You Must Be Some Kind of Therapist

211. Mia Hughes-
===

[00:00:00] Mia Hughes: The crucial part of Deps Psycho Pathologization that I think most people miss [00:00:05] is because they framed the trans identity as healthy when clearly [00:00:10] it's the result of a psychiatric condition. But they reframed this [00:00:15] mental illness as a perfectly healthy identity, which is dangerous in and of itself [00:00:20] because anyone who is suffering from a mental illness is not well served by [00:00:25] everyone pretending that they're perfectly healthy.

[00:00:27] Mia Hughes: But the other crucial part is when they reframed [00:00:30] it as healthy, they made it not only possible to celebrate it, but because [00:00:35] trans activism is so aggressive in its approach, they made it [00:00:40] mandatory that we celebrate it. Wpath shifted that they forced everyone to [00:00:45] celebrate it, and I believe. That's what triggered the social contagion.

[00:00:49] Mia Hughes: Then the [00:00:50] idea lands into the minds of young people. And these young people are not identifying as [00:00:55] having a psychiatric disorder. They're not identifying as having gender dysphoria. They're not [00:01:00] identifying as having autogynephilia, they're identifying as [00:01:05] trans and trans is the healthy identity.

[00:01:09] SKOT: You must [00:01:10] be some kind of therapist[00:01:15]

[00:01:15] Stephanie Winn: today. I have the pleasure of welcoming back to the show, Mia Hughes, who I like to think of [00:01:20] as Mia phone book Hughes on account of my favorite comment from our last episode where someone said I [00:01:25] could listen to her read the phone book. That when, in addition to being a [00:01:30] brilliant, uh, thinker, she's also very pleasant to listen to.

[00:01:32] Stephanie Winn: She probably needs no introduction for [00:01:35] many of you. But, uh, Nia Hughes is the. Director of Gen Spec [00:01:40] Canada, a senior fellow at the McDonald Laurier Institute, and a [00:01:45] writer and researcher on all things, uh, gender scandal. So, Mia, [00:01:50] welcome back. It's so great to see you again.

[00:01:52] Mia Hughes: Thank you for having me. Lovely to see you too.

[00:01:54] Stephanie Winn: I had the [00:01:55] pleasure of finally meeting you in person at the Gen Spec Conference in Albuquerque in [00:02:00] 2025, and you gave this brilliant talk on a topic. You've been [00:02:05] working on a series of papers on the, uh, idea of trans as an [00:02:10] extreme overvalued belief. Let's dive into it. What do you mean by that?

[00:02:13] Mia Hughes: Yes, so when I [00:02:15] introduced this in Albuquerque, it was, for me, it [00:02:20] was the end point of about two and a half years of deep thinking [00:02:25] into this one particular psychiatric concept.

[00:02:29] Mia Hughes: And then I, and then I [00:02:30] throw it into my Albuquerque talk without really understanding that most [00:02:35] people have never heard of the extreme of value, belief, and that it was going to [00:02:40] take far more explaining than I initially realized. So [00:02:45] what it, I'll start with the very basics of what this concept is. [00:02:50] And it's a psychiatric concept that long neglected, for [00:02:55] some strange reason, it started out as the overvalued idea, [00:03:00] and it was coined, the term was coined in 1892 by a German [00:03:05] psychiatrist, Carl Verica, and the overvalued idea [00:03:10] received a lot of attention in British psychiatry, but almost none in American psychiatry.

[00:03:14] Mia Hughes: So I think [00:03:15] that's the problem. And what it describes is one [00:03:20] all consuming idea that overtakes a [00:03:25] person's entire life and drives them [00:03:30] towards some kind of pathological behavior. They're either causing harm to [00:03:35] themselves or they're causing harm to others, or both in some cases. And so I. [00:03:40] I had been reading about trans for a long time, probably [00:03:45] about four years, and you've got all these diagnoses all throughout the, [00:03:50] the history of this disorder being recognized by psychiatry.

[00:03:54] Mia Hughes: You've got [00:03:55] transsexualism, transvestic, transvestic, fetishism. [00:04:00] You've got gender identity disorder, gender dysphoria, all kinds of [00:04:05] diagnoses that never really, nobody ever really knew what they were treating. And [00:04:10] nobody ever really, there's no clarity to these diagnoses at all. Nobody's really getting to the [00:04:15] cause of it, and I was trying to make sense of the diagnosis when I [00:04:20] came across Dr.

[00:04:21] Mia Hughes: Paul McHugh calling trans transgender [00:04:25] identification. An overvalued idea just in passing in this [00:04:30] paper about multiple personality disorder actually. So Paul Mke is obviously [00:04:35] the, the man who shut down John Money. He was psychiatrist in chief at Johns Hopkins. [00:04:40] Very respected psychiatrist and an excellent scholar.

[00:04:43] Mia Hughes: And he just throws into this paper [00:04:45] that trends as an overvalued idea. And that's how I ended up there because I'm like, oh, what's that? [00:04:50] That sounds interesting. And I went into the papers. And so the [00:04:55] overvalued idea, it's just a psychiatric classification in [00:05:00] that it separates trends from delusion and it separates [00:05:05] trends from obsession.

[00:05:06] Mia Hughes: And that's, I think, the crucial [00:05:10] differentiation that we're working with here because. Many people think that a trans-identified [00:05:15] person, a man who thinks he's a woman, is delusional. But in the [00:05:20] actual psychiatric classification, a delusion is idiosyncratic. [00:05:25] It's individually held only You believe that aliens are communicating with you [00:05:30] through the radio.

[00:05:31] Mia Hughes: No one else around you shares that belief or affirms that belief. [00:05:35] So you, you can see that trans doesn't fit into that classification at all because [00:05:40] everybody is affirming this man as a woman, and we're all pretending that there's such a thing as a male [00:05:45] woman. And then obsession. I know that you and I are gonna have a lot to talk about here [00:05:50] because it can't be considered an obsession because an obsession is something that is [00:05:55] ego dystonic, which means it's, it's experienced as.

[00:05:59] Mia Hughes: [00:06:00] Distressing and the, the, the thoughts or the beliefs are, are [00:06:05] experienced as kind of repugnant and unacceptable and in conflict with who this [00:06:10] person thinks they really are. And so they fight against those beliefs and they, they, [00:06:15] they act upon them with, you know, obsessive compulsive disorder. The person will do their [00:06:20] rituals or whatever, but they're fighting against it and they're finding it distressing.

[00:06:24] Mia Hughes: So again, [00:06:25] everybody, I'm sure can tell that trends doesn't fit in there. And the crucial [00:06:30] part about the overvalued idea is that the individual. [00:06:35] Relishes, it experiences it as a true, [00:06:40] authentic expression of their most deepest nature. They, they relish it, they cherish [00:06:45] it. They, they, they embrace it completely.

[00:06:48] Mia Hughes: And so obviously [00:06:50] that makes, so, that makes sense with trends. That is the way these people are experiencing their trans [00:06:55] identities. They're not, they're not finding them distressing and they're not fighting against them. [00:07:00] They're very much rel relishing them and acting upon them. And so [00:07:05] I'm talking about overvalued ideas, but I should explain why in my [00:07:10] talk, I use the term extreme overvalued belief.

[00:07:13] Mia Hughes: And that's because. [00:07:15] So it was an overvalued idea for decades, probably for about a century [00:07:20] until nine. Well, nine 11 comes along and Paul McHugh actually [00:07:25] takes the concept of the overvalued idea and applied it to the [00:07:30] terrorists and, and think about it, it does make perfect sense. He's like, [00:07:35] these terrorists were very much, their minds were [00:07:40] dominated by a very rigid belief, and they acted upon it, and it was a [00:07:45] true expression of their authentic self, and they absorbed it from the culture in which they [00:07:50] lived.

[00:07:50] Mia Hughes: And so Chu was the one who took the overvalued idea and [00:07:55] applied it to a cultural belief. A [00:08:00] belief that is reinforced by a culture or subculture that comes to [00:08:05] dominate a person's mind and propels them in that sense [00:08:10] towards atrocious acts of mass murder or. Acts of [00:08:15] violence. And so that was the turning point for the overvalued idea concept.

[00:08:19] Mia Hughes: From [00:08:20] that point on, it became, uh, of interest to [00:08:25] forensic psychiatry and then a forensic psychiatrist to hear a man [00:08:30] used it to analyze, oh, what's his name? Anders Breck. You know the man who [00:08:35] the, the mass murder in Norway. Terrible act [00:08:40] of mass violence in Norway. This, this man who had been very, very [00:08:45] active in white supremacist neo-Nazi internet, [00:08:50] echo chambers, came to believe that he needed to save Norway [00:08:55] from.

[00:08:56] Mia Hughes: Immigration from, from being invaded. [00:09:00] And so he committed an act, a terrible act of mass murder in the [00:09:05] service of that belief. So then we get Tehir Aman. He coins [00:09:10] the term extreme overvalue belief and he's written a book called The [00:09:15] Extreme Overvalued Belief, and it details acts of mass violence [00:09:20] lone wolf.

[00:09:21] Mia Hughes: Acts of mass violence that are propelled by political [00:09:25] beliefs. But when you read his book, and this was the aha moment for [00:09:30] me, this was when I felt like I'd cracked the code. I read his book and I'm like, goodness me, this is like reading about [00:09:35] trans, the, not that I'm saying trans identified people are in any way [00:09:40] violent, uh, but if you read the way he defines an extreme [00:09:45] overvalued belief, it is a rigidly held, non delusional [00:09:50] conviction that is shared by others in your culture or [00:09:55] subculture that is amplified until it consumes the individual.[00:10:00]

[00:10:00] Mia Hughes: And then the individual it comes to dominate their life. They relish it, [00:10:05] they cherish it, they act upon it, and then they take it to an extreme [00:10:10] where they are. Acting pathologically. Now, to [00:10:15] me, I framed it in my Albuquerque talk. The trans identified person [00:10:20] is not going out and co shooting people or, or being violent towards others.

[00:10:24] Mia Hughes: [00:10:25] They are seeking extreme self harm. They are, they are seeking [00:10:30] from surgeons and from doctors medical interventions that do [00:10:35] terrible harm to themselves. But because they are in the service of [00:10:40] this belief that they, they cherish and they experience as a complete and true [00:10:45] expression of their deepest, most internal nature, they don't [00:10:50] realize that they're pursuing something pathological.

[00:10:52] Mia Hughes: They think they're pursuing life [00:10:55] altering, lifesaving, ethical medical care.

[00:10:58] Stephanie Winn: Well, that's a brilliant, uh, [00:11:00] explanation you've laid out there for us, front and center, the history of the [00:11:05] terminology, the way it connects to other things, and it makes me think of how. [00:11:10] The human mind is such a fascinating thing.

[00:11:13] Stephanie Winn: Um, [00:11:15] I put a lot of emphasis on neuroplasticity in my parent coaching work and in my [00:11:20] course because it's fascinating because so much of the problems and [00:11:25] the solutions here hinge on it. And because late adolescence, early [00:11:30] adulthood is a time of tremendous neuroplasticity. And so when I hear you [00:11:35] describe what you call the extreme overvalued belief and how it maps onto [00:11:40] trans, I think about the meaning making system that a lot of these [00:11:45] young people have.

[00:11:46] Stephanie Winn: Um, this idea enters the picture [00:11:50] that has a lot of allure. It has an emotional pull. It feels like it solves a [00:11:55] problem. And one thing parents frequently get wrong about this is they. They [00:12:00] tend to assume, in my experience at least talking to parents who have trans-identified youth, they [00:12:05] tend to assume that the kid has more insight, more psychological insight than they really [00:12:10] do about, oh, why do you feel this way?

[00:12:12] Stephanie Winn: Or things like that. And, and I explain to [00:12:15] people at least once a week that, that they don't have psychological insight and you [00:12:20] don't have to have psychological insight in order for something to have a powerful emotional pool on you in [00:12:25] order for an idea to be very appealing because of the emotional impact [00:12:30] it has on you.

[00:12:30] Stephanie Winn: And all this can be going on well beneath the surface of conscious awareness. So, [00:12:35] you know, a person's plagued by a problem, a potential solution [00:12:40] appears, they may not have psychological insight into the emotional pull that it has on [00:12:45] them, but then now there's an incentive to map [00:12:50] everything that happens to them.

[00:12:52] Stephanie Winn: To this and, and it can snowball [00:12:55] because of that neuroplasticity, because of our ability to form associations. [00:13:00] Every feeling connects to trans. Just like when I was [00:13:05] counseling someone with a food addiction, um, you know, if I'm happy, I celebrate by [00:13:10] eating. If I'm sad, I comfort myself by eating. If I'm angry, I suppress my anger By eating, you know, [00:13:15] everything connects to food if that is a person's drug of choice.

[00:13:19] Stephanie Winn: Similarly [00:13:20] with trans, I had a bad day for any reason. I had a [00:13:25] distressing emotion. I had a glimmer of hope. I, in whatever happens, I [00:13:30] connect it to this particular. Meaning making system, and then it becomes a self-fulfilling [00:13:35] prophecy.

[00:13:35] Mia Hughes: It does. I mean, I, I agree that these kids, the, [00:13:40] well, I would argue that no one in the grips of this belief understands that they're in the grips [00:13:45] of a belief, and that is by definition what these beliefs are.

[00:13:48] Mia Hughes: The individual doesn't [00:13:50] recognize them as being a psychiatric disorder, but particularly [00:13:55] the kids, because they're just kids, they don't, the, the adolescents, [00:14:00] adolescents don't understand anything. They think they understand everything. They don't actually understand [00:14:05] anything, really, and so that's the particular danger.

[00:14:09] Mia Hughes: That's why [00:14:10] before we hit record, I was saying I really feel as though I've cracked the code [00:14:15] because everything can be explained using this framework [00:14:20] and. What the real danger to these kids? Yeah. They don't [00:14:25] have the, the cognitive maturity. They don't have the life experience and they, and they're [00:14:30] in that period of identity fluctuation, diffusion.

[00:14:34] Mia Hughes: They're not [00:14:35] really sure who they are yet. And then the trends [00:14:40] overvalued belief, the extreme overvalue belief is thrust upon [00:14:45] them because the entire. Movement. The [00:14:50] entire trans activism movement is the extreme overvalued [00:14:55] belief. It has been forced from a tiny subculture, a [00:15:00] fringe group of strange doctors and a few individuals.

[00:15:04] Mia Hughes: It's been [00:15:05] that this overvalued belief has been thrust into the mainstream and [00:15:10] not just thrust into the mainstream, but then forced onto young people [00:15:15] who are still in this fluctuating stage of identity development. And it [00:15:20] does, it does look as if it's the solution. And you're right, once [00:15:25] they adopt it, because they're looking for a, an [00:15:30] explanation for why they feel so bad.

[00:15:31] Mia Hughes: And once they adopt the belief, [00:15:35] once it, it lands in their mind and it just lodges and stays there, then [00:15:40] they can interpret everything through. The lens of [00:15:45] that belief, which is typical of all of these overvalued beliefs. They, they, they just, [00:15:50] they dominate the mind. So if you can, if you've got one belief lodged in your mind, [00:15:55] and it is now central to your very core identity, [00:16:00] of course you're going to, you're going to interpret every experience [00:16:05] through the lens of that belief, because it is the most central part of who you are right [00:16:10] now.

[00:16:10] Mia Hughes: But the, the very, very dangerous thing about this one, [00:16:15] not only is it obviously forced upon young people via [00:16:20] education, media, social media, every single angle basically. And it's, [00:16:25] the belief is elevated to this sacred identity that one, you [00:16:30] cannot question, and two, you actually must celebrate. Don't question it and absolutely [00:16:35] celebrate it.

[00:16:35] Mia Hughes: But at the same time, uh. Lying in weight [00:16:40] is an entire field of medicine, completely guided [00:16:45] by this belief. You see, the entire field of so-called gender [00:16:50] affirming care is built upon the trans overvalued belief, [00:16:55] which I think actually I've got ahead of myself here because I don't think I've [00:17:00] defined the trends overvalued belief yet, have I?

[00:17:02] Mia Hughes: Which I should do. I will [00:17:05] say we, there's a lot of, I'm worried, there's a lot of things not of [00:17:10] projects that I'm working on, one of which is a research project into what [00:17:15] beliefs, what, what beliefs these people hold that drives them towards medical [00:17:20] transition, but condensing it into its simplest form. The, the, the [00:17:25] trends overvalue belief is I [00:17:30] am trends.

[00:17:31] Mia Hughes: My trends identity is healthy. And I [00:17:35] need medical body modification in order to live [00:17:40] a authentic, an authentic, happy life. [00:17:45] That is what I've condensed it into its simplest form. Now, I've [00:17:50] already interviewed a whole bunch of people, is uh, the kind of like a pilot, a test [00:17:55] project for my, for my actual research.

[00:17:57] Mia Hughes: And I got plenty of other [00:18:00] answers. The other variance of this, because it's difficult. The I am [00:18:05] trends. 'cause then these people are like, okay, but everyone has a different understanding or there are many [00:18:10] different understandings of what I am trans means. And so for some people it [00:18:15] was, uh, they believed not so much that they were actually born [00:18:20] in the wrong body, but that they would be happier living as a [00:18:25] member of the opposite sex.

[00:18:26] Mia Hughes: They were not adequately masculine. [00:18:30] So they would be happier living as a woman. They were not adequately feminine. [00:18:35] So they would therefore be happier living as a man. And what, what unites all of these [00:18:40] different beliefs is that they ultimately drive the person [00:18:45] towards seeking hormonal and surgical body modification [00:18:50] as the road to happiness.

[00:18:52] Mia Hughes: So that's the trends overvalue belief. But [00:18:55] think about it, the crucial part to me [00:19:00] is an overvalue belief is [00:19:05] experienced as healthy. And so that's what we are right now doing in this [00:19:10] mad era of trans activism. Wpath trans [00:19:15] activism has des psycho pathologized trans identities, which means [00:19:20] they are presenting trans identities as healthy.

[00:19:23] Mia Hughes: That's the core of the [00:19:25] overvalued belief. And then going hand in hand with this, trans identities are [00:19:30] healthy, is. Medical body modification is a human right. [00:19:35] Okay. That's the overvalued belief. That is these people are [00:19:40] singularly focused on obtaining the hormones and surgeries that they [00:19:45] believe are the only road to.

[00:19:47] Mia Hughes: Authenticity and happiness, and it's [00:19:50] just been transformed into a civil rights movement and [00:19:55] then pushed onto young people who are still in a stage of identity development and [00:20:00] they are just having it lodged in, it just lodges in the minds of some. And then the [00:20:05] entire field of gender affirming care, likewise, is built upon this extreme [00:20:10] overvalue belief that one, trans identities are healthy.

[00:20:13] Mia Hughes: So you cannot [00:20:15] try and help the person overcome their desire, their their trans [00:20:20] identification, because that's conversion therapy. And two, you must [00:20:25] provide the medical interventions that the belief demands because that's [00:20:30] a human right. And if you don't provide those interventions, then you are violating the [00:20:35] human rights of your patient.

[00:20:36] Stephanie Winn: Out of all the brilliant things you just shared, [00:20:40] one piece I can pick up on next is. How this [00:20:45] creates a problematic incentive structure. When there is that [00:20:50] extreme overvalued belief and that is deemed healthy and [00:20:55] dessy pathologized, then we have [00:21:00] actual health and this definition of health pulling into [00:21:05] completely opposite directions.

[00:21:07] Stephanie Winn: So as long as we're operating from a belief [00:21:10] system that, that the mind and body are one, and that something that's [00:21:15] harmful to the body is gonna be harmful to the mind and vice versa, [00:21:20] then we have a coherent value system that allows us to make [00:21:25] decisions that make sense. But you use the word [00:21:30] health, right?

[00:21:30] Stephanie Winn: That the idea with the overvalue belief is that [00:21:35] trans, the trans identity is healthy. And while we know [00:21:40] that, that the. Implications of that identity. [00:21:45] Literally shorten lifespans, increase the risk of all cause [00:21:50] mortality, right? So, so the definition of health there becomes [00:21:55] split and polarized so that it's pulling in two different directions.

[00:21:59] Stephanie Winn: I think we [00:22:00] could even go further than to say that it's thought of as healthy. It's thought of as the only thing, right? It's thought [00:22:05] of as so synonymous with the identity of the individual that to [00:22:10] question it is to question their right to exist. That's where we get a lot of the hyperbolic [00:22:15] histrionic language, and I think it has to be structured that way in [00:22:20] order to survive.

[00:22:20] Stephanie Winn: Because if we treat it as anything less than [00:22:25] that, then we do have to question the health outcomes of these decisions, [00:22:30] right? If we treat this as a choice, then we have to question if it's the healthiest [00:22:35] choice. But if it's. Framed in, in as a life or death [00:22:40] matter, well then it's better to be alive and to exist even if your lifespan is 10 years [00:22:45] shorter and you have Alzheimer's at 50 than it is [00:22:50] to not get to be yourself.

[00:22:52] Mia Hughes: Yeah. It's a totally [00:22:55] different world, and that's the most important part, I think, to understanding all of this [00:23:00] because it, it can seem so completely insane and so completely [00:23:05] mad what they're doing unless you're able to understand the world that they live in. [00:23:10] And so yes, for them, and this is, I I was just reading, [00:23:15] actually I'm reading the Dutch approach, Alex Bakker, the, so it's [00:23:20] this individual transitioned in the, the Dutch, [00:23:25] the early, early days of the Dutch protocol and has written the history of, [00:23:30] of the, the Dutch.

[00:23:32] Mia Hughes: Starting this whole mad experiment. And there's a [00:23:35] wonderful quote in there, um, because the medical ethics side of this [00:23:40] has its ori origins in a Christian hospital. And the individual [00:23:45] who was tasked with presenting to the ethics board, I'm talking in the [00:23:50] seventies here, says something like, you know, the, in the [00:23:55] Christian world, in, in Christian thinking, the [00:24:00] soul or the psyche is more important than the body.

[00:24:04] Mia Hughes: And [00:24:05] therefore if the person's soul or psyche is causing them so [00:24:10] much distress and you can't fix it, then you should [00:24:15] operate on a healthy body. You should cut into a healthy body. 'cause that's what they're debating at the [00:24:20] time. Should we cut into healthy bodies? And so you can see they're [00:24:25] prioritizing psychological.

[00:24:28] Mia Hughes: Wellbeing [00:24:30] and they had basically given up at that point. They're like, there's nothing we can do for these people. [00:24:35] Their psychological suffering is so terrible that the only ethical [00:24:40] justification is to cut into these healthy bodies. That's the [00:24:45] way that they were framing harm. Harm in that world is not [00:24:50] cutting into the healthy bodies harm in our world or the, certainly the world that I live [00:24:55] in is cutting into healthy bodies and it all stems from the fact that they just gave up.[00:25:00]

[00:25:00] Mia Hughes: There's nothing we can do for these people. We can't help them psychologically, so we're just gonna, we [00:25:05] have to help them medically. I would argue that that is because one, they didn't in [00:25:10] the 1970s, they didn't understand autogynephilia, so I think [00:25:15] everybody had an idea that. Erotic motivations [00:25:20] were behind the, the trans identities of many of these men.

[00:25:24] Mia Hughes: Not [00:25:25] all of them, but many of them. But they didn't understand [00:25:30] Autogynephilia at the time. And on top of that, they weren't seeing this as an [00:25:35] overvalued idea because this was just not even something they were considering. So [00:25:40] they weren't approaching it in the right way. I'm not entirely, I have to say, I'm not [00:25:45] entirely convinced that you can talk [00:25:50] someone.

[00:25:50] Mia Hughes: You can psycho therapeutically guide someone out of autogynephilia. [00:25:55] However, I think. I, do all of your viewers know what [00:26:00] Autogynephilia is? Should I explain it?

[00:26:01] Stephanie Winn: I mean, some people might be listening for the first time.

[00:26:04] Mia Hughes: [00:26:05] Right. So Autogynephilia is a paraphilia in which a man is aroused by the [00:26:10] fantasy of becoming a woman, like having breasts, a vagina, being [00:26:15] treated as a woman.

[00:26:16] Mia Hughes: There's the transvestic side as well, dressing as a woman, but it's [00:26:20] largely about medically embodying a female body, like becoming [00:26:25] a woman and having female body parts and bodily functions. And so that drives most [00:26:30] men, or did certainly in the 1970s when they were having these ethical discussions. [00:26:35] But it wasn't the, the, the typology wasn't outlined until [00:26:40] 1989, so they, we really didn't understand what was going on.

[00:26:43] Mia Hughes: These men, [00:26:45] arguably, you can't talk them out of this. Erotic [00:26:50] urge, you know, it's probably quite difficult to do so, but I would argue that at [00:26:55] least, at the very least, trying to help them manage their [00:27:00] erotic desires rather than just simply [00:27:05] giving them the medical interventions that the, the erotic desire demands, [00:27:10] trying to help them manage it is a more ethical, [00:27:15] less harmful way to deal with it.

[00:27:18] Mia Hughes: But it, [00:27:20] it all comes down to how you define harm. And, and again, there is this angle of [00:27:25] all along gender medicine, as you know, has been built on, give me [00:27:30] what I want or I'll kill myself. I don't know if I can say that, if you bleep it out, if I can't. But [00:27:35] this, this threat of, at the very least, if you don't gimme what I want, I will harm [00:27:40] myself, is is the basis of gender affirming care, so [00:27:45] called.

[00:27:45] Mia Hughes: It is the idea that. If we do not do [00:27:50] this for these individuals, they will cause themselves harm. So therefore, [00:27:55] cutting into the healthy body is the least harmful approach and therefore it is [00:28:00] their human right. But I argue that that's not a healthy way to approach [00:28:05] any field of medicine and that everybody needs to just calm [00:28:10] down, take a step back, and, and I think rethink [00:28:15] the entire way that we approach care for all of the [00:28:20] individuals who seek this medical treatment.

[00:28:22] Stephanie Winn: Mia, you described an [00:28:25] attitude of sort of helpless, frantic [00:28:30] incompetence on the part of an unspecified group of individuals, and I'm really curious [00:28:35] who that group is. The ones who said, well, these patients are suffering so badly and [00:28:40] there's no other way to help them. The ones who, who gave up essentially and says, just, just [00:28:45] give the patients what they want.

[00:28:47] Stephanie Winn: Who are these people? Because I have some thoughts about them. [00:28:50]

[00:28:50] Mia Hughes: Who are the individuals who gave up?

[00:28:52] Stephanie Winn: Yeah.

[00:28:53] Mia Hughes: When I was talking, I was talking about [00:28:55] the Dutch in the 1970s, so this was the turning point [00:29:00] as far as I can see in the 1950s, 1960s, [00:29:05] that was mostly going on in the, in the us, John Money, Robert Stoller, Harry Benjamin, [00:29:10] all the rest of them.

[00:29:11] Mia Hughes: And they definitely viewed [00:29:15] cutting into healthy bodies as harm. That was, that was they. [00:29:20] Nobody was really very comfortable. Sending these men [00:29:25] along to have their penises chopped off. It was, it was viewed, surgeons had problems with it [00:29:30] ethically. It was a bit, you know, horrifying for most people. And then it was the Dutch, [00:29:35] it was the Dutch in the 1970s.

[00:29:37] Mia Hughes: They were, they were [00:29:40] doing, they started this experiment. The, they can't find any surgeons, medical [00:29:45] ethics boards are like rejecting it. No, you can't cut into healthy bodies. They were going simply on [00:29:50] that. That was the phrase, it's, it's harm. You are not allowed to cut into a healthy [00:29:55] body That's a violation of medical ethics, which I think most people still to this day would agree [00:30:00] with.

[00:30:00] Mia Hughes: But then in this, in this ethical debate that they were having, [00:30:05] someone came along, was it. Ooh, I can't remember his name. It's gone [00:30:10] completely outta my mind. Someone came along and presented to the ethics board this idea that the [00:30:15] soul, the psyche is more important in a Christian sense, and if the [00:30:20] soul and the psyche are so tortured because of a mismatch [00:30:25] with the body than the ethical thing to do is cut into the body.

[00:30:29] Mia Hughes: And I [00:30:30] think that is just them giving up. They, they weren't, they weren't helping these [00:30:35] largely paraphilic men get over their sexual desires. So they just [00:30:40] gave up and said, okay, we'll just start cutting into the healthy bodies. And of course, that's the Dutch, [00:30:45] that the, it starts there with adults and they do this to adults, but then it's just a short [00:30:50] stepping stone, isn't it?

[00:30:51] Mia Hughes: To doing it to children. So that really is the [00:30:55] origins of the entire medical scandal as we know it in the, the pediatric [00:31:00] sense.

[00:31:00] Stephanie Winn: When I'm thinking about. This Dutch group, I'm wondering what, what [00:31:05] were the professional backgrounds of the people who were coming together to have these dialogues? Because I'm [00:31:10] thinking about it from the standpoint of a therapist, for example.

[00:31:13] Stephanie Winn: You know, how many [00:31:15] of the people arguing for this, well, there's nothing else we can do to help [00:31:20] these people. They're so distressed. Just, you know, do what they do, what they say they want from [00:31:25] us. Um, I mean, it sounds interdisciplinary, right? It sounds like [00:31:30] some of the people involved in this conversation were on the [00:31:35] clinical psychotherapeutic side of things.

[00:31:37] Stephanie Winn: Some of them were on the medical. This is the [00:31:40] whole scandal is, is rests upon the intersection of those two fields and the [00:31:45] intersection being handled quite sloppily. But I'm just thinking from a, from a [00:31:50] psychotherapeutic standpoint, what this points to about the [00:31:55] importance of personal insight [00:32:00] and, uh.

[00:32:01] Stephanie Winn: Training on transference and counter transference dynamics [00:32:05] because, uh, as therapists, we are triggered to feel a lot of [00:32:10] different things toward our patients. Sometimes we feel, we feel helpless, incompetent, [00:32:15] impotent, even powerless, uh, frustrated. And [00:32:20] a good psychodynamic training, uh, teaches the therapist [00:32:25] to, uh, reflect on that as clinical information, learn from it, be able to [00:32:30] discern what is sort, sort of my stuff, right?

[00:32:33] Stephanie Winn: What is, oh, I'm [00:32:35] feeling this way because this is part of my psychological makeup. What [00:32:40] is something that the patient is sparking in me? Because the patient tends to spark this feeling [00:32:45] in people. Um, how can I learn from this? How can I process this? [00:32:50] Right? And so our most frustrating cases, uh, can [00:32:55] really teach us a lot.

[00:32:56] Stephanie Winn: But what I hear happening in that space, when I [00:33:00] imagine. Mental health professionals having a voice in that conversation of saying, [00:33:05] uh, we can't do anything else to help just give them what they want. Is, is that, feels like unchecked [00:33:10] countertransference, to me, that feels like a therapist not having good emotional [00:33:15] boundaries, not being able to differentiate and self-reflect on the experience of [00:33:20] frustration, bewilderment, helplessness, and fear that the patient is sparking in [00:33:25] them.

[00:33:25] Stephanie Winn: And that feels like an ethical failure.

[00:33:28] Mia Hughes: You know, I'm just looking [00:33:30] because, well, the book's right there. If you, if you don't mind, I can go get it. I [00:33:35] think he was a plastic surgeon. I think it was a surgeon. [00:33:40] Presenting to his ethics board. You see, the reason [00:33:45] why I like the Dutch approach, it's a difficult book to get your hands on.

[00:33:48] Mia Hughes: A lovely [00:33:50] lady gave it to me when I was in Belgium actually. Um, the reason I [00:33:55] like it is because it's the stories of the doctors and the psychologists and the [00:34:00] endocrinologists and the surgeons. It's the human element. And that is what we all [00:34:05] kind of lose when we are talking about this. Because we focus on the, the, what I [00:34:10] believe is a medical crime.

[00:34:11] Mia Hughes: We focus on what they're doing and the scandal [00:34:15] without. Understanding the human beings. That all kind of [00:34:20] crossed paths at just the right time with just the right ideas, with just [00:34:25] to make this medical scandal possible. And if I'm not mistaken, the guy who [00:34:30] was presenting to the ethics board was a plastic surgeon, [00:34:35] but then you, you have, it's the Netherlands 1970s, so you've got [00:34:40] the political momentum, the moral enthusiasm of the [00:34:45] time.

[00:34:45] Mia Hughes: They're all swept up in this, and it's an extremely progressive nation. [00:34:50] So I guess I can't really apply any motives [00:34:55] to this person, but there is the possibility as well that. [00:35:00] He was swept up in the, the enthusiasm for the experiment, the [00:35:05] challenge, the, the possibility of being on the cutting edge of this new, exciting [00:35:10] field of medicine.

[00:35:11] Mia Hughes: So the motivations of each of the human [00:35:15] beings in this medical scandal, and there have been so many, are [00:35:20] all fascinating to me. It's totally fascinating to me. But if I, I [00:35:25] do think it was a plastic surgeon, a surgeon presenting to his board. There [00:35:30] were psychologists involved, very few, and that's the other thing that you've gotta understand is [00:35:35] this is a very, very, very fringe field of medicine.

[00:35:39] Mia Hughes: [00:35:40] Almost no one will touch it. They can't find anyone to care for these [00:35:45] individuals. And the idea is out there because at the same time, they're doing [00:35:50] media, they're talking to the press, they're going on television shows to promote [00:35:55] the idea that some people are transgender and that they need these medical treatments.

[00:35:59] Mia Hughes: They're [00:36:00] doing that to help their patients. But every time they do that, there's even a quote in there. The [00:36:05] guy who manages the whole sentence, he says the whole, the whole, um, clinic, he says. [00:36:10] Every time a trans identified person appeared on [00:36:15] television, the phone was ringing off the hook for the next few days because people had saw it and they're [00:36:20] like, oh, that's, that explains what I'm feeling.

[00:36:22] Mia Hughes: I need this medical treatment too. [00:36:25] So they're doing the media promotion to, to [00:36:30] increase acceptance of trans-identified people, but they're also contributing to the social [00:36:35] contagion. But at the same time, nobody in the medical world will go near [00:36:40] this 'cause they all find it repulsive and absolutely abhorrent.

[00:36:43] Mia Hughes: And so then they're [00:36:45] trying to, within their, their hospital increase. [00:36:50] Acceptance of these procedures that they themselves really believe in [00:36:55] and, and so that's why they're coming up with these, in my mind, that's why they're coming up with these ideas of the [00:37:00] soul, the psyche. It's more important, and I, I do think that they're all [00:37:05] swept up by the belief, by the idea, and quite possibly by [00:37:10] the idea that this can make them famous in some way.

[00:37:14] Stephanie Winn: [00:37:15] Yeah, it is. It is fascinating to speculate about the motivations of the [00:37:20] different people involved, because with the surgeons, like you say, there's the excitement of, [00:37:25] you know. Being the first to do something, feeling like a [00:37:30] pioneer feeling. The, the, the thrill, the challenge [00:37:35] of the procedure of, of getting better at something that they've been practicing their whole life.

[00:37:39] Stephanie Winn: And, [00:37:40] and this might be someone, you know, very low and empathy, right? We know [00:37:45] like statistically surgeons are more likely to be sociopathic, uh, [00:37:50] in terms of just their, their brain structure. Um, and then I can [00:37:55] speculate of course about the, the psychotherapist, whether it's the, the lack of insight [00:38:00] into, um, the transference countertransference [00:38:05] dynamics, whether it's also that excitement of, oh, do I have that rare [00:38:10] special patient, right?

[00:38:11] Stephanie Winn: The, the sort of excitement of, oh, this novelty, [00:38:15] this rare condition. Am I going to be one of the ones who's on the cutting edge of. [00:38:20] My field. And in the same way that it has that glimmer, I think for certain parents [00:38:25] who've dropped the Kool-Aid, right? Not listeners of this podcast, but on the other side of that [00:38:30] issue, oh, do I have the special trans child, the magical trans [00:38:35] child,

[00:38:35] Mia Hughes: and isn't there also, I think there might be in many [00:38:40] cases, and you've kind of sensed it with the Dutch at the beginning, it's.

[00:38:44] Mia Hughes: I am a [00:38:45] good person. Look at how much better I am because I can [00:38:50] accept these, these people for who they are. Like I am. I'm [00:38:55] so much more enlightened than these Philistines over here. You [00:39:00] know, I'm, I'm good person because I can accept this and we just need to bring [00:39:05] everyone, everyone just needs to catch up to me and my colleagues.

[00:39:09] Mia Hughes: And that's still [00:39:10] going on in Wpath now to this day. They still, they're still on this righteous quest. They still [00:39:15] see themselves as being the good progressive people, and it's just the, the [00:39:20] transphobic bigots that they have to convince and then they'll catch up and then [00:39:25] everybody will support them. It doesn't, I can understand with the Dutch way [00:39:30] back when, I suppose, because it was all new and the harm was, the harm was there [00:39:35] though.

[00:39:35] Mia Hughes: And that's the thing that, that. Is distressing to read is [00:39:40] it's very, very clear that many of the patients that they saw were not [00:39:45] helped, were not doing well, and yet still they carried on. But if you're still, uh, in [00:39:50] 2026 convinced that you are a good person and the [00:39:55] rest of the world just needs to get over their bigotry and accept trans-identified people for [00:40:00] who they are, of course you are, you are, you are in the service.

[00:40:04] Mia Hughes: You are acting in the [00:40:05] service. You're an ideolog, you're acting in the service of a, a belief and, and [00:40:10] reality. You're not in touch with reality. You've, you've kind of, you've gone into an [00:40:15] extreme area,

[00:40:16] Stephanie Winn: and I think it's even darker because on some level, they know they'll [00:40:20] never get everyone over to their side.

[00:40:22] Stephanie Winn: And so as long as there's another side [00:40:25] combined with that self-righteous mentality, then there's, well, we're, we're better than them. [00:40:30] Right? And, and the more extreme. Evidence we have [00:40:35] of how these things are obviously not good for physical help, the [00:40:40] more distorted the mental ideas have to become, to [00:40:45] continue justifying the destruction of the body.

[00:40:49] Mia Hughes: Well, [00:40:50] I think it just ricochets off them. I think I, I like to think of the belief [00:40:55] as a kind of protective sphere around these people. And so if there's [00:41:00] any evidence of harm, it really doesn't even enter their [00:41:05] mind. It just ricochets off. And that's, we've seen this in, in true believers. So [00:41:10] throughout history, in every mass movement that has occurred, it's, it's not unique to [00:41:15] trends, it's just we're, we're, we're, [00:41:20] it's our job.

[00:41:21] Mia Hughes: That's what we do all the time, is highlight the harm and show the harm. So [00:41:25] it's, it's so. It's a, a fascinating thing to witness. I [00:41:30] think I, I think of the individual with this protective sphere around them. The, the belief [00:41:35] protects them, but think of the entire. Wpath WPATH [00:41:40] exists inside a a, a fortress and, and really truly nothing [00:41:45] penetrates, no systematic review is ever going to sway wpath.

[00:41:49] Mia Hughes: The cast report is [00:41:50] not gonna do anything. Forget any high quality evidence outta Finland. [00:41:55] Forget it. It doesn't mean anything to these people. It doesn't even make it inside. And if, [00:42:00] if by any chance, you know, the C cast report did manage to penetrate [00:42:05] it, got in, and then they produced this insane statement because they read the cast [00:42:10] report just entirely through the lens of their belief.

[00:42:13] Mia Hughes: And it's just transphobia. It's [00:42:15] just the work of right wing bigots who infiltrated the NHS or something like that. So [00:42:20] forget trying to win this, defeat them with evidence. You can't [00:42:25] defeat ideologues with evidence because the evidence means nothing to them.

[00:42:28] Stephanie Winn: Let's take a quick [00:42:30] break and when we return, we'll talk about your campaign to.[00:42:35]

[00:42:35] Stephanie Winn: Re psycho pathologize the trans identity. [00:42:40] Your trans identified kid won't listen to reason, because reason isn't what they [00:42:45] need right now. They need a parent who knows how to communicate in an empathic [00:42:50] yet strategic manner. ROGD repair gives you over 120 [00:42:55] lessons in the psychology and communication tools that actually work when normal [00:43:00] parenting doesn't.

[00:43:01] Stephanie Winn: Plus repair bot your 24 7 AI coach trained on [00:43:05] my entire body of work, ready to help you navigate tough moments in real time. [00:43:10] Visit r og d repair.com and use code some [00:43:15] therapist 2026 to take half off your first month. [00:43:20] So let's talk about your campaign as part of gens spect to [00:43:25] re psycho pathologize the trans identity.

[00:43:29] Stephanie Winn: But I think in order [00:43:30] to do so. We need to talk about how it's been desy [00:43:35] pathologized by groups like WPATH and other trans advocacy groups, [00:43:40] and that really makes no sense when you consider all the similarities that the trans [00:43:45] identity has to things like anorexia, obsessive compulsive [00:43:50] disorder, body dysmorphic disorder.

[00:43:52] Stephanie Winn: Um. I know you mentioned [00:43:55] when you were describing trans as an extreme overvalued belief, um, but even [00:44:00] extreme acts of violence can be connected to this concept. So let's talk about [00:44:05] the psychopathology part.

[00:44:06] Mia Hughes: Yeah, it's a really important part. It's to me, [00:44:10] after years and years of studying this social contagion, medical scandal, I came to the [00:44:15] conclusion that the core of it is [00:44:20] dessy pathologization.

[00:44:20] Mia Hughes: And that is, I took that word, I didn't, I didn't make that up. I took [00:44:25] that word from wpath, the World Professional Association for Transgender Health, which [00:44:30] of course I've been writing about for years and many times in my [00:44:35] writing I had cited the pivotal moment in 2010 [00:44:40] when WPATH released its Des Psycho [00:44:45] pathologization statement, and that is they declare.

[00:44:49] Mia Hughes: They just pull [00:44:50] this idea out thin air, but they declare that trans identities are [00:44:55] a healthy variation of human existence. They actually say, I think they word it [00:45:00] gender diversity, and that's the sneaky thing about these people. They never say [00:45:05] what they really mean because of course, gender diversity is a [00:45:10] healthy variation of human existence.

[00:45:11] Mia Hughes: So most people are like, oh yeah, okay, that's fine. [00:45:15] Some people are more masculine, some more feminine. There's a whole range of [00:45:20] gender expressions out there, but that's not actually what Wpath [00:45:25] meant with their 2010 deps psycho pathologization statement. What [00:45:30] they meant was. Identifying as a member of the opposite sex [00:45:35] and seeking and obtaining hormonal and surgical [00:45:40] body modification is a healthy variation of human [00:45:45] existence.

[00:45:45] Mia Hughes: That's what they really meant. What that is, is [00:45:50] truly, you can trace it to the extreme over value belief it is. They are, [00:45:55] I'm gonna go back to the late 1990s, and this [00:46:00] is when WPATH was called Hida, the Harry Benjamin International [00:46:05] Gender Dysphoria Association. And Hida in its early [00:46:10] days, was a group of definitely [00:46:15] fringe doctors who were trying to help individuals who [00:46:20] wanted this medical treatment, who, who believed themselves to be members of the opposite sex and believed that [00:46:25] they needed this medical treatment.

[00:46:27] Mia Hughes: But then in the 1990s, trans [00:46:30] activism is really starting to gain strength and [00:46:35] trans-identified activists. Began to join Habig dda. And we know that [00:46:40] this is true. You can see it in the or you can see it in the way Habig changes. [00:46:45] Its its approach to formulating standards of care. Its [00:46:50] messaging. But we also know it because Dr.

[00:46:52] Mia Hughes: Steven Levine was one of the original [00:46:55] members of Habig dda, or early days members of Habig, and he [00:47:00] saw it with his own eyes. So he said early two thousands, he was [00:47:05] at one of their annual conferences. And the way he words it, and I love [00:47:10] it, he says there were a lot of cross dressed men in the audience, [00:47:15] and when people were on the stage.

[00:47:18] Mia Hughes: Speaking about [00:47:20] how to diagnose, how to treat, presenting scientific [00:47:25] presentations. These cross-dressed men in the audience would heckle them [00:47:30] because they were, they were saying things that the men [00:47:35] did not believe aligned with the true nature, that they felt that, you know, [00:47:40] they felt that they were women.

[00:47:41] Mia Hughes: And so. Allowing these trans-identified [00:47:45] activists into Heda is what transformed the [00:47:50] organization from something like pursuing science [00:47:55] to an organization that is predominantly guided by activism. [00:48:00] But you've got to understand who those men were. They [00:48:05] were men who were complete their, their lives, their [00:48:10] minds were totally dominated by the belief, the extreme overvalued belief that one [00:48:15] trans is natural and healthy.

[00:48:16] Mia Hughes: So yes, they are women, they are, they are women. They're not, [00:48:20] they don't have a psychiatric disorder. That's the crucial part of this belief is you [00:48:25] believe that you are a member of the opposite sex. You, the, [00:48:30] these individuals get really upset at the mere suggestion [00:48:35] that their identity could be related to a psychiatric [00:48:40] disorder.

[00:48:40] Mia Hughes: They get really upset at the suggestion that their identity is in [00:48:45] any way pathological, and they also get really upset by [00:48:50] anyone who tries to prevent them from [00:48:55] obtaining the hormones and hormones and surgeries that their [00:49:00] overvalued belief demands. They are on this. They have tunnel vision. They are [00:49:05] fixated, and they are on this trek where nothing can get [00:49:10] in their way.

[00:49:11] Mia Hughes: And so this is who populated [00:49:15] Heda, and then it turned into WA as soon as WA [00:49:20] rebranded. It was guided entirely by this [00:49:25] belief that trans is natural and healthy, and medical body modification is a human [00:49:30] right. And because that was the guiding principle inside the [00:49:35] organization, they then launched Des Psycho Pathologization, which is just, [00:49:40] it's just taking the belief and turning it into an, an [00:49:45] entire campaign, an entire political campaign.

[00:49:47] Mia Hughes: So they announced in [00:49:50] 2010 that trans is natural and healthy, and then they make it their business [00:49:55] to ensure that this de psycho pathologization campaign, [00:50:00] um, is embedded into the entire field of gender medicine. First of all, they [00:50:05] succeed in getting it into the American Psychiatric Association because [00:50:10] at the time, the diagnosis was gender identity disorder.

[00:50:13] Mia Hughes: So the [00:50:15] identity is the disorder. It can't have that because the identity is healthy. [00:50:20] So they deps psycho pathologize. They turn it into gender dysphoria [00:50:25] with the diagnosis of gender dysphoria in DSM five, the [00:50:30] identity is healthy and it's the distress that you feel [00:50:35] because you have this healthy identity that doesn't match your body.

[00:50:38] Mia Hughes: The distress is the [00:50:40] disorder. But then think about what that means. That means the only possible way to [00:50:45] treat the disorder is to medicalize the body, to bring the [00:50:50] body in my in, in line with this healthy identity that you just [00:50:55] so happen to have. That's des psycho pathologization. Then [00:51:00] from there, of course they, they go to the World Health Organization next.

[00:51:04] Mia Hughes: That [00:51:05] was the diagnosis was gender identity disorder as well. They [00:51:10] transformed that in 2018 in the World Health Organizations [00:51:15] International Classification of Disease. Version 11, they turn it into gender [00:51:20] incongruence, which is also des psycho pathologization. It's just [00:51:25] you, you, your, your body and mind don't match, and therefore you should have medical [00:51:30] intervention.

[00:51:30] Mia Hughes: That's, that's the diagnosis. And so it all, [00:51:35] the, the crucial part of de psycho pathologization that I think most people [00:51:40] miss is. Because they framed the trans identity as [00:51:45] healthy when clearly it's the result of a psychiatric [00:51:50] disorder. It's a, it's a psychiatric condition, but they [00:51:55] reframed this mental illness as a perfectly healthy identity, which is dangerous [00:52:00] in and of itself because anyone who is suffering from a mental illness is not, is [00:52:05] not well served by everyone pretending that they're perfectly healthy.

[00:52:09] Mia Hughes: But [00:52:10] the other crucial part is when they reframed it as healthy, they made it not [00:52:15] only possible to celebrate it. But because trans activism [00:52:20] is so aggressive in its approach, they made it mandatory that we [00:52:25] celebrate it. So we had, you know, Laverne [00:52:30] Cox, Caitlyn Jenner, I am Jazz. Those were just a tiny few. We [00:52:35] all of a sudden trans-identified celebrities.

[00:52:38] Mia Hughes: So individuals who [00:52:40] have this psychiatric disorder and have medicalized their bodies as a result [00:52:45] of this psychiatric disorder were then thrust into the mainstream. They're, they're [00:52:50] on the cover of magazines. They're celebrated, they're, they're elevated to [00:52:55] almost a sacred status, and everybody is just, you know, forced to go along with this.[00:53:00]

[00:53:00] Mia Hughes: That is, that could only happen. Because they [00:53:05] deps psycho pathologized. It, it, it's impossible. If we were still grounded in [00:53:10] reality, if we still recognize that this was an actual psychiatric disorder and it it [00:53:15] requires ethical psychotherapeutic care, then nobody would be [00:53:20] putting these individuals on the cover of magazines.

[00:53:23] Mia Hughes: But because WPATH [00:53:25] shifted that they, we, they forced everyone to celebrate it. And I [00:53:30] believe that's what triggered the social contagion. Because the moment [00:53:35] we are celebrating it, and we're teaching kids in schools, that some people are trends, and I [00:53:40] am jazz is telling kids that, you know, you can be born with the boy brain, a girl [00:53:45] brain, and a boy body and all the rest of it.

[00:53:47] Mia Hughes: Then the idea lands into the minds of [00:53:50] young people and these young people are not identifying. Think about it. They're not [00:53:55] identifying as having a psychiatric disorder. They're not identifying as having gender [00:54:00] dysphoria. They're not identifying as having. [00:54:05] Autogynephilia, they're identifying as trends. And trends is the healthy [00:54:10] identity.

[00:54:10] Mia Hughes: So the harm that Dessy Pathologization [00:54:15] Unleashed is, is almost immeasurable in my mind. All of it to [00:54:20] all of its stems from Dessy, pathologization. And bear in mind that all of those [00:54:25] social contagion, kids who are exposed to this messaging then fall [00:54:30] into a medical world entirely guided by wpath, [00:54:35] guided by Dessy Pathologization, which means they're not being seen [00:54:40] as having a psychiatric disorder.

[00:54:41] Mia Hughes: They show up at the gender clinic, they say, I am [00:54:45] trans. And everybody in the gender clinic says, yes you are. And that's great. And they [00:54:50] affirm it, and then they provide the medical interventions that the trans identity [00:54:55] demands. So when I gave my talk in [00:55:00] Albuquerque, I simply. I tracked, well, I, I [00:55:05] outlined Des Psycho Pathologization, I explained the harm of it, and then I announced [00:55:10] that Gens SPECT was officially launching its Psycho [00:55:15] Pathologization campaign.

[00:55:16] Mia Hughes: Of course, it's just a play on w [00:55:20] path's wording. I just, and very deliberately, so I understand that perhaps it [00:55:25] was a bold thing to say. And, and believe me, the response was, um, [00:55:30] it was, it was quite, uh, it, it was not well received, let's [00:55:35] just say that. Um, but of course the reason I chose the word re psycho [00:55:40] pathologization is deliberately to show that we are turning [00:55:45] back all of the harm that Wpath Des Psycho Pathologization campaign has [00:55:50] done.

[00:55:50] Mia Hughes: And I stand by it. However, trans activists lost their [00:55:55] minds, of course. Um. That's, that was in no way a [00:56:00] surprise perhaps the, the, the ex, the, the, the lengths that they went to or the, the, the [00:56:05] extreme things that they said. Even that wasn't really that surprising. But there were lots of [00:56:10] calls for extreme acts of violence against Gen Spec members and [00:56:15] such.

[00:56:15] Mia Hughes: That is when they respond in that [00:56:20] way. I will say that that is actually exactly how you would expect [00:56:25] individuals who are. Consumed by an extreme overvalue [00:56:30] belief, that's exactly how you would expect them to react. Because like I [00:56:35] said, one of the defining features of anybody who is, whose mind is [00:56:40] dominated by an extreme overvalue belief is they really, really [00:56:45] respond viciously to anyone who suggests that their identity [00:56:50] is pathological instead of, you know, innate and healthy.

[00:56:53] Mia Hughes: And they also, [00:56:55] they, they react very aggressively towards anyone who they perceive to [00:57:00] be trying to step in the way of them obtaining whatever [00:57:05] goal their belief demands. In this case, it is the medical interventions. But I will [00:57:10] say that people on on so-called our side also responded. Some [00:57:15] people responded quite negatively to my talk and that was.[00:57:20]

[00:57:20] Mia Hughes: Because of my use of the word re psycho pathologization. However, I [00:57:25] still stand by it. And that's because to psycho pathologize [00:57:30] something in, in one part, in, in one [00:57:35] community, that is, it's a dirty word, I suppose. And it comes outta the Antip [00:57:40] psychiatry movement of the sixties and seventies where they viewed [00:57:45] all diagnosis as being oppression.

[00:57:49] Mia Hughes: [00:57:50] You know, it's, it's discrimination or it's oppression. Even schizophrenia or, [00:57:55] or really, really severe mental health issues. They viewed all of it as being a tool of [00:58:00] oppression and therefore get rid of all diagnoses. I'm not, I don't belong to that [00:58:05] world and I didn't realize anyone on so-called our side did belong to that world, but apparently they do.[00:58:10]

[00:58:10] Mia Hughes: I was using. To psychopathology in its [00:58:15] neutral clinical sense. And that means recognizing [00:58:20] something as a mental disorder in order to understand [00:58:25] it and ethically treat it and help the person understand themselves [00:58:30] and overcome to the best of the, the therapist's ability, [00:58:35] help them overcome whatever is troubling them.

[00:58:37] Mia Hughes: I didn't realize that it was going to cause [00:58:40] so much controversy on, on my people I would consider on my own [00:58:45] side. So that was the reason why I chose the word psycho [00:58:50] pathologization. And since then we have [00:58:55] yet to be published, but we've been working on a series of papers. [00:59:00] Explaining what we mean by trends as an extreme over value, belief, and [00:59:05] explaining why psycho pathologization is [00:59:10] necessary.

[00:59:10] Stephanie Winn: I wanna talk for a moment about the DSM five and the term gender [00:59:15] dysphoria. 'cause you talked about the shift where, uh, in previous DSMs it was, uh, gender [00:59:20] identity disorder, right. And DSM five that came out 2013, which is the same year [00:59:25] that I graduated from my, uh, graduate program in counseling psychology.[00:59:30]

[00:59:30] Stephanie Winn: And, uh, as you said, now the push in the ICD 11 [00:59:35] is gender incongruence. So for people who are, like, what's the DSM versus the ICD? So the [00:59:40] DSM is specifically the psychiatric listing. I hate it when people call the [00:59:45] Bible. It's more like the dictionary or the encyclopedia of, [00:59:50] uh, the current understanding of psychia psychiatric [00:59:55] diagnoses, which is obviously heavily politicized.

[00:59:59] Stephanie Winn: Very [01:00:00] influenced by culture, by the pharmaceutical industry. It's, it's a work in [01:00:05] progress, right? I, I would like to do an interview soon with my friend, SOAD Dreezy, because I [01:00:10] know that she's been keeping track of the latest developments toward the DSM six. Right? [01:00:15] So the DSM for listeners is the Diagnostic and Statistical Manual of Mental Disorders.

[01:00:19] Stephanie Winn: [01:00:20] The ICD is the International Classification of Diseases. So it's much broader. It's, it's what doctors [01:00:25] use. And so all of the DSM diagnoses and codes are within the [01:00:30] ICD, but it's a different, much broader classification system. So the ICD is [01:00:35] on the 11 now, where gender incongruence is a term. The [01:00:40] DSM is still on the five released in 2013 where it's, [01:00:45] uh, gender dysphoria.

[01:00:47] Stephanie Winn: And so the shift, as m is [01:00:50] pointing out towards the idea gender incongruence is the most d [01:00:55] psycho pathologized, because it's just saying, oh, your mind and body don't match. And it's not, let's [01:01:00] fix your mind. It's let's fix your body. But I did wanna talk a little bit about the DSM five because it, [01:01:05] it was released at an interesting time in the unfolding [01:01:10] of all of this, and it's actually not clear in the DSM [01:01:15] five what they expect therapists to do about this.

[01:01:17] Stephanie Winn: Um, you know, yes, it says [01:01:20] preference for activities and styles of dress and things [01:01:25] associated with the opposite sex. There's very little to no mention of the [01:01:30] sexual component of that. Um, like you say, the [01:01:35] distress is definitely defining criteria, but that's also the case with anything in the DSM. It [01:01:40] has to cause clinics, uh, excuse me, clinically significant distress or functional [01:01:45] impairment or both in order to meet criteria.

[01:01:47] Stephanie Winn: Um, but if you go out to read [01:01:50] the description of gender dysphoria, the, the narrative component in the DSM. It doesn't [01:01:55] say therapists should or shouldn't do this or that. It's very [01:02:00] neutral. And the rates, the prevalence statistics given are obviously [01:02:05] old. Like the numbers are just intuitively when you read them.

[01:02:08] Stephanie Winn: Those are like numbers [01:02:10] from, you know, 20 years ago. Um, and then it [01:02:15] says, well, some people choose to medicalize this and become transgender, blah, blah, blah. But does it [01:02:20] say, as a therapist you should write a letter encouraging that. Does it say as a [01:02:25] therapist you, you should explore, you know, what this might have to do [01:02:30] with childhood trauma or with paraphilias or with obsessive compulsive deter it.

[01:02:34] Stephanie Winn: It [01:02:35] doesn't say any of that. And I just, I think that's really interesting. And the, the other thing I will put a [01:02:40] little bit of a fine point on is the term dysphoria itself and how it's used now by the [01:02:45] youth because. Uh, like Mia is saying, a lot of them, they don't say, I have [01:02:50] dysphoria. They say I'm trans, but some of them do say I have dysphoria.

[01:02:54] Stephanie Winn: And [01:02:55] again, going back to that idea of the extreme overvalued belief in their meaning making system and how they're [01:03:00] using their neuroplasticity in this chapter of life, anything that goes wrong, anything that [01:03:05] doesn't feel good, that gets labeled my dysphoria and that gets painted in [01:03:10] contrast to the concept of euphoria, the gender euphoria that I anticipate I [01:03:15] will have.

[01:03:16] Stephanie Winn: And that to me feels like just a, a hacking of our [01:03:20] motivation and reward system. Before we started recording Mia, you had mentioned that, uh, when you [01:03:25] talk about cracking the code and your, your research and your writing, you describe feeling [01:03:30] a sense of euphoria associated with cracking the code. And I thought, well, that makes sense.

[01:03:33] Stephanie Winn: I know that feeling that [01:03:35] that dopamine, that, oh, I'm on the right track. I'm discovering something. [01:03:40] And it's like, that's actually what dopamine is meant to do for you. It's meant to reward. [01:03:45] Meaningful effort. It's meant to reward progress toward goals, but it [01:03:50] can also really easily be exploited. So if we think about all the pleasurable feelings that we [01:03:55] get out of doing things like meaningful work or building something or, or becoming [01:04:00] enlightened on a path of, of genuine intrigue, imagine that's the [01:04:05] same feeling, that's the same motivational system that is being hacked in [01:04:10] these kids where anytime they get so-called [01:04:15] properly gendered as opposed to misgendered, right, then they, they feel that little [01:04:20] euphoria, right?

[01:04:20] Stephanie Winn: And it's the placebo effect because they've, they had that extreme overvalue belief. [01:04:25] They've, they've convinced themselves that's what they need in order to be happy. But this is what I mean when I talk about [01:04:30] neuroplasticity. I mean, if that is how you are using your brain. Reinforcing it over and [01:04:35] over, it does become true for you.

[01:04:36] Stephanie Winn: It becomes a self-fulfilling prophecy, and that's why it's so [01:04:40] hard to treat it at this point. So people like Mia and uh, everything downstream of [01:04:45] the work you're doing, we have our work cut out for us, helping these people [01:04:50] untangle all the mental knots that have been tied here.

[01:04:52] Mia Hughes: It's true. I mean, when I said [01:04:55] euphoria, I wasn't joking.

[01:04:57] Mia Hughes: It's when I've been, 'cause I, [01:05:00] because I wrote my whole thesis out into one giant document and as I added [01:05:05] things in and I thinking through all of these areas, I. Every time something slotted [01:05:10] in, it felt like a eureka moment where I just go running through the streets and excitement. [01:05:15] However, the, the euphoria that these kids are chasing, it's artificial or it's, [01:05:20] it's in the future, they build up in their mind that this next medical [01:05:25] treatment is going to bring the euphoria and maybe it does for a short time.

[01:05:29] Mia Hughes: 'cause the mind is very [01:05:30] powerful and you've just, you, you have achieved a goal that you fixated [01:05:35] on and you really believe, yeah, you can create feelings of euphoria, but [01:05:40] it's usually short-lived.

[01:05:42] Stephanie Winn: Are you a freethinking therapist looking for [01:05:45] like-minded community? The Association for Mental Health Professionals is a [01:05:50] sanctuary for holistic critical thinking counselors and therapists who want to stand firm in our [01:05:55] values and reclaim our profession from ideologues.

[01:05:58] Stephanie Winn: A MHP offers its [01:06:00] members a blog and podcast, monthly webinars, and an annual. Each fall [01:06:05] in Texas, visit Association for mental health [01:06:10] professionals.org to join a growing number of like-minded therapists who want our profession back. Alright, [01:06:15] now back to the show.

[01:06:16] Mia Hughes: So Mia, you were saying that in your paper on [01:06:20] re Psycho Pathologization,

[01:06:22] Stephanie Winn: you compare [01:06:25] how we're handling gender dysphoria.

[01:06:27] Stephanie Winn: With how we're handling [01:06:30] anorexia and body dysmorphic disorder.

[01:06:32] Mia Hughes: I think it's the strongest [01:06:35] comparison to help people, like framing trends is an extreme overvalue belief. I [01:06:40] understand that this is a brand new framing and it's taking time for people to understand, [01:06:45] but it can help. When I was reading the literature on, they [01:06:50] were all overvalued ideas back then.

[01:06:52] Mia Hughes: That was the, the concept that people were [01:06:55] using repeatedly. I came across anorexia, [01:07:00] and so in the paper that I've written that has yet to, we've yet to find [01:07:05] a, a journal to publish it, but we're, we're just coming to the end of writing it. [01:07:10] We, I drew the, we drew the comparison between anorexia and it really works well [01:07:15] because anorexia is also a disorder of overvalued idea [01:07:20] in the sense that.

[01:07:22] Mia Hughes: It's usually a, an adolescent girl [01:07:25] or a young woman, and she, the, the idea that [01:07:30] she holds, the belief that she holds is typically something along the [01:07:35] lines of she is, um, one cannot be too thin, [01:07:40] thinner is better and one cannot be too thin. And that fits into [01:07:45] the culturally approved narrative, right? Because [01:07:50] we all, we, we do still live in a culture where thin is considered.[01:07:55]

[01:07:55] Mia Hughes: Better and, and fat. To be fat is considered shameful. There's no doubt about [01:08:00] that. Look at, you know, any popular culture, look at any television show, [01:08:05] movies, whatever. Even with fat positivity movements, we still, we still [01:08:10] live in this world where we value people who are thin over people who are fat. [01:08:15] And so the anorexic just takes that belief to the [01:08:20] extreme.

[01:08:20] Mia Hughes: I mean, in the ICD, we were just talking about the ICD, the World Health [01:08:25] Organization's classification. Anorexia is classified as a disorder of [01:08:30] overvalued idea, and it is the fear of flabbiness. So an [01:08:35] anorexic just absolutely detests any body fat of any [01:08:40] kind, and it becomes this all consuming belief. This, this belief [01:08:45] dominates her mind.

[01:08:46] Mia Hughes: Nothing else. There's nothing else in her life. It's all about [01:08:50] restricting food. Making sure that she doesn't eat anything that [01:08:55] could possibly add even an a, a tiny little bit of body fat, [01:09:00] compulsive behaviors, exercising and, and restricted eating, [01:09:05] obsessing over food. But the crucial part of anorexia is that [01:09:10] she experiences this belief as ego, syn, tonic.

[01:09:14] Mia Hughes: So we're right [01:09:15] back to that term, which is crucial for the overvalued idea or the overvalued belief. [01:09:20] She experiences her desire to be emaciated and, [01:09:25] and no body fat whatsoever as a true expression of who [01:09:30] she is. She doesn't see herself as having a mental disorder in her and [01:09:35] anorexia. An anorexic is not going to show up at a psychiatrist's clinic.[01:09:40]

[01:09:40] Mia Hughes: Asking for help to overcome her anorexia. She [01:09:45] relishes it. She cherishes it. She think she thinks that she is, she typically thinks that she [01:09:50] is better than everyone else and has this warped view that other [01:09:55] people are looking at her and they're, they're jealous and they wish that they could be as thin as she [01:10:00] is.

[01:10:00] Mia Hughes: And so that's why the comparison works really well, [01:10:05] because it's the anorexic family who typically convince her [01:10:10] to go and get psychiatric support. And she will fight against [01:10:15] anyone who tries to make her gain weight because she does not see [01:10:20] herself as being ill at all. And so. [01:10:25] I, when I, when I thought this through, I realized [01:10:30] gender affirming care, so-called the entire field of gender [01:10:35] medicine, is the equivalent of the anorexic showing up at [01:10:40] the eating disorder clinic.

[01:10:41] Mia Hughes: And, and, you know, saying that she's too fat and [01:10:45] she, she needs to lose weight. And the clinic saying, yes, you are too [01:10:50] fat. Here's your treatment, it's ozempic, here's your ozempic. [01:10:55] And then the amazing thing about gender affirming care, the, the field of [01:11:00] gender affirming care is that the way they measure whether or not [01:11:05] these medical interventions are the right thing to do is by self-report.

[01:11:09] Mia Hughes: We all [01:11:10] know that all of the studies in gender medicine. Are not [01:11:15] long-term studies measuring life situation, objective [01:11:20] outcome, how the person is functioning in life. It's self-report. They give these people the [01:11:25] medical treatments that they want and then at the end they say, are you happy? So that's the equivalent of [01:11:30] your anorexic showing up at an eating disorder clinic, being [01:11:35] given liposuction and ozempic.

[01:11:37] Mia Hughes: And then at the end of it, all of the [01:11:40] studies are asking her if she's happy. Now, of course, [01:11:45] she's happy, the disorder that she has propels her towards this. [01:11:50] This behavior, this pathological dangerous behavior to [01:11:55] lose as much weight as possible. And if you give her the drugs and the [01:12:00] whatever, the, the treatments that help her achieve that goal, you are going [01:12:05] to make her very happy.

[01:12:06] Mia Hughes: She, her health will be destroyed, she will be emaciated and [01:12:10] on the brink of death. But if you ask her if she's happy, she will absolutely say she is happy. [01:12:15] That is exactly what is happening in gender medicine. They [01:12:20] take the pathological desire, which is hormones and [01:12:25] surgeries. That is the key symptom of the trends.

[01:12:28] Mia Hughes: Overvalued belief is the [01:12:30] desire for these drastic irreversible medical interventions. [01:12:35] And then they give the individual the very treatments that the [01:12:40] key symptom. Demands. So the treatment and the symptom are [01:12:45] exactly the same. They're one and the same. And then they measure their success by [01:12:50] asking the individual whose mind is completely dominated by this idea, [01:12:55] are you happy?

[01:12:56] Mia Hughes: And because we, we know 99% of [01:13:00] them say, yes, I am happy. The entire field of gender medicine says [01:13:05] then we're doing the right thing. Everything is perfectly fine. The, the madness [01:13:10] of it, when you compare it to anorexia, which everyone can see, is [01:13:15] clearly a pathological disorder. But the point of psycho [01:13:20] pathologization, the point of framing trends as an extreme overvalue belief, and the [01:13:25] point of comparing it with anorexia is to show.

[01:13:29] Mia Hughes: That, as [01:13:30] I said in my talk repeatedly, the madness lies in society. The [01:13:35] madness, the individuals, they are, they are just, they are possessed by an [01:13:40] idea. They have, they're in the grips of a belief and they need help. The true [01:13:45] madness is how we as a society and the medical world [01:13:50] particularly respond to the individuals who are now completely [01:13:55] possessed by this idea because instead of trying to help them, we give them the exact [01:14:00] pathological desire.

[01:14:02] Mia Hughes: We, we fulfill their path, pathological [01:14:05] desire. So the, the i, I suppose I'm pathologizing [01:14:10] society. That's what the point of psycho pathologization [01:14:15] is, is we all have to recognize we have to, one, stop [01:14:20] celebrating. This identity is healthy. We have to stop pretending that these medical [01:14:25] interventions are ethical, medical care, and a human [01:14:30] right, and we need to, it doesn't mean like I know I'm accused of all [01:14:35] kinds of stuff.

[01:14:35] Mia Hughes: They accuse me of trying to exterminate trans identified people. They accuse me [01:14:40] of genocide and all of this, but actually this [01:14:45] group of people will still exist, but we will understand them better. The [01:14:50] people treating them will understand what it is that they are treating. [01:14:55] The people who have the idea will understand what it is that they have, and [01:15:00] all of society will have a better understanding of what is going [01:15:05] on with this group of people and will stop mindlessly celebrating it [01:15:10] without understanding it.

[01:15:10] Mia Hughes: I think I've just remembered what it was. I forgot earlier. It was [01:15:15] because you said the therapists have a really hard time with. [01:15:20] These individuals who show up very much in the [01:15:25] grips of the belief. And that's a key part that is in the paper that I wrote, is [01:15:30] for the, when the person shows up [01:15:35] seeking help, first of all, the trans-identified person, like the anorexic, the [01:15:40] trans-identified person is not presenting to a healthcare professional or a mental [01:15:45] health professional because they want to overcome the trans identity because they don't [01:15:50] realize that they have a pathological condition.

[01:15:52] Mia Hughes: They think that the trans identity is healthy, [01:15:55] and they are showing up because they want the medical interventions and the, [01:16:00] the field of medicine is set up such that they can expect to obtain [01:16:05] them. That's, that's just where we are. Like if you, if you identify as trans, look, this is [01:16:10] this entire field of medicine.

[01:16:12] Mia Hughes: The problem I think, therapist, the [01:16:15] frontline faces is by the time the person, uh. [01:16:20] Presents to a clinic. They are already very [01:16:25] much in the grips of the belief. So Carl Veer, who first outlined the [01:16:30] overvalued idea, he makes very clear that a. The [01:16:35] best hope that you have of loosening the grip of this idea is in its earliest [01:16:40] stages before it totally dominates the person's life.

[01:16:43] Mia Hughes: And he, he uses the [01:16:45] phrase countervailing perspectives. You have to, it's the job of [01:16:50] anyone around this person to introduce countervailing perspectives to [01:16:55] show why the belief is either false or harmful or dangerous or whatever. [01:17:00] But the problem that the therapists you guys face is by the [01:17:05] time the person presents for care, the belief has fully and completely [01:17:10] cemented into the mind.

[01:17:11] Mia Hughes: And once that happens, it's very [01:17:15] difficult, as I'm sure I don't need to tell you to take the young person or to take the, the [01:17:20] whatever age person, get them off course and get the belief to loosen its grip. [01:17:25] It's very much about just planting ideas, gently [01:17:30] present different. Beliefs, [01:17:35] different alternative perspectives, these countervailing perspectives that Verna talked about.

[01:17:39] Mia Hughes: [01:17:40] And so by, by redefining trends in this way and introducing [01:17:45] this whole framework, I want to be clear that I am in no way suggesting, oh, I've [01:17:50] solved the problem. I've saved them all. I haven't in any way whatsoever. It's [01:17:55] just a different way of viewing the trans-identified person. And it [01:18:00] hopefully will give therapists and everybody in the, the medical world a [01:18:05] different way of, uh, a, a way to understand these people and [01:18:10] perhaps help them in a less destructive way.

[01:18:13] Stephanie Winn: I think there's a range of [01:18:15] how dug in patients are when they arrive in the therapist's office. [01:18:20] And um, in my line of work, I'm uniquely suited to hear [01:18:25] all manner of stories. You know, second and third hand stories about. [01:18:30] How one of my client's kids' therapy is going. And of course, I'm perpetually [01:18:35] disappointed in my colleagues, you know, when, when I hear from a, a parent [01:18:40] who really thought that they did their due diligence and screening to [01:18:45] find a therapist who would be neutral, who seems [01:18:50] to have a more, uh, nuanced psychological understanding of these things.

[01:18:54] Stephanie Winn: And [01:18:55] then, uh, you know, time and again, I just keep hearing these [01:19:00] therapists eventually cave in. Uh, or I [01:19:05] hear that they do something naive. So a common mistake that I hear [01:19:10] about is encouraging the parents to quote [01:19:15] unquote compromise on pronouns or something like that. And, and to [01:19:20] me, that shows me that. The therapist has not had enough [01:19:25] experience in this world that you and I are in to recognize that [01:19:30] the ante will keep upping, that the goalposts will keep shifting.

[01:19:34] Stephanie Winn: That this is not a [01:19:35] satiable beast. This is not a, a, a situation that's [01:19:40] amenable to compromise. As you pointed out very early in our [01:19:45] conversation today, social transition leads to medical transition because [01:19:50] again, those neural pathways are being confirmed over and over again that [01:19:55] this is who I am, this is how I must be seen and treated in order to be myself, in [01:20:00] order to be okay, in order to be happy or move on with my life.

[01:20:04] Stephanie Winn: [01:20:05] And that becomes, again, a self-fulfilling prophecy. Um, as [01:20:10] I shared in, I think what will be the previous episode to this one coming out, [01:20:15] um, my personal read on the finished study, I talk about things like the [01:20:20] untested hypothesis and the body as a hotel room, right? So by those two [01:20:25] things, I mean, essentially.

[01:20:27] Stephanie Winn: That the young person is suspending [01:20:30] self care, suspending anything that would help them settle into their [01:20:35] body and grow confident as they are today because this belief system that they [01:20:40] hold gets in the way of them doing so. Right? If you were to get comfortable in your [01:20:45] body the way it is now and accept being recognized as the sex you are, you are, it would mean you're not [01:20:50] really trans or you don't really have gender dysphoria and that defines who you are, right?

[01:20:53] Stephanie Winn: So again, the [01:20:55] incentive structure here is just so whack, but my commentary on the [01:21:00] therapist is, you know, I do hear these stories where. A parent thinks that they [01:21:05] found a therapist who is going to serve their family well, and then the therapist [01:21:10] ends up revealing themselves to be quite naive because they're trying to negotiate with the parent as if they, you know, if you [01:21:15] just give in on pronouns, they'll come around.

[01:21:17] Stephanie Winn: Right? And it's like, that's not how [01:21:20] this works. If you've seen what these kids are like. And that's [01:21:25] why I teach parents that my motto with therapist is guilty until proven innocent. You just have to be kind [01:21:30] of paranoid towards them in today's climate. But I, I really do see [01:21:35] a broad range and I, I see therapists getting it wrong the other way around too, where [01:21:40] sometimes a parent will tell me about a therapist that their kid was seeing before the [01:21:45] gender issue ever came up.

[01:21:46] Stephanie Winn: They were seeing them for some other reason like divorce or something like that. [01:21:50] And then the gender issue comes up. The parent is hesitant to take the [01:21:55] kid away from a therapist they've been working with for years who they have a good relationship with. And the [01:22:00] therapist takes it too far. The kid's actually in a place of uncertainty, but the [01:22:05] therapist jumps to, oh, well then you, you must, you know, go further with [01:22:10] this.

[01:22:10] Stephanie Winn: So that's a, you know, that's a conversation for another time. My [01:22:15] critique of all the things I hear of therapists and I, I, you guys do have a hard job. [01:22:20] You do have a hard job, my colleagues, but there's so many ways to get it wrong.

[01:22:24] Mia Hughes: There [01:22:25] is, I mean, I just hope that by, if [01:22:30] everyone can understand what these pathological beliefs are, [01:22:35] how they function, how their ego, syn, tonic, how the kid does not see, or the young person does not [01:22:40] see that they have a psychiatric disorder, and how countervailing perspectives [01:22:45] can loosen the grip of the belief.

[01:22:47] Mia Hughes: But never in a direct [01:22:50] confrontational way that will just cause the person to further entrench or likely just cut you out of their [01:22:55] life. Um, then hopefully just understanding, first of all, [01:23:00] I think it's just understanding what you're dealing with and I think the, the extreme overvalue [01:23:05] belief does bring clarity to this in a way that no [01:23:10] other classification has so far.

[01:23:13] Mia Hughes: But IJI, I think as well, [01:23:15] something that I haven't brought up is, 'cause I was just talking about countervailing perspectives [01:23:20] that jumped into my mind is when Verica [01:23:25] described this overvalued idea in the, you know, the late [01:23:30] 19th century. Obviously he could never have imagined. [01:23:35] The world in which we live. So like there's definitely, there's the [01:23:40] extreme acts of violence where they're in these internet echo chambers and they're, you know, the [01:23:45] beliefs are being fortified and amplified, and then it just kind of lodges into one [01:23:50] mind and then, and then this person acts.

[01:23:52] Mia Hughes: But there's something [01:23:55] exceptional about trends in that for most of [01:24:00] the, well, for the 2010s, I would argue wider society [01:24:05] functioned like an internet echo chamber. Because trans activism [01:24:10] forbid anyone from deviating from this extreme overvalue belief [01:24:15] that trans is healthy and medical interventions are a human right because of the [01:24:20] climate of fear.

[01:24:20] Mia Hughes: And because trans activism created a society-wide [01:24:25] echo chamber. Many of these young people who got sucked [01:24:30] into the vortex of this belief. There were no countervailing perspectives [01:24:35] anywhere. But I do feel enormous hope now we're in [01:24:40] 2026 and the countervailing perspectives are there, like I've talked [01:24:45] to Detransition who say, well, one, there's a social contagion of [01:24:50] detransition and just that they are encountering a detransition and they [01:24:55] realize that, that this person is exactly like them.

[01:24:57] Mia Hughes: It's the same social mechanism that [01:25:00] tragically drew them all then in the first place when they encountered a, a lost, confused [01:25:05] teenager online saying, I'm trends. Now they're encountering [01:25:10] detransition who are the same as them again, and, and drawing them outta the social contagion, [01:25:15] outta the medical scandal.

[01:25:17] Mia Hughes: But I also think that [01:25:20] because people are now not afraid of trans activists in the same way, of [01:25:25] course the debate is on, the countervailing perspectives are out there. And Detransition [01:25:30] have said they listened to turfs. That's what caused them to detransition. They [01:25:35] just, like, they encountered turf narratives.

[01:25:39] Mia Hughes: Uh, they [01:25:40] encountered the gender critical side. And at first they thought it was [01:25:45] transphobic and terrible, but it lodged in their mind. And then eventually the [01:25:50] idea started to, the belief started to loosen its grip and they realized what [01:25:55] they had been a part of. So I think I, in, I feel [01:26:00] hopeful that countervailing perspectives that were forbidden for so long.[01:26:05]

[01:26:05] Mia Hughes: Which is just reality from reality is, is now permitted. We can [01:26:10] all talk about this. And that is going to, on the one hand, help draw people out [01:26:15] from further medical harm and on, on the other hand, prevent innocent [01:26:20] people from falling into it in the first place.

[01:26:22] Stephanie Winn: And for the parents in the audience, [01:26:25] just noticed that Mia didn't say that they listened to their [01:26:30] parents who were raging turfs, uh, and that, that they said, oh, you're [01:26:35] right.

[01:26:35] Stephanie Winn: Mom and dad, um, detransition, who listened to turfs, came to [01:26:40] appreciate those outside perspectives in their own time, in their own way. [01:26:45] Um, you know, you have to be very mindful of the developmental [01:26:50] stage that they're in and the function that the trans identity serves in their process of developing [01:26:55] autonomy.

[01:26:55] Stephanie Winn: And one of the things I regularly work through with my clients. [01:27:00] Is, uh, letting go of the naive fantasy that your kid's gonna say, [01:27:05] dad was right. Mom was right. That's not how this is gonna go. Right. [01:27:10] You are not the best messenger of these countervailing [01:27:15] beliefs. And as, as Mia pointed out, um, earlier. [01:27:20] The best stage for intervention is early before the beliefs have completely set and [01:27:25] integrated with, and taken over every aspect of that person's like.

[01:27:28] Stephanie Winn: And again, that [01:27:30] wedge needs to be sort of gentle and from the side, rather than directly [01:27:35] attacking something that that person perceives as fundamental to their identity and [01:27:40] their value as a person. So if you are a parent, uh, just know that what we talk about on this [01:27:45] podcast, I say this almost every single episode, what we talk about on this podcast is for our [01:27:50] information, for our understanding of the situation.

[01:27:52] Stephanie Winn: It's not necessarily always [01:27:55] that our approach to communicating about these issues on this podcast is the way that you should [01:28:00] talk to your kids about that. If you have a child in this, uh, you've probably already heard me [01:28:05] advertise my program for parents, but RGD Repair is where you will learn [01:28:10] specifically what communication techniques you can use as a parent that respond to your [01:28:15] child's psychology and that take your family system into account.

[01:28:17] Stephanie Winn: So I just wanted to. Add that note. If [01:28:20] you're a long-term listener, you've heard me say that in all my recent episodes just because the things we talk about [01:28:25] here are not going to be well received. If you take that exact same [01:28:30] message and try to have that conversation with your kid, or heaven forbid, try to play an episode of my [01:28:35] podcast for your child and your bought into this, it's not gonna go the way you hope.[01:28:40]

[01:28:40] Stephanie Winn: That's why we have a whole separate curriculum for learning how to talk about this in your [01:28:45] family.

[01:28:45] Mia Hughes: I'd be interested to know what you think about this. 'cause this is something I've been [01:28:50] just, it's in my mind. I read Hadley Freeman's Good Girls. [01:28:55] So Hadley Freeman, the journalist, had severe anorexia all throughout adolescence [01:29:00] and spent I think like six years in and out of psychiatric care.

[01:29:04] Mia Hughes: [01:29:05] And there's a really interesting part, 'cause I'm always thinking about. What, [01:29:10] what, how do we loosen the grip of the ones who are already in there? How do you loosen [01:29:15] the grip of this belief? And as the detransition have told me, many of them, they [01:29:20] just allowed, they watched one Peter Ian video, and then they just let it [01:29:25] sit in their mind.

[01:29:26] Mia Hughes: And eventually they sought out more, or they listened to a turf and they [01:29:30] thought she was transphobic. But the, the idea lodged in their mind, and the Hadley [01:29:35] Freeman, because it's anorexia, it's a parallel world, but it's very similar. She said [01:29:40] that she was interviewing one of the experts who said very often [01:29:45] the, the overvalued idea, the overvalued belief [01:29:50] loosens its grip.

[01:29:51] Mia Hughes: Definitely not because you're directly targeting it, but the [01:29:55] person in the eating disorder ward, the anorexic who's starving herself, would [01:30:00] overhear the nurses talking on a Friday afternoon about their plans for the [01:30:05] weekend. And gradually the, the, the, the woman would think. I wanna have [01:30:10] plans on the weekend.

[01:30:10] Mia Hughes: I wanna have a life beyond this. And that was the first crack. The [01:30:15] belief, there's a crack in the belief, and there's another world out there. There's a real life that you could [01:30:20] have if you just let this belief go. For Hadley Freeman, I think she says, one of the [01:30:25] cracks, one of the major cracks for her was there was a 30-year-old [01:30:30] anorexic at the, the table having a complete meltdown, like a, [01:30:35] like a toddler over how much butter was on her toast.

[01:30:39] Mia Hughes: And Hadley [01:30:40] Freeman had this, I don't wanna be 30 years old and having a tantrum over [01:30:45] toast. And the belief there was a crack, a major crack in this belief that I need [01:30:50] to starve myself. I cannot have an inch of fat on my body. And so. [01:30:55] It's not directly challenging the belief, but do you think [01:31:00] that, and I know that they also tell parents, parents are not to focus on the, on [01:31:05] the anorexia with their child.

[01:31:06] Mia Hughes: They're to just almost pretend that it doesn't exist and just [01:31:10] act normal and it's no big deal. Because if you focus on it and if [01:31:15] you aggressively attack it, you entrench the belief and you entrench your child. [01:31:20] So what's the, is there a similar, is there a way that parents [01:31:25] can be those nurses talking about the weekend or the, the, you know.[01:31:30]

[01:31:31] Mia Hughes: Put cracks in the belief without the, the young person [01:31:35] knowing. What do you think?

[01:31:35] Stephanie Winn: Yeah, absolutely. I mean this is, this is what I specialize in, right? This [01:31:40] is, this is the conversation I have all week long. And I think that there are far more than those [01:31:45] two options. And I think a lot of people come to me when they have tried [01:31:50] either or both of those two options, right?

[01:31:52] Stephanie Winn: One option being to directly attack the [01:31:55] belief oftentimes in a way that is quite naive to the [01:32:00] function that that belief serves in that young person's life. And then [01:32:05] no surprise that it doesn't go well, right? So that's one option. Another option is to [01:32:10] completely ignore it, like you say, and just, uh, as many people say, [01:32:15] focus on the relationship, fix, you know, nurture the relationship, which I definitely [01:32:20] believe in, but what does that mean?

[01:32:22] Stephanie Winn: A lot of times people come to me because they've been trying to do [01:32:25] that, and that's looked like being conflict. Avoid. Kicking the can down the road, [01:32:30] walking on eggshells, enabling bad behavior, [01:32:35] um, tolerating things that are not helping shape their child's [01:32:40] character development. And just hoping the issue will go away.

[01:32:44] Stephanie Winn: And [01:32:45] oftentimes, you know, these parents, they've done their research, they've read all the same things you and I have. Maybe not all the same things, but, [01:32:50] but they're like, well, gender dysphoria resolves on its own if you just leave it alone. It's like, yeah, [01:32:55] well that, that study that was from a, a time and a different [01:33:00] cultural environment, it's not gonna go away on its own in our current cultural [01:33:05] incentive and disincentive system.

[01:33:07] Stephanie Winn: So, you know, I, I don't [01:33:10] think that nurturing a relationship or, you know, not [01:33:15] directly targeting the issue has to mean total conflict. Avoidance has to mean codependent, [01:33:20] um, dysfunctional, you conflict avoidant [01:33:25] relationships. I think. Sometimes working on the relationship [01:33:30] without directly targeting the belief, but without not targeting it either, [01:33:35] is really a matter of slowing down attuning to what's happening and picking up what your kid is putting [01:33:40] down.

[01:33:40] Stephanie Winn: And that's why I describe ROGD repair as an emotionally intelligent approach [01:33:45] to parenting your way through this. Because if you're slowing down and attuning to what's [01:33:50] going on, kids are giving you all of these moments, right? There's, there's a [01:33:55] moment that they snap at you, or there there's a flash of [01:34:00] fear or a flash of guilt or some emotion, right?

[01:34:03] Stephanie Winn: And what are you [01:34:05] doing with that moment? Can you stop and acknowledge, okay, I saw that. Do you [01:34:10] wanna talk about it? Or, uh, I teach parents to make [01:34:15] empathic guesses. People rely on questions too much. They [01:34:20] think, uh, you know, that's the other advice. Oh, just ask what does that mean to you? Why do you [01:34:25] feel that way?

[01:34:25] Stephanie Winn: Why do you think you feel that way? No, those aren't good questions. I mean, I do have a lesson in my [01:34:30] course on using what and how questions rather than why questions. 'cause those are less [01:34:35] likely to provoke defensiveness. But when you're asking questions, you're letting the kid lead and [01:34:40] you are overvaluing their insight.

[01:34:43] Stephanie Winn: You're overestimating [01:34:45] their insight. So what I do with my clients is we do the heavy lifting as the [01:34:50] adults, and if you go through my course and you take their homework really seriously and you do the exercises [01:34:55] in my program, you're basically mimicking the coaching process. You as the adult, as the [01:35:00] mo, more emotionally intelligent person here, you do the heavy lifting of figuring out what this means to [01:35:05] your child, mapping out their psyche, figuring out their association so that you can make [01:35:10] intelligent empathic guesses so that you can reframe what they're saying in a way that [01:35:15] they feel heard, that you just interpreted it a slightly different angle.[01:35:20]

[01:35:20] Stephanie Winn: And, and, and that's the process by which you gradually untangle these knots in the brain. And [01:35:25] that's what I teach parents to do.

[01:35:26] Mia Hughes: That's putting the crack. So that's your way of, of [01:35:30] putting, it's all about just putting little cracks in the belief. And then [01:35:35] for some it's really fast, it just crumbles. And for others it can take years and years and [01:35:40] years.

[01:35:40] Mia Hughes: But the doubts and the incoherencies, the [01:35:45] inconsistencies, it all starts to add up. And eventually, Stella's got that lovely analogy, [01:35:50] adding pebbles to a bucket. I love that. Eventually the, the, the accumulated [01:35:55] weight of the pebbles outweighs the whole, the belief hand.

[01:35:57] Stephanie Winn: And let me add a really important [01:36:00] piece of this that I don't, I don't ever want anybody to miss this piece.

[01:36:03] Stephanie Winn: It's about the [01:36:05] part of your child that wants to desist. It's about helping the [01:36:10] part of them that wants out of this. There is a part. [01:36:15] So it's not about the cracks that you wanna put in, right? So if you're [01:36:20] a raging feminist turf and you're so angry about men in women's prisons, like, [01:36:25] I get it. Okay, I'm, I'm with you.

[01:36:27] Stephanie Winn: Okay? But if that's not the [01:36:30] area of cognitive dissonance that's most accessible for your child, figure out [01:36:35] what is. Well, thanks for inviting me to talk about my work. I, I, I was talking about my work. Um, [01:36:40] Mia Hughes, it's so good to have you. Thanks so much for coming back on the show. By the way, I forgot to mention this [01:36:45] at the beginning, but if you're still listening and you want more of Mia's lovely phone book [01:36:50] reading voice, um, to put you to sleep, perhaps put you to sleep while learning about gender [01:36:55] issues as she originally appeared on my podcast on episode 107.

[01:36:59] Stephanie Winn: And I will link to [01:37:00] that in the show notes. Um, so Mia Hughes, where can people [01:37:05] find you and all the things that you're up to?

[01:37:08] Mia Hughes: I am only active [01:37:10] on Twitter XI suppose I should get used to calling it, but I can't. Um, [01:37:15] at underscore Crimea River, that's the only social media I have. Although I did [01:37:20] just launch my substack.

[01:37:21] Mia Hughes: I suppose I should plug that. It's the same Crimea [01:37:25] River Mia spelled MIA. And there's one essay on [01:37:30] there, which is a very personal one about my time in Taiwan and about [01:37:35] change and the importance of open futures. I'm a co-host of Beyond [01:37:40] Gender with Stella Iman and Brett Alderman. So you can find beyond gender on [01:37:45] YouTube.

[01:37:45] Mia Hughes: My Canadian writing is on my MLI, my McDonald Laure [01:37:50] Institute page, and then I write for Gen Spec too and keep a lookout for my [01:37:55] academic paper, which I am convinced will get published somewhere, but [01:38:00] I think it's going to be a bit of a lengthy. Process there.

[01:38:03] Stephanie Winn: Thank you so much for joining me. It's been a pleasure.[01:38:05]

[01:38:05] Mia Hughes: Thanks for having me.

[01:38:07] Stephanie Winn: Thank you for listening to you [01:38:10] Must Be Some Kind of Therapist. If you enjoyed this episode. Kindly take a [01:38:15] moment to rate, review, share or comment on it using your platform of choice. [01:38:20] And of course, please remember. Podcasts are not therapy and I'm not your [01:38:25] therapist. Special thanks to Joey Rero for this awesome theme [01:38:30] song, half Awake and to Pods by Nick for production.

[01:38:34] Stephanie Winn: For help [01:38:35] navigating the impact of the gender craze on your family, be sure to check out my [01:38:40] program for parents, our OGD Repair. [01:38:45] Any resource you heard mentioned on this show plus how to get in touch with me can all be found [01:38:50] in the notes and links below rain or shine. I hope you will step [01:38:55] outside to breathe the air today in the words of Max Airman.

[01:38:59] Stephanie Winn: [01:39:00] With all its sham, drudgery and broken dreams, it is still a beautiful [01:39:05] [01:39:10] [01:39:15] [01:39:20] [01:39:25] [01:39:30] [01:39:35] [01:39:40] world.