110 — Pathologizing Normal: The Lure of Identity Labels & Diagnoses

Hi, I'm Stella O'Malley, a psychotherapist in Ireland. And I'm Sasha Ayad, an adolescent therapist in the United States. Through in-depth stories and psychological exploration, we probe the gender landscape within contemporary And we consider the implications of prioritizing personal identity over other aspects of the self. This is the thinking person's take on gender. Join us as we look at gender from a wider lens.

Howdy Stella, how are you this afternoon? I'm good, I'm good. Good to be back chatting with you. Yes, definitely. Um what's going on in the world of Stella these days? Obviously for our YouTube viewers, you're somewhere different today. I am, I am. I'm in a hotel in London. And um it's always it's always great. I like going away once in a while. I like going home always. But it gives me a new it gives me a perspective.

of my life once I get away. I kind of yeah I I kinda get a snapshot of where I'm going at home. It's very good for me mentally. So I'm away but I'm away working, giving a talk and stuff. But it's it's a big uh I think a lot of things are happening, as always, in Gender World. Mm-hmm. Um not so much in Gender World, my book will be released soon. Um what your teen is trying to tell you.

It's I I is I I'm very excited by it. I put my heart and soul into this book. It's been a hard it's been a hard book to write because there's so much to say about teenagers and the idea is to kind of help

Parents, not like immediately turn to therapist, even though therapy can be very helpful, but to see if you can empower yourself by leaning in, learning a few things. There might be just it's like being on a railroad track and you're a little bit off and you get further and further, and if you can tweak it. tweak it back with a c couple of little things. It can make a difference. Yeah. And so that's but we'll talk about that again in the future, I guess.

Okay. All right. Yeah. I just I just think it's great because that's so aligned with a message we're often sharing on this podcast and through our individual work that like you know, we wanna put the the kind of power back in the hands of parents so that they can you know, nobody's gonna love your kid as much as you do. So if you can feel a little more confident parenting them, that makes a huge world of a difference, I think.

And I think parents, we got disempowered. I as a parent know what that's what compelled me to write my first book. We got totally disempowered. And it has continued on until teenage years that we presume other people know what to do with our young distressed kid more than we do. It's it's extraordinary the the the push, as soon as your kid is upset, people say, Are you going to get help? And it's like maybe That's not the right thing. You know, maybe the kid needs more of you.

Um, you your flawed person,'cause we're all flawed, you know what I mean? It's it's it's a kind of a fighting thing. And on that subject, when you give your power away, D Trans Awareness Day is coming up, big big day.

Uh the twelfth the twelfth of March. And it's you know, it's such a it's it's a self organized day. The Detransitioners I think they first organised it in twenty twenty one. and it's a d it's a hashtag all day. There's a there's a website, um dtransawareness.org. So that they're kind of they're self organizing, which is great. It's great to see the detransitioner self organizing. And there's gonna be loads of events and you know, Gen Specter's um supporting

as much as they can all the DTrans Awareness Day events. It's really important to support them, I think, and make sure that people realise that, you know, something has happened to these people and they need to be recognised. We did Jetswick did a brilliant webinar last year, twenty twenty two, for D Trans Awareness Day. And we got loads of people on and they were amazing. And it was really difficult I don't know. Like uh I had a power cut in the middle of it and

It was chaotic, but it was really, really good. It was really really good. Wait, a power cut? What do you mean? Oh like your power went up. I do remember that. I was like, you know that Bohemian Rhapsody video? I was a little pale head. It was strange. It was dramatic for sure. It was dramatic. Yeah, I do remember it. Sinead Water was very good because she seamlessly took over and she was very good. Very, very good.

But yeah, so I think the detransitioners are rising, they're self organizing, they're coming together and I I think that's really amazing.

And I mean if somebody has never really heard of what that means before, I mean most people who listen to our show are familiar with this concept, but we may be getting some new listeners. And for those who aren't aware, detransitioners are individuals who, you know for some time identified as transgender and took some kind of medical steps in that transition process, whether that's cross-sex hormones or in some cases surgeries.

And then for a variety of very complicated reasons, many detransitioners have come to believe that that was a real mistake or that they feel they were harmed by the quick way that the medical system kind of pushed them through towards transition and Their stories are really interesting and harrowing, and they're they're you know an example of what happens when.

the a mental health and medical establishment kind of works from an assumption backwards. Like the assumption is transition is really, really helpful for those who want it and There could never be a possible reason why somebody would want this, but actually it's not gonna benefit them. And so when providers are really affirming that sounds great on the surface because you're giving the patient what they want, you're helping them meet their own goals.

But there's a lack of kind of caution and assessment and slowing down and a lot of detransition stories really exemplify that. Just kind of the quick pace by which all the professionals they met just pushed them along. Yes, yes, yes, I agree with you. Yes, let's get you these hormones. And of course the the ramifications both socially, medically, physically, for their health are huge. And it's a very complicated process.

trying to make sense of that experience and so this Drans Awareness Day is a chance for individuals who've been through this kind of thing to talk about their experiences and bring more awareness to the subject because it's growing and we see uh people coming to this realization and having this experience in pretty large numbers considering how

Typically, you know, ac activists and advocates say detransition is incredibly rare. It's like one percent of people, but actually that's not true at all. And as transition procedures have become more readily available in the last 10-15 years, So have the detransition numbers. So that's what detransition awareness day is. And if you're kind of new to this whole gender world, we would really encourage you to.

Just take part, go watch some of these individuals tell their stories so that you can understand kind of the human perspective behind this very heated and controversial topic. Yeah. I'm glad you brought up the the definition because You know the way that trans has become this blurred, nebulous term that nobody really knows what it is? Yeah. We we all well, all of us nerds who are who are very absorbed in gender notice

that the standards of care in in WPAT they they m they obfuscated the meaning of detransition and made it less clear cut. Well, we had established detransition was a very just like you outlined, it was a very specific process. And it's like it's been reclaimed to be part of the gender journey and part of uh you know, almost open to people move in and move out of detransition and all sorts of phrases and then there's the phr you know, there's different phrases coming in.

And it's just something I'd like we need public awareness around what is an accepted term for trans, which is I would argue medical transition. What is an accepted term for detrans etc.

you know, reverting back after medical transition and maybe desistance is, you know, reverting back to your to your biological identity, never having taken medication in the first place. So that people are clear because It's very hard to feel knowledgeable and have an opinion on something when you're not quite sure what you're talking about.

Yeah, completely. Yeah, I couldn't agree more. Yeah. Yeah. And to bring us seamlessly into today's s subject. Uh you could argue that like the the detransawareness day, the the kind of the rush to medicalize identities, the pathologizing of of normal distress.

into quick fixes and give us the medication. Always looking for the external solution for an internal problem. You could argue that that is really where we land with this With this kind of the pathologizing of normal and the kind of the the the lure of identities that has swept over people since we've taken away other identities such as religion and national identity, other identities have come into place and it's extraordinary really.

Yeah, and I it's interesting too and I was thinking about this topic, just like how Diagnostic labels have become a source of identity as well. So it's interesting cause this of course relates to gender, it relates so much to the stories of quick transition and subsequent detransition, it of course relates to people who choose to kind of continue on with transition and have a gender identity. But but it also relates to so many other things too. As a, you know, as a...

culture, at least you know, Western culture, we went from a place where mental health issues were never talked about. They were really dismissed and they were treated as something you sweep under the rug and you you don't talk about these things.

To a place now where it's so ubiquitous to talk about mental health and it's luckily been depathologized, but in a way, there's there's a way that it has become like a positive sense of identity for people, like a way that people make meaning of who they are as a person.

Which probably has some trade-offs in it as well. It's like You either stigmatize the mental health condition or you turn it into a source of pride and identity, and I can imagine that in both of those scenarios there are negative consequences. Right. So it's just it's an interesting pendulum swing that I think has happened.

Well and that's what it is, it's a pendulum's wing and you know that phrase too far east is west, like we've we've swung too far. Like, you know, having a taboo didn't work and then having it as an identity doesn't work either. And that that is that is the problem. I think for me it it people are searching for an identity. we're shaped by what's going on in the in the zeitgeist in the cultural context.

and it seems it feels like mental health is going on in the cultural context. That's what's going on. But it's quite a shallow it feels like quite a shallow understanding. I remember one client telling me, you know, we have a big kind of T walk every year. It's a great walk. It's for for suicide and it's It's in Ireland it's a it's a great walk.

That everybody does. The whole the whole of the kind of country kind of gets together and they walk from darkness into the light. So they walk into the darkness into the dawn. It's a lovely idea. But I remember at this girl who I knew and she said like, you know, they were all being so awful to her around her mental health and then she said, But they're all out there swinging their

banners darkness into light and we know this concept very well in other contexts. There's there's a lip service given to mental health. Think positive Um this is my identity, this is my my my um my mental health kind of diagnosis. And it doesn't feel very deep and it feels like we're we're doing everybody an injustice. I I don't think it's working. I don't think it's working, even though I think it's fundamentally unhealthy.

to base your identity upon your mental health diagnosis. I also think it's not a very good understanding of mental health diagnosis that we're s we're f kind of putting out there. It doesn't feel like it's good.

When you think about that though, are there specific examples that are coming to your mind? Like what what's um What's on your mind when you say we're simplifying it or it's watered down? What do you what do you mean? Good point. I think when people say, Oh my O C D brain, oh my autistic brain and they don't mean they're O C D brain, they're talking about they're they're neat and tidy or their autistic brain because they they're like being or organised.

It has become such a concept creep that everything is is a mental health. So it's anxiety rather than I'm worried. It's also D rather than I like things tidy. It's it's d do you know what I mean? And um it's it's really, really detrimental to our mental health. It's really detrimental that we've normalized this, that everything is pathological.

And children are growing up in this world so that they dn they don't have a little worry, they have anxiety. And then I suppose some people who've been diagnosed feel very annoyed about that, but also you think the diagnosis aren't infallible and the the vibe from people is you'd swear it was an actual blood test the way people go on about I have an actual diagnosis and it's like well The diagnosis depends on the practitioner, frankly.

Yeah, yeah, I see what you're saying. So you're talking about the way colloquial uh colloquially people use like, oh I'm so O C D which I'm sure I've done this before too. I too and I'm too professional. But yeah, you're talking about the qu colloquial uses of these terms. And then on the other side of that, how like even if you have a legitimate diagnosis from a psychiatrist, that doesn't actually tell us that much. It it's not God talking.

And uh doctors are as fallible as everybody else, and psychiatrists are as fallible, and the diagnosis isn't necessarily gold plated. And I I I I have been shocked since I've been working as a psychotherapist, the difference and respect that is given to a diagnosis. It I yes it unnerves me. I'm like, whoa That that wouldn't be how when you know what the criteria is for the diagnosis, you'd feel a lot less deferential about.

Yeah, yeah, for sure. Yeah, I mean I think it's like people wanna have a legitimized way to say like, look, I'm in pain. I have the paperwork to prove it. You know, like there's something about it there that feels really palpable. And I'm thinking too about like conversations I've had in general in therapy. And I think like, you know, for people who who do feel

And this is so hard to talk about because everybody feels different. But like if you if you genuinely recognize that like everybody else seems to be swimming along Making you know, making do in this particular school system or this particular peer group. And for me, every single step in the road feels like a huge speed bump that I don't know how to get over.

I think like sometimes having a sense of like community with other people who are similar in their quirks, like it can feel comforting. And I think people can feel like I can let my guard down. You know, I don't have to explain like why I do these odd things, because everybody here does these odd things. I I can understand for sure how that is a sense of relief, but I think, you know, w when I think about the problems associated with this trend of like pathologizing normal.

I think there's a way that getting overly identified with labels can really hinder us and it can kind of you know, become a self fulfilling prophecy if you start reading uh s micro scrutinizing all of your behavior through the lens of your label. It can prevent you from having expansive options and having flexibility, which everybody needs to have in order to function.

Yeah, and I I don't know what we're going to do about this as a society because, you know, you and I twenty years ago would have been saying we've gotta get this destigmatized, we've gotta get it out of there We would have been saying the exact opposite in many ways. And I feel like it's it's really It's a balance to be trite, but it is a balance and w why uh it it's really unfortunate.

that people are feeling that because when somebody I was only talking to somebody yesterday and they said a turning point in my life was when I got an online what not an online, when I got a diagnosis for autism. It was a turning point. It made me slot everything into place. I understood all those experiences. I kind of got myself for the first time. It was like absolutely pivotal to my understanding of myself. I've heard loads of people say different things around that.

Variations of that. It can be such a source of relief, such a source of that's what's going on. Now I get it. So it definitely has a place. The problem is it slid into being uh a criteria just like as uh all roads lead to gender, but just like gender, it can be anything. It can it feels like it can be anything. It feels like these are these these kind of we have widened our understanding.

of all of these diagnoses into um or all these conditions into almost anybody could not almost anybody, but there's an awful lot of people can be diagnosed with an awful lot of conditions. And that is unfortunate. Yeah, and I mean I'm thinking about like What would the naysayers say? You know, and the naysayer might say

Well, I mean, maybe you guys operate in a world of people who come to therapists, so by definition you're you're being exposed to a population who either has a mental health diagnosis or is more likely to identify with a mental health diagnosis. But you know, even you know, somebody like Alan Francis, I don't know if you've heard of him, he was like the chair of the DSM for many years, something like that, and he

He now is actually um writes about and speaks about diagnostic inflation and the warning that actually we're over-diagnosing people. And in an interview he said something like Never believed the extremely high rates of mental disorders routinely reported by epidemiological studies in psychiatry. Usually they label about twenty-five percent of the general population as mentally ill in the past year.

and fifty percent over a lifetime. So I mean, fifty percent of people having a mental illness over a lifetime, that that almost makes you question Well is it even an illness if everyone has it? You know, like th there is something to that number.

That you do have to question what what does that even mean anymore? Might it be rejecting the fact that life is hard and so and I think life is actually very hard. And um therefore if you're deeply distressed m mental illness needs to be brought into the equation for a reason for why you're deeply distressed, rather than you've just got a whack from life which can be so deeply unfair and so sad and so difficult.

And that, if I was to renew the public campaign that would be where I'd go, which sounds very grim. Life is hard. Put it on posters. But do you know what I mean? That I think it's actually much more realistic and much more um informative. And when people realise actually I remember it was a realisation for me that other people get as distressed as me.

And I thought, Oh, I didn't think they did. They wear it differently. So they wear like some people wear their distress and you wouldn't know they were distressed. And now obviously as I work as a psychotherapist I know how distressed people get. And you wouldn't know and you know that quote the li the mass of men lead lives of quiet desperation. And I know that was from uh over a hundred years ago or stuff. But I I I think there is something in it. There is an awful lot of pain.

And people just keep going, they find their own way, they knock their own little happiness out of life, be it with something smaller or something bigger. And other people tend to think everybody else is finding life easier. And children in particular in this world are thinking if I'm unhappy, something is wrong.

As opposed to there's a dawning between and I write about this in my in my book, what your teen is trying to tell you, but there's a dawning realisation between the ages of about ten and twenty of Oh my god, life is really hard. Oh the good guy doesn't always win. Oh my god, it's so un it's so unfair. It's really hard. Yeah. That needs to be taken right out of mental health and into yeah, that is life.

Mm. No, that's why I think it's it's like so valuable to have a place for these like philosophical and existential questions about life. And to kind of read You know, these are essentially spiritual questions, but I don't think it has to be framed in that context. Like, these are questions of living. Like I remember reading somewhere that there's

Somebody in psychiatry said all mental health disorders are either like a biological problem or a problem of living or something along those lines. I can't remember the exact quote. But you're you're so right this this kind of awakening that happens to us in our adolescent years can send a lot of people into a very dark place. And if we if we have kind of um

you know, the only tool is the hammer, which is the diagnostic labels. Everything is gonna look like a nail. But actually the suffering and the pain of being an adolescent is really profound and And the realisation the realisation that your friends are lovely and they're not always perfect.

And they're gonna be flawed and that realization is so shocking, especially kids who've been told all these movies and gorgeous literature and gorgeous books about great friendships and then they realise they're not that great. Yeah. Yeah, it's a real uh betrayal of your sense of Like that everything is gonna work out perfectly all the time. Yeah. You know? And that's hard to realize. I do think it's no accident that this this diagnosis kind of era has come in.

after religion has gone out. So in a lot of ways in the Western world When a lot of people who would have kind of gone to religion between tw ten and twenty because it's like life is hard and there was a system. The idea was, yeah, you're going to be confronted with challenges and in the ever a ever after you will be rewarded.

you know, the kingdom of of you know, heaven will be your reward. And that was a great framework for your average ten, fifteen year old to know. Okay, so it's really hard Okay, if you do A B and C you'll get into heaven there's a point to it.

If you do D E and F you'll go to hell. Okay, right, they're the rules. This is the point. This is where I'm going. And yet no, it caused its own trouble and I'm not religious and I'm not saying that's what we need to bring back. I don't think that. But I do think we took that away. mental health. It's like the new religion in many ways. It's it's the kind of oh, so you have to ta get your diagnosis, do get to the therapist, learn uh you know, learn the strategies

And then then get the pills. Yeah, then you'll be okay. And that's just you know, that is the arc of of the detransitioner, kind of going, Okay, I'll do what I'm told, I'll I'll do the framework, I'll I'll follow the treatment path. And then what's gonna be at the end? I'll be happy. And no, whether it's O C D or whether it's uh gender dysphoria, no, that's not at the end of the path. Yeah. Um It's the kind of it's it's also the ability to say like

This is overwhelming to me. I don't quite understand to do. There's gonna be an authority figure that I can trust. That we have put a lot of faith in, whether it's God, a priest, the therapist, the doctor, and they will give me answers. They will give me my step-by-step process. And if I follow that process, I'm not sure. it will be okay. And I mean to be fair, there are a lot of there are a lot of conditions. Especially medical conditions where that works out very, very well.

And I think, you know, you talk a lot about the medical model of mental disorder. And I think this is where it becomes really slippery because if we treat emotional and psychic distress as a kind of medical condition. Then it makes perfect sense to put that faith in the step-by-step medical process, but actually that's not.

that cannot possibly reflect all the things that are contributing or maybe inevitable about some suffering in life. I mean that's that's the medical model and that's where we have a problem. And the medical So there's always examples where it works, but but not for everyone. the problem. And that's why we've got a tricky subject here, because there it does work.

Definitely people will be annoyed listening to us'cause they'll be thinking, it worked for me, the best thing I ever got was that diagnosis. And the years I didn't have it were really, really excruciating. And you're right, listener, you are right.

And then there's a whole other section of people who have clung on to a diagnosis and it has it is it has externalized their problem, they've given away their power, they think it's out there and they um they presume that the doctor, which frankly might as well be the priest is going to g you know, reward them with the happiness and they'd be we'd be better off learning that happiness I it's it's not really a condition that many of us have for a long time. It's it's comes and it goes, you know.

Okay, so this raises an interesting question that maybe we can toss around. What are the characteristics or ways that a person can interact with a diagnosis in a healthy way. Like when somebody gets a diagnosis, what's the difference between a person who takes that and uses it in a way that supports their life and expands their opportunities.

versus somebody who gets the diagnosis and it spirals them into a place that is maladaptive. Like what what do you think? I don't have an answer for this, but like your the way you frame that really actually made me think, okay, there's a difference. Cause some people's diagnoses help them a lot and for some people it doesn't. I remember what comes to mind is I remember a friend of mine, her kid got a diagnosis.

And uh the the the the mental health practitioner said, Okay, this is the diagnosis, this is the framework. You as the parent, you need to read it, you need to learn it. And I thought, Oh that's kind of interesting. She said like put it in a drawer. You've d y you know, don't bring it everywhere with you. You know what I mean? You get the kind of the concept. And it's almost like this is how you work.

And it's taken me many years to figure out how I work. Many years to figure out how I work. And now I've kind of come to terms with how I work. Oh no, I can't do this. I know everybody else likes breakfast. It takes me an hour or two before I can get ready for breakfast. I've made my peace with how I work emotionally. So do you have like breakfast deficiency disorder or something? Like is that your diagnosis?

I could probably very easily get diagnosed with that. Yeah, no, like honestly I not a real diagnosis, by the way, everyone. But I I Uh there's so many quirks to me, to you, to all of us. Do you follow me? And like here I am it you know, I'm forty eight and I've come around to all my multitude of quirks and that's how I work and that's how I work and if I don't get enough sleep and if I don't get You know blah. You know, the humans are are complex. And so totally. Getting a quick

framework, if I'd got one, if there was such a thing as a framework that matched'cause we don't know what diagnoses are to come,'cause maybe I am a diagnosis that is still yet being conceptualised in a lab somewhere. Do you know what I mean? Uh but but maybe it would be very, very, very helpful. But also what would also be helpful at the same time as your diagnosis is knowing that your uncle was like you and also your grandad was like you.

And also actually there's a a kind of a a characteristic from your country of origin that is quite strong in you and that there's also a cultural impact because if you look societally and the people around you that also. And you're then you're getting a nice, colourful, proper understanding of yourself.

Well if you're all about your diagnosis you have missed your family context, you have missed your cultural context, you've missed the the kind of the other influences and you have missed half the picture. You really have.

I love that. I love that. I'm thinking about like the concentric rings. Isn't there like a a psychologist called like Brahminsfeld or something? Do you know who I'm talking about? And he had this This image of these concentric rings. I'll I'll have to look it up, but it's the context that shapes you as an individual. And there's multiple layers of context. And right now we're all about the diagnosis and the framework and the mental health.

And back in the day, like I've said a good few times, but it's worth repeating, as I always do, you know, a hundred years ago you and I would have been completely shaped in our understanding of ourselves, by our our you would have been shaped by your ethnicity, I suppose Egyptian or something, and I would have been shaped by being Irish

And it would have been a major part, and also it would have been I'm a Catholic. And you know what I mean? It would these would have been very major parts of of my understanding of myself. So we're just a moment in time, right now it's all about this. And it's It's missing so much. I really do think if you want to widen your kids understanding of themselves, make sure you bring the the family through.

Make sure you get you get a bit of understanding of your auntie is actually very like you or something like that. You know what I mean? So that they understand there's more there's more going on. We work very hard to maintain high-quality content for the show. To take an even deeper dive and support the show, join our listener community for access to exclusive content, practical tools, and resources supporting gender and identity exploration.

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And I I also think like in addition to understanding the contributing factors to like how you are what you are or how you work as you put it. It also helps, you know, in the context of if someone does have a diagnosis to ask yourself, okay, and then what? You know, I have this diagnosis. It and when I when I work with kids who are we're talking about diagnoses, because I'm not really anti or for diagnosis, I just think it matters how we frame it.

I I really sometimes I encourage kids to pursue a diagnosis and sometimes I tell kids not to get too identified with it depending on how they're interacting with the diagnosis. But you know, I often say, you know, whether or not you have like a piece of paper You obviously have recognized that you have this cluster of traits. So if you have these traits, what things are hard for you, what things are easy for you, and what can we do to help you knowing yourself?

to do the things you care about and to do the things in your world that you wanna do and like what supports do you need, what boundaries do you need to set, like what limitations are there? And I think, you know, not um letting a diagnosis become Um A reason you can't? I mean, of course there are times when, you know, my cluster of traits means I can't do so and so things, like you with your breakfast, right? Or whatever.

But I also think being able to own like some of our unique qualities, even if they're challenging. And still live, you know, still live, still participate, still kind of own it. Yeah. Um I think that's really important and I I know that comes up sometimes in the context of like um you know, some of the neurodivergence movements and some of these contemporary movements, I don't agree with all of them, but what I do agree with is that, you know, we can't um

require people to fit into a very, very narrow set of traits in order to live functional lives. We have to give everyone the space to figure out like knowing my quirks and knowing my traits, how do I live a meaningful life?

And I think if if your child is very absorbed or if you are very absorbed in your identity as your diagnosis, or you know you've over Over-identified, have become over-reliant. You could do worse than checking out, you know. Remember the uh uh the Myers-Briggs tests? Do you remember the personality test? They were very good. You could do worse than checking out some of those type of things, filling in those extensive kind of um what are they called? Questionnaires.

And the Enneagram. You know the Enneagram, the personality Yeah. They're really interesting. They'll give you all sorts back on yourself. You'll go, Oh that is me, oh that is me and you will find the same sense of recognition and acknowledgement of who you are as you will have found with your diagnosis. And you'll go, Oh, there's more to me. D do you know what I mean? That there I think it's really important that we don't narrow ourselves into something because um it doesn't help.

kind of make ourselves a kind of a more one dimensional than we are. We're very complex. And so you have to honour it by bringing in all the different parts of you. I think it could really help. I wanted I I and m myself and Alistair had big, big projects and we still haven't done it about bringing in a a kind of a personality test that brought in gender and brought in the Myers Briggs and m

Very ambitious. I love that. Yeah. Do you follow me? Like a twenty first century kind of understanding of who you are. Because personality has moved to identity. Yeah. Do you know what I mean? Oh yes. And so now what was my personality is now my identity. And that just happened without any of us really noticing it. It happened culturally. in the last ten years ago. I just if I had said I identify as If I had said that sentence fifteen years ago, I think it would have sounded very clunky.

Yeah. Yeah. No, it would have sounded really clumsy. Nobody would have really understood what you meant by that. Um I I did find it the the kind of system I was referencing is called Uh Braun Bronfrennbrenner, Braunfrennbrenner's ecological systems theory. And it starts in the middle with the individual, and then there's a microsystem bigger than that, then a mesosystem and an exosystem and a macrosystem.

It's a it's kind of a theory of child development, but I really I mean I remember seeing that visual. I'm kind of visually oriented, so when I see a graphic like that, it really makes sense to me. Well we'll include something about it in the notes. But you know, all all of this talk makes me think, well, there's two things I'd love to think through with you. I guess one is

We've been cautioning so far about the possibility that we're over-diagnosing people or that people have become overly dependent on what their diagnosis means as a kind of single pathway out of their distress, which we we think is. Mel, it's not necessarily gonna get you what you want. But I also wonder, I mean, do you agree that there is a kind of mental health crisis amongst adolescents? And and how does that kind of relate to this?'Cause I I think there is

But I also think it's been almost self-perpetuated by the obsession with mental health. Like I d it's it's like kind of the atrogenic in a way. This is a massive question that I have agonized over because I know How awful. adolescence was for so many people in times gone by. I've read enough literature. I know how lonely ha it has been. It has been devastating. I know how awful there's been so much secret child abuse. There's been so much awful things happening.

So you kinda think on one level, like we've all got richer and like our homes have all got better, on one level we've made a massive step forward. in our mental health. It really does feel like just like we have in our health and our our you know food and our you know what I mean? But food is actually a very good analogy for this. Because while we made a huge step forward in our food and our diet, we also made a huge step backwards in our diet.

at the very same time if you follow me. So that we've got this vast array of food available to us and at the same time we've the vast ava array of really unhealthy food ava available to us. And so we seem to have You can sink into the bad stuff. And it feels like that. I kinda get into this. I know I'm talking about my book a lot and probably too much, but I get into this in one of the chapters. No, go ahead. Yeah, I do. I go really into this p fact

Are are are they having a mental health crisis or are we looking at it a hell of a lot more? Honestly I'm with you, Sasha. I think it incredibly hard to be a teenager at the moment. And I think you could pick different periods of time and you could say it was very hard to be a mother at that point. It was very hard to be a man at that point. Maybe they were all going to war or whatever. I think it's very hard to be a teenager at this point. I think social media in particular, technology, porn

all the pressures, all the likes and the and the pylons and all that, I I do th and this kind of extraordinary emphasis on mental health, which isn't massively helpful. I do think it's really, really, really hard. And I also think as a society, just to be annoyingly Complicated. As a society we have done something very good for mental health. We have it's like food. We did something great and we brought in an awful lot of bad. Do you know? We did both. Am I make am I as clear as mud here?

No, no, I I think what you're saying is perfectly clear. I think the food analogy is interesting because I kind of I've started thinking about that and looking at it in a slightly different way, which I think is going to be the the road we go towards with technology too. And I even remember kind of you talking about this. Like Um, from my years of like obsession with and research in like the fitness world and the you know, f bodybuilding world, like I try not to label foods as good or bad.

The what the research shows like unequivocally across like tons and tons of nutrition research is like In moderate Any food can be part of a healthy diet that keeps your weight stable and keeps you generally functioning well, organs doing well, blood sugar doing well. And I think the same is probably also true with technology. Like social media is a technological invention that we have not had around very long.

And whenever a new exciting, especially like dopamine stimulating technology comes into the picture, we all just get totally absorbed by it. And I remember you saying, like, there's probably gonna be campaigns popping up, and I think we see this in our own world, where we're recognizing that social media has to be monitored in terms of when it's introduced.

how much time is spent and what type of social media interactions kids are having because that can have a negative impact on their health. And I think the same is probably true for like Questions of identity and how fixated you get on your label. Like it's probably a dose response issue, like so many things biologically, probably also psychologically. So

You know, and personality makes a difference too. Like you can have one kid come across some sort of, you know quiz online like here diagnose yourself and figure out if you're trans and they might take it and get a result and laugh it off and never think about it again. But if you have that kind of personality trait where you get fixed and obsessed

That one cue can spiral you into a very dangerous place, and it could have been some other cue as well. So I think it's really interesting, we'll have to see what happens as We as a society on the macro scale Recognize the impacts of these things. Recognize what does it mean to be an adolescent with this technology in your hand. Like it's gonna be different than being a forty year old, right, with this technology in your hand.

So I imagine we're gonna see a lot of changes, but like right now if you're a parent of a kid or if you're a young person and I mean how many detransitioners do you see on Twitter like They're in true agony over social media comments. Like real agony about it. Yeah. And I really feel for that. And I it may be a personality thing or it may be an age thing, but like I have never really been super distressed by what happens on social media. І і цьо інстрин ансосад тосі.

How these kinds of platforms can really tremendously impact a person's well-being. Whereas for some of us, like I don't even like I don't even take it seriously. Like I don't even take screens that seriously if if that makes sense. I don't know how to But it kinda inoculates me from actually being very concerned because what's happening in with my family, the people who love me and the people I work with, like that's

For me for me it just does it feels more consequential. But if your world exists uh, you know, in these digital spaces I can imagine how hard it is. It's just really interesting. Well we we ourselves, our generation, um, we grew up without that kind of online smartphone, you know what I mean? So this yeah. Therefore we've got a step removed. We've formed we were formed without it.

They are formed with it. And I I do think that makes a difference. They it's like their left arm, if you follow me. If it's so much part of their identity. me and my phone, if you follow me. It's it's so it's it's frightening actually. I I really now I now both my kids are teenagers. I'm I'm

horrified how all four of us, because I'm as bad as them and Henry's who's bad as them, we're all just phone addicts and I'm like, we're gonna have to do some sort of detox'cause we're all doing it. And you know, we were having a conversation, we had somebody for dinner last night and

Somebody asked something we didn't know the answer immediately grabbed the phone. I know. Somebody asked so the conversation went back. We were polite, so we put away our phones after we found this non-event of an uh of a quest. And then uh sorry, I'm rant ranting, but I have to say No, no, no, that's right. Then uh some joke came up and they said, Oh, did you see that online? No I didn't. Oh wait, I'll just get it for you. Uh no, don't get it for me.

Some picture and you just go, Oh yeah, there's the picture. Oh yeah, right. Funny. Yes. Yes. We we're just di we're like and you can see there's a movement, there's a new movement people have, which is to get their phone and then they go away. Oh my god. There really is. Yes. It's a kind of Yes. Yeah. It's frightening It's a jitter that people have and it's kind of one to go for their phone and two

a lot of us don't go for it. We go we we pull away. We know that it's we're in polite society. We need to stop grabbing our phone like like uh like it's a drug. So it's I d I do think that there's There's going to be studies that will show this. I do think that these teenagers they do seem frantic.

And I do think there's a concept called professional deformation where you and I, Sasha, we're seeing the worst of it. We are seeing the worst. We are deformed by our professional life, so we see the worst of it. But what we see is so frightening and you don't meet any therapist who doesn't really agree with us. I I think every therapist thinks

There does feel like there's a mental health crisis among the young people. They feel like they're not enjoying their teenage years the way you would hope they would. I d I really don't think they they're getting through them. Yeah. Sad. You're so right about that movement. That's really interesting. It's like the the Like how you can't even complete a conversation or a thought without referencing something that happened digitally.

Yeah. I be I I think that's a whole other conversation. But I do wanna ask you about this, which I feel like we should do a whole episode about this and we can ask the audience if the following thing I'm about to say should be a whole episode, please let us know.

Um, what about this whole movement of young people online on like TikTok and various platforms claiming to have dissociative identity disorders? Personalities. I mean, that is to me like the exemplar of what we're talking about, of like how a diagnosis can take on a life of its own and totally absorb young people, and then how

But like almost like belief in the diagnosis can bring forth the traits even more palpably. Like this is kind of what you know psychosomatic illnesses are in a way and psychogenic illness. So What do you think of that? Oh I think s I think you're right. And I think this dissociative identity disorder well, we would be dissociated from our identity. You know what I mean? I think people are very dissociated from their identity. So it makes sense that the identities that have

let's say you know the ticks, the nervous ticks that I was kind of just showing you with the grabbing the phone. Yeah. That that those ticks kind of become a more common. They make sense just like the dissociation from yourself because so many people have avatars, they have other identities online, they have very elaborate identities online. So I can see why you'd lose your sense of self.

Um and I I think then you live in a world where everything is pathologized. I can see how it combines into this this kind of scenario where you're you're you're being diagnosed by your online life or your online life is diagnosing you. I'm not sure where this is gonna go though. You know, I'm not sure how this is gonna where are we gonna go? Is there gonna be a pushback? Will people just kinda push back from being online all the time and will that be the kind of result?

Or'cause I was just having a conversation with somebody today in a cafe. And there was uh music coming from the guy across there because he was listening to something. So he was listening to some T V programme or whatever the hell he was. I'm like something like the nineteen fifties, a T V programme but Ecklip. Then there was people to the right who was listening to music. And I was like, There's music at the cafe.

There's your woman to the right, your man to the left, and we're trying to have a conversation and it's awful. And she was saying, Yeah, I'd say in the future we'll all be walking around with our with our kind of pods and you know. Nobody will hear anybody and I was like, we're getting more and more fragmented and more and more kind of atomized into me and my online life.

And that that is all I am. You know what I mean? It's rightning. It's so lonely. It's so lonely for these people. I really do think it's. So bad God. Are you are you saying though that like being immersed in this cacophony of sounds and discordant noises, like are you saying that People were better at tolerating that in the past? Or or are you saying that that's that all these different Like everybody has some kind of electronic stimulation

That's separate. We're all in the same room but we're all doing our own individual things with our electronics. That's what we're doing. experience. Yes. And sometimes what we'd often have in a cafe is the staff would say something funny to the other person and we'd all hear it and smile and there'd be a communal moment. Or a nice sound and you'd look up and you'd catch somebody's eye.

'Cause the lovely song has come on and you'd look back down into your experience. And that's all gone. Not only has that all gone But it's gone into an irritating way of he's got annoying tinny music over there and it's his taste and it's not mine and I can't hear it properly anyway. And she's having a conversation and it's in and it's atomized and it's it's really individualistic. So it's there's this th th it's actually the antithesis of the communal cafe experience, which I used to love.

And it's actually yes it's it's it's we're fighting with each other for ourselves, if you follow me. And and that desire to be part of a larger, cohesive Yeah. keeps popping up in these micro communities online, in these diagnostic obsessed kind of online worlds. Like w the need to be part of like

Oh did you see that? Oh that was fine. Like the need for that doesn't go away, but it keeps getting kind of channeled into different ways and into ways that are s online and ways that are so specific and so particular.

You know, it's like these affinity groups at schools. Like you are going to be amongst people for whom like the the tying the the unifying strand is like your identity or your belief in this political view or your desire to do this or that thing whereas In other times, our sense of identity came from just like

kind of our local environment and your local environment by definition is mixed with all kinds of different people and you're gonna meet people you don't necessarily have the exact same kind of life as, but you all live on forty third street and you go to this cafe on Saturdays. Like

That sense of community is being transferred into like, oh, what's your identity label? Oh, you too, me too. And we're gonna find all the ways that we're so identical. Like it's so, it's a different way of feeling connected.

And a negative way. Because m you know, look it up because it's a lovely song is is joyful or smiling because the you know the the the the manager saying something funny to the the other staff manager. It's it's it there's lots of different ways. Well the the way it has gone online has gone into

Um we will meet over distress. We will connect over distress. That's how we're going to connect. And we're not going to connect over the the more joy the only joy we're going to get is in the connection over distress. That's that's where we get our joy. It's it's it's fundamentally negative.

And it's it's rampant, like way back in the day when you know, when social media was first beginning. And do you remember those a pro anasytes and pro meocytes and stuff like that? Yeah, yeah. That was the canary in the coal mine of where this is gonna go. People finding each other, communities finding each other. And previous to that, like in the nineteen nineties, a lot an awful lot of um a completely different context, but an awful lot of child abuse have found each other online.

And I I hadn't known that but I um kind of Basically child abuse tourism grew. from that because they started swap yeah, they started swapping information about go to this country and you know what I mean? So that there the all sorts of things grew from those online connections. And right from the beginning I would argue a lot of them were negative. The w there weren't positive.

They were and out why that is, I I'm not quite sure other than if you're going online way back then looking for a community, you probably didn't have one. where you were if you follow me. And of course there's always and I'm among them, unusual people who don't find a community very easily.

But you still have to keep a connection with the ordinary cafe community. Do you know what I mean? Because it it brings a lightness to your life. Somebody smiling at ya, you know, because you you your eyes meet because the kid is cute. Do you know what I mean? You you need that totally, totally. And that's where that's where the identities and the pathologies and the diagnoses, they're missing all of that. They're missing all of that colour and context of life.

Yeah. And I think again, like in the right dose and in the right context, like if you have some sort of group you connect with because of this particular thing about you, but you also have a rich

connection with other types of people and other types of contacts, I think that's probably fine. I think when something becomes the exclusive and only way that you find community, that's always a risk. And I think That's also a risk of radicalization, you know, like Getting indoctrinated or going too far down a rabbit hole, that happens when you only have one singular avenue for connection.

It just dawned on me that that's kind of a characteristic of like extremist groups. Like you kind of start rejecting anybody who's not part of that. And I think that same thing can happen in a diagnostic label or any kind of special interest that an individual has. If it's the only way, you risk kind of getting

blinded, I guess, to a degree. That that's such a good point. I remember, you know, when I was growing up and like there was an awful lot of Irish nationalism, an awful lot of fighting around politics and there was a certain type of person. who was very pro Ireland. And they would come out with these slogans. They were so one dimensional. And you know, they'd have their songs and their slogans and it was just that was what they were. They had completely built their identity around that.

kind of personality.

And that's that's what it is now. I do want to go back to before we finish uh on on this, I do want to talk a little bit about you know these diagnoses, you know the way they that they have They've slipped in lots of different ways. So it's not just um ADHD or autism or anxiety, although the and depression that have all slipped into a much wider you would not have got those diagnoses.

thirty years ago. Now, some people would say they were too narrow and too many people were being missed thirty years ago, and now perhaps they're too wide. But arguably they're doing the same with'cause I I was studying it, I I studied it for for my new book. That like you know, things like osteoporosis among older women You know that's a really common one, or being pre diabetic when low we're all pre diabetic, or the new one for myself.

Perimenopausal. No perimalopausal. No, yeah you only have to yawn or you have to just say, Oh, I'm feeling a bit anxious. Perimenopausal. I'm not pairing their hazel. I'm s I'm slightly hassled. Maybe I I'm Perimenopause. The entire fifty-five years before you are Perimenopause. Between Between puberty and menopause, that whole thing. That's so funny something. I was bringing it up, I was bringing a big roll roll up to my perimenopausal and you jumped in Perimenopausal!

Yeah, no, no But that's how our age group I turned around It's because I have ADHD I interrupted you, that's why. No, but it's exactly reflective. It's so reflective of every time you turn around somebody somewhere if you said I'm a bit worried about my mother, you know, she's sick I shouldn't laugh, but she's sick or something. They'll say, Yeah, you you might be perimetapusal. Sorry? What's I got to do?

It's like so random. It's not exactly a conversation I had, but it's similar to a conversation I had recently and I was like, No no no, this is uh just a a worry. that it's absolut has substance that I'm worried about. And I'm not like maybe I am, I've no idea if I am or not. And it's not and I'm sure'cause I've met somebody and, you know, she was told she was married very metabasal and it was

An amazing framework for her to understand. But there's something about the chip chip chip of everybody else, like other people who are getting the false diagnosis. there's something about that that is very detrimental to society and a bigger you know, and the people who say, No, it's good are missing, I would argue, the chip chip chip of of of all the false diagnosis that's been thrown around.

I I re I really I do think it's an issue. And I think if you look at the way I think a reflection of how badly we're doing mental health and I I do think we're doing it really badly, even though we're trying. You know, if there was a God he'd give us top mark for trying. But our performance efforts yeah, yeah, yeah. Our our our our actual action isn't great. When we look at and this is a very serious subject, but I think it's really important to bring it up.

When we look at how we've handled t suicide you can see how badly we've done it. So like years ago s suicide was very taboo and the numbers were low, but they were being miscounted. Because there was a lot of people dying and people weren't admitted because it was taboo. So that was certainly happening. But nowadays, and it's come within me being a child and my children being a child, this has happened.

Nowadays it's become so much the opposite of taboo that children these days are throwing the word suicide around in a very cavalier fashion. And it is a really, really, really bad impact on everything. Because the kid is a kid who has a a a child's understanding of the word and of the impact. Everybody else is an adult, whether it's the teacher, the counselor, or the t or the parent. Yeah.

lightly. Even if it's being said lightly, they can't take it lightly. There's protocols around that word. And so all sorts of protocols get rolled in. I remember, you know, one kid coming to me and she said, You know, I like now that you have all drilled me about this word for seventy two hours, I now realize I was using it lightly. However, like honestly, we all are. We're all doing it. Yeah. And ye guys are all taking it too seriously. And I'm like, yeah, well then society's gone wrong.

Because we we're using th they have been taught it's at the back of their toilet doors, it's when they're washing their hands, it's when they're walking down the school corridor. Do you follow me suicide, suicide, suicide, and they're it's gone into their language. It's gone into their language of distress and they haven't learned that no, no, that is a word you don't bring up lightly and if you bring it up it's you've thrown something onto the table like a concrete block.

that will now everybody has to look at. And I don't want people to be afraid of saying it. I don't want it to be taboo. But it's reflective of the really bad way we're managing mental health. That kids are throwing that word out so lightly. And parents are just about it. They're so upset about it.

Yeah. You know, we did another episode on suicide, and I think most of that was about trying to clarify the misinformation around gender and suicide. But I think you're so right because I hear this a lot, where like a kid in the pangs of their distress will just say something about suicide.

And then all of a sudden of everybody goes into crisis action mode and they're like rushed off to the hospital and the kid didn't really intend for it to be that big of a deal. Like I think this is you're so right that there's something about this. I'd love to talk about this further. This is really important. Maybe we can do that on another episode because Yeah. This is this is like a real kinda phenomenon amongst young people. The the That's a good idea.

Yes, it's a serious talk. And in in fairness'cause because I find an awful lot of adults are saying they don't realise they're devastating me with this and y they kind of the parents are often looking quite angrily at the child for kind of throwing this out like confetti and I'm like in fairness those kids are reflective of their environment. They're all doing it. Therefore it's not just your kid. They're not being manipulative. They have learnt this language.

And they've learnt this way of communicating. They've learned to understand their distress as suicidal. They've learned they've learnt that framework. It's a framework they have learnt. They've learnt to understand their worries as anxiety. They've learnt to understand their sadness as depression.

and they've learned to understand their their despair, which is part of the human condition. We can we can fall into despair because life it can be very hard. And you can have six hours of despair or you can have, you know, an hour of utter despair And then you can go, I need to have a wash, I need to have a shower, I need to get myself together.

Mm. Y you know, and that's not suicidal, it's it's despair, which is a terrible place to be, and also you can move beyond it. We haven't we haven't given them the correct language. I think. I think we've given them diagnosis language or something.

Yeah, I mean I think that's a great example of how clinical labels, clinical language, when not used very, very carefully, can take on This other meaning in the life of a young person, the mind of a young person, that is not actually appropriate and it's not the right framework to help them understand their distress. Yeah. Um before we wrap up I do wanna kind of put a put an idea out there to the listeners. So we have this Patreon listener community that we

are really um proud of and we're also making a lot of updates and changes too. And right now we get a lot of great listener questions. If you join at the QA tier you can submit questions and we answer them once a week. And a lot of our questions have to do with stuff that's going on with

Kids struggling with gender, and a lot of them are from parents, but we have a good number of mental health professionals who are also part of the listener community. And so if you are a school counselor, a therapist, a psychologist, Or if you're like a school personnel, a dean of a school, a teacher, please consider joining our listener community and submitting some questions because we know that there are a lot of different

you know, people and types of professionals who are encountering these kinds of questions in their work and we'd love to address some of those. So if you want to, please go to widerlenspod.com. That's our website. And go to our listener community page and consider joining so that we can engage with you there and also take some of your questions.

And can I add to that, I really feel with gender, you know, it's gone through different phases. You know, for me uh th you know, two years ago was the phase of the parents and the parents' voice and it got lifted and then there was the voice of the detransitioners and the detransitioners' voices got lifted. Now I feel education. I think education, this is the year for education. What's going on in the schools? How are we handling

you know, uh mental distress, gender distress, all sorts of things in the schools. It feels like this is the year for education. I think an awful lot of teachers are really, really in the trenches with this and they're n they're finding it difficult. Genspect released this amazing educational policy for the US. It's a sample policy that lots of different schools oh my God, it's a very serious document.

It's very well referenced. It's very it's very scholarly and it's it's a show. Yeah, it's it's really, really good. Yeah. And I really think the teachers who have been Till now rudderless and without a guide and without direction and frightened, I think now is the year, this is the year, and I'd love us to kind of grapple with this on this podcast because I think it's really important. Yeah, for sure.

Okay, well I think that's a good place for us to sign off and we um look forward to seeing you all next time and we hope you will attend the Detransition Awareness Day conferences and events that are happening all across the Intrawebs. Yeah, they'll be over here. Alright, Stella. I'll see you next time. You'll see them everywhere. Okay, bye. Yeah. Yeah. Alright. Bye. Bye, bye, bye. Thanks for joining us this week on Gender A Wider Lun.

Listener support means a lot to us. If you enjoy the show, please like and subscribe on iTunes and leave a review. For more information, visit widerlenspod.com. There you'll learn about joining our listeners. Our discussions are for educational purposes and are not intended as a substitute for mental health services.