You Must Be Some Kind of Therapist

Swell AI Transcript: 82. Jaime Reed.wav
Jamie Reed: We're setting someone up to live within a lie, because if we're going to initiate testosterone, the other parent doesn't even know that they're there. How is that work out in the family dynamic? We've got a triangulation now between mom, dad, and child. And now we have this new triangulation where mom and child are now, in essence, colluding with the medical providers to lock out dad. And so triangulation, these are not positive relationships for anyone. It doesn't create good relationships. It's setting up the family for conflict.
Stephanie Winn: You must be some kind of therapist. Today I have the pleasure of speaking with Jamie Reid, whose work many of you are probably already familiar with. Jamie entered the spotlight in February of 2023 when she published an article in the Free Press called, I Thought I Was Saving Trans Kids, Now I'm Blowing the Whistle. Since then, Jamie has been on several podcasts, including Triggernometry, Transparency, and Gender A Wider Lens, and she co-founded the LGBT Courage Coalition, which currently has a substack as well as future plans for political action. So, Janie has been praised for her courage as a woman who describes herself as queer and politically to the left of Bernie Sanders, for sounding the alarm with what she was witnessing during her time at the Washington University Transgender Center at St. Louis Children's Hospital, where she began working in 2018 and left in 2022. As an intake coordinator, when Jamie started, she got about 10 calls a month. By the time she left four years later, it was up to about 50 calls a month from about 70% females. What she saw there was so appalling that she went to the Montana Attorney General and worked across party lines to try to bring justice and protect children from the harms that she was witnessing. So, Jamie, it's so great to have you here. Welcome. Thank you for having me. So a lot of people look up to you for your courage, and you've made some statements that make a lot of sense on that, that the health and well-being of children is more important than your own personal comfort. And I think that's one of the more kind of virtuous sentiments that we have on the political left, right? Sometimes if we look at the political left we hear like the safety and health of vulnerable people is more important than an individual's emotional comfort, but it seems like that message kind of gets applied where it's convenient in some situations and not others. And the situation with regard to the transing of vulnerable youth and the harm that detransitioners has been through is one of those sort of blind spots or shadows in the culture where a lot of people are unwilling to face the discomfort and inconvenience of looking at what you've looked at. So I don't want to make you tell your whole story over again because you've already done a good job of telling that in several places. But what I do want to talk about is your courage and how you got to that point of feeling like it was important for you even to work across party lines, work with people who you might see as your political opponents in other situations in order to protect these kids.

Jamie Reed: The great place to start. And I think that word courage keeps coming up, which is part of the reason why we use that in the name of the coalition that I founded. So I have found that in our current climate, it takes courage for some people to simply state their belief in a public sphere. So there has been a lot of silencing on a number of topics. And that's a really challenging place for Americans to just be in. I always found one of our most important principles was freedom of speech. And I always grew up thinking that freedom of speech meant everyone had the right to speech and to speak their mind, even when others didn't agree or if it was unpopular. I always found that was one of the most important principles. So in terms of my own whistleblowing and knowing that a lot of people have called me courageous, it's something that I do actually struggle with because on some level I feel like I would have been courageous if I If I said something sooner, I sometimes feel challenged in the fact that it took a number of years to speak up in the way that I did when I think that the harms and the problems that we were seeing were very clear, potentially as far back as 2019. I do recognize that what I was trying to do for a number of years was raise the alarms within the system that I was working in, in the way that we were trained and the way that I thought that these systems were set up to do. So reaching out to supervisors, reaching out to other staff, talking up in team, you know, speaking up in team meetings, speaking about individual patients. And it was only after seeing for a number of years, not only that go nowhere, but it was starting to get myself and others who had concerns in actual, you know, we were, we were getting in trouble. Um, there was a conversation that occurred in 2022 where one of my coworkers was, was literally told that she was no longer allowed to use the phrase, I have concerns. as a medical professional. And so I think part of being courageous was not just article, but it was probably a number of years of You know, speaking up in a meeting, sending an email, pointing out that this patient doesn't meet criteria, asking what the criteria was that we were actually supposed to be following, speaking up when you saw patients being harmed. So I think for medical professionals within this realm, you don't have to go as far as a free press article. I think for some of us right now, it's as simple as You know, being present within your team and if you're on a team of other therapists or other medical providers and seeing patients in these situations, speaking up on that level first is also a really courageous act. And I think that it's something that needs to really be continued to be looked at within medical professions.

Stephanie Winn: And it does sound like you did experience some of the worst case scenarios that people are afraid to encounter when you did that. A lot of people don't speak up in team meetings or one on one with colleagues because they're afraid of being criticized, silenced, name called, and worse. And those things did happen to you, which is part of why you eventually realized that it was necessary to call in some bigger authorities. Yes, absolutely. What would you say on people who are afraid of those those initial confrontations or the loss of status?

Jamie Reed: So I I know just personally I've pretty thick skin. So I I was I've always been a person who you know in a team meeting. I always have an opinion. I always have a question I always have something kind of to say in the room. So there's some element of it's just my personality that kind of was at the forefront in this kind of situation. It was interesting, though, because it was the same reason why I was hired in the first place. So I was hired in the first place into the center, because on some level, I was hired as an activist. I mean, I was hired because I would speak up for our patients. I would challenge status quo. I would push back, you know, if patients were being misgendered in clinical spaces. You know, that was why I was brought in, because those were some of the skills that I had. And so in that regard, I think that I am not special and that I think a number of the people who come into this work initially come into it because we are kind of brave from the start. to be a therapist or to be a medical professional interested in working with this clinical population I think you intuitively intuitively already have an element of courage and and also have an element of you know willing to look outside the box or at least you should because this is this was new medicine this was a new this was a new field. When it gets to the point where you're, when you're being silenced and trying to be silenced from a very kind of big top-down entity, I really went back to my activist roots, which is, you know, I grew up in the left. I always thought that the left supported the concepts of speaking truth to power, to speaking up against institutional, you know, hierarchy and unfair power dynamics. And so to me, this was just an outpouring of my natural kind of lefty, you know, the way I was raised too. I was raised to speak up, especially when you saw something that was wrong. And then just on a personal level, I'm a mom, and I have a lot of kids who I feel like as a parent I have to demonstrate.

Stephanie Winn: You were talking about speaking truth to power and these sort of traditional leftist values and it often strikes me as ironic that we find ourselves in this political and cultural situation because when I think about this gender wars being caught up as a left versus right issue I think about how leftist values and concerns taken to their natural logical conclusion would warrant concern for detransitioners. They are an oppressed minority that's been harmed by corporations with big financial interests, right? So if you're concerned about the most oppressed minorities, how would you not end up concerned for detransitioners? And it just strikes me as ironic that we find ourselves here. Do you think that maybe part of what accounts for the difference is that there's sort of the aesthetic appeal of the idea of speaking truth to power versus the reality of what it actually feels like when you're actually in the minority and you're not surrounded by a bunch of people who agree with you?

Jamie Reed: It definitely, I mean, you're absolutely right. It definitely is a very different thing to actually enact your values as opposed to having a button on your backpack that claims your values or, you know, slapping on a bumper sticker. To actually be present and live those things challenges authority in ways that sometimes I think what authority is now has changed. Sometimes I believe that the institutional power is now actually held by some of the same activist organizations that I once thought represented me and and even this concept of community in a different way. So we're in a very strange time, where it's no longer okay to just hear the message from the tribe in the way that you believe, oh, it's my tribe. Somebody else, you know, smarter than me has figured this out and I'm just going to go along with it because, you know, my tribe says I should. And one of the things that's challenging for me is that It does start to ask questions of all of the other things that I've always believed my tribe just had right, that they just got right. And so it's forcing me to dig in deeper. In some ways, I think about it in terms of medicine, how I used to be able to just read a paper, a research paper and say, OK, I feel like you know, their conclusions are what they say they are. And now I'm digging into the citations and seeing, are the papers that they're citing actually correct? And it's just changing my way to formulate beliefs into a way that I probably should have been doing so all along, but felt like I could intuitively trust my tribe in ways that I think I no longer can.

Stephanie Winn: That's scary though. I very much relate to that feeling. My tribe has researched this or someone smarter than me has looked into this. In your Free Press article, you talk about how when you were initially presented with these ideas, supporting the idea of gender-affirming care, you gave the benefit of the doubt, assuming, well, this must be well-researched. And that was my feeling, too, when I was first exposed to these ideas. I believe it was 2017 that I went to a training. And so you're presented with these ideas that are so counterintuitive, in a way, because they go on the face of everything we know about adolescent development and standards of care for how we approach psychological issues. But you're thinking, well, an expert, here I am in a room of 150 people, 150 master's level clinicians, and we have an expert up here who my company has hired to teach us. Clearly, there must be research behind this. There must be reasons, right? And I understand that feeling of feeling like you can take things at face value until it gets to that point where you can't anymore. So I'm curious about the journey of the last year for you, because it was only in November of last year that you left that job. In February, the article came out. And I know for me, my first year or so, I mean, I haven't been through what you've been through, but my first year or so as a public figure was really rocky, just being like a normal person coming from the mental health field. I mean, that's maybe the first time I've ever described myself as a normal person. But I mean, in this sense, normal as in not accustomed to any degree of fame, right? And then being in this spotlight was really rocky and I feel like has taken an adjustment for me. And so for you, I can imagine this has been a destabilizing time in your life, but now you're still working at that same university in a different department. You've co-founded a coalition. What has been the adjustment process for you?

Jamie Reed: It's been a slow progression. So the article hit and there was this initial, like a lot of things blew up. So some relationships blew up. There were definitely a number of close family, friends, and individuals who had a lot of anger. They were very angry and I don't blame them at all. And I was very much tied to this center. And there was a number of people who intuitively trusted the center because they trusted me. And so when the article came out, they felt like their trust in the center, their trust in the decisions that they made with their own kids based on trust within me was just completely kind of pulled out from underneath them. And a number of parents who had transitioned their kids were really angry. And what was really challenging for me in the period leading up to that story breaking is the level of secrecy that I had to have. And that's not my normal go-to. My normal go-to is to be very transparent. I actually am a really bad liar. So like, you know, I, even with my kids, if they ask me, you know, like, do I hear the ice cream truck outside? And I'm like, no, no, no, no, no. You hear something totally, like, I'm no, I'm no good at lying. But leading up to that story, because I was entering into the zone of being an actual whistleblower and working with the Attorney General and working with this legal issue, I could not give anybody a heads up, hey, this is coming. And so I know that a lot of relationships were damaged, not necessarily because of what I was saying, but because of how sudden it was. And I also imagine that for all of the other individuals, there are a few who knew what was going to happen within the center, but most of the other staff members within the center, I think up until that day that that article broke, still would have viewed me as their friend. And they thought on some level that I moved on for other reasons than why I really had to leave. You know, there were a number of important serious relationships that just exploded and have not healed. And that is something that I think I understood going into it. And one of the things that I am so grateful about before that article dropped is that I actually had already built a little bit of a team around me. who really tried to spell out exactly what was going to happen. As much as they told me, I, I honestly had zero idea how, I guess, viral the article itself went. I thought, I mean, I thought personally, if a couple thousand people saw it, it was going to be a win. And then when I heard from someone on my team that within the first 24 hours, I believe 1.2 million people had read it, I was like, I was floored. I had no idea that it would have had that reach. But so many people on my team, they warned me ahead of time. They told me this is this is the fallout, how to be prepared for some of that fallout. I wasn't prepared for local media to show up at my door. I wasn't prepared for some of the things that did occur. But the thing that I I'm so surprised by is I think my biggest fear from blowing the whistle was that I would, I would be here now close to nine months later and be alone. I thought I was going to be having lost all of my friends in the center. I knew that was going to happen. I knew I would lose a number of close family friends, but I just really anticipated that, you know, I was signing up to be out here kind of on my own. And what I did not realize was how strong, intelligent, and kind all of these people are in this kind of heterodox, you know, I could not anticipate the number of amazing gender critical people that are out here. I mean, it's amazing. Some of the smartest people I've ever met, the nicest people I've ever met, totally huge numbers of gay, lesbian, adult trans people. The world is, it's amazing. I didn't know that. I didn't know that existed.

Stephanie Winn: That's the other side that it's so important to remember, because I talk to a lot of people who are trying to find their voice, thinking about being more public about whatever concerns they have, and it's so easy to fixate on what it feels like to receive antagonism. But that's the other side of the story, is although those things do cause hurt and fear, and as you said, rifts and relationships can be damaged or broken, but Yeah, the other side of the story is you have so many people coming out of the woodwork to say that they appreciate what you're doing. And for me, it's been totally unexpected. Who from my past would be on one side or the other, you know, surprised to see that a somatic therapist friend from my past attacked me on social media, and yet a former roommate came forth years later saying, I'm a therapist now too, and I appreciate what you're saying. So you just never know. Whether you've been a longtime listener of this podcast or you're new, odds are you know I'm deeply concerned about the gender ideology crisis affecting today's youth. What's often not talked about are the medical practitioners who are pushing this ideology on vulnerable people, or the doctors who are taking a stand against them to protect kids. Which is why I was so excited to find a group that's doing just that. It's called Do No Harm. They're fighting for patients and against identity politics. And they have information for everyone, whether you're in the medical field, a concerned parent, or just a thinker who wants to learn more.

SPEAKER_00: Visit DoNoHarmMedicine.org slash Some Therapist to learn more. That's DoNoHarmMedicine.org slash Some Therapist.

Stephanie Winn: I wanted to look at a few things with you, Jamie, and an opportunity came up, we discussed this before we started recording, that a few days before this interview was planned, a detransitioner shared some of her medical records on X, formerly known as Twitter. I've been in communication with her and she has given her permission for us to look at some of those records together. And I think this will help listeners who are curious about this issue to understand what people like you and I who have worked in the mental health system have seen in terms of just how radically we've departed from the standards of care for how we would normally approach any other issue. So she said that we could credit her. So her Twitter username is at isopodsocks. And she prefers to be just referred to as bugs. So her extended handle is being nice to bugs. So I'm going to go ahead and do a screen share. So for those who are watching on video, you can follow along and you can read. And then for those who are just listening, I'll go ahead and read everything out loud as well. So just let me take a moment to pull up these pictures. All right, we are looking at the records for bugs. So as you can see, she has blanked out a lot of personal information about her name, date of birth, and the clinic, but you can see that she was 19 years old at the time. And so when I look at this, I'm guessing that what we're looking at is something called a soap note. That's because it begins with subjective. So soap notes are a common type of note used in therapy. S is for subjective, O is for objective, A is for assessment, and P is for plan. So I don't have the whole SOAP note here, but we have what starts with the subjective beginning with the section reason for visits. Excuse me, reasons for visit. Number one, G-A-H-T. So that stands for gender affirming hormone treatment. HPI, that means history of present illness. Patient is here today for an initial visit. Patient's birth sex is female. Patient's gender identity is genderqueer slash non-binary slash non-conforming. Patient prefers to go by he, they. Age of awareness was 15. Patient is partially living as identified gender since five years. Patient is living identified gender at work, school, and social. Patient desires masculinizing hormone therapy, gender-affirming surgery, and speech therapy slash voice coaching. Patient reports no current slash prior use of needles to inject hormones or silicones. The following body organs is slash are present. Breasts, cervix, ovaries, uterus, and vagina. Comments. 19-year-old. Wait.

Jamie Reed: Go ahead. You keep reading. I already have comments. You keep reading.

Stephanie Winn: OK. We'll just read the rest of what's on this page for now. So the comments section on the page. 19-year-old AFAB assigned female at birth. Genderqueer human here for initial GAHT, gender affirming hormone therapy, visit. He knew things were off once puberty started. Spent some time trying to figure things out. Wanted to wear neutral clothes. Body changes were distressing. Was a tomboy as a child and always played more with boys but didn't fit into either group. Once he learned that transgender was a thing, he felt that this fits best. Lots of dysphoria with chest, some with voice. Mom very supportive. Will help him give injections. He is very worried about the needles. Dad does not know he is here. Was on Sertraline in the past and it helped with depression but he self-discontinued due to decrease in libido and just feeling numb. Does feel sad and down most days. Trouble concentrating and sleeping. denies homicidal intention, or excuse me, HI slash SI means homicidal ideation slash suicidal ideation, and would like to discuss restarting another antidepressant. Jamie, take it away.

Jamie Reed: What do we see here? OK, so there's a lot to unpack for somebody, I think, who is not within the medical realm. So going back up to kind of your subjective and the history of presenting illness, so immediately a couple of things pop out for me. So I personally always try to figure out or try to have a patient explain to me, what does genderqueer, non-binary and non-conforming mean to them? So what is that actually, how would they actually define that as their gender identity? Those are Those are terms that are used often, but they're in a lot of ways really vague terms if we're looking at actually diagnostic criteria. That does not necessarily fit within some of the paradigms of why we initially started these treatments. That does not indicate to me that anyone is meeting criteria to be diagnosed with anything akin to gender dysphoria. This is a young person, and those terms themselves need a lot more digging.

Stephanie Winn: Can I comment on that just riffing off of that it kind of reminds me of how in certain parts of assessments in a summary of a patient we might include something like their ethnic background like patients ethnic background is Let's say East Indian on dad's side and French on mom's side or something like that like that might be relevant to that person's cultural identity, or in a medical context, there's times when certain ethnic backgrounds might be at higher risks of certain diseases, which would be why that information is important. But this here reads as if it's as matter of fact as that, right? Like as if one can claim, this is my ethnic heritage, right? This is my gender identity as it's, excuse me, wow, I really can't talk today. as if it is a statement of some kind of fact, right? Rather than just what, like you're saying, a child or a young adult is claiming about themselves in the moment without defining it.

Jamie Reed: Yeah. We go on to pronouns. I think it's always important to differentiate if one is primary, if one is secondary, if there's times when pronouns, you know, what does that mean? A lot of this comes back to meaning. So you have to define the meaning because one of the things about this care both sides claims is that it has to be highly individualized. Well, this note just reads as if it's cut and paste. Who uses those pronouns with them? Do they feel distress when other pronouns are used? When did they start using these? Are they used in the home? If they're used in the home comes up very clearly in our second paragraph regarding comments because we have one parent who literally does not know that the patient is even at this appointment. OK, so then we have age of awareness at 15, but then that does not mathematically compute with the patient as partially living as the identified gender since five years. So where's your math? Are they 20? Because it says that they're 19. Doesn't add up. I'm also interested to know what this means for the patient. How do you live as genderqueer, non-binary or non-conforming? Is this a change in dress? Is this a change in hair? Is this a change in presentation? Once those things have changed, have they felt any relief? Have they felt any positive outcome change from those things? Because it's indicating that they have lived in a certain experience but then it doesn't indicate at all has that made the patient feel better or worse. So we have five years of a potential social transition that has occurred and we have no evidence data or anything that even appears that the clinician asked the question has this socially transition helped you feel any better. I don't We don't understand really the prior use of needles. My guess behind it is they're just trying to ascertain whether or not this patient would be able to inject themselves. Most people assigned female at birth are not using injectable silicones. It's primarily used in patients. boys who use injectable silicones. It's not even relevant really here. That last line is really interesting. So this is called an organ inventory. And one of the things that the electronic medical record called EPIC has added, EPIC has huge problems with providing these patients with the best care. And so if you have socially transitioned and we have changed your sex marker in the system, so if this individual's sex marker has now been changed in their medical record to read as male, they added this organ inventory line in a really poor attempt to try to provide decent medical care. So they added this because if a patient who has a uterus and a vagina comes in and they potentially need a pregnancy test but their sex marker in their chart says male, that might be the only indication to a medical provider. that that needs to be something that's screened out. So the only reason why that's there is because the medical system itself has not been able to figure out how to provide the actual needed care for trans individuals. And it's a problem for trans people too, is that they're not getting good quality medical care because we're changing sex markers and charts, not acknowledging the biological reality of the medical care needing to be provided based on natal sex.

Stephanie Winn: And it's so reductive, isn't it? I'm glad he clarified that, because I didn't know that about epic, and it makes a lot of sense. But I'm just looking at this, and I'm sure anybody who's watching, who's seeing these words on the screen, this inventory of body parts, it's so reductive. And us gender critics are frequently accused of reducing people down to their body parts, but that's exactly what appears to be going on here. Yes. Yes.

Jamie Reed: So, in the comments section, these are the kinds of things, this is exactly how probably most of the patient charts in our center, you know, as an outsider would have read, this is what you would have seen. The thing that jumps out to me first is that dad does not know that the patient is there. That's a really big red flag. brings up a number of questions. So is this patient still living in home with dad? And then how does that play out if we're not telling your parent one of the most important relationships in your life? It adds another layer for patients where reality and I hate to use the phrase that we're setting someone up to live a lie, but we're setting someone up to live within a lie. Because if we're going to initiate testosterone, the other parent doesn't even know that they're there. How is that work out in the family dynamic? Mom's giving injections to a 19-year-old. I also think about how that triangulates mom and dad. So we've got a triangulation now between mom, dad, and child. And now we have this new triangulation where mom and child are now in essence colluding with the medical providers to lock out dad. And so triangulation, these are not positive relationships for anyone. It doesn't create good relationships. It's setting up the family for conflict.

Stephanie Winn: Absolutely. I'm so glad that you pointed that out. And let's just acknowledge what we don't know here. We don't know if mom and dad are divorced, if they live together, if they're still married. We don't know, as you pointed out, whether Bugs is living with mom and dad or living with just mom or ever visits dad. We don't know about siblings. We don't know history of abuse from what we're seeing here. But there could be many, many reasons in the family dynamic that this gender dysphoria plays some kind of role, right? It could be an effort to get dad back. It could be an effort to get in touch with one's own masculinity because of a sense of loss around dad or, you know, there's just so many things we don't know. But I appreciate you pointing that out based on based on the assumption that dad is in the picture. What kind of family dynamic would that set up at home? And is the kid actually, by getting involved in the gender stuff, getting sucked into some kind of role in the parent's marriage where they're acting something out to try to either drive a wedge between the parents or pull them together? This is why, you know, in the study of family systems therapy, you look at the role that the identified patient plays in the whole system and whether Unconsciously, their manifestations of symptoms and behaviors is an effort to do something for the family, to get the parents to come back together if it feels like they're on the verge of divorce. I mean, there's just so many things it could be.

Jamie Reed: The clinician should be able to answer the surrounding details before initiating a medical intervention that will cause lifetime impacts physiological changes, and changes with all of the social presentation for this person. And so that's the level of To me it just to me just looks like it's just poor care. You should not be jumping to initiate medical intervention then if the clinician either did not dig in deeper or say somebody needs to dig in deeper before we initiate those changes.

Stephanie Winn: Yeah, and it doesn't say if they've been in therapy before, too. It says she's been on sertraline, but it doesn't say whether she's been to a therapist. Sorry. And we've got to say, yeah.

Jamie Reed: And well, actually, I was going to go on to that next line. So sertraline in itself could have been simply prescribed by a primary care physician. It's like, I mean, it's a real baseline mental health medication. It does not work for a lot of people. It's challenging though, because the patient themselves is acknowledging that the sertraline helped with the depression, but they discontinued due to a side effect. And so then questions I start to raise or think about is, So we're going to initiate another drug. We're going to potentially initiate testosterone. What if it feels better for a little bit and then it causes side effects? We're seeing a pattern of discontinuing. And those are things I also want to flush out with patients too, you know, our Are you engaged to start a treatment that you're willing to stick to and understand what that looks like when you're 19? They also complained that the sertraline caused them to feel numb, which Testosterone causes people to feel numb. So I know so many individuals who talk about starting testosterone and losing the ability to cry, losing the ability to feel in touch with emotions that are not just anger and blah. There are mood altering effects to testosterone in and of itself. And so it concerns me that they were on a drug that was lifting the depression, causing a change in libido and the feeling of feeling numb. And nowhere is there appear to be the education that testosterone itself can also cause that feeling. And clearly they're indicating that they are still potentially clinically meeting criteria for at least some level of general depression. So they're having clinical manifestations of a mental health condition. And they are wanting to restart another antidepressant. So on some level that shows some engagement and willing to attempt to address the depression and also that they feel like the depression is bad enough that they're wanting to engage with some psychotropic medications. But from this alone, there's no indication that the clinician would then state, OK, so let's try to add an antidepressant and let's reassess where you're at with your feelings regarding your gender after we've initiated that treatment.

Stephanie Winn: I really appreciate all this commentary. And I'll tell you, the first thing that struck me, it's so simple. It's right at the beginning. It's number one, where it says G-A-H-T as the reason for the visit. And this is where so-called gender affirming care has just gone so far off the rails to me that, I mean, presumably this is a gender clinic where this is a therapist or a social worker writing this note.

Jamie Reed: So, um, it, this could be an endocrinologist. Really? Okay. Interesting.

Stephanie Winn: I mean, um, yeah. Okay. Interesting. Yeah. I'm, I'm thinking about this from the standpoint of, um, being a therapist and knowing that soap notes are used amongst therapists. OK, so you're broadening that perspective. We really don't know. And Bugs hasn't told us who wrote this, what type of professional they were. But just thinking about this as a therapist, seeing, you know, if I were to assume that this was written by a therapist and seeing reason for visit is to pursue hormone treatment, I would say, wait a minute. You know that's that's not a summary of a presenting problem. That's that's a summary of what the patient thinks the solution is. And those are two very different things. You know it's sort of like if I went to a doctor saying I think I have this particular type of infection and the doctor put reason for visit number one antibiotics. You know, patient is here seeking antibiotics. It's like, well, wait a minute. Patient has these symptoms. Patient is not a doctor. Patient thinks symptoms indicate an infection. Doesn't the doctor have an obligation to figure out whether patient needs antibiotics? Or do we just start with the end goal in mind as determined by the patient?

Jamie Reed: In this medical care, we start with the end goal in mind. And we let the patients define it. Yeah. Are you ready for picture number two? I'm ready for the next one, yes.

Stephanie Winn: I love sleep. Sound sleep is a crucial foundation of good mental and physical health, from mood and concentration to metabolism and cellular repair. And I sleep very well thanks to my Eight Sleep Pod Pro Cover. My side of the bed is programmed to be warm when I get in and cool down to a neutral temperature in the middle of the night so I don't wake up overheated like I used to. How would you customize your bed temperature? Visit 8sleep.com and use promo code SUMTHERAPIST to take up to $200 off your purchase. Even if they're already running another sale, this code will get you an additional $50 off. Eight Sleep currently ships not only within the USA, but also to Canada, the UK, select countries in the European Union, and Australia. Thanks for considering purchases that support the show. So this is a close up of a part of, I guess, what was written later in that assessment, where my understanding from my exchange with Buggs is that this is a part of the assessment that basically said that we did talk to the patient about these things. but the patient doesn't remember talking about them. So for example, I'll just read what we can see on the screen. Expected changes related to hormone and the something. Use of hormones for gender affirming therapy is something. Again, it's cut off. Sexual attraction could change with hormones. Now that's a complete sentence we can see here on the screen and something that Bugs posted on X was that they did not tell me about this. So, in this document, this is basically the clinic's side of the document that the patient received after requesting her records, but she complains that she was never told that her sexual attraction could change with hormones. And it says in the document that she was verbally informed of that, and apparently that this is something that she did experience and it was very bothersome to her. It goes on to say, masculinizing hormones can increase libido. Changes to fertility may be permanent or reversible. Masculinizing hormones may not suppress ovulation. Reviewed fertility preservation options. And then it goes on to say medication route of administration. Routes of administration for medication reviewed, patient opts for, and then it's cut off. What are your thoughts on this one, Jamie?

Jamie Reed: So from reviewing this, it appears they are going to be prescribed tea. It didn't look like from the first note the recommendation was simply yes you can go ahead and start testosterone. I really hope that they had additional documentation from some of the other risks associated with this treatment because if not they're missing all of the medical side effects.

Stephanie Winn: Speaking of, we can look at that next. The informed consent is in the next. Are you ready for that?

Jamie Reed: Well, I will just add, I actually responded on X regarding this because we were not We on the back end were very aware that we had patients reporting to us that sexual attraction was changing with the use of hormones, primarily that individuals who were coming to us same-sex attracted, so natal girls who were primarily attracted to other natal girls, were reporting that once they were on testosterone that their sexual attraction was changing. And for some of them that was really distressing. And some of it was that they had a lot of trauma around men that they had not worked through, sexual assault history, physical abuse history, a lot of these things that in some ways was one of the pathways into seeking this treatment. And then they were finding the treatment itself was causing them to be sexually attracted to these individuals. That was really hard for a lot of people.

Stephanie Winn: Gosh, the human body is such a complex organism and we're messing with it so lightheartedly. It's really scary. Okay, so pictures three through five are the informed consent. Basically, Bugs told me this is the entirety of the informed consent minus her signature. So I'm just going to read all of these pictures out loud for those who are just listening. What is vascularizing hormone therapy? Vascularizing hormone therapy is medicine that can be used as part of your gender transition process. The medicine is called testosterone. What is testosterone? Testosterone is a sex hormone that causes the development of masculine characteristics that can be given as a shot or put on the skin as a gel, a cream, or a patch. Before taking testosterone, you need to know the most common benefits, risks, side effects, and other choices you have. We are happy to answer any questions you have. What are the benefits? Testosterone will change your body in the following ways. Your voice will become deeper. You may grow a mustache and beard. Hair on your body will be thicker and will grow faster. Your clitoris will get bigger. Your muscles may get bigger and stronger. You will probably stop having a period. You will notice less fat on your buttocks, hips, and thighs, and more on your belly. I mean, there's a lot of things left out here, but the first one I noticed is that it doesn't mention anything about balding. What are the risks? Testosterone can increase your red blood cell count, increase the amount of fat and or cholesterol in the blood, increase the chance of getting diabetes, sugar, harm to liver, rare. There may be long-term risks that we don't know about. The risk of testosterone may be higher for people who smoke, next page, are overweight, or have a family history of heart disease. What are the side effects? Acne, thicker and more oily skin, the hair on your head may get thinner or fall out, male pattern baldness, there it is, mood changes, yeah, no kidding, increased sex drive, vaginal dryness, Hmm. A lot of these are really put very mildly. Besides testosterone therapy, what are my other choices? You could do nothing. Another way to masculinize is to have surgery. If you're interested in other options, talk to your doctor or nurse. You can choose to stop taking testosterone at any time. If you decide to do that, talk to your doctor or nurse. We're going to have a lot to talk about here, but I'm just going to keep running through it. What else do I need to know? How long does it take to work? It can take a month or longer. Some of the changes can take two to five years. No one can tell how fast or how much change will happen. How long do I need to take testosterone? You will need to take the medicine forever to keep some of the changes in your body. The following changes are usually not permanent. They will probably go away if you stop taking the medicine. Increased sex drive, changes to your body fat, changes to your strength, faster hair growth. Some of the changes will probably not go away even if you stop taking testosterone. These include bigger clitoris, lower voice, mustache and beard, male pattern baldness, thicker body hair. Can I get pregnant? No one can tell you for sure if taking testosterone will affect your ability to get pregnant. You could get pregnant, or you may never be able to get pregnant in the future, even if you stop the testosterone. If you have sex with a person who makes sperm, you need to use birth control to prevent pregnancy, just in case. If you do get pregnant, you must stop the testosterone. If you think you may want to be pregnant in the future, you should talk to your doctor or nurse about your options before you start testosterone. Your health is important to us. If you have any questions or concerns, please call us. We're happy to help you. Oh, OK, Janie. Take it away.

Jamie Reed: So this is this is standard. These are. This surprises me, not at all. This is what is used frequently. There are clearly a number of things that you picked up on right away. The one area that I find the most challenging is the area that talks about other choices you have. Yeah. So I find that it's very common that the the option that's presented to people is you can do this or you can do nothing. Right. And I think that that is one of the most unhelpful statements that you can ever give a patient in any situation. So it's also not the actual option. So the options here are, what are your other choices? So first of all, they're implying just in choices that there are more than one, and yet they only present the one, which is you can do nothing. Except wait, I'm sorry. They also add this line about you can masculinize by having surgery. I don't even know what they're referencing. You can masculinize by having bilateral breast read. I don't know what they're talking about. How can you masculinize? Masculinize implies facial hair. It implies, you know, all of these changes that we pretty much know primarily are occurring based on the use of teeth. This is just not the case. There are many other options. So the other options should include and can include something as simple as some elements of social transition, your other choices. You could change your clothes. You could change your hair. You could change your presentation to the world. You could also actually seek out therapy. You could use psychosocial supports. You could use psychotropic medications. There are so many different kinds of therapies that you could seek out. And none of that is implying in any way conversion therapy. What it is missing is that if we are giving you this treatment to deal with distress, it is ignoring that there are other pathways out of distress beyond just changing the body. And so, again, part of the reason why these documents feel the way they do is because they don't understand. The clinics themselves cannot directly explain what they're actually treating. So what are you treating? So are you treating a condition, gender dysphoria, gender incongruence? Are you treating a condition that has distress? And if you are treating a condition because it causes distress, the first thing you should always do is see if other non-invasive treatment protocols to deal with distress resolves it first. I still support the legal concept that adults should have the option to access these treatments where they're legal, but The way that people need to have these treatments presented to them is that it has a clear diagnostic picture. How do you meet that diagnostic criteria? And then what is the actual likelihood based on the assessment and diagnosis that this treatment itself could provide you some relief? So what's the outcome? This is kind of garbage because it's completely ignoring what we're treating, which initially why I started doing this because we're treating distress and we thought that these treatments would alleviate that distress. This is not, in my opinion, providing actual informed consent because saying you can do this or do nothing. Clearly, I think what we know from a lot of medical evidence is that it's missing side effects, but it's also missing the longitudinal care issues. So it does not give an individual the true picture of what this means. So what does it mean for a 19 year old to have to grapple with the concept that their blood chemistries are going to be off, that it doesn't spell out any sort of actual statistical probabilities. So for a patient to have true informed consent this would basically need to be completely rewritten. So we know that this is going to affect your cholesterol and we find that X number percentage of individuals on testosterone will end up on a cholesterol medication within X number of years. We do not give any patients any of that information. We don't tell patients that we know if you're If you're doing proper medicine, we also know that testosterone will most likely cause you to have sleep apnea, so you should be monitoring. Are you snoring? Are you waking up in the middle of the night gasping for breath? We know that a lot of individuals end up on statins, on cholesterol medications, have a high risk of diabetes. What does it mean to have a high risk of diabetes when you're a young person? What are the outcomes of having diabetes? And then it also misses some of the really distressing medical evidence that You might actually be needing to make a decision. Do you start this treatment now? Knowing that the trade-off might be that you will have a shorter lifespan. And I don't say that lightly because it's really a big thing for young people and their parents to have to weigh. Is it really worth trying this treatment? to treat some distress that a basic mental health medication might work on, knowing that the flip side is you might end up on four other medications to treat all of the poor outcomes we're going to give you and your life expectancy might be shorter by five to 10 years. That is not demonstrated in this study.

Stephanie Winn: And in Buggs's case, it says patient denies HISI patient. So basically, this patient did not express suicidal ideation, but a lot of people do. And that is one of the big arguments that advocates will use to say why people should have access to these so-called treatments, is that they're suicidal otherwise. And I think there's a serious question to be asked there of if people are already feeling so unstable and so hopeless that they are at any risk of suicide, then I would make the case that those are people who are in the last place to consider, you know, between basically choosing between two options. If you're thinking one option is suicide and the other is doing something that takes five or ten years off your life, well, of course, the latter looks better. But are you really in a mental place to be making those decisions? I think it's cruel that we subject people to making those kind of decisions at all. I think if someone is this depressed, that they're considering suicide, again, not to say that that applies to this particular person, but this person was 19. This person was six years away from prefrontal cortex maturity. Um, so when you're not capable of envisioning a future, is that really a time to make decisions that alter your future? And of course, all the stuff about fertility in here, I mean, was she really in a place to decide, you know, between the possibility of ever being able to get pregnant or not? It's just put so lightly here. And this part about vaginal dryness, I feel like that really does not do justice to the painful atrophy and the lacerations and bleeding and just excruciating pain that some of these young women can be in. You know, same thing with the clitoral growth you've you've talked about and I've certainly says that it may get bigger, but it also ignores it says that.

Jamie Reed: If you go to the, I believe, the next page, I think it's saying that these things might change back. That's, no.

Stephanie Winn: You know that, how, sorry. Well, no, it says these are the changes that probably won't go away if you stop.

Jamie Reed: So it does admit that the bigger clitoris, I'm pretty sure that probably is not the right word there. They're not going away.

Stephanie Winn: Yeah, and the ramifications of all these things aren't discussed, right? So it says your clitoris may grow larger, but it doesn't help these young women understand what that's going to mean for their day-to-day life with the painful chafing that many women experience who've experienced that growth. And another thing that's not discussed in documents like these is the very real likelihood of gender dysphoria getting worse. Right. Because the whole problem with how we're treating this issue is that well I mean here's one angle on it that I think about a lot is that to master our challenges in life, to deal with the root causes of our anxiety and depression on a psychological level, means that we have to come to terms with what we can and cannot change, right? It's like that, what's it called? The serenity prayer is all about asking for the wisdom to tell the difference between the things that we can and cannot change, to take action on the things we can and to accept the things we cannot. And these young people are trying to figure that out and we're doing a terrible job of helping them figure out what goals are worth aspiring for and what goals are unrealistic and unattainable. And choosing to devote your precious life energy and your time while you're young to goals that are unattainable is a recipe for disaster. So what we often see, and perhaps you can speak to this in your own way, we often see with these young people with gender dysphoria that They think that having a hormone or a surgery is going to make them feel better, and then the dysphoria just moves around. They become fixated on a different body part, and then a different body part, and a different level of passing, or a different level of affirmation. And it's always kind of chasing the stangling carrot until they're years into it. Oftentimes, their body has gone through irreversible changes, and they realize, wait, none of this was ever going to make me happy. So they're chasing something illusory, and that's not listed here at all. The possibility that these treatments will not resolve your gender dysphoria, that you might regret them, of course, is one thing, but even that you might not feel satisfied, that you might feel the need for more and more and more.

Jamie Reed: That makes me think of two things. So the first one is that The one thing that these treatments and this whole kind of industry does give to young people is the concept that somebody already came up with the plan and it's laid out and you just have to jump in and then all of the next steps are worked out for you. So it on some level is removing the ideas that you have to make some decisions when you're an adult and you have to live with the consequences of those decisions and some of those will change your pathway forever. And what this gives somebody is, okay, so I'll change my name and I'll get a new pronoun. And then I get started on testosterone. And after testosterone, I go on and have top surgery. And after I have top surgery, then I go on and have a hysterectomy. And after I have a hysterectomy, then maybe I'll have a metoidioplasty. Or maybe by then, you know, it kind of spells out, here's the plan, you just do X, Y, and Z, and then you reach happiness. And what really is going on in our life is it's never that simple. And you're going to fail a lot of times. So instead, it's what are the jobs that you find that are interesting? What do you do you want to go to college? And for so many of our patients, it was some of the general tasks of adolescence they were not meeting. getting a driver's license, learning how to make a phone call on your own, learning how to operate a bank account or to go pick up your prescription at the pharmacy, like adulting tasks. Yeah, they're kind of boring and they suck. And yeah, maybe your parent has done all these things for you in the past. But like, this is what it means to be a grown up. And it's hard and you have to and you're going to fail and you're going to mess up and you're going to overdraw your account and you're to have to figure out how to eat a cup of noodles, you know, for dinner one night. And I think part of what's so alluring is that it's all worked out for you. Just jump on board and, you know, your glitter family will walk you through all the steps. And then the other thing that this document misses that I Even when I was really gung-ho on this treatment and really believed in it, I also always really believed that patients should be working therapeutically all the way through the process. Because the thing that this document misses and the thing that I find people don't think all the way through is that The world is still binary. The world is still existing in a binary gender structure. As glorious as you want to say, oh yes, I'm non-binary, blah, blah, blah, blah, blah. There really is, we live in a binary world. You're not, no individual's changing that because they changed their body. We live in a binary world and so when these individuals get started on testosterone and they are waiting at the bus stop at nine o'clock at night and a woman walks up to them and doesn't intuitively that woman won't stand next to them or will step away from them. Or if you're walking down the street at night and a woman passes you by and they walk to the other side, they cross the street so they don't have to walk by you. There is something that these young people are not acknowledging or addressing or working through that the world is going to treat you in a different way. The world is going to treat you as a man, and the way that we treat men in this world is we have really high expectations for them in certain things, and we We do not treat them with the closeness and the sense of safety that we treat other women. I don't often ever think of myself as feeling afraid if I'm waiting for the, you know, the Metrolink train at night standing on the platform with other women around. And those are things that I wanted my patients to actually really therapeutically and psychologically come to terms with and comprehend before they initiate treatment. And you don't see anything like this on any sort of document like that. And the expectations that we place on men, you know, in my own home, if a contractor comes and my spouse and I are standing there, they're going to ask my spouse technological questions about, you know, when was your A.C. unit last tuned up or you know, asking him to make the decisions on the changes, you know, to the floor plan or like all of these things that all of these pressures and changes and things that we that we put men into. I'm not saying that they're great and that we shouldn't, you know, look to change those things. But those are the things that young people have to recognize are going to be asked of them. If you bring the car into the shop, and you're living as a man, they're going to expect you to know how certain things work and you might not have any idea. And those are challenging situations that I do think cause distress and pain for people that they could have thought through better if they had more clinical therapeutic supports even going into it.

Stephanie Winn: I really appreciate that you brought it up from this angle, Jamie, that social and psychological angle. And I've seen some heartbreaking videos of females who are fully masculinized with the beard and the voice and everything and who read as male. being heartbroken over the lack of closeness available to men in this culture, just not realizing what they gave up until it was too late, just in terms of basic sisterhood and camaraderie and warmth and, and yeah, not being afraid of each other as women. And it is heartbreaking that we're not helping young people really think these things through. So I'm going to end the screen share here and switch gears because we have About 10 or 15 more minutes and I have some questions for you from my locals community. Alright, so I'm going to read these together because members kind of commented back and forth and their questions for you. And then we can take them one at a time. So Christo has two separate questions and then 40 something has some responses to Christo. So Christo first asks, Jamie, based on your experience at the gender clinic, what do you think is driving the recent explosion in transgender identification? Is it more along the lines of bottom-up social contagion or do you think it's more a top-down push from powerful interests and players who are perhaps eager to profit from all the surgeries and medicalization? Was there, were you going to read second part of it? Yeah, actually, I'll go ahead and just read them all and then we can take them one by one. Christo's next question for you is, when many of us hear messages about social justice and oppressor oppressed identities, we find ourselves in a seemingly impossible situation of oppressor. This makes us feel gross and disgusted with ourselves and can feel impossible to resolve or change. Do you think that some, or perhaps many, of those identifying as trans today are, in part, looking for some way to share in a marginalized identity? And then finally, 40-something chimes in, saying, Christo, great question about being positioned as the oppressor, another word for it being persecutor. Thinking about the three roles comprising the drama triangle, I wonder if the gender-affirming clinicians are playing their role as rescuer, acting as if they're protecting the victim, child, from the persecutor, parent. My question to piggyback off yours, Christo, are kids falling into the role of victim as a marginalized identity while ego-driven clinicians are looking to play rescuer or savior?

Jamie Reed: Okay, so lots of great questions. And part of the answers to these questions I think comes from listening to the youth themselves. And so I do believe sometimes youth have insight into their own situation and they're not unaware of what's going on around them. So the first question talked about this top-down versus bottom-up kind of scenario going on here. I definitely see within the patient population that there are a number of patients who are caught up in a social contagion. Social contagions we know primarily affect natal girls in the teenage years. We have so much evidence and so many previous historical accounts of this that I'm more surprised when people are surprised that they can't see that there's some element of this that's a social contagion. And reading some of the other, you know, great minds in this, I was blown away. I met Dr. Hazim from Britain when I was in Finland, and he talked about having patients explicitly tell him that this is basically the new punk rock, that this has taken over what, you know, people used to listen to music and go to shows and that kind of thing. And I heard that directly from patients. I had some patients who specifically told me, this is where this is coming from for me. This is the trend line. This is the way to be cool. This is what's going on for me. And it was only a few of them that had that insight to reflect on that. And I also found that those that had that insight also had some of the stronger relationships with their parents. And so they were open to hearing some of those things from their parents. Their parents, you know, straight up said, this is the new punk rock, that kind of thing. Again, we can go directly to patients who are telling us that, yes, some of them are entering into this because it's a way to become part of a marginalized community. And so I'm trying to find the direct quote, but there was a detransitioner who essentially said the worst thing in the world to be was a white, cis, hetero, straight woman. And so they talked about how they couldn't change that they were white. They couldn't change some people's, they had written that they, you can claim that you're gay or bi, but then when it actually comes to living that out, you know, it's hard to kind of fake it in actual practice. And so the thing that they were writing about that they could identify out of the worst thing that you could be was you just slap, you know, they behind your she or pronoun and you can get yourself out of the oppressive class, that you're no longer in the oppressive class. The thing that befuddles me is why women in general, um, feel like they're in the oppressive class. This to me is a shift in age. So when I was growing up, women did not make up the the high group percentage of people going to college, like it was reverse, like primarily, you know, it was men who were obtaining college degrees. We're seeing now colleges camp, college campuses have now shifted to that. They're primarily made up of women on campus. There are shifts in some of these professional classes where I think some of the younger women who are growing up now, do see themselves as women within the oppressive class, and that's just not something that I ever had experience with when I was a teenager. When I was a teenager, we… were still reflective of the patriarchy, and we, you know, I still lived in an age where… men held the primary reins of power, where… And so I do feel like there's some level of conflict here. Because from my perspective, Women are still facing a number of struggles. We still live in a society where we've never had a woman president. There are still huge challenges for women who work and try to balance home life. And if you still look at raw data, women are primarily still taking on most of household chores, household child care. There's a there is still a struggle but you're the person writing is in is correct that these young women do you feel like the way out of the oppressive class and how to somehow be in the marginalized community is to identify within the LGBTQIA blah blah blah plus whatever thing. And that's just not my assessment. That's what detransitioners have told us.

Stephanie Winn: You can now watch No Way Back, the reality of gender affirming care. This medical ethics documentary, formerly known as Affirmation Generation, is the definitive film on detransition. Stream the film now or purchase a DVD. Visit nowaybackfilm.com and use promo code SOMETHERAPIST to take 20% off your order. Follow us on Twitter at 2022affirmation or on Instagram at affirmationgeneration. And is the one demographic category that you can opt into? I mean, arguably, we could say religion would be a demographic category that a person can choose to opt in and out of. But it really raises the question of if this group is so oppressed and marginalized and has it so rough, Why is it such an appealing group to opt into because you know as we're recording this we're living in an age where there are some concerning acts of anti-semitism on the rise and I think when we're faced with Real anti-semitism and some of the threats that have been made and we look at the history of anti-semitism when you have real persecution of a religious group or an ethnic minority like that, what do people do when they're persecuted is they hide to save their lives, right? So we have this narrative right now, this dangerous, destructive narrative about a so-called trans genocide. And so how can a group that is a victim of genocide also be a group where people are choosing to opt into that group rather than hide that, right? The narratives aren't adding up, but I think it shows just how almost schizophrenic of a position this puts young women into because on the one hand, like you're saying, we do live in a time where more young women than men are going to college. And for many young women, there are better options than ever, depending on what your goals are. And at the same time, the exploitation of women is rife. If you look at the pornography industry and what that's done to heterosexual relationships, we know that that's a driver of opting in to transfer a lot of these girls because they're like, oh, that's what it is to be a girl or a woman. Well, count me out. I don't want to be treated like that. And I think part of what's driving identifying as trans for a lot of males too, not all of them, but for some of the more narcissistic and fetishistic males, there's a sort of sense that men, men has conquered everything and woman is the final frontier. It's the one thing that man hasn't achieved for himself yet. And now that women have relatively more freedom, safety and prosperity, than we have at times in the past, again, depending on the filter that you're looking through. And given how these men have a very distorted concept of femininity based on how porn has warped their brain, it's like, well, then I want that for myself, right? Right at the moment that becoming a woman is finally a desirable status in society, then men want to have it. And it's certain men's desire to co-opt that in the trans scene that pushes certain females in the trans scene to be even more disgusted by those efforts and desirous of a way of opting out. Those are that's kind of my own spin on it. But what do you think about this question that Christo started with about sort of bottom up versus top down? Did you see much of that going on?

Jamie Reed: It's a challenging question for me, because on some level, I I did not ever get the sense that our center was in it for the money. Really the only, the one avenue where there is financial gains is through the surgical arena. An endocrinologist visit, one hour visit, they're going to run a couple labs. It's not actually, these are not high paying return visits. So what pays out really well in medicine is the more things we do to the body, the higher insurance value we get. So the more interventions, the more, if we cut, if we do things, that's what pays out higher. Just talking to your physician actually pays pretty darn low. At the same time, though, we weren't in the red. I mean, we were in the green. We were at least holding our own. I don't know that for most of these centers, they were opening for a financial reason. but yet they were opening for a status reason and there were elements to our work. The fact that we existed at all gave the hospital boost in the HRC ratings, in the diversity indexes. I actually have seen some of these scorecards and how some of these places kind of rate your rainbow-ness and give you, you know, your rainbow scorecard. And, you know, operating a pediatric center was a huge target to get your high rainbow status. And so I don't know how much of it is directly tied to dollars as much as it is to the status and what you can get in terms of kind of buyback from the larger community that you can put up the rainbow flag and put up the trans flag. I do want to just jump back to the thing you're talking about with some of the younger natal boys who are identifying as trans. A lot of what I heard directly from patients is that they were trying to identify out of toxic masculinity, how they defined it. And so they felt like they didn't want to grow up to be a toxic male. And so a way out of that was to was to identify as non-pioneer or trans. And that just reiterates all of these questions that we have as a society regarding values and how we treat one another and And why a young man would think that their only route through malehood is to be toxic is tells me something about what we've messaged to boys and men. And that does really concern me as a mom of five boys, because I feel like what we're messaging them to them is that you can either be toxic and you know the an evil terrible person or you can be female and I think that takes away a lot of the value that men do hold and can hold and you know I'm an anthropologist at the beginning and you know we evolved from you know like creatures who had sex differences on some level because there is some basis for, you know, why our bodies are different and why you might be able to lift more than I could lift or, you know, but I can probably walk farther and longer without complaining than you can. And, you know, There are values to both sexes and importance to both sexes. And I think if we head in any positive direction, it's to teach young people that there are benefits to your sex and your body and what it can do for you and how it can operate in the world. And your sex does not mean you cannot be kind and not be a whole human and cannot be compassionate and cannot be a caring person.

Stephanie Winn: Thank you so much for bringing it around to that, Jamie. And that's a very balancing perspective compared to the more kind of cynical one that I brought about the angle that some sort of, you know, porn sick men have. But I think the two influence each other. I'm not saying that they don't exist. Yeah, I think. It must be very confusing for adolescent boys who are attracted to girls when they have those raging hormones and when they've been exposed to the same porn that some of the more predatory males have been exposed to because it feeds right into that sense that their masculinity is toxic and that their own natural feelings are toxic or harmful to women right that kind of mixture of arousal and disgust and fear and horror and shame that can happen from exposure to these things that kids are seeing. I really feel for them and thank you so much for bringing it around to that compassionate perspective and and for coming at this from your perspective that is at once feminist and also very much concerned with the needs of boys and men and as you said a mom of five boys trying to figure out how to bring them up in this world. So tell us a little bit about what you're up to with the LGBT Courage Coalition and where people can find you.

Jamie Reed: Yeah, so I have been working with an amazing group of lesbian, gay, bisexual, adult, transgender, and other whistleblowers. We kind of coalesced around two kind of core values. So the first one is that we all share significant concerns about the way pediatric gender medicine is currently being conducted in primarily English-speaking, westernized cultures. So Britain, Canada, North America, the United States, Australia. There's so many parallels, you know, in a lot of these cultures. And we just, we all agreed we have really significant concerns about this medicine model. And then the other thing we have really been trying to demonstrate is that the only way out of the silencing of free speech that we're recognizing is that we support one another in being courageous and speaking up. And so we started meeting, we started trying to form relationships, and we've reached a point where we started a substack at the end of this last year's Pride with the idea that we were going to run a substack to highlight voices that are traditionally being silenced within the LGBT. The LGBT is being presented, especially in the United States, as if it's a monolith, as if all of us within the LGBT all are gung-ho about giving kids puberty blockers and cross-sex hormones. And the truth is the exact opposite. I know so many LGBT individuals who are adamantly actually opposed to puberty blockers and cross-sex hormones. So we've been running our substack and we have been working together to try to come up with ways to open up the dialogue in the political sphere that you can support lesbian, gay, and bisexual, transgender people and still not support pediatric gender medicine. So it's a tough conversation for us to have. It's a really tough conversation that we're having right now in the community. I think a lot of people think that if enough of the lesbian, gay, bisexual and trans people just spoke up that we could end pediatric gender medicine today tomorrow and that's just not the case. But we are trying and we are trying to carve out space within these communities to really bring back the idea that we're not a monolithic community and that free speech has to prevail not just for our own community but for our democracy to function just in general.

Stephanie Winn: All right, thank you. That's a beautiful mission. So we'll share your sub stack in the show notes. Is LGBT Courage Coalition also on any social media platforms?

Jamie Reed: Yes, we have a Twitter and X feed. And you can find me on X as well.

Stephanie Winn: Okay, we'll include all of that. Jamie, thank you so much for joining me. It's been a pleasure.

Jamie Reed: Thank you. This has been actually one of the more interesting podcasts I've been on, and I really appreciate you taking this different kind of lens at it. I really, really like that more in-depth conversation. It's been great.

Stephanie Winn: Oh, thank you. I always try when I'm interviewing someone who's done several podcasts, I'm always thinking, what have they not been asked? What's a different angle we can take? So I'm glad that that worked for you. Thank you so much. I hope you enjoyed this episode of You Must Be Some Kind of Therapist podcast. To check out my book recommendations, articles, wellness products, guest episodes on other podcasts, consulting services, and lots more, visit SomeTherapist.com or follow me on Twitter or Instagram at SomeTherapist. If you'd like to go deeper, join my community at somekindoftherapist.locals.com. Members can dialogue with other listeners, post questions for upcoming podcast guests to respond to, or ask questions for me to respond to in exclusive members-only Q&A live streams. To learn more about the gender crisis, watch our film No Way Back, The Reality of Gender-Affirming Care at nowaybackfilm.com. Special thanks to my producers, Eric and Amber Beals at Different Mix, and to Joey Pecoraro for our theme song, Half Awake. If you appreciate this podcast and want more people to find it, kindly take a moment to rate, review, like, comment, and share on your platforms of choice. Of course, just because I am some therapist doesn't mean I'm your therapist. This podcast is not a substitute for medical advice. If you need help, ask your doctor or browse your local therapists online. And whatever you do next, please take care of yourself. Eat well, sleep well, move your body, get outside, and tell someone you love them. You're worth it.