When people hear what they don't want to hear. We've talked about this in a previous episode about, you know, the words becoming violence essentially. It's thrown back of, well, that's hateful because that's not what I want to hear. Welcome to Awake at the Wheel. In this episode, we're going to be discussing issues relating to gender. Specifically, we're going to be looking at some of the research that's relevant to this topic. Additionally, we're going to be looking at some of the politics surrounding this topic in addition to some of the emerging social trends. So to begin with, I think that we should really preface why it is that we're discussing this topic, and I certainly can't speak for both of us, but I'll say from my perspective as a clinician, many of these issues directly will impact us and have been impacting us in the way in which we conduct ourselves in our profession. Secondly, and perhaps most importantly as a parent, the messages and the messaging that is being presented to children starting in preschool in many cases is of utmost importance for parents to understand what to do with all of it. And thirdly, as a general citizen of society, with a lot of the changes that we're seeing, I believe it's incredibly important for us to stay as well versed on both sides of the discussion as much as possible. So, Oren, why is this a topic that's important to you? Well, I've been teaching the psychology of human sexuality and gender for over 20 years. About a hundred times in several universities. And I've watched the information with respect to these phenomena develop, whether it's in a textbook, whether it's among colleagues, whether it's what students are coming with as far as the information they've heard. And I've just seen far too much misinformation. I've seen too much ideology replacing science. I've been seeing too much, let's say self-serving claims, replacing best practices and I've spoken to so many people, whether it's people with gender related issues themselves or their family members who have have just been, let's say, floored by the kind of information that they're seeing, but more importantly, the kinds of distress, confusion, let's say discomfort that they're hearing younger people talking about when it comes to their own bodies, their own sense of gender, their own identity, their own sexuality. And all of these things are interrelated. Anyone who claims to that, they're all separate constructs that have nothing to do with each other is denying reality. So and I've been fighting like for, let's say, for proper understanding or a more comprehensive, fair and balanced approach to dealing with all of this since about 2016. That's when it became really public, because Jordan Peterson, Dr. Jordan Peterson in September or October of 2016, made a couple of videos that became infamous in which he was saying that I am not going to allow the Canadian government to dictate what I what I must say, not what I'm allowed to say, but what I must say. And he was talking about preferred pronouns and he made a few claims. And I have to say that in the early days, I mean, really, if you ask anybody, it was around 2016 that people said, I start, you know, I started to see this become more of an issue. Everything started to explode around then. Technically, it was around 2011, but it was 2016 with Dr. Peterson's videos that it really exploded. And in his first couple of videos and subsequent interviews and talks that he was giving, he was not as, let's say, nuanced and careful and tactful in how he explained his position and the evidence he was providing. So people heard what sounded like transphobic or anti-trans rhetoric. And that wasn't the case. He was just speaking very bluntly and assuming that people would be able to understand what he was saying. And he gave maybe the general audience too much credit. Over the years, he's become more refined. He's become more careful in how he's presented the information. But the information hasn't really changed. The only thing that's changed is there is more misinformation. There are more radical claims. And most importantly, far more young people are expressing confusion, distress or chaos around their own bodies and their own sense of being. And unfortunately, many of them are headed in a really terrible direction, which we'll talk about today. And that's the main thing, is the impact. If it was just a philosophy, if it was just something people talked about, that would be one thing. But the real life impact it's having on the people themselves and the people around them and society in general, it's no one would have predicted this ten years ago. No, no, that's where I'm coming from, trying to be trying to help. So what I will add here as well is that Oren and I are going to make a very concerted effort to ensure that we're focusing on the science, on the research and not insert our own personal opinions, biases and beliefs. Now we're humans, so that may creep in because that's natural. But everything that we discuss, we're going to include links to in the description of our YouTube video and on our website as well for those who are listening to this as an audio podcast. So I want to start with that. And Oren, you discussed where it came from in terms of, you know, the current, I suppose, questioning and exploration of why are people doing this? But in preparation for this podcast today, I was actually looking for where did this start? And what I mean by this is the notion and the idea that gender is socially constructed, because if we go back centuries and there isn't a ton of evidence that is, you know, in the direction of people viewing gender in this way. And let me add as well, this isn't to say that we I'll speak for myself that I don't think that, you know, gender dysphoria and transgender individuals aren't a real thing. But what I'm specifically referring to is this social phenomenon that we're seeing, and we'll get into this topic more, but the rapid onset of gender dysphoria. So in my search for where did this all come from, I came across a study which is formally known as the John/Joan study from the Sixties. So this involves Dr. John Money as well as the Reimer family. So I'll give a very brief overview of what this was about. But the Reimer family in Winnipeg, in Canada had twins, and with these twins when they were infants, there were some issues that came about, I believe, with their urinary tract, and that then subsequently resulted in them becoming circumcised at the age of eight months. Unfortunately, disastrously, it went terribly wrong with the brother Bruce and his horrific accident took place, which instead of circumcising him in the proper manner, it ended in him losing his penis altogether. So obviously this family was despondent, distressed, didn't know what to do with this. They took their baby home and, you know, they they did what they did over the next few months. It's my understanding that they came across something on television with Dr. John Money, where he began discussing the fact that children can be raised in a manner that is socially constructed with respect to their gender. So long story short, they ended up connecting with Dr. John Money in the US, and they did surgery to remove the genitals, remove the the testicles and socially transition Bruce to Brenda and raise Brenda as a female. And one of the caveats of this from Dr. John Money's advice was you cannot tell Brenda that she was born as a male because that will ruin everything. That will ruin what we're trying to do here. So Dr. John Money published a study following these twins over the years, and in his study referring to Brenda as Joan and claiming that Joan lived a happy, healthy, fine life as a female. Later on, it was found out that this was patently false. When Brenda became a teenager, had a moment of crystallization where she knew that she was indeed a male. And I'm leaving out many of the details. And again, we'll we'll link this study to the description. But essentially, Brenda transitioned back to living as a male and referred to himself as David and lived his life as David. And there was a tragic end the story, because understandably, there was a lot of trauma and psychological psychological distress that came along with this. But in so doing this, Doctor John Money was able to propagate the fact that gender is socially constructed. That was kind of the moral of the story here. So Oren, did you want to add anything to that? Well, only that when you look at the history and what Dr. Money did with the boys or boy and girl, there were some concerning behaviors in Dr. Money. He had them engage in sex, play with each other. There was some question about what his motives were, what the the rationale behind it was was. And as you say, this has been this is so falsely portrayed, the adjustment of Bruce, Brenda, David, you know, which was just patently false, as you say. And so, yeah, that's all I'm going to say, that it was a tragedy. You know, again, you'll you'll link the story. I've talked about this with Dr. Alice Dreger as well at my own podcast years ago, and I've thought about it. And, you know, the thing is that people who are too extreme, let's say on the anti-trans side, they will take Dr. Money and Dr. Alfred Kinsey and they will portray them in the most negative light. Now, there does there's a lot of criticism that is warranted. I just don't want people to go too far and, you know, let's say make claims that can't be verified. So let's say that what Dr. Money did, what Dr. Kinsey did, the reality behind it was concerning enough because what they say is these two perverts, they are the ones who, you know, have this maniacal plan to, you know, change your sense of gender and make us all these freaks and so on. That's just hyperbole. And hyperbole doesn't serve anybody. So I hope people will look at the story and realize that the truth is bad enough. We don't need to inflate it with fiction. Absolutely. So nowadays we're seeing a lot of as I mentioned, the term before, rapid onset gender dysphoria. And I think that it would be prudent for us to first distinguish between what clinically diagnosed gender dysphoria as per the DSM 5-TR looks like versus rapid onset, because rapid onset is not currently in the DSM, it's not a diagnosable condition, but it is the name that is being used for the social phenomenon that we're seeing. So what would you like to to say as far as the rapid onset? Well, we're going to talk about it because that I would say I would argue that the rapid onset gender dysphoria (ROGD) that Dr. Lisa Litman originally coined a few years ago I think is 2017. And if it were off by a year, this is my apologies, the data for 2017 that again, when I talked about extreme views, people are trying to totally discredit it. They're saying this is their right. It's not yet a disorder. It hasn't been recognized by the DSM yet. And it may never be because for political reasons, political only, because the phenomenon or phenomena that she was describing was something that so many clinicians, parents, educators saw themselves, and the point is that and before I go further, there are several different types of etiologies and presentations of gender dysphoria, and to treat them all the same, to say, no, no, no, we don't want to understand that somebody could, you know, show these signs early on or later. And the related phenomena that they are so different that they're almost completely like that you can create taxonomies in which they're different groupings. All right. And we'll talk about that as well, that people want to deny that. And so they're trying to dismiss rapid onset gender dysphoria because they don't like the implication and the implications are that many of these young people, let's say, going through puberty, post-puberty, mostly young girls, teenagers, that they suddenly, suddenly out of nowhere. Now, some will argue, don't know they were just repressing it all these years or they didn't want to upset their family. They didn't want to be rejected. So they're really hiding it. Okay. And we will go into that. But the point is that these people suddenly, after never showing any dysphoria, distress, confusion about their gender and usually didn't show any cross gender behavior. So these girls were not acting like boys. Now, many of them may be tomboys. Being a tomboy does not mean transgender necessarily. So the most that you could say is that maybe they were a little bit on the masculine side or on the tomboy side, but that's it. And it was never an issue for them. They just like to play sports. Maybe they like jeans instead of dresses, but again, they never showed any concerns about that were safe. And then suddenly, as teenagers again through puberty or post puberty, they suddenly started saying, I am transgender, I want to bind my breasts. I want to have my breasts removed through double mastectomy. I want hormones that are going to suppress my puberty and then other hormones that will that will be testosterone, going to talking girls to boys anyway. So they're demanding radical, unproven intervention to make huge but potentially life changing and sometimes life ruining alterations to their body. And this is very different from a, let's say, a five year old boy who is extremely effeminate, who if you if you just watched him play for, you know, for an hour and engage and everything like that, if you let him grow his hair, you might go and actually might be a little girl like from the youngest of ages. Whether he whether he shows distress over this or not, the fact is he presents very differently from these teenagers who are, you know, again, biological girls or from an other category one whole totally different category we'll talk about afterward as well, where a boy who stereotypically a boy at a young age as a teenager, he's stereotypically teenage. He plays a teenage boy or you play sports. He has girlfriends, you know, he's a jock, he's masculine and then during puberty, he develops a paraphilia or what some people call a fetish or kink that is sexually connected. That's very different from a young boy who's not acting this way through sexual feelings or through girls who suddenly believe that they're a boy Again, what I'm saying is there are so many different phenomena here. And the reason that people don’t want to talk about it is that they believe that somehow this is going to negate or deny the trans experience. And I'm hoping that when people watch us talk about this, they're going to say, no, no, all we're saying is different people, different pathways and toward feeling this way. And therefore we need different solutions to helping them cope with these experiences that they're having. Right. Can be so distressing that they feel that the only, you know, that some people claim that suicide is either suicide or transition. So if we're going to see something that extreme, we better know what we're talking. And to summarize what you said, they were talking about multiple different things, right? So again, there is the clinically diagnosed gender dysphoria, and then there are many other pieces of the puzzle, many of which and this is controversial, are socially constructed. So, for example, the social contagion of, you know, rapid onset gender dysphoria, meaning, you know, teens are being exposed to a lot of different pieces of media conversations with friends and so on and so forth. And this is not to deny their experience by any means, but that is not necessarily clinically diagnosable gender dysphoria. So I want to talk a little bit more about Littman's research. And there's two pieces of research. One of them was survey research of the parents of individuals who transitioned, and that got a lot of flack. So she did a follow up study which actually was interviewing individuals who detransitioned. So I'm going to rattle off some interesting statistics here that I have noted down. And again, as you said, her and her research came into a lot of scrutiny. And she originally was doing this research with Brown University and is no longer there. There isn't really clear information as to why not, but it is surmised that it has a lot to do with the controversy of her of her research. So let me see here. This is an interesting one that I want to start with. This 62.5% of individuals in the first study who are expressing gender dysphoria also met the criteria for another mental health disorder and or a neurodevelopmental disorder before they began feeling gender dysphoric. So this is really controversial because a lot of the arguments surrounding specifically the development of things like anxiety and depression, the argument is, well, because they're gender dysphoric, therefore they feel ostracized and, you know, as social outcast, so on and so forth. And that develops into depressed mood and anxious distress. But that argument doesn't stand when it comes to neurodevelopmental disorders such as ADHD, such as autism, because as we know, that is something that people are born with. So the next thing that I want to discuss here is, you know, how much of this rapid onset gender dysphoria is really more about personality variance and personality traits, variance in identity, not gender identity, but identity as a whole that are either influenced by psychiatric, psychological disorders or just who these people are in general. And it has nothing to do with gender per se Right, now, just one thing. So if people look up. Lisa Littman if you look at plus one where the study was published, where you pay to publish, you will see something very different than what is claimed online by many people trying to dismiss her study. So because people say that her study was taken down, Brown is so dissociated themselves from her, they didn't want to be connected to her. And so I just want to give a quick background about what ROGD is. People just if people are exposed to something that either makes them feel uncomfortable or goes against what they want to believe, their cognitive dissonance is going to cause them to want to see things differently from how reality really is. They don't want to accept it. So I want to say very quickly, if you just Google Lisa Littman, Dr. Lisa Littman, you know, ROGD study, you will see literally millions of hits where people are claiming that it was totally discredited. Brown doesn't anything to do with her. Plus one took it down. Well, they did take it down because they got so much flak. They did a very thorough review again. And there were minor changes in the wording of there were more caveats. She had to be more clear in explaining that it was recruiting the parents only, not the actual children, and discussing the limitations being a bit more upfront about it. But that's it. The findings themselves were not disputed. No, no. So it's still a credible study. And yes, it would have been nice to have spoken to those people themselves, which she did subsequently. Not the same people that spoke to other people who had ROGD. But and by the way, just this is how this is why I am so intent on discussing this publicly, because few years ago I have to be careful because of confidentiality. But a colleague in a different country almost lost their license. They were threatened with losing their license. And it's not just one person or a few people. Okay. But remember the first case where they were threatened with losing their license if they continue to use the term ROGD. It was considered hateful. Who declares it to be hateful? Yeah. Just because something can be used hatefully doesn't make it a hateful construct. Wanted to touch back on what you said earlier. You know, when people unfortunately, when people hear what they don't want to hear, we've talked about this in a previous episode about, you know, the words becoming violence essentially. It's thrown back of, well, that's hateful because that's not what I want to hear. Right. And it's so hateful that it's going to cause people's death. And that's not the case now. It's again, she's she used a term to describe a phenomenon that she and many others had observed. And I'm glad that she did that. But so, again, it's not technically a term yet, but people just they're trying to discredit the term. They're trying to discredit her and throw out a discussions about this. We're going to talk about other people who've been totally discredited, or at least there's been attempts to discredit them. And it's got to the point that all you have to say is what? LITTMAN Or what a bunch of other names. And they're looking at you as if either how did you not know that they were complete quacks in the same way they're saying, how do you not know that the earth is round or what? You listen to those people. Why don't you just listen to Hitler, okay? Like this is the kind of antipathy that is directed toward them in their work just because people are so afraid of, again, this evidence and these claims that go against what they want to believe. So I just want I really want to emphasize that so that people can do their own due diligence, read the links that we're going to send, and to understand that there's so much bad press against them that is just not warranted. And for folks to go in with this critical and I as possible. Right. Because, yeah, we can't go into reading any research, whether it's on this topic or anything else with our own biases, because that is absolutely going to color what we see and how we see it. Exactly. And when the experts themselves are threatened with extreme sanctions, like losing your license. Yeah, well, that's going to make people back off and they're not going to do their due diligence. They're going to say, well, I've been told I must see things this way. I must do things this way. I'm afraid to do anything otherwise. And if and then if they start to look into this other information now, they're stuck with this moral conscience of this crisis. This crisis of conscience, because they're saying, wait a second, there's all this evidence that's saying that maybe I'm doing the wrong thing. How can it happen? Somebody dedicated their professional lives to helping others. How can they live with the fact that they might be doing more harm than good? That's terrifying. So they’re not even looking at that other information, They would rather just say, Oh, yeah, they've been discredited, they're quacks. So that's why I'm saying it up front at the very beginning. I want to really emphasize that Please go beyond the headlines, go beyond the social media posts and actually look at the work these people have done that are going to be talked about throughout this this whole discussion. And so I've lost the original question. Okay. But we're talking about rapid onset gender dysphoria. And specifically, I think what I was asking was surrounding the idea of personality and these variances in identity that have nothing specifically to do with gender per se. Right. Thank you. Yes. So depending on the study you look at and Bailey and Diaz or Diaz and Bailey, Suzanne Diaz is a pseudonym. I actually had her on my podcast a few years ago discussing her before she had actually published it with with Dr. Michael Bailey this year. They did a follow up where she did a follow up and then Bailey came in to help on more parents. It's a similar methodology to Dr. Lipman. Now, I'm going to be clear here. The parents were recruited from websites run by parents who are very concerned about this phenomenon. And the wording of the survey like to get people in. It was it would lean, it was biased. It was basically telling people like, you know, if you have a problem with this, if your children are struggling and so on, you know, come come to the study. Now, if it was simply, you know, if children are struggling, that's not an issue. But the language was inflammatory, let's say, because these parents are really concerned about what they were seeing. It was affecting them. This was not some abstract construct with some esoteric thought experiment. It was real parents watching their children deteriorate, watching their children leave, the family watching the children become somebody they don't recognize and just become mentally unwell. Again, The deterioration was significant and the making demands that the parents knew were not in the kid's best interest or believed were not in the kids best interest, because, again, these were kids were suddenly saying things that seem to have nothing to do with their historic experiences. So the point is, yes, there may be it's a biased sample, but if you look at all the research on these issues, very rarely will you not see extreme bias in the sampling, in the in the methodologies, in the conclusions that are drawn. This cuts across all research, not just one study. So what these what the Diaz and Bailey study found and what Littman found and what other people have argued is that at least in the Bailey and Diaz study, 6% and I was surprised only 6% of the adolescents had been diagnosed with autism. Now, because they're relatively young and because they're mostly females, we know anyone who knows anything about autism knows that the diagnosis for females is often missed. They are diagnosed with other, you know, let's say, disorders, not autism. It's not used to later on in life that they realize, wait a second, you know, whether borderline personality disorder or some other type of phenomenon, it doesn't really describe me as well as this other diagnosis of autism. So even though it said 6%, first of all, it's much higher than the general public basic, about five or six times higher. And second again, I would argue that many of these younger people will be diagnosed with with autism later on. So that's just one of them. And the depression, anxiety, all these other disorders. Yes, as you said, it could be someone could argue that maybe it's a result of what they were struggling with, whether internally or socially. I get that. But there was also ADHD, OCD, Trauma, lots of trauma. And so and the trauma was not related to gender sexual, oftentimes with sexual abuse or other types of trauma. So the fact is, many of these young people have, you know, whether it's personality or psychiatric condition or psychological conditions, they had issues that were not necessarily related to gender per se. And then but they were related to their difficulty in either feeling comfortable in themselves as a human being, in their identity, and how they related socially to other people interpersonally. They didn't fit in. So if you're told as a 12 or 14 or six year old that, by the way, the reason you feel so uncomfortable, the reason puberty was so difficult, which who is it NOT difficult for, especially for females, the reason that you don't feel like you belong to everyone else is gender dysphoria or you are transgender. I want to pause you there because one of the really controversial things right now is that not only we as clinicians but the general population, it is completely hands off to say that, you know, perhaps this general dysphoria or distress has to do with a previous trauma that's become like, no, how dare you make such an accusation? This person is transgender, they're in the wrong body, etc., etc.. How dare you say that? Right? And no, when when asexuality. So people with zero libido, I mean, it's like I'm shifting gears but it’s very related at first when when this became kind of popularized by Tony Boger. He's not the first person. Dr. Tony Boger from Brock University published study over 20 years ago, 25 years ago, talking about this, and he's written about it since. At first they were saying, look, this is just how we're born. There's no trauma. We're just born without libido. Okay? And to, you know, if this took the same pathway as it's doing with gender related issues, then if anyone would say, well, maybe sometimes there could be trauma, maybe that the person was too young to remember or that they've repressed. If you were to say that, they would say, No, you can't. You know, that's wrong, that's hateful, it's terrible. No, they're just asexual. They're born that way. But with further research where you are saying that, yes, many people who now say that they are asexual did have a history of trauma often relate to their sexuality. So it could have been sexual assault, it could have been relate to their sexuality. Maybe they tried to come out as gay and, you know, they were shunned or beaten or something terrible happened. So they you know, they inhibited their sexual feelings. So, again, all we're trying to do is we're saying we need to look at all of these different possible causal factors. We need to look at all these poorly correlated factors and try to see what is the best way to help people deal with, again, these internal or social interpersonal issues. That's all we're trying to do. And we can't do it. We're not allowed to have discussions, right? Yeah. And the social contagion aspect of it is another controversial piece of the puzzle. And, you know, we've seen this before with other disorders. I know back in my adolescence, anorexia and bulimia, that was one of the, you know, similar phenomena that we were seeing. I want to draw an analogy, though, to the current social contagion aspect of rapid onset gender dysphoria. And what we're actually seeing in the clinic in terms of, I'll say, specifically with ADHD. So there's a lot out there right now, you know, TikTok, put a finger down. If you have X, y, and Z symptoms, oh, you must have ADHD. And we're actually seeing a lot of younger individuals. I'm in for an information session because they are convinced that they have ADHD. But there is this aspect of confirmation bias that people are ignoring that, you know, we can put ourselves into any box if we know the general symptoms, but if it's not being looked at with a thorough evaluation and a trained clinical eye, then we've got a real problem. And what we're often finding is that, you know, not to discredit with these folks are experiencing, but oftentimes it's not ADHD, it's trauma, it is anxiety, it is, you know, any number of different disorders that has overlap in symptoms with ADHD. So I draw this analogy because I think that that's a little bit less controversial of an example to use, but the same principle can be applied to, again, the social contagion associated with rapid onset gender dysphoria. Right. And by saying all of this, nobody would say that you're denying the existence of ADHD. I know it's one of our areas of expertise. Right. We we totally believe in it. Right. And and then there's the ADHD that seems, you know, that people seem to be born with and neurodivergent. And then there's people who seem to meet all the criteria for ADHD. But if you look at it, it's really a reaction to parenting style or, you know, poor coping and so on. So we wouldn't consider that the same in the sense of it's not neurological, it's more environmental. We're trying to delineate between these different factors. So we need to do the same with, again, gender related issues and to deny the fact, as you just said, that if someone is exposed every single day on Tik Tok or other social media to these claims of, you know, A, this is who I am and this is who you may be. B By being this way, by being your authentic self, you're going to have this amazing life. Everything you're experiencing now, all this social isolation, all the feelings of confusion or distress, whatever, it's all going to go away magically. Yeah. When someone sees it from the age of eight or ten or twelve or younger, they don't have the wherewithal to say what it's like. Maybe I'm being sold a bill of goods that's not going to deliver right? They don't have that ability to say that. So all they're looking at is this is the solution. This is the solution. And again, anyone to deny the effects of social contagion is denying reality. As you said, eating disorders, body image issues. Even now with we've seen this whole rise of tics, verbal tics like Tourette’s disorder people claiming this. Right. This is happening. And once again, it doesn't mean that everybody who's now presenting to clinics saying, I have, you know, gender dysphoria or I am trans or I'm non-binary. We're not saying that this applies to everybody. We're saying we need to know how many it applies to, we need to know how to help those people. Right. Because the solution being proposed for those people is 100% wrong. Right. And this course means that we have to do it in their lives. We have to do a better job of evaluating and assessing. And unfortunately, the guidance being given is quite the opposite as far as you know, we have to affirm and it's it's I don't know what what other way to put it, but it makes my brain hurt because it is our job to be as thorough as we can when we're investigating anything. Right. And that's the ethical guideline that we must follow, moral and ethical. And here's the thing, Bill C-4, it was called Bill C-16, then Bill C-6 now is Bill C-4 in Canada. This was a nightmare. It's worded better. Now, I just want people to understand this because. It might sound like we're throwing things right or I'm throwing things randomly, but they're all going to tie together. I want people to understand that if you're coming from it as a parent or as the individual has these feelings or as a clinician trying to help these people or as an educator, we are being hamstrung. We're being prevented from taking that through approach that you mentioned. So, Bill C-4 makes it illegal for to conduct conversion therapy in Canada is not just not just lose your license, you can risk going to jail, whether is you're trying to transition someone's sexual orientation or their gender identity and they conflated it. And we're going to talk about several conflations today. I'm going to talk about the first one, which is conversion therapy for again, for for sexual and sexual orientation versus gender. When the bill was first proposed, the wording was so terrible, it was so ambiguous that asking any questions whatsoever. So literally, if a kid came in to see a five year old child came in and said that it's a boy and they said I'm a girl, if the way it was worded, if a clinician said “Oh? Why do you think so?” Or “Let's explore that” Which is a normal line of questioning in our job, by the way. Which is a normal line of questioning. Exactly. So doctors Kenneth Zucker and James Cantor went before the Senate. I think it was January, February, and it was either 2018 or 2019. Again, I always apologize for the years, but they went there and they argued passionately, saying the wording is terrible, we need to change it. So they did change it and it says explicitly and they'll say for because again, people are are being too hyperbolic. I want people to know the truth behind the bill. The law that if you simply ask questions, just explore without bias, that's not going to be considered conversion therapy. So now if a child comes in, they're five years old and the boy says, I'm a girl, they say, Well, why do you think so? That would not be considered. However, here's the problem. The wording states, as long as they're not showing a preference for a quote unquote cis gender identity. So the cis gender for believe or not. I asked this at my class all the time at Toronto, at TMU, a very progressive university, and not everybody knows cis gender, is it came out in, I think 1996 or seven. The term was used to describe somebody whose sense of gender matches their biological sex. I am a man. I am biologically male. I feel like a male. I am cis gender. Okay? Whereas transgender would be the opposite. And by the way, a little side note here, I understand why they would use that term. I don't like the politics behind it. Likewise, I refuse to play into political into the ideology. But if someone said, you know, either you're trans or well, the alternative would be normal. And if you say that, you know, cis people are normal and I'm using the term I don't use the term CIS policy, non trans people are normal. That means trans people are abnormal. So I understand why they wanted to come up with a complimentary term for transgender cisgender. They want to destigmatize, even apologize. I get it. I won't use it because of the politics, but I understand why they're using it so that so people understand that the term. So getting back to now now I forgot again I'm sorry. I just that there's so much stuff that we have to. We’re talking about. Bill C-4. Thank you. Okay. And if people don't know, I tell this to all my students after I had open heart surgery a few years ago, my the ability to stay on focus, sometimes it's much trickier. So for myself, because after the surgery. So I apologize if I get derailed. Thanks, Malini. So, Bill C-4, Hey, it's supposed to allow the clinician to, again, to explore without bias. And the bias can only be in the direction it's in the bill, you know, a cisgender or a heterosexual identity. So if a therapist and we've seen many cases, I've had so many people around the world, including in Canada, states and elsewhere, write to me and tell me or reach out to me and say, my child came in. And by the way, whether the child or the person themself, I've had both cases. All right. So I'm going use the first person account where someone comes in. They told me they came in and they were saying, look, I'm having this. I'm after during puberty. I felt really uncomfortable. I think I’m -- andthis is a female-- and I think I'm into girls and I'm feeling, you know, I'm confused. I'm lost, as she said, that the therapist, like really quickly, really quickly is like, you know, saying you must be trans something along those lines. Okay. Now I wasn't there. I'm just hearing what she recounted. Okay. But why would we deny her lived experience if that's what she says happened? Why wouldn't we believe? And she was saying, and if you surprised because the therapist kept telling me to push for this, you know, this trans answer, and she's like, maybe there's other issues. And she was trying to say, I've had trauma. I was assaulted when I was younger I always had, you know, I felt uncomfortable around my body after the as she was trying to see that. And she said that the therapist kept trying to push and she said, the therapist, I'm not going to be too specific. Let's just say that the therapist had a very personal reason to believe that being trans was the answer, which. Again, like any other disorder that is so antithetical to what we are supposed to be doing, we can't do that in our profession. I don't care if it's if it's trans issues, PTSD, ADHD, we can't just say, Oh, you look like you have this disorder. That's not how it works. Exactly. Right. And but that's what they're saying is happening. It is. Is how we find it is happening. And that, according to Bill C-4, that would be fine because they weren't promoting a cisgender pathway. So here's the problem. If someone is completely neutral and they have not tried to persuade the person one way or the other, they're just exploring without any bias whatsoever. If the patient subsequently doesn't like, let's say, what's happening, if the patient maybe has certain personality features that make them more prone to misinterpreting or to being hostile and going after people they don't know that they think have wronged them, then if they made a claim saying that my therapist was biased, etc., how does a therapist. Yes. Prove to a you know, to the to the licensing agency or board that what they did was not biased, was ethical, so on and honestly recorded all their sessions. Right. And shown exactly, and even then, even if there was an audio record official, the visual because the patient would say, well, their words were this, but. Their body language was such that. The body thing right? So everyone that I've spoken to, including myself, is terrified to deal with these issues because they don't know. Sorry, let me rephrase it. Everyone who wants to be ethical. Yes. Who wants to come in completely without, you know, a set notion of what this issue is? They're terrified. People who've been promoting gender ideology for years, they have no fears because that again, the bill does not apply to them. No. So and it's so ironic. We think about it. We talk about conversion therapy. If someone is trying to say to people who aren't transgender, yes, you are transgender, that's literally the definition of conversion. Right? Right. They're trying to convert their identity, their body. Yet that's not considered an issue. That's not conversion therapy. So that's Bill C-4 in Canada. It passed is not just again, it's not just a licensing issue now. It's a legal issue. So not only would you have to then base your your board, you know, licensing board, you would also or college, you would also have to face the law potentially. Right. Just for trying to help people. So and so what's happening is so many people are backing off and now all these younger people are going toward one stream. Now, I'm not saying that everyone who you know, who who's on it in that stream is unethical or incompetently pushing people into it. I'm not saying that, but there are many anecdotal accounts of them being either pushed or not having enough due diligence, getting hormones prescribed on the very first session after speaking to a therapist for an hour, people say that never happens. There are so many accounts, sometimes recorded accounts of people getting that in Canada, in the States, in the UK. So pretend it's not happening would be to deny reality. Yeah. So I want to go back to something that you mentioned earlier. The, you know, the falsehood of, well, if I transition, then I'm going to feel better. It's going to solve all my problems. And the fallacy with that, in terms of, you know, from a clinical perspective, we know that typically there's there's more to the story that's not being addressed. And this one factor isn't going to fix anything or everything I should say. Pardon me, but I want to go back to the Littman study as far as what she specifically found in her second study. So with respect to the fact that, you know, some of these children, that transitioned thought that transitioning would make all of their distress go away. But in fact, what her study found with that 61% return to identifying as their birth sex, 14% ended up identifying as non-binary and 8% continued to identify as trans. So the detransitioners have often been ostracized from their community. So this causes some secondary problems as well that nobody's talking about. And this is I'm telling you right now, I've said this many times it's a tragedy because the people who who say that I am the most compassionate, I am the most tolerant, and I demand that you be compassionate, tolerant, too. Oftentimes they at the least compassionate and want to know how we know this look. Look at how they talk about the Detransitioner or the amount of hate, vitriol, just slander and defamation and libel laid against these people. It's horrific. So what they're saying is, well, they were never really trans in the first place. Well, we'll talk about statistics later on, but there are many, many people for whom we could say the same thing, which is they were never trans in the first place. So why are we pushing to transition them when that's not the best answer? Right? So it's heartbreaking because people are transitioning. They've already had either hormonal or surgical procedures that have again affected their functioning. You that you can hear the distress in their voice, the regret. And and I've watched so many videos, I've spoken to so many people who've gone through this, and it's heartbreaking. And so to anyone to try to minimize that, to try to sweep it under the carpet because it goes against the narrative that's the opposite of compassionate, tolerant, ethical, humane. Okay. So, yeah, it's the other thing is this. Even if they haven't medically transitioned, they've already joined groups, whether it's online or at their school or something like that, where they're part of that group, they're part of that family through their gender identity. Right. I want to focus on identity. Right. Because being part of a group is such an important part of our identity. So is it the gender issue or is it the lack of relationships and the lack of belonging that's contributing to a lot of that distress? Exactly. And it is when you speak to people, it clearly is. Again, many of them felt like social misfits. So now they do have that group. And when you're transitioning from childhood into early adolescence, that's such an important transition in our lives, not just for puberty, but again for social in our social context and at all ages. At all ages nine is the high 90% of people. Because we're social animals, we need to feel a sense of belonging. And if we don't and you talk about neurodiversity, like with ADHD or autism, people with addictions, one of the worst things a person can feel is like “the other,” excluded, not part of the group different from other that and we've talked about this before and this is what they feel. So if they're given a solution again, even if there's no medical transitioning involved, it's just taking on this identity that feels right in the moment and they're being validated, they're being glorified for it and they're being accepted for it. So when you have that to suddenly say, Everyone, I think I made a mistake, that's extremely hard. Even for smaller issues, for people to accept for something like this, your own, your core sense of being, at least that's what it feels like when you're always not all the time talking about your gender. It does become the be all end all right to suddenly go. I was wrong and sorry, everyone, I've got to leave you, okay? They can't do that. So they're struggling. And I'm going to say right now, I'm going to throw it again. It sounds like I'm going off on these tangents, but I see the same issues when I deal with children who are going whose parents are going through divorce, the sense of loyalty, torn loyalties. I want to do right by mommy, I want to do right by daddy. And they're fighting. I'm feeling torn. Okay. It's the same thing. But in this case, it's I want to do right by myself and I want to do right by my group. Right. And how do I reconcile that they're betraying one or the other and it is causing and exacerbating confusion and distress. We hope that you found this discussion thought provoking so far. Join us next week to hear part two on Awake at the Wheel