Jesse Singal: Should Kids Medically Transition?

Jesse Singal questions the science of "gender-affirming care."

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Jesse Singal: Should Kids Medically Transition?

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Should kids medically transition between genders?

The number of kids diagnosed with gender dysphoria has surged in recent years. In America, diagnoses have almost tripled from about 15,000 to more than 42,000 from 2017 to 2021. In the United Kingdom, the number of minors referred to the national Gender Identity Development Service grew from 51 in 2009 to 1,766 by 2016, leading to yearslong waitlists for care within the government-run health system.

This surge caused England's National Health Service to commission an extensive study of youth gender treatment. That study is known as the Cass Review, and its results dropped on April 10. The review's author, former head of the Royal College of Paediatrics and Child Health Hilary Cass, concluded that modern youth gender dysphoria interventions are informed by "remarkably weak evidence" drawing on studies "exaggerated by people on all sides of the debate to support their viewpoint" and that "we have no good evidence on the long-term outcomes of interventions to manage gender-related distress." The science, it turns out, is not settled—or anywhere close to it.

NHS England opted to stop routine prescriptions of puberty blockers following the review's publication, as have NHS Scotland and the Welsh government. Major American medical groups such as the American Psychiatric Association, American Medical Association, and American Academy of Pediatrics, all of which endorse prescribing puberty blockers for gender-dysphoric kids, have yet to officially respond.

American media coverage of the Cass Review, which could throw the entire youth gender treatment paradigm in this country into question, has been remarkably muted. But today's guest is never muted. Jesse Singal has been covering this topic—and taken a lot of heat for it—for years in the pages of publications such as The Atlantic, The Dispatch, and on his Substack, Singal-Minded.

Watch the full conversation on Reason's YouTube channel or the Just Asking Questions podcast feed on Apple, Spotify, or your preferred podcatcher.

Sources referenced in this conversation:

1. The Cass Review
2. "Putting numbers on the rise in children seeking gender care"
3. "What Went Wrong at the Tavistock Clinic for Trans Teenagers?" | SEGM
4. "Hilary Cass: I can't travel on public transport after gender report"
5. "Mermaids' response to The Cass Review - In Depth"
6. States with legislation to curb "gender-affirming care"
7. M.P. Dawn Butler admits to misrepresenting the Cass Review

Sources referenced in Just Ask Us Questions:

1. Reason TV: "A private libertarian city in Honduras"
2. Reason TV: "Don't 'Abolish the Police.' Privatize Them."

Timestamps:

• 00:00 Introduction to the Show and Topic: Kids and Gender Transition
• 02:14 Media Coverage and Jesse Singal's Insights
• 04:50 The Impact of Social Media and Activism on Youth Gender Medicine
• 09:36 Exploring the Tavistock Controversy and Its Implications
• 12:38 The Debate on Informed Consent and Medical Ethics
• 28:37 Social Contagion Theory and Its Effects on Gender Identity
• 34:03 Scrutinizing the Science Behind Gender-Affirming Treatments
• 42:32 Navigating the Complexities of Youth Gender Medicine
• 43:03 The Role of Data and Evidence in Gender Transition Debates
• 44:34 The Impact of Politics and Misinformation on Transgender Health Care
• 47:34 Exploring the Cass Review's Recommendations on Gender Medicine
• 49:24 Comparing Gender Medicine Practices: U.K. vs. USA
• 51:25 The Influence of Activism and Politics on Medical Standards
• 55:16 Addressing the Concerns Around Puberty Blockers and Hormone Treatments
• 01:20:32 Just Ask Us Questions: A Discussion of Anarcho-Capitalist Security

• Producer: John Osterhoudt

Comments

[Longtobefree]

Should kids get tattoos?
Should kids be allowed all other elective surgery than genital mutilation?
Should kids be allowed to vote?
Should kids be allowed to drive?
Should kids be allowed to buy drugs?
Who is John Galt?

[American Mongrel]

You forgot to ask if they should be tried as adults for various crimes.
Whether they should be able to marry.
Join the military.
Log onto pornhub.
Withdraw from their IRA.
Run for President.

[MrMxyzptlk]

Should they be subjected to religious brainwashing?

[American Mongrel]

Should they be subjected to philosophical brainwashing?

[Vernon Depner]

Yes.

[Rick James]

Like Gender transition? It’s a good question. I lean “no”, but children make adult decisions all the time, so it's complicated.

[Vernon Depner]

Should murder be illegal? I lean "no", but people kill each other all the time, so it's complicated.

[Rick James]

Now you're getting it.

[MrMxyzptlk]

This is how I know you're a Republican and not a Libertarian.

Is there a direct and easily determined victim? If yes, it's a crime. If no, it's not a crime.

Murder? The dead leaking body.
Rape? The woman with the black eye and the cunt full of sperm.
Theft? The person who is missing the stuff he legally owned.
Kidnapping? The kid in the fucking cage.
Sex change surgery? Um.. well... hmm...
Selling weed? Well... society.. er... um...
Prostitution? Hmm.. society something...
Drag Queen Story Hour? But it's gross!

Get the idea?

[Mother's Lament]

children make adult decisions all the time, so it’s complicated.

Like moving in with their 42 year old boyfriend who's got a car and gives them date money and weed?

[VULGAR MADMAN]

Hmmm, can a child sue a doctor into oblivion for mutilating them?

[Vernon Depner]

There are lawsuits in the pipeline. We'll just have to wait and see.

[MrMxyzptlk]

So, do you want kids to be coddled by the government and their parents or do you want them to get experience making decisions so they can grow up to be adults who have some self reliance?

You can't have it both ways. You need to give them increasing responsibilities and liberties as they age so they learn.

[American Mongrel]

We should teach them that there is no right and wrong other than what the majority of their culture believes at a current point in time.
However, if the ascendant cultural power disagrees with that majority, then right and wrong is as defined by this new cultural elite until such a time as their beliefs are shared by the majority again.
Does that about sum up atheism?

There is no morality in the wild or in science. So fuck off with your nihilism or anarchy or whatever you're on.

Answer: the same reason we don't fuck children you amoral tard.

[Mother's Lament]

We should teach them that there is no right and wrong other than what the majority of their culture believes at a current point in time.

Fuck, we shouldn't even teach adults that, but I'm sure that Shrike will beg to differ.

[Vernon Depner]

If Shrike became convinced there was an objective right and wrong, he would have to hang himself.

[Zeb]

It's not impossible to have a strong moral sense as an atheist and I think people who claim otherwise are ignorant or lack imagination. That said, looking at how things are going, I don't know that most people really develop that sense absent some religious structure.

[Vernon Depner]

Only someone gifted with strong empathy and high intelligence is capable of being both Materialist and moral.

[Mother's Lament]

Given that most atheists are somewhere on the autism spectrum, that empathy requirement is a bit of a bear.

[MrMxyzptlk]

Well, lacking a strong moral sense I will reply, "fuck you with a running chain saw you cum guzzling slut."

[MrMxyzptlk]

Sorry, I just noticed my reply got shifted to your message. My apologies. Too late to delete it.

[American Mongrel]

For the record I don't care what you subject your offspring to.

[Vernon Depner]

So, you're a monster like Jeffy.

[Mother's Lament]

That's pretty low, man.

[MrMxyzptlk]

You really only see things in black and white don't you. If someone isn't a Republican on board with everything you believe in they are all the bad things rolled into one.

[Graf Fuddington von Fuddrick]

Like by democrats, into the Church of Progressive Orthodoxy?

[R Mac]

“Log onto pornhub”

Who tf logs into pornhub?

[JesseAz]

Hunter Biden. He spent a shit load on porn sites.

[VULGAR MADMAN]

What kind of loser pays for porn?

[JesseAz]

Maybe I was whispering. HUNTER BIDEN.

[MrMxyzptlk]

Well, if their numbers are to be believed a lot more people than admit to it.

[Gaear Grimsrud]

Whoa. Reason goes there.

[Rick James]

Yes, like questioning COVID, now that it's safe.

[Vernon Depner]

Of course not. Why even bother to discuss this, as if there were two sides? The only question is, should the "doctors" go to prison, or just into the woodchipper?

[Minadin]

Put the woodchipper in prison and sort it out later.

[MrMxyzptlk]

So, the penalty for disagreeing with you is either prison or being tossed in a woodchipper.

Well, I guess that's nice to know.

[HorseConch]

No.

[Dillinger]

>>Should Kids Medically Transition?

the question as framed is a loss.

[mad.casual]

youth gender treatment paradigm

Imagine chopping off children’s hands and referring to it as “youth carpal treatment paradigm”, much less lamenting that the Cass Report would call it into question or need to.

[Dillinger]

>>Imagine chopping off children’s hands

removed from an earlier version of the song ...

[Its_Not_Inevitable]

Imagine there's 72 genders
It's easy if you try

[Mother's Lament]

‘How many genders, Winston?’

‘Two! Stop it, stop it! How can you go on? Two! Two!’

‘How many genders, Winston?’

‘Seventy-two! Seventy-two! Seventy-two!’

‘No, Winston, that is no use. You are lying. You still think there are two. How many genders, please?’

‘Two! Seventy-two! Two! Anything you like. Only stop it, stop the pain!

Abruptly he was sitting up with O’Brien’s arm round his shoulders. He had perhaps lost consciousness for a few seconds. The bonds that had held his body down were loosened. He felt very cold, he was shaking uncontrollably, his teeth were chattering, the tears were rolling down his cheeks. For a moment he clung to O’Brien like a baby, curiously comforted by the heavy arm round his shoulders. He had the feeling that O’Brien was his protector, that the pain was something that came from outside, from some other source, and that it was O’Brien who would save him from it.

‘You are a slow learner, Winston,’ said O’Brien gently.

‘How can I help it?’ he blubbered. ‘How can I help seeing what is in front of my eyes? Male and female are two.

Sometimes, Winston. Sometimes they are five. Sometimes they are seventy-two. Sometimes they are all of them at once. You must try harder. It is not easy to become woke.’

[Graf Fuddington von Fuddrick]

And people are still reluctant to accept the necessity of getting rid of the leftists.

[ObviouslyNotSpam]

If you throw in the rightists, you've got a deal!

[MrMxyzptlk]

I'm not on board with killing people because I disagree with them.

[Vernon Depner]

removed from an earlier version of the song …

Don't worry Kyoko. Momma's only looking for her hand in the snow.

[Vernon Depner]

Let's all just stipulate air quotes around "transition".

[Zeb]

The whole idea of "affirming care" for a psychiatric disorder just seems completely backwards. You don't give affirming care to someone having a manic episode or someone who is suicidal (unless you are in Canada or Belgium I guess). You especially don't do that for teenagers. Who the fuck thinks severely depressed teenagers make good decisions about their lives?

[Moderation4ever]

Care for a psychiatric disorder can be extremely complex and difficult. Treatment us often specific to the individual. Some patient and conditions respond well to drugs, others to talk therapy, and still others to other treatments. There is no medical indicators or tests to monitor treatment for mental health condition and progress must be by assessing how the patient functions. In the case of real gender dysphoria patient improvement is seen following transition. It should be point out this improvement is not a feature of some surgical intervention and that patients may live as the trans sex without physical alteration.

Having said all this I am concerned that people are overcompensating and perhaps being too quick to label gender dysphoria. Frankly no mental health condition label whether for bipolar, depression, schizophrenia, or other conditions should be put on a patient too quickly.

[Zeb]

I'm not saying there is an easy answer to treating gender dysphoria (in fact, I think I'm saying exactly the opposite). "Affirming care" is exactly where people are pretending there is an easy answer.
And I think you are spot on in the second paragraph. I'm open to the idea that some people may be happiest pretending to be the opposite sex or taking hormones or whatever. And adults can do whatever they think is best. But applying this stuff to fucked up, depressed, angry teenagers just seems like a terrible idea. If your intent is to help them live a happy life.

[Vernon Depner]

If your intent is to help them live a happy life.

Happiness should NOT be the main goal of psychotherapy. When presented with a delusional or disassociated patient, the goal should be to get them back into contact with reality. That certainly can lead them to be LESS happy. But once they are grounded in the real world, then the aspects of their lives leading to their unhappiness can be worked on. If your life sucks, it's HEALTHY to be unhappy.

[MrMxyzptlk]

I am dying to read your definition of "reality".

[Nachtwaechter Staater]

Only you fucking progtards refuse to understand a definition of "reality".

[MrMxyzptlk]

So you can't answer the question?

[Vernon Depner]

I shan't improve on the dictionary.

[MrMxyzptlk]

"the world or the state of things as they actually exist, as opposed to an idealistic or notional idea of them."

Sound like a good definition. Not much room for the supernatural and other collective delusions. I can accept that as a definition.

When do we start deprograming the children who were indoctrinated into believing in an imaginary sky fairy and his fellow sub fairies?

[A Cynical Asshole]

...applying this stuff to fucked up, depressed, angry teenagers just seems like a terrible idea. If your intent is to help them live a happy life.

Perhaps the intent isn't really to help them live a happy life?

[MrMxyzptlk]

Unfortunately kids are the ones who wind up the experiments in new ideas of psychiatry. In the 80s and 90s the theory was "repression" and kids were basically pressured into saying that mommy and daddy were using them in Satanic rituals. So they said that in court and the psychiatrists were "expert witnesses" so the totally innocent parents went to prison for being Satanists. It went along with the general Satanic Panic gripping the nation at the time so no one thought anything about it. The lazy parents looking for reasons their kids were depressed and suicidal were given excuses by professionals.

This "gender theory" business is just the latest panic that comes from parents who don't want to take responsibility looking for reasons their kids are depressed and suicidal. Those "experts" tell them if the kids aren't "transitioned" they will commit suicide. This excuses the parents totally and any suffering is visited on the kids. It's a win win for shitty parents.

This is the latest thing to blame. As such it needs to run its course like the Satanic Panic, the Heavy Metal Suicides, the Dungeons and Dragons teaches Satanism crap and all the rest. It will be replaced with something else soon and parents will be angry that the professionals took advantage of them.

I'm not saying it's right. But it's inevitable. Want to fix it? Fix parents. Not the kids.

[mad.casual]

In the case of real gender dysphoria patient improvement is seen following transition.

So what you’re saying is the entire field is rife with utterly untestable non-science and sometimes self-fulfilling prophesies actually fulfill themselves even if only untestably falsely.

Thanks for diffusing on behalf of mutilating children and not informing anyone of anything, you fuckstick.

[MrMxyzptlk]

Psychiatry isn't an exact science and as such shouldn't be trusted automatically. However lazy parents who don't want to see themselves as the problem are looking for excuses as to why their kids are fucked up. Psychiatrists with a sociological axe to grind come to the rescue of those parents an give them the excuses they want. "It's not your fault, the child is simply born into the wrong body. All we need to do is treat that problem and your child won't be suicidal and depressed any more."

Parents who are willing to put in the hours and do the hard work don't tend to be the targets of these ideologues. Their kids aren't depressed and suicidal so they don't show up on the psychiatrists radar.

Trying to ban the "treatments" are bound to fail every time because lazy parents want excuses and will fight tooth and nail to avoid being blamed for having fucked up their kids. If you manage to do so in a given state they will take the kid across state lines. Ban it nation wide and they will take the kid wherever they need to go.

The solution is lawsuits, just like the ones against psychiatrists who pushed the Satanic Panic.

[Roberta]

It is indeed backwards. Why is it of any more benefit to affirm someone's "gender" by medically altering their sex or appurtenances thereto, than it is to affirm someone's race by treating them medically in some way that alters their preference for eating watermelon?

[mad.casual]

The whole idea of “affirming care” for a psychiatric disorder just seems completely backwards.

LOL. U sexy AF for a schizophrenic.

[A Cynical Asshole]

Should Kids Medically Transition?

No.

[Ersatz]

-FULL STOP-

[wingnutx]

"Gender affirming" is Orwellian as hell.

[Mazakon]

That the North American left still seems committed to transitioning kids is astonishing. I’ve always felt they’re more revolutionary than their European counterparts but now they’ve taken it to such a vile extent.

[Rick James]

Yeah, but did you see what Ron DeSantis did?

[Roberta]

Are kids transitioning to meat?

[Vernon Depner]

A modest proposal?

[Mother's Lament]

A Modest Proposal for Preventing the Genitals of Poor Children from Being a Burthen to Their Psyche or Country, and for Making Them Beneficial to the Publick,

[Zeb]

And they seem to be going full steam ahead on it still despite lots of European countries backing way off. Sweden, who was pretty much the pioneer of medical sex change stuff started changing directions several years ago.

[shadydave]

This happens a lot with the Scandinavians. The UK and American intelligentsia longed for the "Scandinavian model" of economics, and ignore the fact that those countries abandoned said model long ago. There's a 7/11 on every corner in Norway, and Burger King has a line around the block.

These are market economies with high welfare spending, just like us. And Norway of course is backed by massive oil wealth supporting a tiny population.

[Vernon Depner]

I have a theory that the Anglophone world is more vulnerable to "gender" nonsense because English does not have gendered nouns.

[mad.casual]

I have a theory that the US is specifically susceptible to "gender" nonsense because after "Three generations of imbeciles is more than enough." we spent 5 generations reversing the process by forcing competent people to go slaughter Nazis and, when they got back, forcing them to subsidize the production of morons in the name of fighting poverty.

[mad.casual]

Dude,

The Soviet Union officially banned the procedure [transorbital lobotomies] in 1950 on the initiative of Gilyarovsky. Doctors in the Soviet Union concluded that the procedure was "contrary to the principles of humanity" and "'through lobotomy' an insane person is changed into an idiot". By the 1970s, numerous countries had banned the procedure, as had several US states.

In 1977, the US Congress, during the presidency of Jimmy Carter, created the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery – including lobotomy techniques – was used to control minorities and restrain individual rights. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.

The overlap between states willing to stick a spike in women's brains and the states that refuse to tell a teen boy who thinks he's a girl to grow a pair and put on his big boy pants would be interesting.

[Rick James]

I see Liz Wolfe keeps pushing Reason in a more Trumpy, alt-right direction. I approve.

[Vernon Depner]

Trump was the most friendly president ever to sexual minorities.

[MikeWNC]

How so? Trump still seems pretty hardcore socially conservative as opposed to libertarian.

(It looks like people are usually straight up hostile in these comments but I’m actually just genuinely asking for your point of view.)

[Eeyore]

I'm in the group of people that believe you should exhaust other choices before genital mutilation - like crack and heroin. I might just be old fashioned.

[Vernon Depner]

You can get off heroin. You can't grow back your dick and balls.

[VULGAR MADMAN]

Jeffy knows that from experience.

[Eeyore]

The heroin part or the growing balls back part or both?

[VULGAR MADMAN]

Both.

[Diarrheality]

As a married guy, I quickly discovered having my balls cut off was no fun.

[A Cynical Asshole]

Just out of curiosity, does your wife keep them in a trophy case, or mounted to a wall in the living room?

[Diarrheality]

I believe she keeps them in her purse, but I'm too frightened of her to look.

[Graf Fuddington von Fuddrick]

Likely in a hope chest, on the nightstand next to her side of the bed.

[Rick James]

Breaking: New Pride flag released. Got a purple circle thingy in it.

[A Cynical Asshole]

At this point, I kind of wonder if the whole thing is just a scheme to make money off of selling updated pride flags to idiots every year.

[Eeyore]

"You know there are many types of love in the world: Mother-daughter love, husband-wife love, Simon-Garfunkel love."

[mad.casual]

I don’t know how, but I never realized it was a whole composite thing like how the flag of Scotland and England were mashed up into the Union Jack and there are actual whole flags representing each LGTBQIA2+ faction. I thought as each new faction arose they just modified the flag, not invented or retconned whole new flags to categorically LARP under.

Now, I really kinda want a shirt with the lesbian, aromantic, and polyamory composite pride flag on it that says, “I’m just here for the lesbian clusterfuck.”

[Bill Falcon]

Any society which condones sexual mutilation of children with a mental illness or just having problems fitting in groups is a society too far gone to save. No...let me say this again..No, No, and No. The pedos and groomers and weirdos who are supporting this are immoral. This should not even be up for debate.

[MrMxyzptlk]

We as a society cut the foreskin off of male babies for no reason based in reality. When will we stop inflicting this religious idiocy on baby boys?

When we stop then maybe we will have some moral ground to stand on about further genital mutilation later in life.

[StevenF]

Jesse Singal questions the science of "gender-affirming care."

FALSE. What is being discussed is gender DENYING "care". Affirming gender = "anyone with a Y chromosome is male and anyone without a Y chromosome is female".

[Michael Ejercito]

No doubt about it!

[AT]

"gender-affirming care"

The mere use of that term directly states that you support intentional child mutilation.

Because anyone with a brain knows that term means nothing. There is no such thing as "gender-affirmation" because gender is not a self-defined (or, worse, defined by an abuser) thing to be "affirmed". And there is no "care" in what you're talking about when you use it.

It's a euphemism and an oxymoron. Just like "gay marriage" or "transgender." These are not actual things. By pretending like they are, by mere use of the terms, you are admitting that you are not operating in reality.

[MrMxyzptlk]

We're you circumcised? Because that's genital mutilation as well. Even though it was started as a religious thing, less pleasure from masturbation so the boy won't masturbate because that is sin for some reason, now most parents have their boys mutilated purely for social reasons. So they don't look weird when communally showering after participating in a sport or so they don't ask questions if they see their father naked. Pretty silly reason to lop 20% off the top.

[AT]

Comparing apples to zebras again, huh?

Also, it's pretty clear that you have no understanding of what circumcision is. But, like a typical braindead leftist, you'll throw out terms you heard somewhere and try to make some kind of asinine point with them.

Tell you what, you go learn what circumcision actually entails and then come back. When you can accurately describe it, I'll provide you the rebuttal. If you still want it.

[MrMxyzptlk]

Seriously.

Why do I bother with Republicans.

Fuck off.

[AT]

I have no idea. Or any idea why you’d direct that comment at me. Because I'm not a Republican.

Also, language.