In this episode of The Right Idea, TPPF's Brian Phillips and Derek Cohen break down how political activism has seeped into Texas healthcare — influencing diagnoses, treatments, and public policy.

They’re joined by Dr. Lisa Ehrlich, internal medicine physician and former TMA trustee, and Joseph Figliolia, Manhattan Institute policy analyst and author of a major report on the TMA’s drift into ideological advocacy.

Together, they examine:
* How the TMA embraced gender-affirming care despite weak evidence
* Why many physicians feel silenced
* How institutional capture happens inside medical organizations
* The impact on children, parents, lawmakers, and the practice of medicine
* What reforms are needed to bring medicine back to evidence-based practice

00:30 – Thanksgiving politics & family discussions
03:40 – Today’s topic: Gender ideology in healthcare
05:18 – Guest introductions: Dr. Ehrlich & Joseph Figliolia
05:42 – Why Joseph investigated the TMA
07:23 – Is the TMA doubling down despite national pushback?
09:07 – Evidence problems & reversals in Europe
10:25 – Dr. Ehrlich: What clinicians saw on the ground
11:38 – Social contagion & the rise of gender questioning
13:12 – Vulnerable populations & patterns emerging
14:58 – Why endocrinology led the shift
16:02 – “Science by consensus” and activist medicine
17:36 – The problem with WPATH & activist guidelines
18:33 – How TMA was captured: institutional mechanics
19:23 – Why doctors stay silent
20:57 – Fear of being labeled discriminatory
22:08 – Dr. Ehrlich: Intimidation inside the TMA
23:56 – Identity sections and cultural politicization
25:05 – Personal attacks vs scientific debate
26:31 – Medicine requiring ideological pre-commitments?
27:55 – Historical parallels (e.g., lobotomies)
28:58 – Pandemic mandates & ethical shifts
31:09 – Three separate issues: dysphoria, treatment, ideology
32:57 – Suicide risk, treatment failures, evidence gaps
34:18 – Is someone funding this movement?
36:01 – TMA’s definitions avoid “gender dysphoria” entirely
37:44 – The financial incentives behind affirming care
38:39 – Do associations influence medical boards?
41:15 – How TMA influences Texas policy
42:07 – Is Texas protecting kids effectively?
43:30 – Evidence-based standards being ignored
44:56 – CME problems: outdated, debunked studies
45:14 – Can the TMA be fixed?
47:34 – Structural governance problems
49:24 – What shoe drops next?
51:07 – The comprehensive HHS gender dysphoria review
51:35 – Dr. Ehrlich’s advice for physicians afraid to speak up