In this episode, Therese Markow and Dr. Ximena Lopez discuss the challenges faced by transgender youth, emphasizing the importance of gender-affirming care. Dr. Lopez explains the difference between sex and gender, noting that gender dysphoria is distress caused by a mismatch between one's gender identity and sex assigned at birth. She describes treatment options, including puberty suppression and hormone therapy, which can significantly improve mental health and reduce suicidality, particularly in teens. Dr. Lopez also criticizes state bans on gender-affirming care for minors and cites numerous studies showing its benefits, as well as discusses the inconsistencies in hormonal therapy for children and teens. 

 Key Takeaways:

• In medicine and psychology, gender and sex are two different things. While aligned in most people, they are not aligned in those individuals on the transgender, nonbinary, or intersex spectrum. 

• Adults who transitioned later in life typically knew they were different when they were young, but didn’t have the language or awareness. 

• When a child comes out as transgender, most parents are typically in denial. It is not until their child or teen is depressed and often suicidal, that the parents are willing to take the next steps with their child. 

• Gender-affirming care at the beginning of puberty can help to pause the puberty of the incorrect gender where changes happen that cannot easily, if at all, be reversed later in life.

• Puberty suppression can be reversed on the off chance the individual changes their mind. 

"Most of the stress comes from the adult world, and if the adults are transphobic and influence their kids to be transphobic, then we can also see kids who are transphobic, and then they can bully and discriminate. If it's a very affirming school where there are policies to protect transgender students, and the teachers and all the staff are on board, then that promotes well-being." —  Dr. Ximena Lopez

Episode References: 

• TEDMED Talk: How one pediatrician is supporting transgender youth:     https://www.youtube.com/watch?v=ViqvPknY4HE 

Connect with Dr. Ximena Lopez:

Professional Bio: https://profiles.ucsd.edu/ximena.lopez 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

In this episode, Therese Markow and Dr. Janine LaSalle discuss Dr. LaSalle’s research on autism, focusing on prenatal gene-environment interactions. She explains that autism affects one in 36 children and talks about how genetic and prenatal environmental factors, such as maternal health and chemical exposures,  play a role in autism. Dr. LaSalle discusses how they use placental DNA to identify epigenetic marks linked to autism, aiming to predict probability of autism before birth in order to intervene early. The conversation highlights the importance of understanding these factors to develop early intervention strategies.

 Key Takeaways:

• It's almost impossible to compare autism incidents across time because the diagnostic criteria have changed many times over this span. There's no definitive laboratory test for autism.

• A number of genes have been identified that increase the risk of autism, genes that affect prenatal neurodevelopment.

• Maternal obesity, maternal asthma or fever during pregnancy, and preterm birth are a few examples of maternal health factors implicated in autism. Environmental exposures during pregnancy that increase risk for autism include air pollution and some pesticide exposures - these have the best evidence because they can be measured easily.

• Prenatal identification of newborns at risk for autism allows treatment to begin immediately after birth to improve their developmental trajectories.

• While little boys have a much higher incidence of autism and ADHD, the mechanism underlying the sex difference is not understood. 

"The best explanation for most cases of autism is really the combination of common environmental factors and common genetics." —  Janine LaSalle, Ph.D.

Connect with Janine LaSalle, Ph.D.:

Professional Bio: https://health.ucdavis.edu/medmicro/faculty/lasalle/ 

Website: https://mmi-lab.ucdavis.edu/ 

UCDavisMind Institute: https://health.ucdavis.edu/mind-institute/

UCDavis Genome Center: https://genomecenter.ucdavis.edu/

LinkedIn: https://www.linkedin.com/in/janine-lasalle-70149415 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

In this episode, Therese Markow and psychologist Dr. Elizabeth Scott,  discuss narcissism, its clinical definition and the characteristics of “malignant narcissism”. Dr. Scott explains that narcissism involves patterns of grandiosity, a need for constant admiration, a lack of empathy, high levels of manipulation, and the narcissist’s “kryptonite” - criticism. They view themselves as the victim, never at fault. Despite their arrogance, they are very insecure. Dr. Scott also discusses why treatment is challenging and why therapy often focuses on managing symptoms rather than the deeper core issues. They can’t see that they have a problem, and thus are resistant to treatment

 Key Takeaways:

• The myth of Narcissus illustrates the danger of excessive self-focus, which is the hallmark of narcissism in clinical terms and is becoming increasingly common in some aspects of our modern society. 

• Narcissists are very good at manipulation. They consciously will do things to sort of manage their image in the eyes of others. They may appear to show empathy at times in a relationship, but it's usually more of a means to an end than a genuine concern for the feelings of others.

• Criticism is like a kryptonite to a narcissist, so even the mildest critique can provoke a strong defensive reaction: anger, denial, or shifting the blame to somebody else.

• You cannot change a narcissist's behavior, but you can control your own responses to it. Think about limits and then give yourself leeway within those to protect your own mental health. 

"[Narcissists] might mimic empathetic behaviors to achieve their own ends, but it's more about manipulation than genuine caring. So they can understand maybe what empathy looks like, but not really get how it feels and how it's supposed to feel and how those behaviors are supposed to be rooted in something inside them." —  Elizabeth Scott, Ph.D.

Connect with Elizabeth Scott, Ph.D.:

Twitter: https://x.com/ElizabethScott 

Facebook: https://www.facebook.com/AboutStressManagement/ 

Website: https://drelizabethscott.com/  

Instagram: https://www.instagram.com/dr.elizabethscott/ 

Book: 8 Keys to Stress Management: https://www.amazon.com/Keys-Stress-Management-Mental-Health-ebook/dp/B00AJUKO5M 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

Dr. Adam Schiavi is an assistant professor of anesthesiology and critical care medicine and neurology at the Johns Hopkins University School of Medicine. His areas of clinical expertise include anesthesiology, neurological critical care, disorders of consciousness and brain death diagnosis, clinical ethics, critical care medicine, and traumatic brain injury.

In this episode, Therese Markow and Dr. Adam Schiavi discuss how the definition of death has changed throughout history, what the current definition is, and how that is determined by the medical technology of the time. Brain death is the current definition of death, medically, but what happens to a body after brain death is determined can vary depending on the state you live in. This can be a trying time for families and for the providers involved with the now-deceased patient as the definition of death is not understood by everyone. They also discuss how brain death differs from other states of consciousness and how people often confuse the terminology of those different states, as well as the ability to hope for healing from all but brain death.

 Key Takeaways:

• The total cessation of all functions of the brain is the current definition of brain death in the United States. This definition is based on a clinical exam testing all parts of the brain, typically done by somebody certified in doing brain death determinations.

• You have to have a reason for the neurologic exam to be declining. Without a reason, you can't call somebody brain dead.

• You can replace every organ in the body, but you cannot replace the brain and when the brain dies, the body dies all the time 100% unless those organ systems are artificially supportive. 

"Our culture changes with technology and the way we define death is a part of culture. As that culture has shifted, the way we define death has also shifted with our new technologies of how we can actually determine whether people are dead." —  Dr. Adam Schiavi

Connect with Dr. Adam Schiavi:

Johns Hopkins Bio: Adam Schiavi, MD, PhD, MS   

Email: [email protected]

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Katie Pelch discuss the harmful and pervasive effects of PFAS, also known as "forever chemicals." Found in various consumer and industrial products, contaminating air, water, and soil, they never break down. Dr. Pelch works for the Natural Resources Defence Council (NRDC) and has been studying PFAS throughout her career. Along with their many uses PFAS have been linked to serious health issues, including cancer and reduced vaccine effectiveness. The NRDC advocates for banning non-essential uses of PFAS and encourages public awareness and involvement in regulatory efforts. Dr. Pelch shares with us the prevalence of PFAS, its dangers, and the regulation or lack thereof.

 Key Takeaways:

• When you heat the nonstick cookware above a certain temperature, some of the PFAS can migrate from the pan and into the food you’re going to eat, or they could enter the air that you breathe.

• Exposures from the air that we breathe and from our skin have generally been less well studied, but there is evidence to suggest that PFAS do enter our skin.

• Per the CDC, at least 98% of people in the United States have PFAS in their bodies. 

• The EPA stepped up in a big way this year by finalizing the regulation of six PFAS in drinking water. This ban was preceded by many states proactively setting enforceable limits to PFAS in drinking water, some banning the unnecessary use of them entirely by 2032. 

"Not only are PFAS persistent in the environment, but they're also persistent in our bodies, and in most cases, we don't have a great way to get PFAS out of our bodies. So the two most highly studied PFAS can last in our bodies for years." —  Dr. Katie Pelch

Episode References: 

• Dark Waters: https://www.imdb.com/title/tt9071322/ 

• The Devil We Know: https://www.imdb.com/title/tt7689910/ 

• Environmental Working Group: https://www.ewg.org/ 

• PFAS Exchange: https://pfas-exchange.org/ 

Connect with Dr. Katie Pelch:

Professional Bio: https://www.nrdc.org/bio/katie-pelch 

LinkedIn: https://www.linkedin.com/in/katiepelch 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.  

In this episode, Therese Markow and Dr. Alex Hinton explore the potential for genocide in the U.S., highlighting historical and contemporary atrocities. Dr. Hinton emphasizes that genocide can target groups based on social constructs such as race, gender, and sexuality, among others. They discuss the rise of white supremacism and hate speech, and Dr. Hinton identifies risk factors such as political upheaval, economic instability, and armed militias. Dr.Hinton also stresses the importance of critical thinking and depolarization to prevent genocide, and suggests an easy way for everyone to do so without committing 40 hours per week to stay abreast of all of the issues and topics. 

 Key Takeaways:

• Genocide and mass violence are not typically planned from the beginning. They often evolve from other behaviors stemming from upheaval and past atrocities, scapegoating, grievance, and legitimation of formed hierarchies. 

• Hate speech is everywhere—left, right, and center. Wherever someone is on the political spectrum, they can agree it's bad. The problem is that people sometimes disagree about what constitutes it. 

• People are busy. Trying to keep informed can be a full-time job. One little thing everyone can do pretty easily to begin to do this in general, as we enter the political cycle, just pick a left-leaning, more centrist, and right-leaning news media source then on the top of the hour, turn on the TV, and flip between them and see the headlines.

"Ideology is central to all genocides, in some sense. Ideologies provide legitimation to disempower groups, and to legitimate different forms of hierarchy within a society and in the extreme. That then lays the basis for saying that groups are inferior." —  Dr. Alex Hinton

Episode References: 

• We Charge Genocide - The 1951 Black Lives Matter Campaign: https://depts.washington.edu/moves/CRC_genocide.shtml 

• 2019 Citizenship Amendment Act: https://www.uscirf.gov/resources/factsheet-citizenship-amendment-act-india 

Connect with Dr. Alex Hinton:

Professional Bio: https://sasn.rutgers.edu/alex-hinton

Twitter: https://x.com/AlexLHinton  

Center for the Study of Genocide & Human Rights: https://x.com/Rutgers_CGHR 

Check out Dr. Hinton’s writings mentioned in this episode: 

• It Can Happen Here: White Power and the Rising Threat of Genocide in the US: https://www.amazon.com/Can-Happen-Here-Rising-Genocide-ebook/dp/B08L9JHRN6 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

In this episode, Therese Markow and Dr. Alex Hinton discuss the complexities of genocide, its definitions, and the role of perpetrators. Dr. Hinton gives us the conventional, legal, and social scientific definitions of genocide and gives examples of how these affect the legal battles and social impact of different incidents, highlighting the Khmer Rouge mass killings in Cambodia. They also discuss the moral and legal implications of perpetrators and why none of us can be complacent in our understanding of genocide.

 Key Takeaways:

• There are three main definitions of genocide. Most recognize it as mass deaths, often perpetrated by a state figure. The UN legal definition requires intent. And the social scientific definition expands beyond the UN definition.
• While genocide is an atrocity, not all atrocities are genocides. Similarly, not all mass murders are genocides.
• When legally looking at the genocide perpetrators, the courts typically go after the architects and lower-level individuals are often brought in as witnesses. However, the question of who the perpetrators are is a moral and ethical question still being debated.
• Education is key - the dynamics that gave rise to Auschwitz are all around us and we are all part of them. We must be self-critical, reflexive people as a first step to make sure that we don’t have a recurrence.

"It's a potentiality that exists for ourselves and for our societies. You know, it's not comfortable. Many people will say ‘no,’ but that's the starting point of prevention, because only when you have that realization can you effectively begin to take action to stop genocide from taking place." —  Dr. Alex Hinton

Episode References:

• Ordinary Men: Reserve Police Battalion 101 and the Final Solution in Poland by Christopher R. Browning: https://www.amazon.com/Ordinary-Men-Reserve-Battalion-Solution/dp/0060995068 
• To Save Heaven and Earth: Rescue in the Rwandan Genocide by Jennie E Burnet: https://www.amazon.com/Save-Heaven-Earth-Rwandan-Genocide/dp/1501767119/ 

Connect with Dr. Alex Hinton:

Professional Bio: https://sasn.rutgers.edu/alex-hinton

Twitter: https://x.com/AlexLHinton  

Center for the Study of Genocide & Human Rights: https://x.com/Rutgers_CGHR 

Check out Dr. Hinton’s writings mentioned in this episode:

• Why Did They Kill?: Cambodia in the Shadow of Genocide: https://www.amazon.com/Why-Did-They-Kill-Anthropology/dp/0520241797 
• Perpetrators: Encountering Humanity’s Dark Side: https://www.amazon.com/Perpetrators-Encountering-Humanitys-Stanford-Studies/dp/1503634272 
• Anthropological Witness: Lessons from the Khmer Rouge Tribunal: https://www.amazon.com/Anthropological-Witness-Lessons-Khmer-Tribunal/dp/1501765698/ 
• It Can Happen Here: White Power and the Rising Threat of Genocide in the US: https://www.amazon.com/Can-Happen-Here-Rising-Genocide-ebook/dp/B08L9JHRN6 
• Pol Pot’s Secret Prison: https://www.ronslate.com/pol-pots-secret-prison/ 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.  

In this episode, Therese Markow and Dr. Alan Rogol discuss the complexities of gender, sex, and identity in elite sports, with a focus on the societal expectations and controversies surrounding gender eligibility in sports. Dr. Rogol touches on some of the history of women’s identities in elite sports, including some from the recent 2024 Paris Summer Games. Throughout the discussion, Therese and Dr. Rogol highlight the need for inclusive politics and having a respectful approach to athletes’ identities. This is a complicated topic, still undecided as to what is fair and acceptable. 

 Key Takeaways:

• When women were allowed to compete in the Olympics, originally it was only allowed in three events: croquet, golf, and tennis. All were considered socially appropriate, with no bodily contact, and while wearing normal clothes of full, layered skirts. 

• Sex and gender are not the same thing. Gender is self-identified, an expression, and is changeable. There are also varieties of sex - sex at birth, sex of rearing, legal sex, and chromosomal sex. 

• Many of the girls who find out they have an XY chromosome after being identified as female at birth often don’t find out until later in life. Because  while they had testosterone, they also had a gene that prevented their bodies from responding to it. These girls never developed as males, and in fact went through female puberty, but lacked a uterus.

• The IOC has many drugs that are banned except for certain situations. These include testosterone, endocrine drugs, growth hormones, and insulin among others. 

"It is not the level of absolute testosterone that you have that counts. What counts is the stuff that is biologically active, and that is very complicated, and that's why numbers aren't so helpful." —  Dr. Alan Rogol

Episode References: 

• Personal Account: A woman tried and tested by Maria José Martínez-Patiño: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673605678415.pdf

• The New York Times: Running in a Body That’s My Own by Caster Semenya: https://www.nytimes.com/2023/10/21/opinion/running-body-semenya.html 

• Critically Speaking Episode 9: You Go Girl: Testosterone with Dr. Alan Rogol: https://criticallyspeaking.libsyn.com/009-dr-alan-rogol-you-go-girl-testosterone 

Connect with Dr. Alan Rogol:

Professional Bio: https://med.virginia.edu/faculty/faculty-listing/adr/ 

LinkedIn: https://www.linkedin.com/in/alan-rogol-49b18018/ 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

In this episode, Therese Markow and Dr. Charles Easley IV discuss the significance of a father’s lifestyle before conception and its effects on prenatal development. This comes about not by mutations in the sperm DNA, but through heritable changes in the way the father’s genes are turned on and off during the development of the fetus.  THese changes are referred to as epigenetic. So it’s not just about the mom, They thus explore the paternal origins of health and disease, highlight animal studies and human cohort studies that demonstrate intergenerational transmission of epigenetic changes, and discuss the dangers of toxic chemical exposure on male sperm.

 Key Takeaways:

• To study the paternal effects on the fetus, we are able to do animal studies in the lab, however, for human studies, we can only study in cohorts after the fact, such as with the Dutch Famine, Michigan PBB, or, lately, the effects of COVID-19.

• Gary Miller is one of the leaders studying how paternal exposure prior to conception can have profound effects on the lifespan and healthy aging of future offspring.

• While we cannot pinpoint all the chemicals as having a lasting effect yet, it is important to try to be as healthy as you can. Certain chemicals, such as BPA and certain pesticides, have been studied to have an effect.  And not just the mother during pregnancy.

"We've got a lot more evidence to suggest that what the father does prior to conception can have a profound effect on the genes that are expressed during development, and can have profound effects on how these organs develop in the offspring." —  Dr. Charles Easley IV

Episode References: 

• The Dutch Famine Birth Cohort: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934722/ 

• The Michigan PBB Cohort: https://stacks.cdc.gov/view/cdc/3929/cdc_3929_DS1.pdf 

• The Poisoning of Michigan by Joyce Egginton: https://www.amazon.com/Poisoning-Michigan-Joyce-Egginton/dp/0870138677 

Connect with Dr. Charles Easley IV:

Professional Bio: https://publichealth.uga.edu/faculty-member/charles-a-easley/ 

Website: https://www.easleylab.com/ 

Email: [email protected] 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

In this episode, Therese Markow and Dr. Daniel Aaron discuss the inadequate oversight of food additives by the FDA, particularly the agency's GRAS or “Generally Recognized as Safe” process, which allows unsafe additives to reach the market without proper scrutiny. Dr. Aaron highlights industry conflicts of interest, the lack of reporting requirements, the need for stricter regulation to protect public health, and discusses what is needed for the FDA to be better able to make impactful changes. 

 Key Takeaways:

• The majority of food additives in the US are not vetted by the FDA. Since 1958, food additives have been presumed safe until proven otherwise. 

• The Clean Eating movement in the US is indicative of the skepticism of the American food supply. 

• While the FDA used to maintain a list of GRAS substances, today, reporting to the FDA is not required. 

• Europe uses a more precautionary approach to food additives. The EFSA must approve all chemical substances prior to their use in foods. 

• Food additives are known to cause synergistic harm. However, the FDA poorly regulates single additives so it is not surprising that its consideration of interacting chemicals is insufficient.

"The FDA is the most accountable to corporate power. The largest impediment, in my view, to food regulation is funding. FDA’s Food Center has been underfunded for decades. Further funding from Congress is needed, but our legislators often are supported by industry that doesn't necessarily want a more robust review of food additives." —  Daniel Aaron, M.D., J.D.

Episode References: 

• Bystanders to a Public Health Crisis: The Failures of the U.S. Multi-Agency Regulatory Approach to Food Safety in the Face of Persistent Organic Pollutants by Katya S. Cronin: https://scholarship.law.gwu.edu/faculty_publications/1725/ 

• EFSA: https://www.efsa.europa.eu/en 

• FDA Food Center: https://www.fda.gov/food 

Connect with Daniel Aaron, M.D., J.D.:

Professional Bio: https://faculty.utah.edu/u6052921-DANIEL_G_AARON/hm/index.hml 

Email: [email protected] 

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: [email protected]

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.