In this episode, we speak with Joe Figliolia, author of the Manhattan Institute’s new report on institutional capture inside the Texas Medical Association, and Dr. Lisa Ehrlich, who has seen that reality up close. We revisit the AAP’s 2018 Rafferty policy, walk through Texas SB 14, and note the latest news of a Texas doctor losing her license under the new law.

From Ignaz Semmelweis to the mechanics of trade guilds, 501(c)(6)s, and runaway diffusion, we trace a recurring pattern: when ideology replaces evidence, institutions fail—and vulnerable patients pay the cost. We close with a reflection on Five Days at Memorial and what happens when no one in the room is allowed to say “stop.”

Links & References

* Deep Dive — Texas Medical Association / Institutional Capture • Article page: https://manhattan.institute/article/the-anatomy-of-institutional-capture-gender-medicine-policy-and-the-texas-medical-association

* AAP / Jason Rafferty (2018) Policy Statement• AAP journal page: https://pubmed.ncbi.nlm.nih.gov/30224363/

* Texas Law — SB 14 (Final Enrolled Text)• Official Texas Legislature PDF: https://capitol.texas.gov/tlodocs/88R/billtext/pdf/SB00014F.pdf

* Texas Doctor Licensing News • Texas OAG Press Release: https://www.texasattorneygeneral.gov/news/releases

* Ignaz Semmelweis (history of hand-washing and medical resistance)• NPR/PBS feature: https://www.pbs.org/newshour/health/ignaz-semmelweis-doctor-prescribed-hand-washing

* Trade Guild (definition)• Britannica: https://www.britannica.com/topic/guild

* 501(c)(6) Overview• IRS: https://www.irs.gov/charities-non-profits/other-non-profits/irc-501c6-organizations

* “Runaway Diffusion” • Diffusion of Innovations (Everett Rogers reference gateway): https://journals.sagepub.com/home/sgo

* Book — Five Days at Memorial (Sheri Fink)• Publisher page: https://www.penguinrandomhouse.com/books/213878/five-days-at-memorial-by-sheri-fink/

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In this week’s Informed Dissent—our first real fall episode—Jamie Reed, Lauren Leggieri, and Cori Cohn take a darker turn, exploring how speech—whether protected, restricted, or weaponized—shapes the moral landscape of medicine, therapy, and the digital world.

Our two deep dives reveal that speech isn’t an abstract legal theory—it can be tied to real harm. First, we examine the Chiles v. Salazar case and the Washington Free Beacon report, “The Problem With Conversion Therapy Bans.” We discuss why therapists should be held to standards that prevent abuse, but why those same regulations must never conflate honest, exploratory therapy with coercive “conversion” practices.

Then we turn to The Washington Post’s devastating piece, “White Tiger 764,” a story of digital predation, manipulation, and cruelty that shows how words—and silence—can both destroy.

From therapy rooms to Discord servers, this episode asks: when do words heal—and when do they harm? As autumn settles in, we look unflinchingly at the cost of speech, censorship, and what happens when comfort replaces truth.

🔗 Resources & Mentions

* The Problem With Conversion Therapy Bans — Washington Free Beacon

* Teen’s Live-Streamed Suicide Set Off Exhaustive Search for “White Tiger” — The Washington Post

* Chiles v. Salazar (Colorado Supreme Court, 2025)

* “Lolcows” — a term from harassment forums like Kiwi Farms referring to individuals targeted and mocked for amusement or ideological reasons.

* “Hug box” culture — insular online spaces that offer constant affirmation but little accountability, leaving users more isolated and susceptible to manipulation.

* Etsy’s Rules for Minors:

* Terms of Use — users must be 18+; minors (13–17) may participate only under direct parental supervision.

* Can Minors Sell on Etsy? — minors must operate under a parent’s registered account and disclose supervision.

* Imagery of Minors Policy — prohibits nude, partially nude, or suggestive images of minors.

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What should count as a mental disorder—and who gets to decide? In this week’s deep dive, Jamie Reed, Lauren Leggieri, and Cori Cohn examine how the DSM (Diagnostic and Statistical Manual of Mental Disorders) became one of the most politicized documents in modern medicine. From the pathologizing of homosexuality to today’s debates over “gender dysphoria,” the hosts explore how psychiatric labels have shaped medicine, culture, and identity itself.

Recorded in the wake of the 2025 SEGM Conference in Berlin and the Genspect Conference in Albuquerque, this conversation looks at competing proposals for a new diagnosis—or whether “gender-related distress” belongs in the DSM at all.

Jamie and Lauren join from the road while traveling through the Pacific Northwest on their speaking tour.

Drawing on insights from leading critics of psychiatry, including Dr. Paul McHugh and Dr. James Davies, the hosts trace how clinical consensus replaced scientific rigor—and how ideology continues to define what counts as care.

They also discuss what “bad therapy” really looks like and why the cell phone generation faces unique psychological challenges that psychiatry has yet to understand.

Links for Show Notes:

SEGM

SEGM 2025 Conference, BerlinSept. 11-14th, 2025https://segm.org/Berlin-2025

Dr. Paul McHugh

The Psychiatrist Who Shut Down America’s First Gender Clinic Speaks OutInterview of Dr. Paul McHugh, University Distinguished Service Professor of Psychiatry at Johns Hopkins University School of MedicineBeyond Gender podcastJul 17, 2025

“Psychiatry is a discipline that’s not come of age.” - Dr. Paul McHugh

(48:46)

Notable fact: Dr. McHugh (1931–) co-founded the U.S.-based FMSF in 1992 to support families accused of abuse via “recovered memories,” often critiquing psychotherapy techniques for inducing false memories. The FMSF dissolved in 2019, after completing its contributions to the 1990s “memory wars” in therapy and legal contexts.

Dr James Davies

AD4E Festival - Dr James Davies - The Making of DSM.ADisorder4Everyone YouTube ChannelSep 25, 2020Dr. James Davies, accredited U.K. psychotherapist and professor of Social Anthropology and Mental Health at the University of Roehampton, London, presents at the ‘A Disorder For Everyone’ online festival, held September 18, 2020. The making of DSM. Dr. Davies is co-founder of CEP (The Council for Evidence-based Psychiatry).

CEP (The Council for Evidence-based Psychiatry)

Diagnostic system lacks validity

Statement: “Psychiatric diagnostic manuals such as the DSM and ICD (chapter 5) are not works of objective science, but rather works of culture since they have largely been developed through clinical consensus and voting. Their validity and clinical utility is therefore highly questionable, yet their influence has contributed to an expansive medicalisation of human experience.”https://cepuk.org/unrecognised-facts/diagnostic-system-lacks-validity/

Psychiatry & Big Pharma: Exposed - Dr James Davies, PhDThe Weekend University

“by reclassifying painful normality as psychiatric abnormality we have created the illusion of a psychiatric epidemic” -- Dr. James Davies

(3:07)

Regarding Dr. Robert Spitzer & DSM 3, 4, 5

Stella O’Malley and Mia Hughes Recount Robert Spitzer-Led Updates to the DSMBeyond Gender Podcast, Clip from Episode #18https://x.com/stellaomalley3/status/1937598587157852616

During his presentation at the A Disorder 4 Everyone! (AD4E) Festival, Dr. Davies recounts his interview with Dr. Robert Spitzer (chairperson of DSM-III) regarding the lack of biological basis and reliance on consensus for DSM disorders:

(14:06)

An Orchestrated Consensus becomes “Clinical Consensus”

“we took over because we had the power” - Robert Spitzer

(30:00)

Mia Huges at Genspect

“The Upstream Battle: Challenging the False Belief Fueling Medical Harm” Mia HughesPresentation at the 2025 Genspect The Bigger Picture Conference, Albuquerque, NM

Cori Cohn at Genspect

The recording of his speech has not yet been released. As soon as it is we will include the link in a future episode.

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Relaunch: Introducing Lauren Leggieri

Welcome to the relaunch of Informed Dissent! Each week, your hosts — Jamie Reed, Lauren Leggieri, and Cori Cohn — cut through the noise of the gender culture wars, tackling the stories behind lawsuits, medical controversies, school policies, and the very meaning of “gender.”

In this episode, Jamie introduces new co-host Lauren Leggieri. Lauren reflects on the moments that shaped her advocacy — from the Gavin Grimm Case in Virginia to early protests at the Endocrine Society Conference and the American Academy of Pediatrics Conference in Orlando.

She shares her experiences of being “canceled,” landing on the Transgender Map, and featured in Jennifer Block’s recent documentary. For Lauren, embracing her role as a gender non-conforming lesbian and emerging as an effective advocate has been a defining part of her journey.

Next week: A Tale of Two Conferences — Society for Evidence Based Gender Medicine and Genspect, and the battle over what belongs in the DSM, and who actually has a say over that determination.

Enjoy the show and we welcome your comments below!

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Production or subscription questions or concerns:

Email [email protected] with “Informed Dissent” in the subject line.

In this episode, Cori and Ben take the mic without their cohosts to reflect on two pressing stories shaping the gender debate. We begin with former Mermaids CEO Susie Green’s latest effort to advance the cause of medical transition for children. From there, we turn to the recent tragedy in Minneapolis, examining how quickly it has become a political football for competing ideological tribes. What does this moment reveal about the trans movement today? And how do these flashpoints illuminate the wider struggle over truth, narrative, and power in the culture war?

* The Webberleys

* Susie Green’s TEDx talk

* Minneapolis shooting

* “Tired of being trans”

* Westman’s history

In this episode, we discuss the activist-led campaign to discredit systematic reviews conducted by researchers at McMaster University because they were funded by SEGM (the Society for Evidence-Based Gender Medicine). We examine the researchers’ response, whether the campaign gained traction, and what it reveals about the politicization of evidence.

From there, we step back to look at the broader landscape of systematic reviews on “gender-affirming care”—and whether the American public realizes just how weak the evidence base actually is. This naturally brings us to the University of Utah’s August 2024 review, which claimed that the evidence shows these interventions to be safe and effective. We break down what the Utah review got wrong and why its conclusions stand in sharp contrast to other systematic reviews.

Links:

McMaster statement

Gordon Guyatt

“No pride in pseudoscience” op-ed

WPATH suppresses publication of Hopkins reviews

SEGM - Utah report

Handmaid’s Tale season 6

The Human Scale

Wardley mapping

Alien Earth

Today, Corinna and Ben speak with the psychiatrist Dr. Lauren Schwartz. Dr. Schwartz is a senior fellow with Do No Harm, the lead author of a 2025 paper on the health risks of estrogen use in males, and the coauthor of a chapter in Lawrence Krauss’s new anthology, The War on Science (“Gender-Affirming Care: The Abandonment of Medical and Academic Standards”).

* Arkansas ban stands

* Air Force reneges on retirement benefits

* DoE investigates Kansas

* “Emerging and accumulating safety signals for the use of estrogen

among transgender women”

* The War on Science

Today we talk about the latest gender clinic closures and “pauses” on pediatric transition services and speculate about what the future holds for the young people who’ve been harmed by these practices. Who’s going to help them? How will they help them? Will anyone be held accountable for harming them? We discuss the case of Avery Jackson, the trans-identified boy who at age nine appeared on the cover of National Geographic’s 2017 “Gender Revolution” issue. Avery, medicalized at 11, is now in his late teens and identifies as nonbinary.

If you enjoyed this episode, please consider becoming a paid subscriber!

* Leor’s piece on Meredithe McNamara

* Lisa’s piece on Avery Jackson

* “Gender Identity 5 Years After Social Transition”

* “I Transitioned My Child - I Regret It”

* NY Times article on blue state closures

* Chameleon’s Substack piece

* Ken Zucker

* My Mom Jayne

* Sandpipers

* Albion’s Seed: Four British Folkways in America

* Kandinsky art

* The End of October

Today the gang discusses the Trump Administration’s severing of its partnership with the Trevor Project, as well as California Governor Gavin Newsom’s recent appearance on the Shawn Ryan Show. Plus news headlines, announcements, and more!

* Trump defunds the Trevor Project

* TP’s 2023 fiscal report

* Trump Admin cutting off federal funding to hospitals providing GAC for minors

* Newsom on the Shawn Ryan Show

* “Trans woman shares struggles from behind bars in Lorain County men’s prison”

* PATHWAYS study

* Cis White Gay: The Making of a Gender Heretic

Thank you for your continued support!

Cori, Jamie, and Sarah catch up on their gender-related travels, which took Jamie to Washington DC for the Federal Trade Commission workshop on consumer fraud in gender medicine and Cori and Sarah to France for the European Society for Child and Adolescent Psychiatry conference. We also discuss new research on sexual satisfaction and whether or not it's possible to improve on the French man-on-the-street by adding cowboy boots.

* Tune in to the full FTC workshop here

* Glenna Goldis on consumer fraud in gender medicine

* Hannah Barnes on problems with the UK's proposed puberty blocker trial

* Cori Cohn on Missing Evidence: Why We Still Don’t Know What Surgery Does to Puberty-Blocked Boys

* New preprint from the Dutch clinic: Sexual satisfaction and dysfunction in transgender adults following puberty suppression treatment during adolescence

* LGB Courage Coalition at the Endocrine Society conference