Gender: A Wider Lens

Sasha and Stella sit down to discuss their thoughts and reflections on the Pioneer interviews they’ve conducted so far in the series. This analysis attempts to synthesize what they’ve learned, what differences in perspective they hold compared to their previous guests, and reiterate the importance of these discussions within the wider context of childhood transition, scientific inquiry, and deep exploration of all things gender.

Links:

Butch Identity Development

Extended Notes

• Sasha and Stella give a mid-series update on some of the thoughts they have had so far and talk about the range of guests they've had on.
• This series started with a bang with Dr. Paul Vasey and his research in Samoa.
• Is it more acceptable now for women to socially transition?
• Our society is obsessed with femininity. Sasha explores whether more masculine women get thrown to the wayside because of it.
• Is all of this genetic or not? Stella thinks there is a hereditary component to all of this.
• People who feel like they have a genetic mental health condition vs. an environmental mental health condition feel alienated. When it’s deemed “environmental,” it feels more human.
• Can we nurture ourselves into a different place from where we started? Stella says yes.
• Just because you are susceptible to something, doesn’t mean you will become it or that you are it.
• Where did the concept of puberty blockers come from? Why did it make sense as a form of “treatment”?
• Guest Michael Bailey had some thoughts on whether it made sense for trans men to marry or have a partner.
• Can you have a successful relationship when you have autogynephilia?
• Stella knows so many functioning alcoholics. You can always live what looks like a successful life, but underneath the surface, it’s in shambles.
• Stella is curious to see if anyone is doing research behind trans porn and who is watching that.
• The whole field around children with gender dysphoria has been badly handled.
• Guest Dr. Steve Levine talked about the chain of trust researchers have with one another and how there’s very little cross-checking the actual work.
• Stella is shocked that people want to silence researchers who have dedicated the last 20‒30 years of their lives within a particular field. Why silence them?
• Guest Carole Hooven experienced sexual assault and wanted to understand, through researching monkeys, why we were aggressive to one another.
• Sasha and Stella have some interesting guests lined up for you!

This podcast is sponsored by ReIME and Genspect. Visit Rethinkime.org and Genspect.org to learn more.

For more about our show: Linktr.ee/WiderLensPod

Riittakerttu Kaltiala, M.D., Ph.D., BSc, is a professor of adolescent psychiatry in Tampere University and chief psychiatrist in the Department of Adolescent Psychiatry at Tampere University Hospital. She is a specialist in psychiatry, adolescent psychiatry, and forensic psychiatry. She has been clinically involved in carrying out research on adolescent gender identity issues since 2011 when one of the two nationally centralized gender identity services for minors was opened in Finland, in Tampere University Hospital. She has been actively involved in service development, continuing education, and scientific writing and collaboration nationally and internationally, and in her home country she has been invited as a member of major national initiatives related to transgender treatment guidelines and legislation. She has published numerous scientific articles on adolescent mental health epidemiology, psychiatric health services research, and clinical adolescent psychiatry.

Riitta tells us about the shift around 2010 in Finland in which health policymakers, politicians, activists, and human rights groups pushed for the inclusion of adolescent and child services for gender transition. The adolescent psychiatrists scrambled to accommodate these new demands but recognized that identity consolidation is known to take more time and they had concerns about such early interventions. Nevertheless, they began developing a program for childhood gender services based on the literature in other countries such as the UK and Netherlands. They were astonished and quite confused when the populations arriving at their services reflected a very different demographic in age, sex, and presentation of other comorbid psychiatric issues. They saw a shift again around 2015 which continued to confound the clinicians. Riitta tells us about reading the Littman ROGD research which accurately documented what she and colleagues were seeing. Dr. Kaltiala also tells us that predictions of improvement and symptom reduction reflected in the Dutch literature were not observed in their work, and describes how Finland has moved towards prioritizing psychological care and meeting all the needs of young patients who present with GD, rather than focusing only on the gender transition requests.

Links:

Dr Kaltiala’s Website:

Riittakerttu.fi

Adolescent GD Current Perspectives:

Ncbi.nlm.nih.gov/pmc/articles/PMC5841333

Lisa Marchiano — Outbreak:

Tandfonline.com/doi/full/10.1080/00332925.2017.1350804

GD and ASD: A Narrative Review

Pubmed.ncbi.nlm.nih.gov/26753812

Extended Notes

• Riitta talks about how she got into psychiatry and got to work in this field.
• When did Riitta first come across gender identity? She shares the backstory.
• Riitta talks about how it was decided in Finland in 2009 that children and adolescents also needed gender medical intervention. What was the motivation behind this?
• It is during adolescence that young people seek and experiment with their identity. However, it is normal for them to change or evolve in 2‒3 years. It is part of the process of stabilizing their identity.
• It’s hard to expect in adolescent psychiatry during the early phases of adolescent development that the person would already be ready with any aspect of identity.
• In the beginning, most of society did not have an idea about gender identity issues so it was not discussed much, including in the medical
  
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Ray Blanchard was the psychologist in the Adult Gender Identity Clinic at the Clarke Institute of Psychiatry 1980–1995. Much of his research in those 15 years concerned transsexualism and milder forms of gender identity disorders. In 1995, he was appointed Head of the newly created Clinical Sexology Services at the CAMH. This unit comprised the Adult Gender Identity Clinic and the Kurt Freund Laboratory, the latter being the oldest laboratory in North America for the psychophysiological assessment of erotic interests in sexual offenders and other men with problematic sexual behavior. Blanchard retired from the CAMH in 2010. Since his retirement, he has continued to be active in research on human sexuality, often in collaboration with former students, colleagues, and their students.

Today, Ray tells us how he got into the field, as he was primarily interested in conducting sex research. And then he found himself in a gender identity clinic. He got interested in boiling down the cumbersome and sprawling categorizations of gender dysphoria and deemphasizing women’s clothing. He wanted to uncover the wider framework that explains a variety of behaviors for dysphoric males. The term autogynephilia was born. Ray describes common misunderstandings about the term and addresses some myths about AGP, clusters of behavior, and what he calls “erotic mislearnings.”

Links:

Dr. Blanchard’s Publications

Men Trapped in Men’s Bodies: Narratives of Autogynephilic Transsexualism, by Anne Lawrence

The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism, by J. Michael Bailey

Extended Notes

• A little bit about Ray and why he decided to work in sexology.
• What kind of classifications were there at the time for “transsexualism”?
• From 1980 to 1995, the females who wanted to transition in Ray’s clinic, all of them were attracted to other females.
• Ray talks about his observations with his patients that had autogynephilia and some common themes he saw within this group.
• Ray suggests listeners watch the difference in manners between Blaire White and Caitlyn Jenner.
• Ray shares his experiences in this field and how it’s changed throughout the years.
• Did Ray ever receive backlash for his work?
• Ray doesn’t believe there’s a connection between sexual abuse and gender dysphoria.
• Are male-to-female transexuals more likely to be pedophiles? Ray says no.
• Can autogynephilia be passed down to children? Is this genetic?
• Sasha wonders if it was easier to get the truth out of the patient back then vs. now; a time where people have an agenda to prove they’re trans.
• Having one erotic paraphilia tends to predispose you to other paraphilia. It’s not just an “autogynephilia” thing.
• Ray shares his thoughts on why pedophiles become pedophiles.
• What are some of the misconceptions of autogynephilia?
• Out of Ray’s clinical practice, only two women stood out as different from a gynophile.
• How come so many males transitioned in their late 40s?
• Ray shares his thoughts on trans widows and how they must be feeling when their partner comes out as trans.

This podcast is sponsored by ReIME and Genspect. Visit Rethinkime.org and Genspect.org to learn more.

For more...

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com

Dr. Steve Levine is Clinical Professor of Psychiatry at Case Western Reserve University School of Medicine.  He is the sole author of several books: Sex Is Not Simple in 1989 (translated to German in 1992 and reissued in English in 1997 as Solving Common Sexual Problems); Sexual Life: A clinician’s Guide in 1992; Sexuality in Mid-Life in 1998 and Demystifying Love: Plain Talk for the Mental Health Professional in 2006; Barriers to Loving: A Clinician’s Perspective in 2013; Psychotherapeutic Approaches to Sexual Problems: An Essential Guide for Mental Health Professionals in 2020.

Dr. Levine is also the Senior Editor of the first (2003), second (2010), and third (2016) editions of the Handbook of Clinical Sexuality for Mental Health Professionals. He has been teaching, providing clinical care, and writing since 1973 and has generated original research, invited papers, commentaries, chapters, and book reviews. He has served as a journal manuscript and book prospectus reviewer for many years. He was co-director of the Center for Marital and Sexual Health/Levine, Risen & Associates, Inc. in Beachwood, Ohio from 1992-2017. He and two colleagues received a lifetime achievement Masters and Johnson’s Award from the Society for Sex Therapy and Research in March 2005.  He was given his Department of Psychiatry’s Hall of Fame  Award in 2021.

In our conversation, Stephen is posed the question: Why are we so prone to reductionism in our thinking about transition and gender? He explains the “chain of trust” in medical school training and academia and how it can lead to a broken system and low-quality procedures being used on a massive scale. Additionally, Dr. Levine’s deep perspective on love, intimacy, and what makes us human reflects the great wisdom he has gained from over fifty years working as a psychiatrist.

Links:

Solving Common Sexual Problems (1997), by Stephen Levine

Sexual Life: A Clinician’s Guide (1992), by Stephen Levine

Sexuality in Mid-Life (1998), by Stephen Levine

Demystifying Love: Plain Talk for the Mental Health Professional (2006), by Stephen Levine

Barriers to Loving: A Clinician’s Perspective (2013), by Stephen Levine

Psychotherapeutic Approaches to Sexual Problems: An Essential Guide for Mental Health Professionals (2020), by Stephen Levine 

Extended Notes

• Stephen was first introduced into this field by a suicidal man who wanted to become a woman.
• Despite working with this person for a number of years, she later did commit suicide.
• Sixty-three percent of teenagers now identify as a non-binary person.
• It seems now that if you claim a trans identity, your childhood, your backstory, is totally...
  
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Dr. Zucker is a registered clinical psychologist in Ontario. He received his Ph.D. at the University of Toronto in Developmental Psychology in 1982. He is a Professor (Status Only) in the Department of Psychiatry, University of Toronto, and in private practice. He was the Chair of the 2013 DSM-5 Work Group on Sexual and Gender Identity Disorders. He is a past President of the International Academy of Sex Research and has been the Editor of Archives of Sexual Behavior since 2002. Since 1976, Dr. Zucker has worked clinically with children and adolescents with gender dysphoria and their families. His research spans a variety of areas, including epidemiology, diagnosis, and assessment, associated mental health challenges, causal mechanisms, and long-term follow-up.

In our discussion, Ken describes the early years of working with childhood gender issues starting in the 1970s. We talk about the changes he’s seen in the kinds of kids, families, and therapists in the field. Politics has always been present in the world of gender identity treatment, but this came to a head for Ken when he was fired from his position at the CAMH hospital in Toronto 2015 after activists made some wild accusations and hospital administrators became fearful for their positions. After a three-year legal battle, he was finally vindicated and compensated. Even with his decades of leadership in the field, Zucker was not protected from this early cancel-culture manifestation. We talk about what his story means for individuals in practice and the field more broadly.

Links:

Dr. Zucker’s Website: 

Kenzuckerphd.com

Sexual Identity Conflict in Children and Adults: 

Amazon.com/Sexual-Identity-Conflict-Children-Adults/dp/071560774X

Extended Notes

• Ken talks about how he accidentally got into the studies of gender identity disorders.
• He shares about when he met Sue Bradley and joined her gender identity clinic for children and adolescents at the Clark Institute of Psychiatry in Toronto that she just started in the early ’70s.
• What was it like working with this study, it being taboo at the time?
• Ken also talks about the parents that brought their children to their clinics. What led them to seek help?
• Anxiety about sexual orientation is still an issue that many parents struggle with.
• Ken shares the shift in focus of their research studies from the ’70s to the early 2000s between children and adolescents.
• How much impact do social media and the internet have with rapid onset gender dysphoria? Ken also shares his insights on this.
• Ken talks about his experience and the various views of the subcommittees within the DSM (Diagnostic and Statistical Manual of Mental Disorders) during his involvement with them.
• Ken gets into more details when their clinic got closed in 2015, being one of the early targets of cancel culture.
• With newer administrative heads in their child program, the criticisms they received in 2015 would have been taken differently if it was still managed with Sue Bradley and their former bosses.
• Ken shares what were his thoughts at this time. Did he think that his career would be ruined thereafter?
• Ken also talks more about the lawsuits he then filed against newspapers, the hospital, and one of the administrators of their program due to libelous comments and defamation, among other things.
• People being accused of things and these things going viral get them canceled as opposed to having an exchange of ideas has become a pervasive issue in the last years.
• Ken also shares his interactions with both new and old colleagues and how they fear for their...
  
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