Aaron Kimberly is a mental health clinician with longtime experience providing care to transgender and gender questioning patients. He is also a trans man who made his transition fifteen years ago. In recent years, he has been speaking out against what has become the prevailing wisdom and standard protocol in transgender medicine: that people identifying as transgender, even adolescents and sometimes children, effectively “know who they are” and have a right to begin hormone therapy without comprehensive psychological assessment. Known as the affirmative care model, this approach has been promoted by activists and largely embraced by the medical establishment and the mainstream media. In many cases, the alliance with that approach comes from a fear of being labeled transphobic or of “gatekeeping.” But as listeners of The Unspeakable know, the issue is far more layered and complex than the many people in general public—and even many well-meaning health care providers—realize. On the heels of a January 13, 2022 New York Times story, which for the first time gave credence to the idea that the affirmative care model might not be the best approach for young people (and which featured two time Unspeakable guest Dr. Laura Edwards-Leeper), Meghan returns to the topic to speak with Aaron about what’s gone awry in gender medicine and why so few people have been willing to talk about it.

Guest Bio: Aaron Kimberly is (by his own terms) a transsexual man, born female with a rare ovotesticular intersex condition. He’s worked as a mental health clinician since 2008 in hospital and community settings. In 2021 he founded the Gender Dysphoria Alliance to educate about different types of gender dysphoria from an evidence base, without the lens of political ideology. He is also co-host of the Transparency podcast.