would disrupt the trial.

[01:20:40] Ben: And if I knew that I'd be sitting there like sobbing, they'd throw me out. [01:20:45] So, you know, I ran into the bathroom and like, just like lost it. 'cause uh, you know, it was really devastating. A mother who felt that she had done everything for her child and had trusted someone and had trusted and violated, uh, to be that let down, uh, and to have that [01:21:00] cost on her child forever.

[01:21:01] Ben: She expressed that so powerfully. And, you know, we hear these suicide threats thrown around all the time online by doctors, by Olson Kennedy. Um, and we know that they're not necessarily backed up by sound [01:21:15] research. And here we were in the flesh. Live in front of me hearing the cost of those threats. You know, and that's what I'd like to say to people.

[01:21:24] Ben: There's this trans woman named Julie Ray Goldstein, who's always on blue sky, dismissing all these [01:21:30] cases, is all being, you know, all being ci flagrant abuses of the legal system, that kind of thing. And, you know, I, she never takes seriously any of the claims to sympathy of any of the plaintiffs in these cases.

[01:21:43] Ben: They're all just political [01:21:45] pawns. And, you know, I'd really like to say to Julia, I, I would like you to sit there in court and listen to this one and see the distress in her face and. To ask yourself whether you're really being fair in the same way that she would ask of me like, are [01:22:00] you being fair to all the young people who would be helped by this?

[01:22:03] Ben: You know, are you just over focusing on rare exceptions? You know, and having that sort of destroy the whole narrative and all the legal landscape that would permit these treatments for other [01:22:15] people. So, you know, these are, I think, fair questions, but it, it travels me how absolute as trans activists are about this and, and frankly, you know, it's clearly a losing strategy.

[01:22:26] Ben: Um, which is not to say necessarily that I think that the right wing wouldn't [01:22:30] have come after this field, regardless of trends, activists had done. They won't give an inch if it's on, you know, trans girls inclusion and girls sports, you know, or it's like they minors absolutely have to have this surgery and they'll, you know, no one will ever say, well, why do they have to [01:22:45] do it now?

[01:22:46] Ben: Couldn't she have waited 18 months till she was 18? You know, what, what was the rush? Is she literally gonna die in that period of time? So that was, you know, the argument by the defense. How is the mother to know that she might not have killed herself? And this idea [01:23:00] of an absence that doing nothing is not a neutral act.

[01:23:03] Ben: You hear that all the time, and I always have a problem with that, just logically saying, I don't know about, okay. Theoretically, yes, but in medicine, when you propose an intervention, the onus is on [01:23:15] you as the, as, let's say, an advocate of that intervention to prove that it's safe and effective. And it's a balance of risks and benefits favorable to the patient.

[01:23:24] Ben: It's not. The onus is not on people who think that either shouldn't have [01:23:30] it or just have questions about it to prove that not doing it is better. That's not how this works, like quite literally.

[01:23:36] Stephanie: All right. A few more questions. David Atkinson asks, what are the lessons for both sides regarding future Drans lawsuits?

[01:23:44] Ben: You know, clearly [01:23:45] what was very effective by Deutch was hanging them in their own words. And if nothing else, he had a very solid and slick presentation. In his closing argument, he had one slide after another in which he hung another words, and the real crucial parts were in red, [01:24:00] you know, and he went through one after another and you could see it.

[01:24:03] Ben: 'cause it's hard to remember. You've, you've had all this information just thrown at you. I was having so much trouble keeping everything straight in my notes. You know, I had hundreds of pages of notes like, oh yeah, he did see that. So to have it [01:24:15] refresh in your memory flow after blow, you're like, well, you're right.

[01:24:20] Ben: They did hang themselves, whereas the defense was just trying to ni around the edges. Oh, Erica Anderson changed her story about whether she had gender dysphoria being the affidavit, [01:24:30] her time in the stand, you know, that meant she lied under oath. You're like, well, it's, as she said, she got new information.

[01:24:38] Ben: It reminds you of COVID. You know, like we found out new information, we changed our story. We should have done a better job of saying in the first place that we weren't sure, [01:24:45] you know, but that's formal, that's part of science, blah, blah, blah. So, you know, it, I don't know if the defense could have had a better strategy, but their closing was very weak.

[01:24:53] Ben: And the only time they really brought in the larger philosophical question of kids should receive this was in the [01:25:00] closing. Neil Kornfeld, the defense attorney, said There's an elephant in the room, and then he put up a sly of an elephant in a room, which was a little corny. And uh, it's this idea, you know, what you said came up in jury selection, which I was not permitted to attend.

[01:25:13] Ben: And I didn't know about this, but, you know, [01:25:15] one of the potential jurors had said like, should they be giving this to kids? So he finally acknowledged that larger question then that that might influence their decision making, like it or not, you know, unconscious bias, that sort of thing. But Deutsch, you know, I think very [01:25:30] successfully just slammed them for having a crappy presentation.

[01:25:34] Ben: A lot of gimmicks, Sabrina Sellers, the other defense attorney for Einhorn, he used this big piece of, of paper where she was writing this thing she called not Einhorn, about things that were the [01:25:45] kids doing. And it was your idea to get the binder and it was your idea to get the surgery and, and your idea to change your name.

[01:25:51] Ben: And I, I didn't know this, so Einhorn said it's an age old gimmick in defense. Defense attorneys will use some sort of prop [01:26:00] to get people to look away from the testifying witness. And I was like, oh, I didn't know that. Apparently, like everybody knows this. In, in litigation, but it did seem like a, a gimmick to me.

[01:26:11] Ben: And also it, you know, all the, almost all the things that were on that [01:26:15] list know were, were reversible. You can grow your hair, you can change your clothes back, whatever you want. You change your name again, you know, except for the surgery. This was about the surgery. All those are the things are kind of immaterial, you know, when it came to, does she have her breast or a [01:26:30] lot, you know, you, you, yes, you can get reconstruction, but you can't breastfeed again, it's expensive, it's difficult, you know, you're gonna have to have breast implant replaced several times in your lifetime.

[01:26:39] Ben: All these things. It's not the same thing. And again, going back to Olson Kennedy, she very famously [01:26:45] said in a leaked video of a training she gave a few years ago, she was training mental health professionals about writing these letters. And I think it was, and this training was for insurance companies purposes, not necessarily to a doctor, but you got real sassy in this little [01:27:00] presentation.

[01:27:00] Ben: And people, you know, you're talking about this idea of, well, what if they regret it? And she said. I'm trying to get the exact quote is, you know, if you, if you're disappointed in the end or something, you know, she said you can go out and get them about breasts and that, [01:27:15] that's her attitude is you can go out and get them.

[01:27:18] Ben: Okay. So what does that entail? It's expensive, it's difficult, you know, they're risk involved with any surgery. It's not the same thing and you can't breastfeed and, you know, she lost some sensation or nipples. She has, she, she's such a [01:27:30] nerve pain and numbness. Um, but there was a big thing about how that had never been documented by any doctor, so there was no documentation of that.

[01:27:36] Ben: We had to take her word for it. Um, but one of the things she did say, you know, convincingly is I don't trust doctors given my bad experience with that. Like, [01:27:45] that's convincing. So, um, so she, she said at least that she does have this pain, so. Um, you know, you can take that at face value or not.

[01:27:53] Stephanie: Well, and we know from p Pisha Mosley's case, what can happen to young women who have their breasts removed and then [01:28:00] later have a baby.

[01:28:00] Stephanie: Pisha has been through a lot of pain and needed a lot of extra medical care because her breasts were trying to lactate but couldn't.

Yeah.

[01:28:08] Stephanie: Um, so

[01:28:10] Ben: she still had some milk ducks, you know, in there, but they not connected to the nipples. So she had [01:28:15] breast milk accumulating that couldn't exit her body. You know, she said positively.

[01:28:18] Ben: It was very, very painful.

[01:28:19] Stephanie: Been so hard for her.

[01:28:21] Ben: Yeah.

[01:28:21] Stephanie: Okay. Um, Lisa, an lo asks, I'd be interested to know whether the defense team tried to take cover in referencing guidance from professional [01:28:30] organizations such as American Psychological Association. If so, does this type of defense open the door to naming the, these orgs as additional defendants?

[01:28:38] Ben: I'm not remembering specifically. I could be getting this wrong, but they might have mentioned them a few times. Just sort of like saying in the air that lots of different medical [01:28:45] organizations, you know, endorse these types. But it wasn't very specific. No one pulled out the 2018 Rafferty statement from the a a p, you know about the general affirming care method?

[01:28:55] Ben: Nothing that specific. No.

[01:28:57] Stephanie: Okay. She also says, also would like to [01:29:00] know if any of these cases involve simultaneously filing complaints to licensing boards. And before you answer that, Ben, I will just say, uh, for, for those who lack context, it's much, much, much easier to file a complaint to a licensing board.

[01:29:12] Stephanie: It's free, it's private, it's anonymous, [01:29:15] and I have, uh, guidance on how to do it on my website. Um, at some therapist.com/read, there are instructions for how to file a licensing board complaint. So now you can go ahead and answer. Uh,

[01:29:28] Ben: I'm not aware that there might be. I just don't [01:29:30] know.

[01:29:30] Stephanie: Okay. Um, Biore Reality Colorado or Bio Reality Co.

[01:29:35] Stephanie: Uh, is there risk of an appeal?

[01:29:39] Ben: I don't know.

[01:29:40] Stephanie: Okay. And finally, last question, Vance says, [01:29:45] isn't this more of a sloppy doctors didn't follow WPAs standards of care more than it is a standards of care shouldn't be honored at all because trans kids don't actually exist

[01:29:55] Ben: technically. Yes. So the question is, how many doctors at there are that sloppy?

[01:29:59] Ben: [01:30:00] So, you know, is it 5% or is it all is, are there nevertheless, people who at least extensively owning the standards of care under wpath, who are, are still sloppy? So you, you know, I'm not saying one could argue or one did argue, let's [01:30:15] just say in, in the, the case against Joanna Olson Kennedy argues that she was sloppy, uh, despite being the high Prince princess of WPATH standards of care.

[01:30:25] Ben: So. She has, she has, she's made very clear that she has her problems both [01:30:30] with the DSM definition of gender dysphoria. So on my StuffSack I've been publishing, someone leaked to me like 12 hours of training videos that Olston Kennedy has given about the gender affirming care method. And she makes very clear, for example, that she does not believe that [01:30:45] distress should be a criterion, um, in the DSMs definition of donor dysphoria, that you don't need that to treat these kids.

[01:30:52] Ben: So she's, she's among those who are advocating to change things like within WFA to, to loosen the standards. She's made that [01:31:00] very clear. So, you know, the, and I'm not saying that, you know. And I, I can't tell you for sure whether she was sloppy with clementine ring in particular, but we can say, you know, the sequence of things of how they happened.

[01:31:13] Ben: And we can also say [01:31:15] that, uh, you know, she has advocated against these types of assessments. So, you know, so for a jury to decide whether she indeed was sloppy to the point where, um, you know, that violated standards of care provided she meets a jury. 'cause we'll see if they ever win the appeal to get the case [01:31:30] actually going.

[01:31:30] Ben: Four. So

[01:31:31] Stephanie: this will be my last question. Having studied everything that you've studied and having sat in on this case, imagining a future DETRANSITION lawsuit, may maybe one of the other 28, um, [01:31:45] imagining that that suit found that the doctors and therapists followed the WPATH standards of care to a t, what do you think that would do for the case?

[01:31:58] Stephanie: And the, and the [01:32:00] plaintiff was still injured.

[01:32:01] Ben: It would require that they believed and that the expert witnesses, I suppose, also believed that the WPATH standard of care were the legal standards of care. Um, for that, the case is supposed to hinge upon that, but yeah, I, I, well, let's just say they won that case.

[01:32:14] Ben: I [01:32:15] think that would really buttress the standard of care by the WPATH as being, you know, a more legitimate document one could say, I suppose

[01:32:23] Stephanie: you mean look, you mean if the defendant won that case.

[01:32:26] Ben: Um, the Right, exactly.

[01:32:28] Stephanie: Right. So a lot I [01:32:30] think hinges in terms of like looking toward the future with all these other det trans lawsuits in process, um, we don't know how much of a role the WPATH standards of care will play in those cases, or what version of the standards of care would've applied at that time.

[01:32:43] Stephanie: As you said, it was seven [01:32:45] at the time, um, which is what I was trained on and had a lot of questions about at the time. Um. But, uh, I, I think that this is where I am gonna kind of end on a question mark. Um, and maybe, maybe you're on that same question mark. Uh, because I'm thinking [01:33:00] based on what I've learned from you about Fox variants, um, historic victory, um, as, as much as WPATH standards of care did not play prominently and were followed to a TI, I still think that a case like this would have a lot to [01:33:15] go on, even if they could demonstrate that the standards of care, the wpath standards of care were followed.

[01:33:21] Stephanie: And this could potentially call into question the validity of Sta of

[01:33:24] Ben: Chloe Cole's case could do that in fact, and lend Kayla Lovells. So [01:33:30] Chloe Coles is set to go for jury in April of 2047. And there's another one I'm liking on her name that's going BEF in Missouri on August 3rd of this year. It's gonna start.

[01:33:43] Stephanie: Alright, well Benjamin [01:33:45] Ryan, thank you so much for joining me. Uh, tell people where they can find you.

[01:33:49] Ben: So my substack is ben ryan.substack.com x and blue sky, although I don't know that many of you're using Blue Sky. They're both the same as Ben Ryan writer, and [01:34:00] my website is ben ryan.net.

[01:34:02] Stephanie: Thanks so much.

[01:34:03] Stephanie: It's been a pleasure.

[01:34:04] Ben: Thanks Stephanie.

[01:34:05] Stephanie: Thank you for listening to you Must Be some kind of Therapist. If you enjoyed this episode. Kindly take a moment to rate, review, [01:34:15] 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.

[01:34:24] Stephanie: Special thanks to Joey Rero for this awesome theme song, half Awake and [01:34:30] 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 [01:34:45] show plus how to get in touch with me can all be found in the notes and links below Rain or shine.

[01:34:52] Stephanie: I hope you'll step outside to breathe the air today in the words of Max Airman. With all its sham, [01:35:00] drudgery and broken dreams, it is still a beautiful [01:35:15] [01:35:30] world.