In this episode, I welcome back Glenna Goldis, a lawyer with extensive experience in government and advocacy, to discuss a recent Health and Human Services review on gender medicine. We dive into the report's findings, which critically assess the evidence for both the alleged psychological benefits and the physical harms associated with gender-affirming treatments, particularly for minors. Glenna highlights that the evidence supporting psychological benefits is shaky at best, while the report emphasizes the significant physical risks involved, including the lack of prior animal studies.

We also explore the ethical implications of pediatric gender medicine. The report categorically states that it is unethical to subject adolescents to hormonal and surgical interventions, arguing that the risk-benefit profile is unfavorable. Glenna and I discuss the concept of medical consumerism and how it relates to patient autonomy, questioning whether giving patients what they want is always ethical.

Additionally, we touch on the historical context of gender medicine and its ties to homophobia, emphasizing how this practice has disproportionately targeted gender-nonconforming individuals. Throughout our conversation, we aim to unpack the complexities surrounding gender identity, the responsibilities of medical professionals, and the societal implications of these treatments. Join us as we navigate this critical and timely discussion.

Glenna Goldis is a lawyer in New York with experience in government, fraud investigations, and domestic violence advocacy. She publishes Bad Facts, a newsletter about the movement for trans rights. She first appeared on this podcast in episode 148. Executive Orders Decoded: Attorney Glenna Goldis Explains Impacts on American Families.

 00:00 Start

[00:02:51] Gender medicine review implications.

[00:05:35] Evidence of psychological benefits.

[00:09:06] Gender euphoria debate.

[00:10:44] Gender euphoria scale discussion.

[00:14:03] Physical harm from hormones.

[00:17:44] Pediatric gender medicine ethics.

[00:22:17] Ethics of social transition.

[00:24:40] Ethical dilemmas in psychotherapy.

[00:27:22] Therapist's role in gender identity.

[00:31:29] Medical consumerism in healthcare.

[00:37:20] Authority of medical professionals.

[00:40:53] Sexual trauma and trans identity.

[00:44:11] Homophobia in medical practices.

[00:47:11] Gay patients and trans representation.

[00:50:10] Young lesbians and identity confusion.

[00:52:56] Lesbian identity and challenges.

[00:58:43] Compassion for confused individuals.

[01:00:55] Therapy and gender dysphoria.

[01:02:29] Internalized homophobia in therapy.

[01:05:40] Therapy and LGBTQ+ considerations.

[01:10:48] Ethics of gender affirming care.

[01:13:06] Cultural climate in psychotherapy.

[01:18:20] Cultural change and gender dysphoria.

[01:21:11] Black market for hormones concerns.

[01:25:18] Education and litigation in government.

[01:28:12] Legal challenges in gender medicine.

[01:31:38] Opening up the discourse.

[01:36:05] Navigating gender impact on families.

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SHOW NOTES & transcript with help from SwellAI.

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Show notes & transcript provided with the help of SwellAI.

Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.

Watch NO WAY BACK: The Reality of Gender-Affirming Care (our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration.

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