TOTAS

The US Committee on Energy and Commerce held hearings on 14 June, 2023 which included debate over a proposed amendment which would restrict graduate medical education funding to pediatric hospitals that performed certain gender affirmative care. The bill was sponsored by Texas rep Dan Crenshaw and a lively debate over the issue took place in the hearing. Testimony given and questions taken by: Dr. Meredithe McNamara, MD, MS, FAAP, Assistant Professor, Yale School of Medicine Dr. Miriam Grossman, MD, Child, Adolescent, and Adult Psychiatrist Key Moments - Chapters: 00:00 Master Edit 00:00 McNamara Testimony 00:09 Professional Background 00:57 Medical Political Issue 02:05 5 Categories of Misinformation 02:33 Gender Dysphoria Medical Condition 03:13 Medical Trainees 04:00 Banning Transgender Kids 04:32 Trans Teen Example 05:15 Grossman Testimony 05:31 Professional Background 05:47 Sex Assigned at Birth 06:31 European Halt on Intervention 08:05 Suicide 08:32 Psychotherapy 08:54 Debate Over Standards of Care 09:59 Experimental Care 10:38 Question to Dr McNamara 12:36 Misinformation 13:01 Conversion Therapy 13:28 Suicidality 14:12 Correction regarding precocious puberty 14:20 Growth of Affirmative Care Clinics 14:37 Q: Is the US an outlier? 14:59 Clarification on Precocious Puberty 17:30 Q: What are the long term impacts? 17:35 New Population 18:24 Q: Shifting Population and Long Term Outcomes 18:42 ROGD Population 19:13 Parental Rights and Privacy 19:42 Question Dr McNamara 20:22 Q: What would be the impact on Care? 22:14 Q: Impact on Training? 23:19 Q: Impact on Pediatric Workforce? 24:16 Question McNamara 24:16 Q: Importance of Pediatric and Mental Health care 26:02 Question Dr. McNamara 26:07 Statement on Politicization 27:36 Statement on Suicide 29:07 Q: How does Affirmative Care improve outcomes? 31:12 Question McNamara 31:12 Q: What impact will bill have on Trans Youth and Peds Workforce? 34:04 Question Dr. Grossman 35:40 Q: What treatments for dysphoria are backed by data? 39:42 Question McNamara 39:46 Statement on Government Role in Healthcare 42:46 Q: Please Explain Informed Consent in Affirmative Care 45:21 Statement from Vice Chair 45:58 Statement on Partisan politics 47:03 Q: What is age appropriate gender affirming care? 48:19 Q: Do Professional Associations Support Affirmative care? 48:33 Q: Is the US an outlier? 50:52 Question McNamara 50:58 Statement about partisan politics 53:06 Q: Anything to add or correct? 54:48 Statement Crenshaw 59:35 Statement on Politicization 01:01:04 Q: What type of care would be disrupted? 01:01:54 Statement regarding Boston Children's Hospital and Surgery 01:02:45 Q: What of the dangers to healthcare workers? 01:04:05 Statement 01:05:59 Crenshaw Statement about Culture War 01:06:35 Q: Concern for unknown long-term effects of affirmative care? 01:07:00 Q: What do you mean by cherry-picked data? 01:07:41 Q: Wouldn't you want strong evidence of benefits for therapy? 01:08:18 Q: Is there any strong evidence of benefit at all? 01:08:51 Question McNamara and Grossman 01:09:24 Q: Is an XY Chromosome Assigned at Birth? 01:10:26 Q: Have there been controlled trials of the benefit of affirmative care? 01:12:06 Crenshaw Statement on Affirmation 01:14:16 Q: What of the lack of evidence? 01:15:01 Q: How have professional associations been affected by activists? 01:16:11 Question McNamara 01:17:15 Q: What of Low Quality evidence for Standards of Care ? 01:19:12 Q: What is the process that patients and families go through to get care? 01:19:58 Q: What is the importance of having both medical and mental care? Sources: - https://energycommerce.house.gov/events/health-subcommittee-legislative-hearing-examining-proposals-that-provide-access-to-care-for-patients-and-support-research-for-rare-diseases - Bill text: https://crenshaw.house.gov/_cache/files/7/3/7394a6ec-0490-4e34-a160-cc485e4628c1/99A1262D6DC8161B24BCD8C7C684784C.chgme-reauth-02-xml-35-.pdf

Many exmormons hold the position that you cannot be devoted to scientific or objective truth and also be a Mormon or hold LDS truth claims to be true. This question of "epistemology" or theory of knowledge which can separate justified belief from opinion is central to many discussions about faith and belief. Jacob Hansen and Dan Ellsworth are both faithful members that have wrestled with this issue and found a reconciliation that allows them to find footing in both faith and science. In todays discussion we explore their epistemology and how it can sort truth claims coming from several different perspectives.

Call In and Talk about whats on your mind

All your Balenciaga are belong to us - Exmormon content creator edition. Featured: John Dehlin: https://www.youtube.com/@mormonstories Bill Reel: https://www.youtube.com/@MormonDiscussion Radio Free Mormon: https://youtube.com/playlist?list=PLq34QmiHsNjdSYebjG7e6ftoildD1Sp5W Rock Waterman: http://puremormonism.blogspot.com/ New Name Noah: https://www.youtube.com/@NewNameNoah Nemo: https://www.youtube.com/@NEMOTHEMORMON Jonathan Streeter: https://www.youtube.com/@thoughtsonthingsandstuff974 Tanner Gilliland: https://www.youtube.com/c/ZelphOntheShelf Anthony Miller: https://www.youtube.com/@lifeafterdeconstruction3897 John Larsen: https://www.youtube.com/@JohnLarsen1 Allan Mount: https://www.tiktok.com/@allanmount Background: https://knowyourmeme.com/memes/balenciaga-ai-videos

Review of different media representations of the concept of 2+2=5 in addition to an exploration of the utility of this concept through the lens of different philosophies, with the assistance of ChatGPT.

Ohio House Families, Aging and Human Services Committee - 5-19-2022 Helena Kerschner, a detransitioned woman, proponent, statement and Q&A session for HB454, Save Adolescents from Experimentation (SAFE) Act. 00:00 OH HB454 Session 2e - Helena Kerschner 10:12 Question Rep Edwards 12:46 Question Rep Smith 17:51 Question Rep Click 24:28 Question Rep Liston Sources: - Bill text as introduced: https://www.legislature.ohio.gov/download?key=19106&format=pdf - Bill Tracking Page: https://www.legislature.ohio.gov/legislation/134/hb454 - Source Video Archive: https://www.ohiochannel.org/video/ohio-house-families-aging-and-human-services-committee-2-17-2022 - Support document: https://search-prod.lis.state.oh.us/cm_pub_api/api/unwrap/chamber/134th_ga/ready_for_publication/committee_docs/cmte_h_families_aging_1/testimony/cmte_h_families_aging_1_2022-05-19-0900_1395/hb454.helena.proponent.pdf

Ohio House Families, Aging and Human Services Committee - 5-19-2022 SB454 Session 2d - Dr. Andre Van Mol 00:00 OB SB454 Session 2d - Dr. Andre Van Mol 00:19 Dr. Andre Van Mol 07:18 Questions 07:22 Question Rep Liston 10:26 Question Rep Edwards 13:20 Question Rep Smith 18:01 Question Rep Click 22:42 Question Rep Humphrey 24:52 Question Rep Liston 30:33 Question Rep Click Sources: - Bill text as introduced: https://www.legislature.ohio.gov/download?key=19106&format=pdf - Bill Tracking Page: https://www.legislature.ohio.gov/legislation/134/hb454 - Source Video Archive: https://www.ohiochannel.org/video/ohio-house-families-aging-and-human-services-committee-2-17-2022 - Support document: https://search-prod.lis.state.oh.us/cm_pub_api/api/unwrap/chamber/134th_ga/ready_for_publication/committee_docs/cmte_h_families_aging_1/testimony/cmte_h_families_aging_1_2022-05-19-0900_1395/hb454.dr.andre.van.mol.proponent.pdf

Ohio House Families, Aging and Human Services Committee - 5-19-2022 Maria Polaris, Cardinal Support Network, proponent, statement and Q&A session for HB454, Save Adolescents from Experimentation (SAFE) Act. 00:00 OH SB 454 Session 2c - Maria Polaris 00:16 Maria Polaris 11:29 Questions 11:31 Question Rep John 13:55 Question Rep Smith 19:02 Question Rep Edwards 21:26 Question Rep Ginter 24:41 Question Rep Liston 27:21 Question Rep Click 40:49 Question Rep Smith Sources: - Bill text as introduced: https://www.legislature.ohio.gov/download?key=19106&format=pdf - Bill Tracking Page: https://www.legislature.ohio.gov/legislation/134/hb454 - Source Video Archive: https://www.ohiochannel.org/video/ohio-house-families-aging-and-human-services-committee-2-17-2022 - Support document: https://search-prod.lis.state.oh.us/cm_pub_api/api/unwrap/chamber/134th_ga/ready_for_publication/committee_docs/cmte_h_families_aging_1/testimony/cmte_h_families_aging_1_2022-05-19-0900_1395/hb454.maria.polaris.ohio.gender.map.pdf

Ohio House Families, Aging and Human Services Committee - 2-17-2022 Dr. Daniel Weiss, Endocrinologist, proponent, statement and Q&A session for HB454, Save Adolescents from Experimentation (SAFE) Act. 00:00 OH Bill 454 Session 2b - Dr. Daniel Weiss 00:14 Dr. Daniel Weiss 05:58 Questions 06:07 Question Rep Troy 08:54 Question Rep Liston 15:03 Question Rep Edwards 17:44 Question Rep Ginter 21:50 Question Rep Smith 22:24 Question Rep Liston 29:31 Question Rep Cutrona 30:55 Question Rep Click Sources: - Bill text as introduced: https://www.legislature.ohio.gov/download?key=19106&format=pdf - Bill Tracking Page: https://www.legislature.ohio.gov/legislation/134/hb454 - Source Video Archive: https://www.ohiochannel.org/video/ohio-house-families-aging-and-human-services-committee-2-17-2022 - Support document: https://search-prod.lis.state.oh.us/cm_pub_api/api/unwrap/chamber/134th_ga/ready_for_publication/committee_docs/cmte_h_families_aging_1/testimony/cmte_h_families_aging_1_2022-05-19-0900_1395/hb454.daniel.weiss.proponent.pdf

Ohio House Families, Aging and Human Services Committee - 2-17-2022 Matt Sharp from the Alliance Defending Freedom, proponent, statement and Q&A session for HB454, Save Adolescents from Experimentation (SAFE) Act. 00:00 Ohio SB 454 Session 2a - Matt Sharp 00:49 Matt Sharp Alliance Defending Freedom 05:38 Questions 05:45 Question Rep Liston 08:02 Question Rep Smith 11:34 Question Rep Denson 13:25 Question Rep Humphrey 16:16 Question Rep Edwards 19:29 Question Rep Liston 26:23 Question Rep Troy 27:58 Question Rep Smith 33:02 Question Rep Click Sources: - Bill text as introduced: https://www.legislature.ohio.gov/download?key=19106&format=pdf - Bill Tracking Page: https://www.legislature.ohio.gov/legislation/134/hb454 - Source Video Archive: https://www.ohiochannel.org/video/ohio-house-families-aging-and-human-services-committee-2-17-2022 - Support document: https://search-prod.lis.state.oh.us/cm_pub_api/api/unwrap/chamber/134th_ga/ready_for_publication/committee_docs/cmte_h_families_aging_1/testimony/cmte_h_families_aging_1_2022-05-19-0900_1395/hb454.matt.sharp.proponent.testimony.pdf

Pioneering filmmaker Hu Jie uncovers the tragic story of a teacher beaten to death by her students during the Cultural Revolution. In 1966, the Cultural Revolution exploded throughout China, as Mao's Red Guards persecuted suspected Rightists. Bian Zhongyun, the vice principal of a prestigious school in Beijing, was beaten to death by her own students, becoming one of the first victims of the revolutionary violence that would engulf the entire nation. In THOUGH I AM GONE, Hu draws upon photographs taken by Bian's husband, Wang Jingyao, whose impulse to document his wife's death makes him a spiritual forebear to Hu's fearless work. Hu also incorporates vivid accounts from surviving witnesses and archival footage to depict the deadly madness of the era. "One of the Cultural Revolution's most shocking and perplexing cases. We can only imagine how difficult it is for Hu to produce his films; only a committed person who takes what he does as a 'calling' can persist." —Dr. Weili Yu, Yale University, in the journal Asian Educational Media Service "Though none of his works have been publicly shown in China, Hu Jie is one of his country's most noteworthy filmmakers." —The New York Review of Books "A profoundly moving memorial to the victims of Mao's senseless political violence." —ReelTime Arts "Packs a powerful punch in just over an hour...Director Hue Jie exploys a collage-like approach, interspersing archival footage and propaganda songs with present day interviews with Wang and other survivors of this tragic period of history." —Twitch Film "Though I Am Gone challenges the authorities; the mainland may have sanctioned other films which broach the so-called '10 years of catastrophe' but Hu's film is still banned." —South China Morning Post "Hu Jie's body of work puts a human face on some of the worst horrors of the Communist Party's recent history." —Public Radio International Best Film, Chinese Documentary Film Exhibition Jury Prize, Reel China Contemporary Documentary Festival Melbourne International Film Festival Hu Jie documentary. IMDB: https://www.imdb.com/title/tt1666814/ A.I. upscaled with english subtitles and narration.

At the 2016 WPATH Symposium in Amsterdam, Dr Polly Carmichael - the head of the GIDS clinic at the Tavistock in the UK gave a presentation which reviewed the referral patterns, social context and outcomes of the early intervention program at the clinic, treating children with gender dysphoria. This presentation was cited in the recent book "Time to Think" by Hannag Barnes which describes the evolution and eventual dissolution of the clinic in the UK. She describes the service and makes some surprising admission including: - The departure of the clinic from the selection and exclusion criteria of treatment guidelines based on the Dutch Protocol. - The preliminary results of kids treated with puberty blockers which show no improvement on the various assessments given prior and after treatment. - The implications of the almost 100% of patients that went on to further hormones and surgery after puberty blocker therapy - that it means the concept of blockers as a diagnostic tool or "time to think" are not accurate. Index: 00:00 Introduction 00:39 Opening remarks 02:02 History of GIDS 02:59 Demographics 05:05 Equity of Access 07:44 Referrals by the Numbers 09:57 Why the Rapid Growth in Referrals? 12:19 Press Coverage 13:51 Teaching Gender in Schools 14:43 Referrals by Natal Gender 16:00 Associated Difficulties 17:09 Anxiety 17:54 Autism Spectrum 19:04 Self Harm 20:28 Service Protocol 22:00 Service Users Pathways 23:02 Possible Pathways 24:35 Informed Consent 25:56 Physical Interventions 26:56 Puberty Blockers 29:36 Ages at Puberty Blockade 30:59 Differences from the Dutch Experience 31:53 Questions to Ponder 33:28 Rapidly Changing Landscape 34:48 Awards 36:56 Transgender Provider Tries to grab mic from de Vries 37:12 Segregation Source: https://av-media.vu.nl/Mediasite/Play/581e58c338984dafb455c72c56c0bfa31d?catalog=2d190891-4e3f-4936-a4fa-2e9766ae0d0d Check out "Time to Think" by Hannah Barnes here: https://swiftpress.com/book/time-to-think/

On Feb 21, 2023 the Florida House Health & Human Services Committee heard testimony from David Leatherwood, representing the Florida chapter of the activist group Gays Against Groomers. He outlined the group's opposition to the use of "the LGBT community" as a shield by radical activists to push for indoctrination and tacit sterilization of gender diverse youth. He describes a hijacking of the LGBT community at large by trans activists who use coercive and threatening tactics to silence differences of opinion and demonize those who don't agree. He points out that this situation has led to a backpedaling of the general acceptance of LGBT individuals in society, as this coercive situation has made it more preferable to be labeled anti-LGBT than to endorse the irreversible harm to gender diverse children. His primary theme was to make the case that it is NOT bigotry or hatred or anti-LGBT to speak up against those who would indoctrinate and medicalize and thus sterilize gender diverse kids, many of whom are just discovering their sexuality. The main presence of Gays Against Groomers can be found at: https://www.gaysagainstgroomers.com/ Index: 00:00 Intro 00:12 LGBT Community as a Shield 00:42 Advances in LGBT acceptance threatened 01:19 Trans Movement is Culty 01:41 Minors Cannot Consent 02:03 Coercive Ideological Enforcement 02:27 Making Anti-LGBT label sound reasonable 02:57 Standing up for kids is not anti-LGBT 03:45 Follow the Money 04:30 Affirmation is trans-ing away the gay 05:09 Stop medicalizing gender nonconforming kids Source: Source: https://thefloridachannel.org/videos/2-21-23-house-health-human-services-committee/

On Feb 21, 2023 the Florida House Health & Human Services Committee heard testimony from licensed pediatric endocrinologist Dr. Michael Laidlaw on the subject of the medical consequences of hormonal and surgical intervention in kids with gender dysphoria. 00:00 Intro 00:00 Dr. Michael Laidlaw 00:35 Definitions 01:02 Diagnostic Dilemma 01:35 Basic Biology on Sex 02:06 Gender Affirmative Therapy Stages 02:22 Long Term Mortality in Sweden 02:56 Action of Puberty Blockers 03:37 Cross-Sex Hormones 04:27 Side Effects of Cross-Sex Hormones 05:56 Surgery - Mastectomy 06:31 Surgery on Minors 06:43 Surgery - Penile Inversion Complications after Puberty Blockers 07:18 Surgery - Phalloplasty 07:46 Endocrine Society Guidelines 08:42 WPATH Standards of Care 09:31 Exploratory Therapy 09:57 Affirmative Therapy is NOT a Standard of Care Source: https://thefloridachannel.org/videos/2-21-23-house-health-human-services-committee/

On Feb 21, 2023 the Florida House Health & Human Services Committee heard testimony from Oxford sociologist Michael Biggs PhD on the subject of the medical research behind the use of puberty blockers to suppress puberty in kids with gender dysphoria. Index: 00:00 Intro 00:17 Background 01:04 Puberty Supression 02:01 Precocious Puberty vs Dysphoria 02:40 The Dutch Study 03:50 Replication Failures 04:41 What is known about Puberty Blockers? 04:57 Surgical Complications 05:27 Bone Effects 05:54 Sexual Dysfunction 06:25 Emotional and Cognitive Development 06:43 NHS Reversal 07:08 Recommendation Source: https://thefloridachannel.org/videos/2-21-23-house-health-human-services-committee/

Part 2 of a Review and Commentary on Rep Gary Click's introduction to Ohio HB-454, also known as the Save Adolescence From Experimentation, or SAFE ACT. The act deals with limiting medical and surgical transition of minors in the state of Ohio. The bill did not make it out of committee, however the discussions by various witnesses and committee members were an excellent review of all sides of the issue. In this episode, parent and witness to the proceedings, Jeannette Cooper, joins us to review the introductory statement and Q&A Session from 17 Feb, 2022. Official HB-454 Documents and sourcefiles: https://www.legislature.ohio.gov/legislation/134/hb454 CHAPTERS: 00:00 Intro 00:50 Humphries - Blockers vs Surgery 03:11 Discussion 14:06 Question Rep Caruthers - Doctors or Hospitals Consulted? 15:30 Discussion 33:41 Question rep Gunther - Religious Motivations? 35:34 Discussion 40:32 Followup Question - Informed Consent 41:13 Discussion 45:35 Question Rep Denson - Medical Expertise 46:38 Discussion 58:49 Question - Child Custody Issues? 01:00:35 Discussion 01:10:16 Question - Taking Sides and Criminalizing 01:12:34 Discussion 01:20:56 Question Rep - Any supporting Professional Organizations? 01:25:51 Discussion 01:30:13 Black Hole of Accountability 01:32:38 Florida Hearing Referral 01:49:33 Question Rep Liston - AAP vs ACP 01:50:20 Discussion 02:02:02 Flawed foundation of the AAP Policy Statement 02:24:21 Cascade Iatrogenesis 02:33:57 Liston - Activist vs Professional Groups 02:36:30 Discussion 02:38:26 Liston - Schools and Social Transition 02:41:39 Discussion 02:49:44 Liston - Schools Hiding Trans Status from Parents 02:50:25 Discussion 02:55:47 Followup Click - Possible History of Abuse 02:55:58 Discussion 02:56:32 Followup Click - Schools Overriding Parental Judgement 02:57:16 Conclusion

Review and Commentary on Rep Gary Click's introduction to Ohio HB-454, also known as the Save Adolescence From Experimentation, or SAFE ACT. The act deals with limiting medical and surgical transition of minors in the state of Ohio. The bill did not make it out of committee, however the discussions by various witnesses and committee members were an excellent review of all sides of the issue. In this first episode, parent and witness to the proceedings, Jeannette Cooper, joins us to review the introductory statement and Q&A Session from 17 Feb, 2022. Official HB-454 Documents and sourcefiles: https://www.legislature.ohio.gov/legislation/134/hb454 INDEX: 00:00 Start 00:31 Introduction 02:45 Jeannette Cooper 08:03 The legislative process 09:37 Click Clip 1 12:08 Special Interest Groups 15:36 Children age and consent 19:42 Competing Ideologies 21:57 Childhood Development and influence 23:01 Stereotypes define or expand gender 25:47 Dynamic Human Experience 27:22 Child with Dysphoria vs Trans-kid 28:16 What is Governments Role 32:01 Medicine has messed up before 38:38 Click Clip 2 40:09 Click did his homework 42:47 Click understood the controversial nature 43:45 This is not a partisan issue 49:23 Click Clip 4 53:03 Weak Evidence and Faulty Assumptions 56:04 Cascade Iatrogenesis 57:40 Watchful Waiting is now impossible 59:37 LGBT community is mixed on this issue 01:03:48 On the term - Transgender 01:06:39 Identity Foreclosure 01:09:49 Click Clip 4 01:10:47 Intersex 01:12:46 Click - comorbidities 01:16:52 Comorbidities 01:19:54 Affirmation trumps all other therapies 01:21:32 Integration vs rumination 01:24:55 Victimhood 01:27:39 Sexual Abuse 01:28:54 Conversion therapy 01:41:53 Click - Affirmation is coercive 01:43:16 Suicidality and Consent 01:51:56 Watchful waiting and Exploratory Therapy 01:53:16 Manipulation in retrospect 01:54:32 Urgency of Suicide 01:56:21 Social Media effects 01:58:09 Social Cultural Context 01:59:57 Click - Watchful Waiting and the Experts 02:04:30 Heterodox Experts 02:09:09 Gender Dysphoria vs Disorder 02:14:59 Teens and competency 02:22:47 Complexities of Informed Consent 02:28:59 Consent in psychological conditions 02:33:47 Q&A intro 02:34:38 Rep Liston Question 02:37:44 Discussion 02:45:24 Rep Liston Followup 02:46:51 Discussion 02:53:57 Rep Liston Followup #2 02:55:41 Discussion 02:58:54 Rep Humphries Question 03:02:05 Discussion Stay Tuned for Part 2!

Serbian surgeon Miroslav Djordjevic explains the dilemma of tissue availability for sex reassignment surgery. He explains that since there are both male-to-female and female-to-male transitions taking place, it is conceivable to create a tissue bank so that surgically removed penises, testicles, ovaries and uteruses from one set of patients could be surgically grafted onto the other set of patients. What medical ethical considerations may apply to such a proposal? When should medical ethics curtail the imagination of doctors who see opportunities for new techniques and procedures? See Dr. Djordjevic's US based practice profile here: https://profiles.mountsinai.org/miroslav-l-djordjevic Read more about this proposal here: https://medanthroquarterly.org/critical-care/2021/06/trans-body-is-a-valuable-resource/ See the full Dutch Documentary about Gender Dysphoria and emerging issues in Trans healthcare here: https://youtube.com/watch?v=6LRPiEJCU5g

When people bring up concerns about the affirmation only approach to children with gender dysphoria (which involves social , medical and surgical transition) We are left to wonder what do the critics think should be done instead? The kids are real. Their distress is real. Should nothing be done?  The term "watchful waiting" is often used, but that sounds like doing nothing. Is that really all we can or should offer these kids?   Watchful waiting doesn't mean doing nothing for kids who are in distress. It's an older term for a process that's now more commonly called "Exploratory Therapy." It isn't that simple though - the idea that affirmation may not be the right choice for every child and that there is a role for understanding a  dysphoric child's history and underlying psychological issues is itself controversial.  Some critics equate it to the unethical practice of gay conversion therapy. But is that true? What exactly is exploratory therapy for gender dysphoria kids? This question was directly addressed in a January, 2023 livestream by mental health professionals from the Gender Exploratory Therapy Association, hosted by the Foundation Against Intolerance and Racism in Medicine. This video is an excerpt from that presentation. PRESENTERS: *Roberto D’Angelo* is a psychiatrist and psychoanalyst in private practice in Byron Bay, Australia. He is a Fellow of the Royal Australian and New Zealand College of Psychiatrists. He is a training and supervising analyst at the Institute of Contemporary Psychoanalysis, Los Angeles, and President of the Society for Evidence Based Gender Medicine. He has authored publications about psychotherapeutic treatment of gender dysphoria and has critiqued the gender affirming approach. He works with adolescents and adults with gender distress. *Sasha Ayad* is a Licensed Professional Counselor who works in private practice, and has treated adolescents for over 10 years. Her work focuses on teens and young adults struggling with issues of gender dysphoria and gender identity. Sasha is a founding board member of the Society for Evidence-based Gender Medicine and of the International Association of Therapists for Desisters and Detransitioners. Along with Stella O’Malley, she hosts the ‘Gender: A Wider Lens’ Podcast. Sasha holds a B.S. in Psychology and an M.Ed. in Counseling Psychology. CHAPTERS: 00:00 Introduction 01:29 Exploratory Therapy - Background 03:42 Open to a Range of Outcomes 05:25 Dysphoria Emerges in a Context 07:30 Identity is Developmentally Informed 09:06 Comorbid Conditions 11:15 Sexual Development 12:59 Occurs over time 15:51 Evidence Based Approach to Suicidality 17:07 Informed Consent 17:59 Not Conversion Therapy 19:50 Trans Identity not universality adaptive 21:26 Affirming interventions not universally helpful 23:14 Does not obfuscate biological facts 25:01 Learn More REFERENCES: Original Full Presentation: https://youtube.com/watch?v=SbrUfxaw7QI Gender Exploratory Therapy Association: https://genderexploratory.com/ Foundation Against Intolerance and Racism in Medicine: https://www.fairforall.org/fair-in-medicine/ Society for Evidence Based Gender Medicine: https://segm.org/ Genspect: https://genspect.org/

Transgender people are becoming more widely seen and accepted. There are many positive and celebratory stories about medical and surgical transition in the media. What is less commonly seen are the stories of individuals who transition and then realize that it was not the right choice for them after major and irreversible changes have been made to their body. In many cases, these regretters originally presented with multiple complex underlying psychological issues - however the affirmation-only model of treating these individuals leads to their gender issues becoming the priority, rather than first addressing such co-morbid conditions as depression, PTSD, anxiety or body dysmorphic disorder among other considerations. Stories of regret and detransition should provide important information to doctors and institutions about the ethics of these interventions and the criteria for recommending patients to surgery without first addressing underlying issues. This type of reflection and revision of clinical criteria, protocols and policies does not appear to be happening, however, possibly due to strong pressures made by activist forces both inside and outside of the medical profession. In 2018 a Dutch documentary aired which looked into one such story of regret and examined the medical institutions and clinical culture which led to the tragic outcome for this individual. Also examined are the influences of social media and the phenomena of regretters who disappear from the view of clinics and the public due to the irreversible harm they experienced as well as ethical considerations in selecting patients for surgery and even the ethics of allowing euthanasia for patients harmed by this therapeutic pathway. The documentary is presented here with english voiceover based on the original captions. Originally aired in December 2018 Original Source: https://www.bnnvara.nl/zembla/artikelen/transgender-met-spijt

The Trans Train Part 4: Puberty Blockers, Complications and Consent _______________________________________ In part 4 of the Swedish Trans Train Documentary Series, the story of Leo is told. Leo was a biologically female child who experienced gender dysphoria and was socially transitioned to a boy. Leo was started on Puberty Blockers and maintained on it for years without adequate monitoring of the known complication of bone density loss and pathologic fractures. The episode explores how gender clinics may fail to inform parents and patients of the risks of hormonal intervention and how the system is not adequately tracking complications and adjusting policies when complications arise - with cases and complications falling into the gaps between the psychology, endocrinology and surgical clinics and the healthcare system more broadly. See the original source here: https://www.svtplay.se/video/33313874/uppdrag-granskning/uppdrag-granskning-transbarnen _______________________________________ In May of 2021 Sweden announced a change of their policy regarding the medical and surgical transition of children. The change came in the wake of several bombshell documentaries which explored the issue of medicalization of children experiencing gender dysphoria in Sweden and Europe. The controversial documentary series examined the evidence base of the protocols, the ethics of treating children who cannot consent and the degree of oversight and accountability that clinics held for their patients. The english speaking world isn't aware of much of what the documentaries uncovered because of the language barrier, as the films are mostly in Swedish. English captions have been made available and for the first time the films are presented here with english voiceover to make them more accessible. _______________________________________ This transition protocol for children based on "The Dutch Study" had previously been used by clinics in Sweden since around 2014 to start children on puberty blockers leading to cross-sex hormones and surgery. The "Dutch Study" was originally designed with strict criteria for inclusion which were not being applied to the exploding population of mostly young women who were starting to seek treatment for dysphoria. As such, most patients being put on this "trans train" of affirmation and medicalization were a different population group than those studied in the original Dutch protocol. As a result, the issues of regret and detransition began to be come more common as people for whom the Dutch Protocol was not designed for started to see that medical and surgical transition did not solve their issues. When these stories started to leak out, the Swedish investigative journalists at "Mission: Investigate" started talking with regretters and detransitioners and approached the hospitals and clinics who were treating young people at the time to figure out what was going on. Over the next several years subsequent episodes of Mission: Investigate explored other aspects of the modern discourse about the medical treatment of gender dysphoria. The revelations of this series were eventually led to the national health system in Sweden reviewing their protocols and issuing an official policy halting the implementation of the Dutch protocol in treating children with gender dysphoria.

Taking calls and discussing the Swedish documentary "Trans Train" Part 2 Part 2 of the Trans Train documentary series covers claims of suicidal attempts among trans teens waiting for surgery, comorbid psycological issues and the potential for conversational therapy to add patient insight which affects their perception of gender identity. These issues are confronted against the backdrop of new legislation proposed to reduce barriers for kids as young as 15 to have breast removal surgery without parental consent. Check out the full documentary here: https://youtu.be/diNeyQKQg8M

In part 3 there is a brief update about Alexsa Lundberg, a famous transwoman in Sweden who was profiled in the second Trans Train episode. She makes the difficult disclosure that if she had it to do all over again, in light of the new evidence about risks and outcomes, she would likely not have chosen to undergo sex reassignment surgery and would have, instead, chosen to live life as a feminine gay man. On the political front, the government order a new review of the evidence basis for transition surgery of minor after the findings of the first two Trans Train episodes. The result is that the health ministry now opposes sex reassignment surgery for minors as there is insufficient evidence to justify endorsing the intervention. There remain questions about puberty blockers and cross sex hormones and the public discourse about detransitioners and regretters continues to evolve. _________________________ In May of 2021 Sweden announced a change of their policy regarding the medical and surgical transition of children. The change came in the wake of several bombshell documentaries which explored the issue of medicalization of children experiencing gender dysphoria in Sweden and Europe. The controversial documentary series examined the evidence base of the protocols, the ethics of treating children who cannot consent and the degree of oversight and accountability that clinics held for their patients. The english speaking world isn't aware of much of what the documentaries uncovered because of the language barrier, as the films are mostly in Swedish. English captions have been made available and for the first time the films are presented here with english voiceover to make them more accessible. _______________________________________ This transition protocol for children based on "The Dutch Study" had previously been used by clinics in Sweden since around 2014 to start children on puberty blockers leading to cross-sex hormones and surgery. The "Dutch Study" was originally designed with strict criteria for inclusion which were not being applied to the exploding population of mostly young women who were starting to seek treatment for dysphoria. As such, most patients being put on this "trans train" of affirmation and medicalization were a different population group than those studied in the original Dutch protocol. As a result, the issues of regret and detransition began to be come more common as people for whom the Dutch Protocol was not designed for started to see that medical and surgical transition did not solve their issues. When these stories started to leak out, the Swedish investigative journalists at "Mission: Investigate" started talking with regretters and detransitioners and approached the hospitals and clinics who were treating young people at the time to figure out what was going on. Over the next several years subsequent episodes of Mission: Investigate explored other aspects of the modern discourse about the medical treatment of gender dysphoria. The revelations of this series were eventually led to the national health system in Sweden reviewing their protocols and issuing an official policy halting the implementation of the Dutch protocol in treating children with gender dysphoria.

Part 2 of the Trans Train documentary series covers claims of suicidal attempts among trans teens waiting for surgery, comorbid psycological issues and the potential for conversational therapy to add patient insight which affects their perception of gender identity. These issues are confronted against the backdrop of new legislation proposed to reduce barriers for kids as young as 15 to have breast removal surgery without parental consent. _________________________ In May of 2021 Sweden announced a change of their policy regarding the medical and surgical transition of children. The change came in the wake of several bombshell documentaries which explored the issue of medicalization of children experiencing gender dysphoria in Sweden and Europe. The controversial documentary series examined the evidence base of the protocols, the ethics of treating children who cannot consent and the degree of oversight and accountability that clinics held for their patients. The english speaking world isn't aware of much of what the documentaries uncovered because of the language barrier, as the films are mostly in Swedish. English captions have been made available and for the first time the films are presented here with english voiceover to make them more accessible. The Trans Train Part 2 - Aired 09/10/2019 _______________________________________ This transition protocol for children based on "The Dutch Study" had previously been used by clinics in Sweden since around 2014 to start children on puberty blockers leading to cross-sex hormones and surgery. The "Dutch Study" was originally designed with strict criteria for inclusion which were not being applied to the exploding population of mostly young women who were starting to seek treatment for dysphoria. As such, most patients being put on this "trans train" of affirmation and medicalization were a different population group than those studied in the original Dutch protocol. As a result, the issues of regret and detransition began to be come more common as people for whom the Dutch Protocol was not designed for started to see that medical and surgical transition did not solve their issues. When these stories started to leak out, the Swedish investigative journalists at "Mission: Investigate" started talking with regretters and detransitioners and approached the hospitals and clinics who were treating young people at the time to figure out what was going on. Over the next several years subsequent episodes of Mission: Investigate explored other aspects of the modern discourse about the medical treatment of gender dysphoria. The revelations of this series were eventually led to the national health system in Sweden reviewing their protocols and issuing an official policy halting the implementation of the Dutch protocol in treating children with gender dysphoria.

Taking calls and discussing the Swedish documentary "Trans Train" This documentary covers the evidence base, ethics and responsibility of the medical profession in treating children with gender dysphoria with hormones and surgery - particularly in light of the reality of transition regretters and detransitioners. Check out the full documentary here: https://youtu.be/MVEZ7gELcgY call in or comment to share your thoughts.