Maintenance Phase - "Rapid Onset Gender Dysphoria"

Episode Date: May 9, 2024

Panic! At the endocrinologist.Thanks to Jules Gill-Peterson (jgillpeterson.com) and Julia Serano (patreon.com/juliaserano) for help researching this episode and Evan Urquhart and Parker Molloy for fact-checking!Support us:Hear bonus episodes on PatreonDonate on PayPalGet Maintenance Phase T-shirts, stickers and moreBuy Aubrey's bookListen to Mike's other podcastLinks!Origins of "Social Contagion" and "Rapid Onset Gender Dysphoria"What does the scholarly research say about the effect of gender transition on transgender well-being?Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming CareFresh trans myths of 2017: “rapid onset gender dysphoria”Rapid Onset of Gender Dysphoria in Adolescents and Young Adults: a Descriptive StudyThe Detransitioners: They Were Transgender, Until They Weren'tHow the idea of a “transgender contagion” went viral—and caused untold harmMental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care'Rapid Onset Gender Dysphoria' Is Biased Junk ScienceA careful step into a field of landminesDetransition, Desistance, and Disinformation: A Guide for Understanding Transgender Children Debates Recognizing and responding to misleading trans health researchThanks to Doctor Dreamchip for our lovely theme song!Support the Show.

["Sexy Music Plays"] Uhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh uhhhhhhhhh you have to you have to tag line us I do what have you you you can tell me to pull this one back if it's too close to home you'll hear a lot buzzer sound hi everybody and welcome to phase, the podcast that's pretty much just on Twitter to start shit with transphobes. Oh, oh, you're subtweeting me. You were 10 seconds in and you're like, I saw Mike's online presence yesterday. I did. That is accurate. I did see your online presence yesterday. I apologize for who I am on the internet and in person and on podcasts. For the record. I'm very sorry about that. This is a good way to approach growth and accountability. I apologize for who I am. All of my behavior and thoughts.

I'm Michael Hobbs. I'm Aubrey Gordon. If you would like to support the show, you can do that at patreon.com slash maintenance phase. Wait, wait, wait, wait, wait. We have news on that though. And we do have news on that. God, we have so much housekeeping.

Okay, let's do this as quickly as possible. Mike and I have been talking about the show and how to keep it going with his other podcast, with my books and movies and all of that. And the way that we're going to do that so that the show doesn't go away is we're just going to have a slower pace than we have in the past. Instead of, you know, an episode every two weeks, it'll probably be closer to an episode a month. The thing is, we're both stretched thin lately because Aubrey is finishing her next book

and has been doing this movie, and I'm doing another podcast, and also I have some, like, other upcoming stuff happening. Basically, we were talking about, like, what our options are, and it's like one of them is to just, like, lower our standards for the show and just, like, churn out episodes and like stick to it every two weeks schedule, but like we don't want to do that. And the other option is to just stop doing the show and we also don't want to do that. And so what we're gonna

do is we're gonna keep our shows to like the level of quality that we're comfortable with and we're just gonna like release them when they're done. We're gonna continue doing Patreon bonus episodes every month. Those are like a little bit like more hangouts. Those aren't that difficult to keep the pace going. We think like we've always said that like there is no such thing as a bad reason to stop supporting us on Patreon. Like if you're not comfortable because the pace of the episodes is gonna slow down and you're like, ah, there's probably other shows that I could support. Completely fine with us. Like we absolutely do not want you to feel bad about that.

And you have been very outspoken about this, and I could not agree more. We're also big fans of like, hey, do you want to go join the Patreon and then download everything and then quit the Patreon? Yes, yes. That's totally fine. So also, if you want to do that and just like once a year, sign up, don't have a lot of bonus episodes and then cancel, that's also super chill. Anyway, this is just to say that like the episodes will continue until morale improves.

We love you. We don't want to go away. We don't want to make bad shows. Yeah, we want to be able to meet our own standards being like, you know, productive, helpful media. Speaking of helpful media, Aubrey has further housekeeping. Oh, it's very fun. It's happening. it's finally happening.

I am the subject of a documentary called Your Fat Friend and you can currently stream it. Anyone. It's directed by Jeannie Finley, who is like an absolutely brilliant director. This is her ninth feature. Jeannie. And it was shot over a six year period,

starting when I was writing anonymously on medium. And your makeup was hella different. It was so different. I was really into an extremely dark lip. Yeah. It's available almost everywhere. All you have to do is go to Jolt.Film, rent it for yourself. You can send it as a gift to friends and family.

And I'm just really excited for people to actually, all the way, be able to see it. Go watch it. Yay! Okay, we're finally into the show. Housekeeping done. Housekeeping complete! Today, Aubrey, we are talking about rapid onset gender dysphoria. Yes. Which, according to what you told me eight minutes ago before we were recording,

you don't know anything about. you haven't heard of this concept. We've touched on this a little bit in the show. I spent a number of years of my life organizing around trans healthcare as like my main thing. I continue to know and love many, many, many trans people and sort of like stay tapped into parts of the conversation. But the parts that I have tapped out of

are the parts that are like full moral panic shit, which is a lot of it right now. Although, okay, so I was going to actually ask you for a favor in this episode. Oh, I know there's a lot of people who just like don't know that much about like youth gender affirming care, which is what we're going to be getting into. And one of the things you find in a lot of moral panics is there's always this argument that like, we should be allowed to ask questions. You can't even ask questions. And like, I want to stress, you are allowed to ask questions. And like, people are allowed to be curious about this issue and even a little bit concerned about this issue, right? Like, all of us have dealt with the American medical system. I, you know,

I know friends that were prescribed antidepressants, like very young and look back and were like, I don't think I was ready for that, and I don't think that was appropriate for me at that time. And so what I'm trying to do in this episode is to like speak to those legitimate concerns, and like lay out the information of like what we know. And so I was gonna ask you to be our like proxy for like people who might be a little bit concerned about this. Yeah. And so channel your inner reply guy. Ask the tough questions. I have an inner reply guy. You have an outer reply. You're just channeling me now. You're doing a mic impression. But so I think really the starting point for this entire conversation and like the good faith people that we're trying to speak to is that like there have always been trans

people. Trans people are real. If you don't agree with that as a premise, then like I have nothing to say to you. Trans people are real and not new. Yes. Pretty much every kind of person, including trans people, have been around for as long as there have been people. So for this I talked to Jules Gil-Peterson, who is a historian, and she wrote an entire

book about the history of trans medical care and trans medical care for kids. The field of trans health care, I mean, again, this goes back much further, but kind of modern trans gender-affirming care starts with the synthesis of estrogen and testosterone in the 1930s. In the 1960s is when we first start developing, like, the field of gender-affirming care. We start using hormones and plastic surgery for trans people. By 1979, we have the first medical standards of, like, exactly the steps and, like, what this should start looking like. Those are the Harry Benjamin standards, yeah?

He pioneered the care, and then we got the sort of formalization of standards. I think it was like 10 or 12 years after his book came out. Yes, and I will say the Harry Benjamin standards are not beloved by trans people. This is also something that Jules Gil Peterson talked about is that like the the history of trans gender affirming care is like I mean first of all we didn't call it gender affirming care right it was mostly like trying to talk trans people out of being trans. You know, a lot of the stuff that you hear now kind of uses this much more recent history as like the starting point. They're like, oh, they just like out of the blue started doing gender affirming stuff on trans people.

But like, they were doing stuff to and with trans people for much longer than that. But it was mostly trying to talk them out of it and trying to get them to live as cisgender people. And so in the 1990s is when we start getting the first studies on like does this kind of care work? How do people feel about it afterwards? The first studies come out of Sweden. There's one that tracks every single person who got gender-affirming surgery between 1972 and 1992, and only 4% of people regret getting the surgeries and, like, have gone back. In 2014, we get a comprehensive review of every single surgery that's been done

over 50 years in Sweden, 2.2% regret rate. It's fascinating to me that regret rates have become such a big part of this conversation because most of the rest of the time, cis people do not care how trans people feel or do not act as if we care how trans people feel. Right? So much of the history of trans healthcare

is the history of cis people's discomfort with giving trans people what they have been very clearly, very consistently needing for a long time. That's a weird thing for a reply guy to say. Oh, sorry. A little bit weird. I'm switching into reply guy mode. I think that's a little bit weird for someone

who has one job, for someone who has one job for this show. Interesting. I'm gonna be bad at it, but I'm gonna try. Put on a goatee and some Oakleys. The thing that I thought I would say as the introduction to my reply guy thing, this is how bad I'm gonna be at this, was I know you are, but what am I?

Oh yeah, that's pretty good actually. Ha ha good actually. Just go, nuh-uh. Yeah, fourth grade reply guy. One of the things to really say, and this isn't something that is really disputed if you really get down to it, is that gender-affirming care in adults is extremely successful. And we're talking about regret rates that are like one half to one third what regret rates are for like nose jobs and like knee replacements. Like, people really feel better after they get this kind of care. There's, it's still preliminary, but there's early results from a survey of 90,000 trans people and among people who have been taking hormones. Their regret, like, I strongly regret getting this, is under 1% and just kind of

transition in general, it's only 3% of people say that they're either less satisfied with their life or like very unsatisfied with their life. There's also a systematic review that looks at 55 studies of gender affirming care in adults. 51 out of 55 find that gender transition improves well-being, and the other four find mixed results or just like no finding at all. So basically you can't find studies that find harms, like I'm worse off. And so again, I mean, this is a show about like the foibles of having overconfidence in medical research and overconfidence in existing medical systems, and so I'm not going to say that like every single person who's ever gotten gender affirming care loves it and it's perfect in every way. Like this is a field that continues to be refined, but there are very few fields in medicine and medical procedures for which you find this kind of satisfaction. The idea that there are simply two genders is something that we have built up so many systems

around. It's a major organizing principle. And I think part of what happens for this stuff is that people feel this sense of like worldview upheaval happening and they take it out on trans people who are the people who they see as being responsible for that worldview upheaval, right? So basically, as we start getting more and more data on gender-affirming care and how it makes people more satisfied with their lives, it sort of makes sense to people in the field that we have this kind of care that works for adults, and we know that a lot of trans people, not all, but many trans people, start to show signs of being trans at like four years old. We should probably start to explore this for kids. And so another thing

that Jules Gilpetersohn mentioned was that, again, this is not the first care for trans adolescents, but the care for trans adolescents had always just been conversion therapy. They're like, I'm a girl. No, you're not. That was basically how it worked. And so basically everything else they've tried manifestly isn't working. Right? And so they're like, OK, as a last resort, let's try like affirming these kids gender. And so in 1987, the first clinic in the Netherlands starts providing the first gender affirming care to kids. In 1997, we get the first study that is published of these like very early patients. Actually, I was gonna this isn't yellow, but I'm gonna send it to you. You're seeing green. Oh, it's not in anything. It's just in well for you and I paste that it's in nothing.

But for me, it's a good thing we had that lead up that fascinating, fascinating look behind the scenes. Sint-tlating peek behind the curtain. If you sign up on Patreon, this is the stuff you get. Woo! It's pure gold, but I can't see the gold. Adolescence is a phase in which many identities, e.g. political or religious, are developed. Professionals fear that experimenting with certain aspects of gender, such as gender role behavior,

will lead adolescents to conclude that they have a gender identity problem and that they will, as a result, wrongly seek a medical means of resolving their confusion. The chance of making the wrong diagnosis and the consequent risk of postoperative regret is therefore felt to be higher in adolescents than in adults. I think that this is the heart of all of the anxieties around this issue, especially from people that haven't had gender

dysphoria as kids, is that you think about your time as an adolescent and you're like, yeah, I was playing around with my identity. You know, you're a goth this week and you're a prep the next week and you are in different social groups. And, you know, we want to make sure that we're establishing that kids are really trans and really sort of settled in this identity before they get any kind of irreversible medical procedures. That's something that strikes most people as like fairly reasonable, right? But the reason why I wanted to include this is it shows that from literally the first study on this, the doctors know this too. The idea that this extremely obvious thing is not also obvious to the doctors who are practicing this kind of medicine is fairly implausible,

and it shows up in the studies. They're like, hey, look, we know this is the time when kids are experimenting. And that might include some like gender expression experimentation. And so we want to make sure in this field that we're you know, we're talking to the kids, we're getting some kind of holistic assessment. This is something that the field has been aware of since literally day one. I'm in the bag for big child. I'm in the pocket of big child. I was, you know, raised by a lady who's an early childhood brain development expert. That was her field. Piajayhive. Piajayhive, rise up.

Her assessment has very consistently been that our issues around children are that we don't believe them when they tell us what's going on. That we get ourselves into really sticky situations when we decide that children as a whole are unreliable narrators like necessarily. That's not a carte blanche. I believe you when you say there's a monster under your bed. Right. But that is a you're telling me there's a monster under your bed. And I believe that you're really afraid of something that fear deserves tending to. And so this first study kind of sets a precedent

of like a lot of the further studies. The study, they basically look at the first 22 kids who got gender-affirming care, and they ask them three years later, are you happy about it? And zero regret. All of the kids are like very happy with this. And we get another study in 2011 of the first 70 patients

at this Dutch clinic. Two-year follow-up, all of them continue the treatment, they're now doing puberty blockers and hormones. We also start getting surveys from other countries, so in 2014 we get a survey of 84 kids, which is every single patient that this clinic in Vancouver saw over 13 years. They find a reduction in suicide attempts. We also get the first studies out of the UK gender clinic, one of them follows 201 kids, and finds improved psychological functioning. In 2014, we get a study that follows 55 patients for an average of seven years, and they find that they have the same mental health markers as cisgender kids, which is actually huge because trans kids tend to

have higher rates of depression, anxiety, suicidality, lower quality of life, and of course, higher gender dysphoria than cis kids. And so the fact that if we're intervening early enough, it's like, holy shit, these kids are roughly the same as their cisgender peers. That's actually like a really big deal. That phenomenon is something that I feel like I observe more sort of weaponized by like deeply anti-trans folks than like understood with compassion as like, oh, my God, we could tackle a bunch of mental health stuff before it even really develops.

Right. Yeah. But it very often ends up being like, well, look at these unstable trans people. Right. Yeah, exactly. More often how that gets built. So I just want to pause here in like 2014, 2015, to say that like all of what we're seeing in youth gender affirming care medicine at this point is like fairly standard, right? We do this with lots of other medical treatments. We have this thing that seems to work in adults. Over time, we kind of slowly expand it to kids, right?

If we have like a migraine treatment that's like, hey, it works in adults, let's see if it works in kids. As you get more data, you kind of make bigger studies and you start giving it to more kids and you just develop like a body of research over time. You know, this is a podcast that, you know, has criticized other studies for being really small. And like a lot of these early studies are on like, 100 200 kids they're really small. So we're not going to say that that we've established that this care is like definitively great for every single person who gets it under every single circumstance.

But yeah, this is promising enough to continue doing it and to continue doing it on larger numbers of kids. Yeah, this is essentially what has happened, right? In the first two decades of this field, you have a lot of small studies coming out, mostly because you're simply not giving this care to that many kids, right? The clinic in the Netherlands says they have nine patients per year for the first couple years. This isn't really a debate about, like, is this the perfect care for every single person

all the time or not? It's like, is this promising enough to keep giving it to people? And at this point, it would be bananas to stop giving care to kids on the basis of the fact that there aren't larger studies when large studies are literally impossible. It becomes this sort of chicken or the egg thing, which is like, we need larger studies in order to provide more care to more trans people. And we can't provide more care to more trans people until we have larger studies. Exactly. So what we have basically is the field exploring gender affirming care for

kids throughout the 2000s, 2010s. But that's all kind of under the radar. I don't know about you. I like was not aware of this at all until it started showing up in popular media in kind of the mid 2010s. It's like, you know, it's again, it's like a very small field. And so we finally get the first appearance of this as an issue in the mid 2000s, where I can't find exactly sort of patient zero for this,

but in 2006, we get a Barbara Walters special about this kid named Jazz Jennings who transitioned and was living as a little girl. And then there's an Atlantic article called A Boy's Life. God, the amount of misgendering in this era. They're misgendering and deadnaming this kid throughout the article. Jesus fucking Christ. So there's this entire decade where trans people in general are getting more visibility, and we start getting these little inklings of like the trans kids thing. There's a Oprah special in 2011, there's a 2013 article in the New York Times. We then in 2014 get the time cover, like the transgender moment, right, like, Orange is the New Black is on

and LeBrun Cox is in it. Caitlyn Jenner comes out in 2015, you know, cover of Vanity Fair, huge deal. There's all these bathroom bills in 2016. Yeah, prior to all that, we get Chas Bono. Yeah, Chas Bono, yeah, exactly. It's just like, this is becoming a much more prominent issue. And also, this is really the end of the gay

marriage fight, right? Obergefell is 2015, I believe. And it's sort of like at the time, the Christian right, they just lost, right? Like gay marriage, you know, in public polling, in the law is recognized everywhere. Yeah, there's a lot of all of a sudden, there was a lot of anti porn advocacy, which was like, you guys just have free time. It was just a real mission drift moment of like, oh fuck, we lost our thing. And unfortunately, they have found their new thing. What you start seeing is these inklings

of this issue of what they call gender confusion. Right, that's the whole fucking trans-trender fucking bullshit. Yeah, it was, we don't know what we're talking about. And like, this is the way that they conceive of like trans people just like as a group, is basically people that, people that, you know, as kids they're confused,

as adults they're like sex perverts. I mean, that's the thing that I find really remarkable about so much of the sort of, both the studies and the discourse around this, is that it feels like there's so little accounting for the immense force of transphobia. Aubrey, I just want to point out that we've been recording for 40 minutes and you haven't done any reply guy shit.

Not one reply guy! The duality of the show is that you can't pretend to be a reply guy and I can't pretend not to be a reply guy. For like even five minutes. Neither one of us can manage. Listen, our identities on this are consistent and persistent. That's actually the perfect metaphor for this. We can stop now.

See, it doesn't work. So for this, I interviewed Julia Serrano, who is a biologist. Oh, wonderful. Yeah. I'm drawing heavily on her work. She has a very detailed timeline. The way that she described it was there, there's just kind of these like swirling anxieties, right? Because a lot of parents are reading these articles.

And so in 2015, we have the establishment of three websites. The first is called fourth wave now, which is supposed to be referenced to like fourth wave feminism? Wow! Uh oh, I hate it. So this is an excerpt from the About page. You should probably do a British accent for all these, because whenever I think of transphobia, it's in a British accent in my head. They're mutilating the kids, innit? No, no, no, absolutely not. What did they do? That was impeccable.

Governor. Not. That was impeccable. Governor. Fourth wave now was started by the mother of a teenage girl who suddenly announced she was a quote unquote trans man. After a few weeks of total immersion in YouTube transition vlogs, the daughter has since desisted from identifying as transgender. After much research and fruitless searching for an alternative online viewpoint, this mom began writing about

her deepening skepticism of the ever-accelerating medical and media fascination with the phenomenon of quote-unquote transgender children. Boy oh boy, the level of scare quotes in this. There's a weird reluctance to identify these as transphobic websites. But I feel like if you're putting the term trans man and transgender children in quotes, remember in the 90s how they used to put gay marriage in quotes in extreme right publications. It was like, they're trying to call wives and wives. I think we can be comfortable looking back on that and being like that this was homophobic. If you look through the archives of this website, every single post is about how discrimination against trans people is kind of overblown

and the suicide rates aren't really all that high. You know, some of the post titles are neuroplasticity, the gaping logic hole in the transgender house of cards. Another one's called how is this not a cult? Another one is baby boomers head explodes. How did identity politics gain all this traction? Oh, good. It's part of identity politics discourse. Exactly. There's I was gonna read you a whole paragraph but it's so boring. They also have some like, Soros stuff? So there's a post called The Open Society Foundations and the Transgender Movement.

Oh fuck. Maybe you don't want to say it's transphobic? I don't know if I really want to litigate that, but like this is an anti-trans blog. This is a blog of anti-trans messages. I think that's like pretty well established. I think we can probably all agree at this point that ex-gay conversion therapy is also a pretty fucking homophobic venture, right? And the contours of the sort of debate

around the existence of trans people are really similar to that. You aren't who you say you are. You can't be trusted to narrate your own identity. I would say actually arguably the unreliable narrators of their own identity are people who display this kind of gatekeeping to other people's identities. If you're doing this kind of thing, I don't know that you get to decide if your actions are bigoted or not. So that's one of them. That's fourth wave. Now there's another one called transgender trend, which I'm going to send you. Oh, fuck off. I know. We are an organization of

parents, professionals and academics based in the UK who are concerned about the current trend to diagnose children as transgender, including the unprecedented number of teenage girls suddenly self-identifying as quote unquote trans. Suddenly, we are also concerned about legislation which places transgender rights above the right to safety for girls and young women in public toilets and changing rooms, along with fairness for girls in sport. It's about fairness in girls' sports. This, like, idea that this gives aid and comfort to people who want to sexually assault girls and women,

that's the one where I'm like, I don't know how you see this as anything other than bigotry. Well, this is what's so fascinating to me, is like, you know, slippery slope arguments are a mainstay of conservative rhetoric, right? There's like, a man's gonna marry his horse a mainstay of conservative rhetoric, right? It's like a man's gonna marry his horse or whatever. But what's wild about the bathroom stuff, the trans bathroom stuff is that

the slippery slope they're warning of is already in place. People already use whatever fucking bathroom they want. What I would say to a paragraph like this is it sounds like you're really concerned with sexual assault. What is your work here on actual sexual assault, right? It's very strange to be like, I'm very concerned about sexual assault, therefore, man, do I hate trans people, right?

Or like, I don't trust them, right? Where you're like, that's not a one-to-one. Those are two disconnected statements that you are making. So those are the first two websites. There's also one called youthtranscriticalprofessionals.org, which we're not going to go as far into. It's now defunct, but it's basically the same thing. We're medical professionals, we're doctors, and we're concerned about the medicalization of trans kids, blah, blah, blah, blah, blah.

So these websites pop up in 2015. On February 20th, 2016, we have the first ever claim that social contagion is the reason why kids are trans. This appears as a comment on the about page for 4th Wave Now. Boy, you fucking boy. We're gonna dive into this because it has a lot of components that we still see now. Boy, you fuckin' boy. We're gonna dive into this because it has a lot of components that we still see now. So I'm gonna see this. This is from a commenter called Skeptical Therapist.

There is this episode of Star Trek The Next Generation where the crew is introduced to a mysterious alien video game. It slowly infiltrates the crew and Wesley Crusher and another young ensign watch as the adults around them slip into addiction. Wesley begins to sense that something is amiss and goes to find Captain Picard. He is so relieved to find the captain and to be able to confide in him. As Wesley leaves, we see the captain reach into his desk with signature sang-froid

and take out a gaming device. He too has been infected. As we suspected, the game is really an insidious mind-controlling apparatus that will allow an alien race to gain control of the ship. This is what this trans madness feels like to me. Long windup. I have some comments about the length and tone of this. So this is another relatively long excerpt where she talks about her own experience. The alien mind control device made its way into my home

about two years ago when my then 11 year old daughter begged me for a tumblr account since her friends all had one. Foolishly, I consented without looking into it further. I wish I hadn't. This trend toward all things pan slash bi slash non-binary slash gender fluid slash trans etc. has had a huge amount of energy among kids my daughter's age. I have watched it with some degree of suspicion and concern, but last month the degree of my alarm grew. She started dropping provocative hints,

such as asking if she could get a buzz cut. I found some writing she had left around the house where she wondered to herself whether she were quote unquote really a girl. She was very excited a few weeks later when a new friend came out as trans. For the record, this is a kid who has never had any gender nonconforming behavior at all. She has always been interested in art and dance at school. She is a little socially anxious, and that is the only thing that makes her susceptible

to this, I think. This is really the er example of this social contagion phenomenon, right? Where we have a kid, no signs of transness, and then all of a sudden, right, they get on Tumblr, a couple of their friends are trans, and then boom, mom, I'm trans. We then have another important component. I'm gonna read this paragraph. It isn't that I am a hating ogre. I think if I really believed that my kid were profoundly

unhappy in her body, that this narrative was coming from her and not from social media and the kids around her, I would be reacting very differently. I would also be having a different reaction if I could convince myself that gender identity experimentation were essentially harmless. Girls want to pretend to be boys? Sure, why not? But it is absolutely chilling to think that these kids who are just doing what teens do get support from the adults around them that let them get stuck in the experiment so that many of them wind up permanently changing their bodies. This is another very important component and comes up so often in these accounts. It's like, I'm not a transphobe. If all I thought was this was like a little identity

thing, I wouldn't be so mad, but this is different Something is going on that is gonna push her into Medicalization and in all of these irreversible procedures it feels like it's operating on this like emotional Register where it's like I need permission to be uncomfortable with this Also, it feels really telling this I think that if I really believe that my kid were profoundly unhappy in her body, that kind of language is, like, requiring an amount of performed suffering in order to believe this identity.

Right? And I think that sort of rhetoric is, feels like it's popping up more and more. Yeah. You can't be trans because you're not unhappy enough. I'm not seeing you suffer in the body or gender presentation that you currently have. Ergo, your identity is not real, which is also something that is, boy,

oh, boy, pretty much guaranteed to create some suffering. So I guess you did it. So, OK, final thing, this is like the final component of this. And I'm really belaboring this because all four of these components will show up in every single account of social contagion, like from now until forever.

So here's this. Her current school is wonderfully progressive and nurturing, but the school administrators all seem keen to jump on the quote unquoteunquote trans is terrific train. They proudly proclaim to prospective parents that there are several kids transitioning in the upper school. Oh, this is a private school, baby! Upper school! I recognize my people. Oh, okay. I thought it was like the top floor, but okay. It seems like this fact is sort of exciting to everyone and establishes without question,

they're all accepting super liberal cred. I have decided that the cult indoctrinators have had free access to her beautiful 13 year old brain for two years now. And it is time that I intervene and fight for my daughter. This also relies on this myth that it's like you're a lone voice of reason in an unreasonable world. It's so fascinating to me that being like, hey,

we've had trans students here who are allowed to be who they are has been translated in this person in their brain to the trans is terrific train. It feels like such similar energy to the like glorifying obesity energy. Right. Right. Right. Where you're like, you just saw a fat person who didn't look sad. Right. And you're seeing it as like you're trying to indoctrinate me. Like it just is wild to me.

The ways in which people tell on themselves in public. Right. I was talking to my brother about this last night. He was like, man, a thing that he has said to me many times is that the things that are most opaque to us about ourselves and the things we think we're keeping as secrets, we're actually just like blaring out to everyone around us. Yeah, this is like when my therapist said that I'm a nervous wreck. Thanks. Throughout this entire panic, we're going to see a lot of

claims about existing institutions being worryingly pro-trans in ways that seem a little dubious to me. Partly from what I've read, and I've interviewed numerous trans teens around the country, I've interviewed parents of trans teens, I've interviewed clinicians. This is not an experience that I've seen even in affirming contexts. We don't see this like, I hope you're trans, I want you to be trans. It's still a really, really difficult process of coming out. I just think about like being this kid and if your mom was saying these things about you on the internet.

Although I actually, part of me thinks that this might be fake. There's something a little perfect about the fact that it all started With a fight over having a tumblr account Something Julia Serrano mentioned to me because we were talking about this decade before this increased visibility of Transrides and the emergence of this myth a lot of this is a proxy for Anxieties around kids and the internet right right? Whenever we have a new technology, whether it's graphic novels or jukeboxes or automobiles, there's a huge panic about how kids are using this technology. And of course, there's huge anxiety about the internet and teenagers and social media and everything else. And so the fact that there's this trans

thing, you know, people transgressing gender norms, which makes people uncomfortable in general, and then we can also kind of blame it on the internet, right? We can say, well, There's this trans thing, you know, people transgressing gender norms, which makes people uncomfortable in general. And then we can also kind of blame it on the Internet, right? We can say, well, she's going on Tumblr and now she's trans. It's just like this this perfect combination of two existing sites of huge anxieties for parents. And there's later studies of like the people who are using these websites. And it's mostly middle class, you know, upper middle class white women. Nothing bad has ever come from the anxieties of white upper middle class parents,

right? This is like the same kind of suburban fear that gave us like the stranger danger panic. Sure. This is just a group that is like, you know, prone to anxiety, especially anxiety around teens, anxiety around technology. And it is a group of people who are very accustomed to their anxieties becoming a centerpiece of public policy. Exactly. It's also, can I speak to the manager energy? I demand to speak to whoever, who can fire you? Yeah.

I say this as a person who is of that group of people. As a member of the Karen community, I just want to call out my own people. It's the idea that every feeling that I have deserves tending to through policy and public discourse. Exactly. So this is just a random comment on the about page of this blog in 2016. So a week later, the blog turns it into a post. It has the headline Tumblr snags another girl, but her therapist mom knows a thing or two about social contagion. I was planning on going down a deep rabbit hole on the concept of social contagion. This is

something that's come up tangentially in other episodes. I decided not to mostly because it seems like it's a pretty contested concept. I read this really interesting meta-analysis that had something about like gun violence. Like there's this theory that gun violence is socially contagious. There's these kind of peer influences that normalize using guns to like solve disputes, right? And there was one study that found that one of the best predictors of somebody who's arrested for gun violence is how many previous incidents of gun violence have there been in their neighborhood. Okay, that might be social contagion, but that also might just be a poor neighborhood. And then the other one they mentioned was that apparently there's a spike in gun violence when there's more depictions of gun violence on TV. But that actually feels like

a different phenomenon to me, because it's not peer-to-peer influence. I started to notice this since I came across this literature, that people just invoke social contagion. It's like, oh, it's social contagion, but like, isn't that just like we do things that our friends do? Which is just totally normal behavior, right? Like my friend says, this book is good, and then I read the book.

But then also, if a friend of mine is like, clinically depressed, I don't know if that would transfer to me in the same way, right? And you know, there are studies of depression, there's a study that compares roommates, college roommates, when one has depression and the other doesn't, and you would expect if social contagion was true, the second roommate to develop depression over time, and that doesn't happen. It clearly depends on what is being contagious, and the relationship of the two people. It just is like, we should just talk about transgender identity as transgender identity rather than trying to put it in this frame of this concept that kind of works sometimes

and doesn't and just isn't really like all that useful of a way to look at this. The energy of this feels so similar to the post Columbine is Marilyn Manson to blame. Yeah. Discourse where I'm just like, guys, we got to rule out like 129 things before we get to Marilyn Manson. Exactly. So it's not totally clear how this happens, but relatively shortly after this blog post on fourth wave now, the concept of social contagion starts like going viral among conservative writers. So in August, the American conservative publishes a piece called the cult of transgender dude, which quotes a parent who like emailed the author and says, as a parent living the nightmare of having a teen who suddenly announcedces she's transgender, I can tell you there are no doctors who will do anything but agree.

There is no science behind this. There is no way to medically diagnose her. Her therapist knows that she is not transgender, but fears there's no way we can stop her. There's also, shortly thereafter, a David French, current New York Times opinion columnist, column in the National Review called the tragic transgender contagion, where he basically repeats this myth of gender confusion. He's like, yeah, there's some people that say they're trans, but actually they're confused about their gender. And he also says, gatekeeping has been replaced by cheerleading.

In the UK, where records are easier to obtain, clinics are facing an explosion in demand for quote unquote gender identity treatment. At one major clinic, referrals quadrupled. At another, they increased 20-fold in 10 years. So these are all relative statistics, right? They're increasing 10-fold. Remember the first year that the gender clinic opened, it had two patients? Right. I mean, you could say that about a lot of small businesses from year one to year two. It's always wild to me how like the actual articles on this always contain the information debunking themselves. He mentions later in the piece he's like oh the staggering rise etc and then he says this UK gender clinic they've had an unprecedented increase from 697 referrals to 1398 referrals in 2016. So that's like 1400 referrals to this gender clinic in the

UK. There are 8 million kids between 10 and 19 in the UK. So that's 0.0175% have gotten referrals to the gender clinic or one in around 6000 kids. These are also just referrals, right? There's already at this time years long waiting lists. And then once you get referred, you still have appointments and you sort of then go through the process and you may or may not get a referral to endocrinology. So these are very small numbers. But of course, all of this kind of reinforces this idea of like social contagion. They're just reaching for like, somebody has to be responsible for this. Right. Right, right.

It can't just be that some people are trans and now there is like more of a way for more of those people to come out. Right. Than 50 or a hundred years ago. We have been recording for an hour and 44 minutes and we're getting to the thing that's in the title of the episode.

Fucking Christ, Mike. We're getting to the actual. Oh no. This is a left-wing podcast. It's like 90% context. Is this a two-parter or a no partner? We just never get to the topic so all of that is bouncing around in 2016 in February of 2017 we get the first appearance, finally, of the term rapid onset gender dysphoria. This appears in a study by a woman named Lisa Litman, who is a professor at Brown. Before she was studying women's and reproductive health, she has no background in trans anything, but she publishes in February 2017 this very short poster abstract. It's like a column and a half in the Journal of Adolescent Health. The title is Rapid Onset of Gender

Dysphoria in Adolescents and Young Adults, colon, a descriptive study. So this is the text of the study. So this is under purpose, this is what it says. Parents online are observed reporting their children experiencing a rapid onset of gender dysphoria, appearing for the first time during or after puberty. They describe this development occurring in the context of being part of a peer group where one, multiple, or even all friends have developed gender dysphoria

and come out as transgender during the same timeframe and or an increase in social media slash internet use. The purpose of this study is to document this observation and describe the resulting presentation of gender dysphoria inconsistent with existing research. The existing research indicates that most trans people realize relatively young, and it's not something that just kind of like suddenly occurs in adolescence. So kind of on its face, it's like, okay, this might be like a new phenomenon. However, the first two words of this are parents online. So this is not a survey of trans people who say, hey, I suddenly

got this identity. It's not that they developed gender dysphoria suddenly, it's that it felt sudden to their parents. As a project, it's so weird to try to propose and describe a phenomenon of self-discovery from other people. And by asking other people who have alarmingly high rates of rejecting their own children for this specific thing. Exactly. This is not just a survey of parents. This is a survey of parents who were recruited on

Fourth Wave Now, Transgender Trend, and Youth Trans Critical Professionals. Those three websites we talked about earlier are where the researcher posted the advertisement recruiting participants. Boy, oh boy, oh boy. It's like saying, oh, we wanted to find out how many teenagers are worshiping Satan.

So we went to parentswhothinkther teens are worshiping satan.com, and we surveyed a bunch of parents. And wouldn't you know it, 99% of teens are worshiping Satan. Yeah, it just feels like a reverse engineering of like, the science is here because I'm uncomfortable. Exactly. It just feels like such a classic overreach.

So the study, it just says like, okay, we got 164 parents to fill out this survey. It says, you know, 93% are female, 94% are white. I think this is important. 88% of parents answered that they believe transgender people deserve the same rights and protections as other individuals. But not my kid. This is again, this thing, this constant invocation of like, we're not transphobes.

We just want to say, right? You know what it is? It's the parental version of NIMBY-ism. Like it's fine in theory, but not in here. Not in my back child. Okay. NIMPK.

Yes. So despite this thing of like 88% of respondents say that like, I'm chill with trans people, 76.5% of people say that they believe their child is incorrect in their belief of being transgender. And then we get into the like super red flag stuff. Oh, that wasn't the red flag stuff. Well it's getting to like the sort of like the more comedic red flags, honestly. Some of the things that are in this are like genuinely hilarious.

So here's the next couple of paragraphs. It's not all hilarious, but we'll get there. Although the expected prevalence rate for transgender young adults is 0.7%, 39% of the friend groups described had more than half of the preexisting friend group becoming transgender. On average, 3.5 friends per group became gender dysphoric.

So this is again asking parents for like objective information that they would have no idea about. Like my parents did not know the makeups of my friend groups. Where friend group activities were known, 64% of friend groups mocked people who were not transgender or LGBTQ?

This is my favorite shit! Honestly, seems low. They hate you because you're straight. It's reverse discrimination! This is such a fucking tell-to-be of just like how janky this survey is. It's also like you're talking about teens and children. Yeah, there's no, this has no relevance. They're making fun of you because you wear skinny jeans.

They're not making fun of you because you're straight. Also, it's like you're asking parents what their teens are making fun of them for. The answer is everything. Everything. You embarrass them in every way. Wait, keep reading, keep reading, keep reading. Where popularity status was known,

64% of adolescents had an increase in popularity within the friend group after announcing they were transgender. Again, it's like, how would parents know this? How would parents know this? Also, ask the trans kids. Yeah, it's not. Do people like you more for being trans?

That's really weird. Adolescents and young adults received online advice that if they didn't transition immediately, they'd never be happy and that parents who didn't agree to take them for hormones are abusive and transphobic. You said that it's like, this is coming from a place of anxiety. It's also, you can tell it's coming from some place of resentment too. Yes! It's like they're sitting around and they're mocking us. Like why would you even ask this?

Adolescents and young adults expressed distrust of people who are not transgender, stopped spending time with non-transgender friends, withdrew from their families, and expressed that they only trust information about gender dysphoria that comes from transgender sources. Cis people are like super on one about trans people. So I'm like, that's reasonable. The thing is, it's funny that like it's sort of purporting to be a description of this phenomenon where people realize they're trans really quickly. What it really is is a portrait of like what transphobic parents think is going on

with their kids and online. Like none of this actually sounds like what you find on the internet, or like the advice around trans people, and this whole thing of like, they're gonna call you transphobic. They don't even spend time with their non-transgender friends anymore.

It's like dude, like 1% of the population is transgender. Every trans person is spending time with people who are not transgender. Also, this is like a core part of identity development, right? Yes. When I was in college, I was like, I don't talk to straight people, right? And then you fucking come out of it.

Yeah, like whatever, yeah. The place that that comes from is not like a deep seated bigotry against straight people or cis people or whatever, it comes from hard and fast signals from other people that you are not wanted here. That is born of very clear behavior from other people. It's born of transphobia. Another thing that I think is really important to stress here after this study gets published is the entire concept of rapid onset gender dysphoria is actually distinct from social contagion in like meaningful ways,

right? Because just because somebody discovers that they're trans quickly or suddenly doesn't mean it's not true. Right? There's something very weird at the center of this, that it's like your discovery of your status somehow invalidates the status. So, I mean, the thing that I always think of is, I have an uncle who lives in Berlin, and his husband, whose name is not Fritz, but I will call Fritz, grew up in East Germany, and like, of course, was not exposed to any information about homosexuality the entire time that he was growing up What fritz says is that like he knew he was different But he couldn't put his finger on it and when he was I believe 19

He was watching a documentary on East German TV. There was like not a sympathetic documentary But it was a documentary about like homosexuals and he says the minute he heard the word, he was like, that's what I am. Yeah, yeah, yeah. On some level, that is rapid onset homosexuality. Right? He finally had a term for it. But first of all, he is gay, like he's now married to a man, and that's not invalid for people to sort of have this epiphany or sudden realization, and like, yeah, you know what?

Sometimes that does come from a friend, sometimes that does come from something you see on TV or fucking Tumblr, who knows? But that doesn't mean that it's not true, right? There's just this really weird desperation to find some excuse to say that this whole thing is invalid, but like, it's not even clear at this point that rapid onset gender dysphoria even is a fucking thing because nobody's interviewed actual trans kids about their experiences, right? So this entire concept is from a fucking blog comment, right? But then also, nothing about this phenomenon, even if it is true, means that it's all a fucking trend or it's fake or they're going to desist eventually. It's just just like another way that people discover things about themselves. I think one of the biggest tells in a bunch of the stuff

that we've talked about today is the lack of curiosity. It's fascinating to me how rarely when people go, oh, there are all these kids and they might all be trans and blah, blah, blah, that no one just goes, OK, then what? Yeah. Then if there's trans adults. And then... Uh... Unclear.

So, basically, after this extremely brief, not very indicative of anything study of quote-unquote rapid onset gender dysphoria comes out, we then get this concept slowly moving from the right, from conservative publications, into kind of polite mainstream news. So in 2017, there's a BBC documentary called Transgender Kids, who knows best. In the Globe and Mail, which is kind of a center-right publication in Canada, there's

an article called Don't Treat All Cases of Gender Dysphoria the Same Way. This is a little excerpt. Rapid onset gender dysphoria, seen primarily in teenage girls and university-aged young women, is characterized by a sudden desire to transition without any signs of gender dysphoria in childhood. It typically emerges after an individual has spent much time researching gender dysphoria online. A 2017 study found an association between this phenomenon and having a friend or multiple friends identify as transgender, suggesting similarities to a social contagion. These girls frequently also have other mental health conditions like autism or borderline

personality disorder that should be the focus of concern instead. This is another this is kind of the the final component of this myth that starts appearing at this time that what we're really talking about here is kids with mental health problems and they might say they're trans but they're really just acting out the fact that they have autism or they're borderline or they're depressed or something else. This is like a very important component of this myth going forward. Well, also, this is where I'm going to channel Matt Bernstein.

Oh, Matt Schiff. This is indistinguishable from the rhetoric in like the 2000s and early 2010s, specifically around marriage was just like, yeah, if we do this, then it will be cool to be gay. It's very funny to me that there are so many straight cis people out there who are like, wait a minute, what if there are more somewhere? And I'm like, surprise, there totally are.

That's the thing, it's, this is what is so frustrating to me is like, so much of this is driven by like very explicit homophobia and transphobia. There are people who have like legitimate questions and like I'm fine to speak to those people, but there are also a lot of people who cosplay as someone with reasonable questions who are just fucking transphobes and homophobes. Absolute sea lions.

Yeah, exactly. There's lots of that shit going on too. To me, it's just like such a fucking, yeah, it's just such a perfect like little distillation of like where this is because it's the same messages, right? But it's sounding it's like sounding more polite now. Yeah, it's like, well, you know, there's a study that says you know, this rapid onset gender dysphoria, there's like, these it has these characteristics. It's like, I can see reasonable people reading this and being like, oh, interesting. Yeah, yeah, yeah, yeah, yeah, not like in in totally good faith and being like, oh, wow, okay. Because most people don't know a a trans person and they don't really have a lot of context for this issue. At one point, we did a focus group specifically on trans health care with cis people. I had heard for years and years and years just like knowing one queer or trans person like can make a whole world of difference for people and I was always sort of like, yeah, we did a focus group and asked people to list off the words that they associated with the word transgender as the like opening exercise. Pariah was a word that came up over

and over again. Someone wrote murder. Okay. And then we got to this last guy and he was like, Fine lover. What? Hardworking. Hall and Oates fan was one of it. And I was like, what is going on? So the moderator of the discussion group was like, it sounds like your words are different than everybody else's words. What's going on there? And he was like, oh, I work with a gal

down at the post office. She's great. Oh, that's so funny. He was the one person in the room who was like close to a trans woman. Yeah. And his words were just like night and fucking day. It's also it's so funny that he also seemed to misunderstand the brief where they're like, what do you think about transgender people as a group? And he's like, Janine loves Steely Dan and the Orioles. I don't know that you understood the question, but you know what?

I'll take it. Your heart is in the right place. But then, I don't know if you remember this internet blowup, but in this kind of wave of laundering, we have an article in The Stranger, Seattle's alt-weekly newspaper, called The D-Transitioners. They were transgender until they weren't. What the fuck, the stranger? Let's read a couple paragraphs.

Oh, fucking shit. This one's kind of long. Jane, a 53-year-old woman in Southern California, lived as a trans man for nearly 20 years before discovering radical feminist forums online and, soon after, opted to transition back. I really thought I was trans, Jane said. I really believed it, 100%. I was even fired from my job for coming out.

The idea that the perceived boom in the trans population is due to peer pressure or social contagion can be uncomfortable for trans people and their supporters. It's also a theory frequently pushed by the right. In reality, no one knows exactly why so many people seem to have recently come out as trans or some other form of genderqueer. It's a mystery. The writer and trans woman, Julia Serrano,

argues in an essay on Medium that this is due to the shift from the old gatekeeper system of trans healthcare to the newer model that, quote, takes trans people's experiences and concerns seriously. Increased visibility and social acceptance are also logical explanations for the perceived growth in the trans population. More people are aware it's an option now. But as a study published this year in the Journal of Adolescent Health notes, parents have begun reporting, quote, a rapid onset of gender dysphoria in adolescents and teens who are, quote, part of a peer group where one, multiple, or even all friends have developed gender dysphoria

and come out as transgender during the same time frame. So what do you think overall? It just feels like it is holding all this shit at arm's length and is like, uh, it could be increased visibility, it could be social acceptance, it could be all these other things, but it's not. Right. We still have the fundamental problem that there's no actual evidence of this phenomenon of rapid onset gender dysplasia. Yes, correct. We don't have anything other than the study that is proposing it. And also, as we see in almost all of these articles, the story doesn't even have examples of it. So Jane, the lead character, we meet her when she's 53. It appears she transitioned in her

30s. There's one other source in this article who started taking testosterone at 20. I mean, maybe it's peer pressure, maybe it's not, but as a country, we're kind of comfortable with adults making their own decisions as far as the medical care that they need. Also, none of these people appear to have been rushed through medical transition. Another source in this article, who the author calls Jackie, is 17 when she starts reading about trans issues online. And then it says in the article, it took another three years and the passage of the Affordable Care Act for her to start hormone therapy. At this point, we're talking about

adults, and adults can do whatever they want with their bodies. There isn't really any question of like people being rushed into surgeries and rushed into care. These are the conclusions of someone who has never sought health care in the United States. Yeah, yeah, yeah, yeah. Like doctors will just be like right this way. I'm gonna take us I'm now gonna take us down a 45 minute tangent about my Kerbal Tunnel

and how long it's been, since anyone has given a shit about it. Hang on, I gotta pop some popcorn. We're gonna do some wax skeleton talk. The article is basically just saying like, there's some people who identify as trans, and then at a later point in their life, they no longer identify as trans,

which I've never seen anybody deny. Like, there's this weird thing, this kind of narrative that goes around online that, like, you know, trans people refuse to acknowledge the existence of D-transitioners. I've never heard a trans person say that, even, like, privately. Like some people, like, your identity changes over the course of your life, and so some people transition and later D-transition. This is a phenomenon that exists. Based on all the data we have now, it's quite rare, but, like, I mostly see trans people

being, like, really charitable and really chill with these people, and also, I see most detransitioners saying just like, yeah, this, it's part of, like, the journey that I'm on. There's also, according to the research that's come out about this, there's also a huge amount of people who detransition because it's really fucking hard to live as a trans person.

If you had asked me about my regret rate on Paxlovid when I was tasting pennies, I would have been like, really high! Also, it fucking got rid of COVID for me, so like, I'm good. I do regret the cherry bark extract for my... whatever the fuck that was. Where's my article?

So we're seeing this narrative start to show up like almost everywhere, right? We have like center's publications, far right, center right, and even like relatively far left publications, who are all kind of pushing this thing of like, it's a little mysterious, I'd like so many guys are trans and like, there might be this thing where it's like rapid onset. I think this really crescendos and an important chapter in the mainstreaming of this is a 2018 cover story in The Atlantic. The story was originally called,

Your Child Says She's Trans, She Wants Hormones and Surgery, She's 13. But they've since changed the pronouns because the model on the cover was using he, him, or they, them pronouns at the time, and it appears that this outed them to their parents. It's not totally clear what happened. Oh, fuck! But it's now called, When Children Say They're Transgender. the time, and it appears that this outed them to their parents? It's not totally clear what happened.

Fuck! But it's now called When Children Say They're Transgender. To be fair to this article, it doesn't use the term rapid onset gender dysphoria. It's not explicitly proposing this as an explanation, but again, we see the same pattern where it's kind of entertaining this social contagion theory as if it's like on the same level as greater trans acceptance means that more people are coming out as trans, right? It's kind of proposing these two things almost as if like it's like a 50-50 thing, right? And it's really constructing this like the mystery of why so many people say that they're trans

all of a sudden. So we're going to read a relatively long excerpt, because I think you really have to get like the full context of this article to see what it's doing. When parents discuss the reasons they question their children's desire to transition, whether in online forums or in response to a journalist's questions,

many mentioned quote unquote social contagion. These parents are worried that their kids are influenced by the gender identity exploration they're seeing online and perhaps at school or in other social settings, rather than experiencing gender dysphoria. Many trans advocates find the idea of social contagion silly or even offensive, given the bullying, violence, and other abuse this population faces. They also point out that some parents simply might not want a trans kid.

Again, parental skepticism or rejection is a painfully common experience for trans young people. Michelle Forcier, a pediatrician who specializes in youth gender issues in Rhode Island, said the trans adolescents she works with frequently tell her things like, no one's taking me seriously, my parents think this is a phase or a fad. But some anecdotal evidence suggests that social forces can play a role in a young person's gender questioning. I've been seeing this more frequently, gender clinician Laura Edwards Leeper wrote in an

email. Her young clients talk openly about peer influence, saying things like, oh, Steve is really trans, but Rachel is just doing it for attention. Scott Padberg, one of Edward's Leapers patients, did exactly this when we met for lunch. He said there are kids in his school who claim to be trans, but who he believes are not. Quote, they flaunt it around like,

I'm trans, I'm trans, I'm trans, he said. They post it on social media. I heard a similar story from a quirky 16 year old theater kid who was going by the nickname Delta when we spoke. She lives outside Portland, Oregon with her mother and father. A wave of gender identity experimentation

hit her social circle in 2013. Suddenly it seemed no one was cisgender anymore. It says, you know, some anecdotal evidence suggests social forces can play a role in a young person's gender questioning. We've got this kid Delta who's like, oh, suddenly everybody's trans around me. You don't really notice it doing it,

but it is proposing this as like a legitimate option based essentially on just like anecdotes like teens saying this really appreciating that Portland looms large in these anecdotes. I think this is our third. Blame Portland when in doubt. Sure, sure. I mean, I think, listen, I think the language of this section is a lot like the perceived

boom language in the last one, right? Which is like, journalistically, your editor isn't gonna let you say, like, this is caused by a social contagion, and a smart journalist who's been around the block kind of knows that they have some level of responsibility to accurately describe what's going on here, regardless of how they feel about it.

So this, to me, reads like another example of like, we want to promote this idea, we wanna elevate this idea, and we have to do that in a careful way so that it sticks. We're gonna dive in on the story of Delta in a second, but this article does something that we see, the same pattern that we see in so many of these kind of identical at this point feature stories that are like about the tricky debate

over trans medicine for youth. It doesn't really investigate whether or not this social contagion theory makes any sense. Like we looked at the evidence, here's what we found. It basically just like proposes it as a theory while not actually offering any evidence for it. So in the article, the article profiles a bunch of different people who transitioned and later ended up detransitioning, but none of them were rushed through medical procedures. So the opening anecdote of the article is somebody named Claire who identified as trans for a while and then eventually doesn't identify as trans anymore, and her parents say like, we're worried that if we had taken her to a gender clinic, they would have pushed her through physical transition and she would have

regretted it. But nothing happened. That's just a hypothetical. This is where this as a project really reveals itself to be about cis people's anxieties about the existence of trans people. This is not and has never really been about healthcare. Healthcare is just sort of a foothold. It's a system where we can have some influence. And you focus on kids because, again, that's another place where you can have some influence and you focus on kids because again,

that's another place where you can be like, I'm just concerned for their safety. Are you not concerned about kids? It's a very Mrs. Lovejoy, won't somebody please think of the children kind of thing. There's also someone whose timeline is a little murky, but it appears she socially transitions at 15, gets hormones at 16, and a mastectomy at 17. There's also somebody who socially transitions at 15, starts hormones at 17, gets a double mastectomy at 20, and D transitions at 22, so that's a five-year process. There's another person who transitions in her late 20s, so just irrelevant to this issue completely.

This Scott Padberg kid, who was mentioned in the previous paragraph, starts getting assessed by therapists at age 13. He is 16 when he's featured in this article, still has not had top surgery, so he's in the middle of a three-year process that includes, it appears, very intense assessment by a medical professional. There's yet another kid who identifies as trans in 2014 and gets a mastectomy in 2017. So it's not really clear what the intermediate steps are, but again, three-year process. And this kid talks about a eight-hour assessment by two clinicians and weekly visits with a psychologist before they transition. I don't know what the scandal is about any of these, right? They're just straightforward, they are not being rushed. This is the other thing about the like sort of this idea of like rushed care. If you know

anything about the fucking standards of care for trans people, you know that it's almost impossible to quote unquote rush care. Yeah, it's really funny to read like the popular press that just constantly raising the specter of like kids being pushed into these surgeries versus the academic press that is all about the barriers. There's cost barriers, there's logistical barriers, not everybody lives near a clinic. It's actually in reality really hard to get this care and yet we're constantly being told by these magazine articles that it's too easy or that we should be worried that

it's too easy. There's a debate over whether it's too easy, or that we should be worried that it's too easy, or there's a debate over whether it's too easy. And it's a fairly easily answerable question, even in the text of these articles, right? They can't come up with any examples of it happening. It actually reminds me a lot of the razor blades in apples on Halloween myth. There's no example of this ever happening.

Can I prove that it hasn't happened? No, but surely at some point, if we're supposed to be afraid of something, we should have a decent number of clear-cut examples of it taking place. And the fact that this is 2018 when this article is published, but we're now in 2024, and there's a couple things that maybe get close, although a lot of those haven't really been confirmed, but we're still getting in these articles, these stories of people transitioning at 25, and people with years-long transition periods, like the person who sued the UK gender clinic had a five-year process and admits that she saw psychologists more than 10 times in that process.

If that's rushed, then all medical care in the US and the UK is rushed. It's not happening at a breakneck pace. Yeah. So we're gonna zoom back into Delta, who is this kid who identifies as trans at 13. And so we are going to read the description from the Atlantic article.

Delta's parents took her to see Edward Zleaper. The psychologist didn't question her about being trans or close the door on her eventually starting hormones. Rather, she asked Delta a host of detailed questions about her life and mental health and family. Edward Zleaper advised her to wait until she was a bit older to take steps toward a physical transition. As Delta recalled, she said something like, I acknowledge that you feel a certain way, but I think we should work on other stuff first, and then if you still feel this way later on in life, then I will help you with that. Other stuff mostly meant her problems with anxiety and depression.

Edwards Leeper told Delta and her mother that while Delta met the clinical threshold for gender dysphoria, a deliberate approach made the most sense in light of her mental health issues. At the time, I was not happy that she told me that I should go on and deal with mental health stuff first, Delta said. But I'm glad she said that because too many people are just gung-ho like, you're trans, go ahead, even if they aren't. And then they end up making mistakes that they can't redo. Again, we include a quote from a teenager saying that this is common when we've seen no evidence that it's common, but anyway. Footage not found. Yeah. Also,

if people can't get health care until they deal with their anxiety and depression, uh-oh, I'm never getting health care. Yeah, no one will will get healthcare. We're all anxious and depressed. Fuck. Delta's gender dysphoria subsequently dissipated, though it's unclear why. She started taking antidepressants in December, which seemed to be working. I asked Delta whether she thought her mental health problems and identity questioning were linked.

They definitely were, she said, because once I actually started working on things I got better and I didn't want anything to do with gender labels. I was fine with just being me and not being a specific thing." So basically, I mean, I know that's a long excerpt, but essentially the story we have here is she says that she's trans, but then it turns out she's experiencing some kind of depression, anxiety stuff. And once we start working on the depression, anxiety stuff, it turns out, ah, she's not trans.

Like the trans-ness was kind of an output of the fact that she was depressed and anxious. And once you deal with those underlying issues, the trans-ness goes away. It's essentially a symptom, right? This is extremely important to this narrative, right? The fact that these kids are, again, basically confused. Right, they're not trans, they're just mentally ill. It's very similar to the narratives that we got around gay people in the 80s and 90s, when gay people also had much higher rates of depression and anxiety, were more likely

to use drugs, were more likely to kill themselves. That was seen as an output of the gayness, right? Why should we affirm gay identities? Like, these people are killing themselves at high rates, they're all sad to be gay. We should be fixing the gayness, right? Why should we affirm gay identities? Like, these people are killing themselves at high rates. They're all sad to be gay. We should be fixing the gayness, right? Because it's obviously causing them a lot of distress. But when we have marginalized groups that have higher rates of mental health problems, we should at least entertain the possibility that the depression and anxiety are outputs of being trans in a transphobic family and a transphobic school and a transphobic country. I came out when I was like 15 and got medicated for depression and anxiety that same year. That medication didn't make me straight. Right. Zoloft is not a conversion therapy.

Once we get deeper into Delta's story, things get even worse. So after this article comes out, both Transgender Trend and Fourth Wave Now, these anti-trans blogs, both positively promote the article. They're like, we think this is great. At one point, someone says, kind of in reply to one of these tweets, someone says, hey, it's kind of weird that the Atlantic article didn't link to Fourth Wave Now because Fourth Wave Now has a lot of resources that parents could use if their kids are trans.

And someone from 4th Wave Now replies, families profiled are 4th families. That was the censor's line in the sand. Removal of any mention of 4th. So 4th Wave Now, according to this person, helped this article come about and provided sources. And then, it appears late in the editing process, any mention of that was removed. Yikes.

This is where it gets really bad, Aubrey. So, this kid, Delta, her mother is a blogger at Fourth Wave Now. And at some time before the Atlantic article, she writes a post laying out her timeline of what happened with Delta. She starts off with sort of scene setting. She says that she got, you know, her daughter started to identify as trans. She then got really radicalized on this

when she saw a special about a National Geographic cover about like the changing nature of womanhood and how these like the way that that femininity is changing in like different cultures around the world and she talks about this a little bit and then she says, from that point it was like a cascade of ideas came into focus for me. I had small epiphanies about how all this impacted civil rights. The transgender politics and policies have the potential to undo civil rights for all people. If civil rights are not based on material reality, then anyone anywhere can undo them and change them. This seemed extremely dangerous to me. When that idea hit me, it was like a sucker punch. It was the pulling of the thread that began to

unravel the tapestry of transgender ideology. This is the UK shit of just like, somehow acknowledging and making space for trans people is like an assault on cis women. You said pregnant people and now nobody can get medical care at the hospital anymore. Right, right, right. That's the reason we don't have abortion. People use different words. Okay, but then here is this mother describing her account of what actually happened with Delta. Just before this time, my kid was insistent on seeing a gender therapist and getting into a gender clinic to start transitioning. I dragged my feet. When we went to doctor appointments for totally unrelated things, they would refer my child to the gender clinic,

even though we'd already been, and tell my child they shouldn't have to suffer and that they could easily take testosterone to alleviate these horrible symptoms like periods and breast development. It happened every time. The doctors wouldn't stop dangling the bait. Because of the turmoil this caused, I had to stop taking my child to the doctor unless it was an emergency. Jesus hell. When we started on the new transgender journey together, my child and I decided that no matter

what, this was not going to be the life focus. We opted not to join any queer youth support groups. What I've seen in those groups is that life becomes very narrow. One doesn't play music, they play queer music. One doesn't play music, they play queer music. One doesn't do art, they make queer art. My kid even began to notice this and didn't want to make life all about being transgender. What? So she then describes what is essentially like a campaign, years long, of telling her daughter that she's not really trans.

She says that they watched this BBC documentary together, what appears to be at her behest. And then as they're watching it, she sort of reiterates to her daughter that like, you'll never really be a man. Like, you can transition, you can get surgery, hormones, whatever, but like, you're never really gonna be a man. It's never gonna work.

And the daughter apparently breaks down crying and sort of accepts this. And eventually kind of accepts this and Eventually kind of drops this whole thing. God this narrative of like oh she started working on her depression and like then the trans thing Went away. I mean, maybe that's true, right? I don't love the way that we litigate these fucking anecdotes and like national media But also another fairly plausible explanation of this is that she has a pretty transphobic mom who just kept saying no you're not No, you're not. No, you're not and eventually she capitulated right and this person lives with their parents their parents determine what their life

is gonna look like what they have access to whether or not they go to the fucking doctor exactly it's telling that none of this I think fairly explicit anti-trans rhetoric shows up in the article, right? We get a little bit of explanation of like, the mother was skeptical, but nothing on the level of this. It seems like the mother really self-radicalized during this process. And then we have this idea of that like, oh, well, you know, it was really, you know, the mental health stuff all along.

And like, maybe it wasn't. Maybe she would have desisted anyway, we don't know. But it's like, it's very telling to me that, you know, again, we're constantly told to worry about parents and doctors kind of pushing kids into transitioning too quickly. But the much larger problem is people talking their kids out of it and people refusing to get their kids care and parents who are so skeptical, the kids do have to go through a really upsetting puberty before they can get any appointments with doctors, right? Much less the money and the insurance and all the other

barriers. We're talking about this issue as if it is a level playing field, and not kids with marginalized identities, versus very politicized adults. Yeah, yeah, all kinds of social, cultural and political power that those kids do not have, right? There is this sort of tone and tenor of a bunch of this stuff that's like, I'm speaking truth to power. And I'm like, do you mean children?

I also think it's worth noting that it's like, you know, it's now 2018 when this article comes out. What we're basically talking about here is a two-year process where this concept of social contagion and rapid onset gender dysphoria appear on a pretty fringe anti-trans blog and within two years they are on the cover of the Atlantic. Man!

Next episode we are going to talk about the extremely unfortunate story of how this ends up getting further laundered into government policy, but for now, you know, first of all, I have no idea how this Atlantic article came about. I have no idea behind the scenes what the recruitment was. I also don't really care, right? If you're telling the biography of a moral panic, what you're looking at is the messages that were available to the public. What were people reading and hearing at the time? And what Americans were hearing was that, you know, trans rights are becoming more visible. You have these, you know, fairly fringe websites. You have this social contagion theory that starts bouncing around on the right. You then have academic journals who begin to explore this phenomenon of rapid onset gender dysphoria. And then you have cover stories in prestigious national magazines kind of further exploring this phenomenon and talking about the debate within medicine, right?

But then if you zoom in on any of these components, it's all just the same fringe websites. Yes. This website invents the concept of social contagion. The concept of rapid onset gender dysphoria is based on interviews with people from these websites. And then The Atlantic writes an article that includes people who are bloggers on this website. Again, it appears like this groundswell, but we're just talking about like one blog that's doing this and a relatively small number of people. And again, we have no real evidence that there's any reason to consider this possibility at this point.

And I also, in the same way that we talked about rapid onset gender dysphoria, that just because your onset was rapid doesn't mean that it's not true, I also think the entire concept of social contagion is also worth kind of thinking about a little bit. Because to me, it's like the conversation about whether or not kids identify as something they're not because it's trendy just feels totally irrelevant to me like I I'm gay some kid who identifies as gay when he's 13 because he sees something on TV and then eventually a year later he's like yeah probably not I okay I that actually like a world where that kid is able to explore in like a affirming

environment is great. I would much rather have quote unquote too many people identifying as LGBT and have the space to figure it out for themselves relatively young than a world where people are constantly telling them no you're not, no you're not, no you're not. I just don't care that much, right? The actual debate here, the extent to which this is a social dilemma or like something that needs to be litigated in the cover of fucking national magazines is a medical systems question, right?

It's like, are people getting irreversible treatments when we don't know what their actual status is? To me, again, I think that is a reasonable question to ask, right? There's a good faith way to have this conversation. And again, years of this panic now, speaking from 2024, we still don't have any evidence that that's happening, right? The fact that a kid identifies as trans because they see it on TV, I think that's much more rare than, like, people think it is. But, like, is that possible? Sure. But the solution to that, if we're really so concerned with kids finding out whether they're really trans

before they get any kind of medical procedures, then we should make social transition as easy as possible. Then we should make schools as accepting as possible, right? The best way to know if you're, like, really a girl is to try living as a girl for a while in a supportive environment. There is this idea that just questioning itself is like a sinister activity that has to be born

of something, you know, manipulative or something, again, sinister, right? And I just don't think that that's true, right? And actually, in a lot of ways, that's sort of what your teenage and 20s years are for. You try on a bunch of shit and you go, Oh, actually, I don't really like death metal. Yeah. And that's absolutely OK. And I think if we slotted this into that territory of just like, Oh, you're trying shit on.

Maybe it's a thing you love for forever. And maybe it's not like that feels like actually a really healthy place to be. That kind of framework makes space for trans identities to be as legitimate as cis identities, right? When we consider it a choice worth making. A lifestyle. A lifestyle choice. Yeah, yeah, yeah, that's right.

That's what I meant to say. I know your real views. But like, when we make space for people to actually explore and actually interrogate, instead of just fucking defending themselves against attacks all the time, then more people can come to clearer understandings of who they really are. I also think like to kind of pull rank here as a gay person. Pull rank over who? Over the straights.

Over the straights. I thought you were saying over me. Oh no no that would be so fucking funny if I'm like gatekeeping this podcast now. As a gay man. I think as queer people, first of all this entire idea feels identical honestly to this whole panic of like they're recruiting your kids. I think nobody wants to say recruitment because that is like Anita Bryant sort of flavor to it at this point, right?

And the panic about gay teachers in the 80s. But this is what they are talking about, right? This like indoctrination, you know, they're going to use your child's confusion and their mental illness and their vulnerability to tell them they're trans, right? That's basically what they're saying, right? And I think as queer people, I think we know very intimately that you can't be recruited into a sexuality and a gender identity that you don't have, right?

Because we all tried recruiting ourselves into fucking straightness. And there's no amount of stigma that will make queer or trans people cease to exist. It will just make their lives fucking impossible. Like I, when I was a teenager, I like tried making out with girls and stuff and like dating girls and like it did nothing for me.

It was like, oh, my tongue is on someone else's tongue. It was so fucking gross. Like the whole thing of like sexual attraction is like, it's more than the sum of its parts, right? You don't think about like, oh, I'm putting my, like my mouth hole on someone else's orifice, right's like how did we get here my well give give let give me space Let me let me get there But like I, I think

I think there's a fear among straight cis people that like, experimentation is going to like somehow ruin their kids. And I think like, most people are not gay. I think if your straight kid like, dates a boy for a while, he'll be fucking bored the way I was bored when I dated

girls. And then you figure out, like, oh shit this doesn't work for me. They're not you're not gonna be tempted by something. You don't want right and this is why when we talk about these like you know as if like telling young kids about the existence of trans people is gonna like make them trans. I've been really lucky to get to know a lot of trans people and the way they talk about their gender identity when they were kids like somebody I talked to for me and Peter's episode on this said that it's like she felt static in her brain. And then when she put on girls clothes for the first time, the static went away and she like felt at peace.

And like, I have put on girls clothes for like costume parties and stuff. And like, I don't feel anything because I'm not trans. I'm not afraid of experimentation in that way. Because if you're not trans, you not it's not gonna like tempt you It's like this is this is what I think Like is really missing from this is that like people are afraid of somebody exploring their identity as if they're gonna be like Bewitched into thinking that they're gay or trans but like that isn't how it works But Michael the doctors wouldn't stop dangling the bait

That was my attempt at being a reply guy. You finally got there. I finally got there. You couldn't do it with your voice though. That was like the least convincing. I had to have a voice. I can't. I can't. Thanks for watching!