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Why Are There No Lower Age Limits for Puberty Blockers, Hormones, and Gender-Transition Surgeries?—Dr. Miriam Grossman | PART 2

In part one of my interview with Dr. Miriam Grossman, a child and adolescent psychiatrist, we discussed the origins of gender ideology and how this ideology has spread across the fields of pediatric medicine, psychology, psychiatry, and education.

Now in part two, we discuss the guidelines for treating gender dysphoria in the United States and how they are radically different from standards in other countries like the United Kingdom or Sweden.

What should parents do if their child says their gender is different from their biological sex?

And why are kids being taught about gender, sexuality, and genitalia at younger and younger ages?

Missed part one? Watch it here.

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Jan Jekielek:

Previously on American Thought Leaders.

Dr. Miriam Grossman:

People are paying a massively high price for these medical experimentations.

Jan Jekielek:

In part one of my interview with Dr. Miriam Grossman, a child and adolescent psychiatrist, we discussed the origins of gender ideology and how this ideology has spread across the fields of pediatric medicine, psychology, psychiatry, and education. Now in part two, we discuss the guidelines for treating gender dysphoria in the United States and how they are radically different from the standards in other countries like the UK or Sweden.

Dr. Miriam Grossman:

Throughout the United States and Canada, there’s no lower age limit for these medical treatments.

Jan Jekielek:

What should parents do if their child says their gender is different from their biological sex? And why are kids being taught about gender, sexuality and genitalia at younger and younger ages?

Dr. Miriam Grossman:

By the time they’re reaching high school, they have already seen and heard so much, they’re molding the child to have certain attitude.

Jan Jekielek:

This is American Thought Leaders, and I’m Jan Jekielek.

Mr. Jekielek:

Tell me about Florida’s Parental Rights In Education bill.

Dr. Grossman:

In Florida, they passed a bill saying that kids up to third grade and including third grade would not be provided instruction on sexual orientation and gender identity issues. Our sex-ed organizations like SIECUS (Sexuality Information and Education Council of the United States) and Planned Parenthood have been campaigning and wanting and writing curricula for kindergartners and first graders for a long, long time, for 20 years or so, and that includes this material.

Mr. Jekielek:

Why?

Dr. Grossman

It’s a vision. It’s about changing the world. I think that there are many well-meaning people that are involved, and they don’t understand what’s really at the bottom of this. Again, it’s a worldview. That worldview is that children are sexual from cradle to grave. This idea was introduced by Kinsey, with the Kinsey model of human sexuality, which is the model of anything goes. We are human animals. It’s the model that says Judeo-Christian morality and sexual restraint is unhealthy. It’s going to harm people. 

We have to teach children that they are sexual, and that they have every right to explore and express their sexuality at every age. Therefore, why not go into kindergartners and let kids know that and teach them about their private parts and about masturbation and about sexual orientation, and so on and so forth. Because at the bottom of it all is this presumption that children and infants are sexual. Infants.

If you look at the mission statement of the founder of SIECUS, which is the Sexuality Information and Educational Council of the U.S., the premier sex education organization in this country, and extremely powerful all over the Western world, and not only Western, the whole world, funded by our tax dollars. If you look at their original mission statement from decades ago, the founder of that organization, Mary Calderone, says that parents need to become aware of the erotic potential of their children and infants.

This is what these people believe. A lot of them were pedophiles. So, this approach toward our children and our sexuality education comes from that philosophy. Now, of course, it’s very destructive philosophy because children are not sexual creatures. Children only become aware of any sexual attraction or eroticism or anything like that when they go into puberty, and there’s this release of sex hormones and it affects their brain and their bodies and they begin to change and become interested in sex.

But when they’re in kindergarten, no. When they’re in second grade, fourth grade, normally, no. When kids are taught these things in kindergarten or first grade or second grade and they’re taught the medical terms for their genitalia, there’s an underlying message there. The message for the child is that it’s okay to talk about these things in school. Not only is it okay, but your teacher is the one who knows these things. You can turn to your teacher with your questions and concerns. It’s okay to talk about this in a classroom full of girls and boys.

If you’re nervous about it or embarrassed, you need to get over that. There’s all kinds of underlying messages here when little kids are taught by their teachers the proper names for their genitalia. What we have, starting with Kinsey, and even before Kinsey is a new vision for human sexuality, for sexuality that is without any sort of restraint, without inhibition, and without judgment.

Just celebrating practically any form of sexual expression. One thing that is important for you to know about and your listeners is something called SAR, which stands for Sexuality Attitude Reassessment or Restructuring. SAR. And SAR is basically a seminar that has existed since, and was developed in the late ’60s for any individual that is getting certification in any field related to human sexuality.

They’re small groups, 10 or 12 people, and they are exposed over a number of hours to a multimedia program of explicit sexual behaviors. The point of the SAR is to desensitize these individuals. Because it was felt, and it’s still felt, that people who are going into the field of human sexuality might have their own anxiety, opinions, judgments, or negative reactions to certain forms of sexual expression, and that those opinions and reactions might interfere with their ability to help whoever is coming to them, or to educate their students. It’s a tool to desensitize individuals, so that after the seminar, they no longer will have any negative reaction, and they will be open and accepting of whatever it is that comes in front of them.

Now, the way that I would describe this process is that it is an intentional breaking down or eroding of natural sensitivity, modesty, and healthy inhibitions that almost all of us are born with, and that we don’t necessarily want that to happen. In certain contexts maybe we do, but certainly not across the board, and certainly not in children. We have to look at this very closely, because as I said, these seminars still exist and attendance at these seminars are required in many of the programs that give certification to people who want to go into these fields.

Mr. Jekielek:

And just quickly, it isn’t children that are attending these, so how does this connect with children? Why did you mention that?

Dr. Grossman:

Okay. If I could, I want to just describe for one minute how one of these SAR seminars was described. There was an Esquire journalist in the ’70s who attended one of these seminars, and it’s just important for me to tell you what he said. The room was darkened and there were multiple large screens in front of the group. On those screens were projected very explicit sexual behavior. He basically felt bombarded with these high impact stimuli over and over again over the course of a few hours. He reported that after a while, he felt dizzy and nauseous. He was having a visceral reaction to it. 

He felt that after a while he just needed to surrender to the experience and not fight it, which was his initial reaction. He had to surrender to it. And then, by the end, nothing was shocking. Obviously, such a high impact, highly stimulating visual and auditory experience is going to have a permanent effect on the brain. It’s going to form memories that can’t be erased, and it’s changing a person. 

The way that children are relevant to this is, in my opinion, a similar approach is being used with children. In other words, in sex education, one of the goals is to have the children become open-minded and to accept every possibility of sexual expression. I can think of two examples. One I came across is on the Planned Parenthood website, and this was many years ago, actually, in 2007. They had at that time tools for teachers to use in the classroom.

One thing that they suggested was a game for middle school and high school students in which the kids would pair up. You could have two girls, two boys, or a boy and a girl pair up. They wear sticky notes with a term related to sexuality. One of the kids puts the sticky note on their head without reading it, and the other person has to give clues or answer questions to help that person who has the sticky note on their head figure out what it says there.

This is presented as a sort of icebreaker, as a way for the kids to get comfortable talking about sexuality. Obviously, if that one kid with the sticky note is trying to guess what it says there, they’re going to have to go into all sorts of perhaps uncomfortable questions and areas in their discussion, as they’re trying to figure out what it says on their forehead.

Then, after that “game”, the kids will sit down and talk about what it was like, and they’ll process how it felt and did they feel embarrassed or not. It’s trying to work out what the sex educators would call inhibitions or anxieties, and trying to get through those to eliminate them, and to erode them. That is a process that’s similar to SAR, to Sexual Attitude Restructuring. 

I’ll tell you something else. The practice that we now have had for a long time of teaching little kids, five-year-olds, six-year-olds, the anatomically correct terms for their genitals is also a form of SAR. The justification of sex educators in bringing that material to little kids is that they say, “Look, they have to have the right words in order to report if they were molested, if they were touched in an inappropriate way, in an inappropriate place. The kid needs to have the vocabulary, so we need to tell them what these different areas are called.” 

I disagree. If we’re going to have any discussion of this whatsoever at school is a question in and of itself. Why can’t they get this at home? It could be presented to them in the form of, “Look, those parts of your body that are covered by your bathing suit are private. No one should be asking to see them or touching them. That is unsafe touching. That is not allowed. If anyone wants to do that or anyone tries to do that, you scream and run away and tell an adult.” That’s all. 

We don’t need them to know about testicles and vulva and clitoris and vagina. They don’t need that when they’re five-years-old. In presenting them with that kind of explicit material they must use diagrams. I still haven’t figured it out. How are you teaching five-year-olds these terms that they probably haven’t heard before without a diagram? I believe that it is eroding their natural sensitivity and embarrassment.

Mr. Jekielek:

I’ll share with you an experience I don’t think I’ve shared before, but it must have been in grade one or grade two in the early ’80s when I was in a class where we certainly talked about all this. In fact, I think we saw a pretty explicit film explaining how babies are made. And this is when you’re around six-years-old. So, that would’ve been in the early ’80s. What do you make of that?

Dr. Grossman:

It’s interesting that you still recall it pretty clearly so many years later. My first reaction to that is that it certainly made an impression on you. It sounds like a lifelong impression.

Mr. Jekielek:

It certainly did. Yes.

Dr. Grossman:

Do you remember the emotions that were connected to the experience?

Mr. Jekielek:

There was much laughter and rigamarole in the room. That’s what I remember.

Dr. Grossman:

Okay. That usually would mean a sense of embarrassment and probably a sense of anxiety. Laughing, awkward shifting around in your seat, making some noise, all probably due to some anxiety. It’s important to point out that I’m not at all surprised that you were exposed to this.

But I also think it’s important to point out that to this day, the American Academy of Child and Adolescent Psychiatry states that children, in terms of learning about sexuality and reproduction, they should, at that age, grade one or two for sure, should only be provided with the information that they ask about. No more than that.

It’s amazing, because this is really excellent. The information they have there is excellent. Too bad nobody follows it. The sex educators don’t follow it. Kids are not miniature adults. Kids are not able to process information the way an adult does.

That’s why puberty is so important. Because the brain matures and we begin to process emotions and ideas differently. But when you’re in first or second grade, you’re a kid. Your thinking is very concrete. Many kids who find out about the sexual act think that it must be violent, or they can’t grasp what it might be like as an adult, because they’re kids. 

That first grade film that you saw was only the beginning of a long process. Each year there’s going to be more material that’s added. I would imagine that by the time these kids got to fourth, fifth grade, for sure, they’re learning about more explicit things. They’re putting condoms on bananas. They’re learning about the different types of birth control, oral sex, anal sex. This is being introduced at fairly young ages.

Aside from the inappropriateness or the moral question of whether kids should be exposed to this material, I just want people to be aware of the process of desensitization that’s going on, so that by the time they’re reaching high school, they have already seen and heard so much in this area. It’s not just facts that they’re giving. They’re molding the child to have certain attitude. And that’s how you change the world. You change the attitude of the young kids.

Mr. Jekielek:

Let’s talk about this diagnosis of gender dysphoria. I understand that prior to this new diagnostic and statistical manual, DSM-5, the newest version, there was a different way of looking at this issue, and it’s just not generally known.

Dr. Grossman:

The bible of psychiatry is the DSM, the Diagnostic and Statistical Manual. We are now at DSM-5, and that came out in 2013, but the APA (American Psychological Association), was working on it for almost 10 years before it came out. The DSM-4 had a diagnosis of gender identity disorder, GID. 

It referred to kids and adults who have a deep sense of discomfort with their sexual bodies, or gender identity disorder. It was considered a psychiatric disorder. When time came to come up with a DSM-5, there was a decision to change it and to no longer call it a disorder, but to simply call it gender dysphoria. 

But let me first explain something. When the APA goes through this process of deciding what’s going to go into the DSM and how these psychiatric conditions are going to be described, what are the criteria, which by the way, is very, very important—this is where it’s decided what insurance is going to reimburse for.

If you’re going to have a diagnosis and it has a code, that means you can put that code in the paperwork for the reimbursement from insurance. And that’s very important, to say nothing of the importance of something being considered a disorder or not.

People should understand that that process of making these decisions around the DSM is restricted to a committee or a workforce of maybe 10, 12 or 15 people. The members on that workforce are chosen by the president of the American Psychiatric Association. 

Now, keep in mind that not every psychiatrist in the United States is a member of the American Psychiatric Association. And then, on top of that, when there’s an election in the APA for the president, not everyone votes.

The point that I’m trying to make, is that these decisions that are made in terms of the DSM are not necessarily representing a majority of practitioners. It may, but we don’t know. We don’t know because there’s never been a referendum, and there’s never been a huge vote of thousands and thousands or tens of thousands of practitioners on these issues.

The development of DSM-5, not only regarding gender, but regarding many other issues, was highly controversial. There were vastly differing opinions on many of the changes that were proposed. And people felt so strongly. Especially, there were two prominent psychiatrists at that time, and one of them, Robert Spitzer, had been the head of the development of the DSM-4.

So, he really understood this whole process. Dr. Spitzer was very unhappy about the way that the DSM-5 was being developed, and another psychiatrist as well, a prominent psychiatrist, Allen Francis. Now, from what I understand, and again, I am an outsider in all of this, there was a work group. It was composed of people who have a special interest in this area. And so, there were quite a number of people that could be described as activists.

For example, the doctor who was the head of the work group, Dr. Drescher is his name, he is very open in explaining the decision to drop gender identity disorder, and instead call it gender dysphoria, in which the focus is no longer on the disorder of feeling alienated from your body and feeling like you can’t accept your biology.

It moved away from that. Instead, it focused on the dysphoria, which means the discomfort or the unhappiness or anxiety that comes from having to go out in the world and not being able to be perceived in the way that you want to be, not being able to live the way that you want to and pass as a woman or a man, and be treated in these stereotypical ways. So, that leads to a person feeling unhappy and uncomfortable.

With gender dysphoria, the focus in terms of treatment and in terms of diagnosis is the dysphoria that comes with that. I was saying that Dr. Drescher talked about how that decision was largely based on the stigma that was attached to a gender identity disorder diagnosis. There was a wish to eliminate the stigma.

So, why not eliminate it altogether? Why not just remove this whole subject from the DSM? Well, you can’t remove it, because then you don’t have a diagnosis for the insurance companies. If these people who are suffering in this way want to have some sort of a treatment, whether it’s psychological treatment or endocrine hormonal treatment or surgery, you need that diagnosis. You need that code to put on the form for reimbursement.

Mr. Jekielek:

If there is this diagnosis for a kid of gender dysphoria, if a kid identifies that they are experiencing gender dysphoria, parents will be told, “If you don’t deal with this, your kid might commit suicide.” Of course, nobody would ever wish that on anybody, hopefully. Is this a reasonable thing to say? How common is this?

Dr. Grossman:

Now, of course, everyone’s on the same page. Every suicide is a terrible loss and a terrible catastrophe. There’s so much misinformation out there about this. However, the data doesn’t support it. Let me point out, for example, that at the world’s largest gender identity disorder clinic, part of the Tavistock Clinic in London, they reported that out of 15,000 kids that were seen between 2010 and 2020, the suicide rate was under 1 per cent. And that not only included the kids seen, but also the kids on the waiting list who they were unable to see, those kids that didn’t get treatment.

A suicide rate of under 1 per cent is really extraordinarily low. We see higher suicide per cents in the gay, lesbian and bisexual populations, which have an elevated suicide risk. Kids who are diagnosed with borderline personality, or who have other diagnoses of depression and anxiety, or who are on the autism spectrum, all those groups of kids have higher rates of suicide. The thing is, Jan, those are the very specific kids who are more likely to have gender identity issues.

It’s such an oversimplification to the point of falsehood to tell parents that because of your child’s gender identity issue, and that because you’re not accepting their new identity, they’re at risk for suicide. It is so much more complex than that. To top it all off, we don’t have evidence that those kids who are treated, who are affirmed and who are put on hormones and might get surgery later on, we have no long-term data that their suicide rates and their levels of mental health are any better after all that treatment.

The adults in the room have to be looking at the child in terms of their entire lifespan, not just how they’re going to feel in a few months, or even in a few years. If you’re sitting with a 14-year-old child, or let alone an eight-year-old child—some of these kids are eight or nine-years-old—one day this kid is going to be 20. One day this kid is going to be 30, and then 50.

We want them to be healthy and thriving throughout their lifespan. We have to have a much bigger horizon than the child has. The child is only thinking about now. I have patients saying all the time, “This is what I want now.” I reply, “Well, what about in five years? Do you think that you might want something different?” They say, “Oh, I don’t know. I don’t think so. But this is what I want now.”

You know what it’s like to be a teenager. Now is everything. What I am now, I’m an expert. I know what I want. I’m never going to change. I want it, and I want it now. But the adults have to be looking at it differently. 

Regarding suicide risk, and again, suicide is very, very different than suicidality. Suicidality is having thoughts of maybe wanting your life to be over, wanting to hurt yourself, but not actually acting on it. And then, there’s the people who have thoughts of just harming themselves. They may cut themselves, they may burn themselves, they have self-injurious behavior.

That’s a different diagnosis. Suicide is a very complex issue. What we see happening with some of these providers, therapists and doctors and teachers, guidance counselors and politicians, they are simplifying things to the point of untruth. 

And we have to be very careful about that, because do you know why? We know that suicidal behavior can have an infectious, contagious nature to it. When there’s a suicide in a middle school or in a high school, there often follows a cluster of suicides, and this has been studied.

Now, we certainly don’t want to be bringing up the possibility of suicide to parents with their child in the room, and making them the bad guys and saying, “If you don’t use your child’s new name and pronouns and you don’t go with this 100 per cent, your child right here may commit suicide.” 

That is wrong on so many levels. You’re placing a wedge between the child and their parents. The parents are in almost every instance, well meaning, loving, and devoted parents. These are parents that want the best for their child in the long term.

Here you have this practitioner, this educator who is planting a seed in this child’s head that their parents are on the other side, and they are not safe to be with. That is a phrase that’s used over and over again. Is the home safe for you? Kids will say over and over again, “I feel safe in school. I don’t feel safe at home because my parents are not supportive.” Well, maybe the parent is just being really careful, just like they would want to be careful and ask questions about any medical process that their kid would go through.

Getting back to the suicide point, the data that we do have, the best study that we have, which is long term of individuals that went through treatment comes out of Sweden, a 30-year study. It shows that even after going through the gender reassignment and living as the opposite sex, the rates of mental health disorders and suffering, and the rates of suicide are alarmingly high.

You can look at the de-transitioners, and we have thousands of them now, these are kids who were affirmed and who got all the gender affirming treatment and whose parents did go along with it. They are talking about feeling suicidal because of where they are at now. They are recognizing that their original mental health issues were never addressed. They still have their depression and anxiety and trauma.

They may have been molested or they may have had some terrible loss that they went through, or they may be on the autism spectrum. There are all these vast number of things; OCD, ADD, all kinds of things. They’re realizing that those things were not addressed. They were placed on an assembly line toward medicalization. Now, they don’t have their breasts any longer. They may not have the genitals that they were born with.

They may have a whole slew of medical problems from the hormones that they’re on and from the surgeries that they went through. We can’t ignore that. These are the kids that are 10, 15 years out from those who are 12 and 15 and just starting on the process. Why are they being silenced? Why are they being canceled? 

If this was any other field in medicine that was doing experimental procedures on young people, we would be anxious to listen to them and want to know, “Hey, how are you doing? Let’s follow up with you from year to year. How are you with all that stuff, now that you’re 30-years-old?” Well, they’re not doing that.

Mr. Jekielek:

Aside from the DSM-5 gender dysphoria diagnosis, there’s some sort of guidelines that come from somewhere that explain how this should be done, presumably. Where’s that coming from?

Dr. Grossman:

The guidelines come from a few places, but I think the most important one to mention here is an organization called WPATH, which stands for World Professional Association for Transgender Health. WPATH. The practitioners, the doctors, the surgeons, the hospitals, the clinics where all this is going on will point to the WPATH guidelines and say, “These are the widely accepted guidelines.” 

The question is, should they be widely accepted? They are not accepted in various places in Europe. They have been rejected. But we here in the United States and in Canada are still following WPATH guidelines. In fact, at their annual meeting, which took place recently, our Assistant Deputy of Health and Human Services, Dr. Rachel Levine, gave the opening address, I think it was. So, it clearly has the very strong endorsement of the government. 

What is WPATH? What we could do here is look at the guidelines themselves, in order to answer that question. You can look at the WPATH guidelines, now called Standards of Care Version 8, which came out this year, 2022. First of all, what struck me is the language. I see, over and over again, gender affirming care. We’re using that word affirming, which normally sounds wonderful. You want to affirm people, right? That’s a good thing.

But what are we affirming? We are affirming their perception of themselves or who they want to be, but in affirming that we’re also denying something. We’re denying their biology. We’re denying their genetics, their chromosomes, their natural state, and how they were born. We have to deny their biology. I would argue that their biology is actually their true reality. So, gender affirming care is an Orwellian manipulation of language, and it changes the way that we think about all this. 

I see the phrase top and bottom surgery. What is top surgery? It’s the removal of healthy breasts. It’s a bilateral mastectomy. That’s the surgery that we do for individuals with breast cancer. It’s a very serious surgery. It’s a permanent surgery. To use the term top surgery is a euphemism that makes it sound not so serious.

The women who have gone through the bilateral mastectomies and then regret it, they speak in a very emotional, moving way about what that’s like for them and about the scars on their chest and how they may have gone through that surgery before they even had a chance to experience the sexual pleasure that they may have had one day from having breasts, and the pleasure of nursing. You may be aware that some people will rank that experience of nursing their child very high on the top of any wonderful, pleasurable, meaningful experience they’ve had in their lives.

All that has been taken away from them and taken away at a time when they’re extremely vulnerable. They have comorbid psychiatric conditions, and they are led to believe that having their breasts removed is going to make them feel better. They’re going to like themselves better. They’re going to be perceived as being male by the world. They’re not going to have men staring at their chest which makes any woman uncomfortable, and that’s normal, by the way. 

But I’m just getting back to the ideological language that’s found in the standards of care of WPATH. WPATH is actually an advocacy organization. They advocate for transgender individuals. They have, in terms of their leadership, many people who are activists and who are transgender themselves. 

They have a certain mission in mind and they advocate and they lobby for the transgender community. Now, there’s nothing wrong with that. But there is something wrong when that organization passes itself off as if it was purely a medical organization that wanted to help practitioners and provide guidelines to make the most medically accurate, up-to-date research supported decisions to protect patients from harm. Now, WPATH eight is more radical than number seven.

Because, for example, in the current Standards of Care version 8 that is used now throughout the United States and Canada by practitioners, by clinics, by hospitals, there’s no lower age limit for these medical treatments. They don’t want to specify a lower age limit such as 16, which, in my opinion, is already an outrageously low age limit to go through these life-changing permanent disfiguring and sterilizing treatments. But now with the current standards of care, it’s even lower than that.

It’s a decision to be made by the child with the practitioner, with or without the parents. The current standards of care of WPATH say that practitioners should challenge parents that are hesitant—challenge them. This is really troubling. And our health and human services is holding up these standards of care as what all of us doctors and nurses and all the organizations are supposed to be following. That’s what we’re supposed to be doing.

No. I’ve been working with families for almost 40 years. It’s very rare to come across parents who do not want the best for their kids. I’ve been in a position of having to call Child Protective Services, and I’ve been in a position of reporting parents and even recommending that a child be removed from the home. This is not those kinds of homes.

Now, parents are losing their kids because of organizations like WPATH. Another phrase that I look for in order to determine how much or how little ideology there is, is the phrase, “sex assigned at birth.” Okay. Sex is not assigned at birth unless you’re one of a very rare case of about one in 5,000 individuals that is born with ambiguous genitalia, that we used to call a disorder of sexual development, in which it’s not immediately clear whether the child is male or female.

In 99.98 per cent of individuals, male or female is clear, and it’s determined at conception, not at birth. So, with that phrase, sex assigned at birth, the goal of that phrase is for us to begin thinking that male or female is arbitrary. Male or female is a doctor or nurse’s opinion, and it can be changed. It’s not inborn.

When I see that phrase, sex assigned at birth, I know that there’s already a lot of ideology there. Another thing I want to point out, WPATH has suggestions of reading material for kids. One of the books that they recommend is something that is strongly in favor of, and oiling the tracks toward gender affirmation care, toward transitioning to the other sex. While kids should certainly be respected and supported and helped through this difficult time, they need to be warned that the transgender path in life is a difficult one.

And whereas, it is one option for them, and it may be one answer to their distress, this is what I tell people, “ I don’t believe it’s the best answer. I believe that there may be other answers for you.” And I certainly wouldn’t want a young person to be given material that looks very official from WPATH or from whoever it is celebrating this process that ends in medicalization.

“This is how you’re going to find your true self. This is going to be the answer to your issues. You’re going to feel so good this way.” Furthermore, WPATH recommends a book that includes historical figures who they say were transgender and they give, as an example, Joan of Arc. They say that Joan of Arc was a transgender. I think that’s quite ridiculous.

Some other things that WPATH is advising practitioners that is troublesome is that when a kid comes in and they’re going to start doing the social transition, they advise practitioners to teach the girls how to bind their breasts and boys, how to—you may not be aware of this term—tuck. Tuck. Let me explain to you what that is. Binding is when girls want to achieve an image of having a flatter chest, and so they wear these garments called binders. 

A binder is a very tight, elastic garment that is worn under the clothing, and they wear them for hours and hours. The instructions are to not wear for longer than eight hours, but many girls do. Now, this is not a benign thing. First of all, they can be painful. They can cause shortness of breath, because they hamper the full capacity of the lungs to inflate. They can hamper breathing and cause shortness of breath. 

That’s a big deal because you have to exercise and you have to go up and downstairs and you have to be in gym class. You don’t want your breathing to be hampered. They can cause rashes. There’s incidents of actual damage to ribs, like broken ribs. So, wearing a binder is not a benign thing.

Tucking. This is going to be a little disturbing for your audience to hear. In male anatomy, the testicles are originally in the lower abdomen. Before a boy is born, that’s where they originate. Then, the testicles are supposed to travel down the inguinal canal and descend. They go down to where they’re supposed to be. That canal does not open up to the exterior of the body, but it’s a canal that’s still open to the testicles. The testicles can be pushed up back into that canal.

And so, boys are taught this, and you can find this online. It’s pretty shocking, actually. You can find instructions on how to move those testicles back up into the inguinal canal, and how to move the penis back between the legs and tape the penis. If all this troubles you, it should. It’s dangerous, and it’s painful. You can harm your fertility. 

And again, instead of giving kids these techniques which deny who they are, and that are dangerous, we need to explore with the kid, “I recognize that you have this distress and I’m here for you. Together we’re going to figure out what is this about. Why do you want to become a different person? How will that help you? How will that improve your life and your relationships? How will it improve the way that you feel about yourself?”

And a lot of the de-transitioners feel, “Yes, this process really was going to lead me into a life where I would be perceived as a boy. I would be a boy.” You know what’s also very shocking, Jan, is that some of them think that their breasts are going to grow back—so much for informed consent.

Finally, WPATH says, the current standards of care say that the mental health issues that a person may have, or a child may have when they present and want gender affirming care, those mental health issues don’t necessarily need to be resolved. They don’t necessarily need to get mental health evaluation or treatment. 

They should have access to hormones and surgeries without anyone having to come in and saying, “Wait a minute. You have schizophrenia.” Yesterday, I was introduced to a case with a person with diagnosed schizophrenia. It’s a very, very serious disorder in which a person is disconnected from reality, might be having hallucinations, and might be having delusions. That person got gender affirming surgery. 

I remind you that our current government is supporting WPATH. Not only that, Dr. Levine stood up and said that we need to all be ambassadors of this message about gender affirming care and for hormonal and surgical treatments with no lower age limit. That’s how extreme it is in this country right now.

Mr. Jekielek:

I can’t help but think, given everything we’ve talked about today, that there’s almost a social contagion among our medical organizations and practitioners. Because I can’t fathom why everyone, given the preponderance of evidence suggesting not enough information, or even opposite indications, why so much of the medical establishment could be supporting this.

Dr. Grossman:

People have to understand that in medicine, there’s a chain of trust. You’re taught very early on in medical school, in residency, that you follow the guidelines from your professional organization. You can’t be sitting there all day and all night doing research into getting to the bottom of things. There’s no time for that.

You go to your professional organization, and you trust that they’ve done the work and you trust that they have the priority of “do no harm.” The priority of the patient’s health and welfare comes first. Now, sadly, that chain of trust no longer exists.

What I want parents to understand is that when they go to their pediatrician’s office, it’s more likely than not that their pediatrician is still trusting that chain of information from the authorities. Parents are not getting the information that they need. They’re being led to believe that the science is settled. And nothing could be further from the truth.

Mr. Jekielek:

I have to say, it reminds me of how we’ve approached Covid over the last few years. It almost feels like an analogous situation.

Dr. Grossman:

There are similarities, and just like with Covid, the price that is being paid and will be paid by young people and their families is enormous. It’s enormous.

Mr. Jekielek:

Why are there so few medical practitioners like yourself who are talking about this?

Dr. Grossman:

First of all, there are more than you might think, but it’s going on beneath the radar. They’re not writing articles and getting interviewed. They’re talking about it privately in emails over coffee. A lot of doctors are outraged and distressed and just can’t believe it. 

I get a lot of emails from medical students, people in their residencies, people who are considering going into mental health, social workers, psychologists, and they’re asking, “I’m not going to go along with all this stuff about affirming gender without doing the mental health part of it first.” 

But it seems like in order to enter the profession of medicine or psychology or psychiatry or social work, that you have to go with that. They ask me, “What should I do?” So, I encourage them. I say, “You’re the people that we need.” We need people that are not going to see this as a civil rights issue. They’re going to see it as a medical, mental health issue.

We have to listen to the people who have been through this process, the de-transitioners. And the suffering is such that I can’t read it sometimes. To see what my colleagues have done to these kids and how they’re suffering, it’s just a nightmare.

Mr. Jekielek:

There’s an incredible body of knowledge that you’ve shared here today. You might be a parent, or you might be a grandparent watching, you might have friends. What do you recommend people who are concerned about this with family members or friends, and what do you recommend they do in this climate?

Dr. Grossman:

First of all, just in general about being a parent these days, it is very challenging and complex. You have to understand that your child needs a framework of understanding the world. They need some sort of system of being able to sort out what’s true, and what’s not true. “Who can I listen to, who should I not necessarily listen to?” Our kids are sponges. You need to give them that at home from an early age, a structure of how to know what’s true and not true. 

What I’m trying to say is that you have to reach your child first. There’s a reason why they target younger and younger children. People now are asking all the time, “But they’re so young. Why the drag shows for kindergartners? Can’t it wait a few years? Why?” Well, of course, they have to target the young kids because they need recruits, they need believers, they need soldiers that are going to go to battle for their cause.

And so, you have to go to the youngest kids. That’s when they’re the most vulnerable. That’s when they’re the most naive and they’re the most gullible. And they’ll believe anything an adult tells them, practically. That’s just a general comment about being a parent or a grandparent. 

If you have a child that you notice is changing the way they present to the world and how they speak about themselves in terms of male and female, then you very much want to get educated about this topic. It’s not a difficult thing to do. You just have to know where to go. There are so many resources online and there’s so many groups of parents that are educated and that support one another. 

If your child comes to you with this announcement, this very shocking announcement, you want to try and remain calm. You want to say, “That’s very interesting. Tell me more about this. I don’t know exactly what you mean.” 

“I can see that it’s really important to you, and whatever’s important to you is important to me. I can promise you that I’m going to learn as much as I can. We’re going to learn as much as we can about this, and I’m going to get really educated and we’re going to start to have conversations. It’s not all going to happen in one conversation. It’s going to be an ongoing conversation.”

That’s what I would say to parents. It’s not going to necessarily pass in a few weeks or a few months. Do not assume that your pediatrician knows everything they needs to know about this. Don’t assume that at all. Don’t assume that the therapist will know, or the guidance counselor, or the principals and teachers at school. More likely than not, they will have only heard the ideological side of this argument. They’ve been led to believe, for example, that puberty blockers are 100 per cent reversible.

The research is very, very poor around these experimental therapies. On the other hand, all these people, the pediatrician and the guidance counselor and the people at your kid’s school are going to speak about it in a very definitive way as if this is done deal. This is known, this is established, there’s no argument. And if you do have an argument and you are questioning, then you have your own issues. You’re transphobic and so on and so forth.

But if you ask the guidance counselor and the pediatrician, “Did you know that if we lived in Stockholm or in London, did you know that puberty blockers wouldn’t be available to my son or daughter? Did you know that in those countries, they’ve decided that there’s insufficient, inconclusive research around using puberty blockers on kids?”

I would bet a large sum of money that the pediatrician and the guidance counselor and principal will not be aware of that. These kids, 10, 12-year-olds, even eight-year-olds, because some kids enter puberty that early, and so conceivably they could be given a rubber stamp of approval.

If a girl that enters puberty when she’s eight or nine says, “I’m really a boy. I don’t want to enter girls puberty.” She could be approved for receiving puberty blockers and her eggs will not mature. Her eggs will never mature. Her eggs need estrogen to mature.

Infertility is one of the most common causes of depression in our country. Infertility is a huge thing, as well as is having a biological child. We’re saying that this little girl has the right and the capacity to make informed consent about a decision like that. Now, is that crazy? That is crazy.

We would not do this in any other field of medicine, but we are doing it when it comes to so-called gender affirming care. The goal of this movement is to erase the differences between male and female, to erase these fundamental truths, these biological truths that are eternal. They want to erase them. Now, I don’t have a question in my mind that in the end they will not prevail, and that the truth will prevail. Mother nature will prevail. She always does. The question is, how high is the body count?

Mr. Jekielek:

Dr. Miriam Grossman, it’s such a pleasure to have you on the show.

Dr. Grossman:

Thank you so much, Jan, for having me. Thank you.

Mr. Jekielek:

Thank you all for joining Dr. Miriam Grossman and me on this episode of American Thought Leaders. I’m your host, Jan Jekielek.

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