156 - "WPATH Has No Respect for Medical Ethics" with Mia Hughes

Hi Stella! Hello, how are you doing? I'm doing well. Uh we had Mia on the show today, Mia Hughes, the author of the report that accompanied the WPATH files released recently. And that was an amazing conversation. Yeah, we got into all sorts with Mia. You know, I consider her a friend now. I've just got to know her in the last few months quite intensely with the W Path files and

She wrote such a it's a such a beautiful piece of writing. It's such an important piece of writing, the report that goes with W path files the W path files being the leaked conversations.

from the internal channels from W path. But Mia is a real she's got a wealth of information and she she imparts it in such an interesting way. And this conversation that you and I had, Sasha, with Mia was it was so interesting because not only did we talk about the W Path files, but we also talked a lot about the medical scandals that have happened.

And the ethics of all of this. You know, w w just because we can, should we kind of aspect of it. So th there's so much in this conversation. I think we could have gone on for hours. It's already a very long conversation and we could have gone on for hours. Yeah. And what I really appreciate too,'cause those those listeners who are here, you might have heard of Mia before. She's an amazing expert. profile Twitter X where she writes really informative and deep thinking threads about

um, gender and gender medicine. But we also got to hear a little bit more about her personal story, which I haven't heard her share anywhere, like how she became aware of this gender stuff, her kind of journey for lack of a better term, from being

actually very what she calls woke to like realizing something very strange was happening in response to J.K. Rowling's very reasonable tweets. And so She kinda tells us how she got into this and how she really quickly realized that something very unhealthy is going on, not only with the way people responded to JK Rowling, but when she discovered what's happening to kids. and so she just went from, you know, someone who left a career of teaching to homeschool her kids, to stay home with kids, to

becoming a full-time writer covering gender issues. So um it was a great conversation. We're we're sure everyone will appreciate it. Mia has a very clear and concise way of speaking about these things. It's she almost speaks as though she's written what she's gonna say. She's like so put together. It's really nice to listen. Sh shall I read her bio and then we can jump in? Mia Hughes is an Ottawa based journalist primarily covering the gender issue for environmental progress.

With a particular focus on the controversy of pediatric medical transition and how trans rights can collide with the rights of women and the LGB community. She also researches media bias and other issues for environmental progress as well. She previously covered the gender issue for the post-millennial and has been published in The Critics.

Lesbian and gay news, and gender dissent. Mia is a British mother of three living in Ottawa, Canada, and before becoming a journalist, she was a teacher. So with that, we will let you enjoy our conversation with Mia Hughes. Hi, I'm Stella O'Malley, a psychotherapist in Ireland. And I'm Sasha Ayad, an adolescent therapist in the United States. And this is gender a wider

Through in-depth interviews, personal stories, and psychological exploration, we seek to open up the discourse around this hot-button issue. Join us as we look at gender from a wider Hi Stella and welcome Mia, we're so glad to have you. Thanks for having me. I'm happy to be here.

I feel like it's my two pals here because me and me and Mia have struck up a a friendship and Sasha's my old sagosha so I'm I was just gonna say you you guys have been working together a lot lately with the release of the W Path file so I know you guys have become um quite friendly and acquainted with one another and and I'm hoping to learn a little bit more about you today, Mia, and then of course for our listeners as well. So just really glad you're here.

So we were thinking about starting just in case people who are listening here aren't familiar with What is WPath? What are these WPath files? Why does this really even matter? Maybe we'll just start with a little bit of background. So can you kind of share what is WPath? What is this organization? Right, the World Professional Association for Transgender Health. This is This is a group that has a very carefully crafted public image um as a leading scientific and medical organisation.

Um advocating for the best evidence based care for transgender people. Uh they've been around since nineteen seventy eight. They they formed and they were the Harry Benjamin International Gender Dysphoria Association, Hibigda. And rolls right off your tongue, doesn't it? Right. It's not the best acronym. So in my mind, I like to think I being generous, I like to think that in the early days, while this was a really obscure field of medicine and probably attracted some unusual types.

I would like to think that in the early days they were at least pursuing science in their own way. They were at least looking for the best way to help people suffering from what we now call gender dysphoria, which w whatew however you want to define it, it's you can be quite sure that the suffering is real and the the pain is real. And then I think around the late nineteen nineties this organization took a turn.

for the ideological. And I think the reason for that is because activists started to join the group. More and more trans activists Because the political trans rights movement was really getting off the ground at the same time, running parallel, and a whole bunch of activists started to join Hibigdum. And then they s they they're less pursuing science and more pursuing activism, with a sprinkling of science in there for good measure.

And as the the first decade of this century progresses, we've got just more and more activists join and then in two thousand and seven this is the pivotal moment. they rebrand, they the they become W Path and it sounds very professional and and uh very respectable, the World Professional Association for Transgender Health. Very fittingly, I think they self identified as a world leading medical and scientific group. They just gave themselves this name and it and it and people fell for it.

So then you've got they're very much involved in activism. Around like twenty ten they make this crazy statement, the de psychopathologization of gender dysphoria, d gender identity issues. where they decide, based on no science whatsoever, that gender identity disorder is not a mental health issue.

It's a perfectly natural, healthy state of being, and the the the issue is the the discomfort that you feel because your body and your gender identity don't align. And from that point on it becomes affirmation. affirm the gender identity, and to treat the discomfort The only option is medical transition. I if i if there's nothing you can do about the identity that's natural and healthy, all you can do is treat the discomfort with this medical pathway. So

Standards of Care Seven comes out in twenty twelve. This is very, very clear the the ideological shift at this point that it's all affirmation, it's all medical intervention. And y you know, psychotherapy viewed very suspiciously as conversion therapy and the the role of mental health just becomes a facilitator for medical transition. You're just writing the referral letters and off you go. And then you know, a decade passes between Standards of Care seven and Standards of Care Eight and

they really plunge into ideological terrain at this point. W most people many people n will know about the infamous standards of care eight eunuch chapter, you know, when you when a when a when a a healthcare organisation, supposedly scientific, supposedly medical, releases a guideline with a an entire chapter on eunuch as a valid gender identity in need of surgical and hormonal castration.

You know something has gone very wrong within. And what went wrong was political activism. They became overrun with activists.

Yeah. And I'd love to add too, in addition to becoming more and more oriented towards kind of ideological and political activism, This group, as you mentioned, the self appointed kind of authority on trans medicine. was indeed looked to by medical associations and physicians and training programs and medical schools a as the people

Who are experts in the field and that they know best. And it's really interesting. I think by definition, when you have a condition that used to be quite marginalized, quite uh atypical, qu quite small in numbers.

I think the general public and maybe even n normy physicians who aren't in this world, they think it must take specialized knowledge to understand this because it is such a kind of an anomaly. So I think it almost Whether it was deliberate or not, it kind of was it almost felt inevitable that you could have fringe views coming to dominate this area of medicine because I think it's so unfamiliar to most physicians, doctors, therapists, people in general.

And so can you talk a little bit about the influence that WPATH has on the treatment of of individuals? Like they're not just a weird activist fringe group that's self appointed. They're really taken seriously by kind of big institutions. That's the remarkable thing. You see, I can understand how we were well, how I on the outside, as a totally non medical person, was due.

Because it is very impressive. They they they've got a peer reviewed journal, they've got this giant bibliography of of scientific literature that to the to the average person it looks legit, you know, you got hundreds and hundreds of citations. But yeah, the fact that they they have such influence within the medical world. We've got, you know, all I live in Canada, so all across Canada, every gender clinic looks to W path.

for guidance on how to treat people suffering from gender distress. We've got, you know, major all of the medical associations I don't know if it's accurate to say I guess they do follow WPATH's lead. So the AMA, the Endocrine Society, the AAP But it's also more than that because it's the W Path members very often are also members of the Endocrine Society. So if you look at the Endocrine Society's guidelines

Yeah. Twenty seventeen, I think it was, half of them are W Path members. So it's not just that These organizations are looking to W Path for guidance, but those org these organizations are populated with W Path members who then on the inside are spreading the gender affirming ideology that that stems from W pass.

We've got all over the world you see people quoting WPASS Standards of Care. Like Standards of Care Eight, I think whenever I see that on a on a medical uh a clinic's website, I think, have you read it? Have you read the Eunic chapter? Could I add a a a kind of a really insidious aspect of it? In Ireland, for example. In Ireland they rejected W path.

But the uh if the for the adults, the children still um uphold the W Path um guidelines for want of a better phrase. But what people use is this phrase international best practice and it sounds very, very impressive.

And so again and again in all sorts of activist world when they're trying to bring in some extraordinary things like phallus preserving vaginoplastys and eunuch identities and some extraordinary interventions, they say, well international best practice supports this and it's y you you have to be very confident in yourself to say no to international best practice. So th to me that's a really underplayed, heavily influential aspect of W Pass.

It takes a lot to dismiss a document that has hundreds of scientific pieces of literature s cited in it as well. You see, even for me I read the Eunuch chapter when it came out and totally mind blown and everything, but only recently did I go in and start reading the actual citations. And only then did I realise what absolute garbage they all are. I I the just

Study after study after study with no control groups whatsoever, high loss to follow up or, you know, no follow up or three month, six month follow up periods, just absolute garbage science. And If you don't click on those citations, you won't know that. You'll just see hundreds of citations and every statement is backed up and it's a very con convincing facade. Mm-hmm.

So i in the report you wrote recently about these leaked WPATH files, you you talk a lot about this. Can you give us give listeners an overview? What was Lee or the Um what did you find in these leaked documents? And I'd love to talk about the WPATH response in a minute. I'm trying to kind of go the step by step. There's so much here, but what did you guys You and Michael Schellenberger in the organization Environmental Progress. What did you discover in these leaked documents from WPAT?

So this is an internal they have an internal messaging forum. Everyone who is a member of WPath has access to this forum. We got I c I don't even know. Maybe it's about 150 pages at this point of screenshots of these internal messages. And basically what you see in there, and the whole point of the report, is t when I say I make two points that this is not medicine and this is not science.

So inside the forum, first and foremost, when I think medicine, I think first do no harm. That should be the overarching principle of medicine. And then in the forum you see members discussing very obvious harm and it's iatrogenic harm. So it's it's harm that has been uh has occurred because of the treatment that these people are providing to a very distressed and vulnerable cohort of patients.

So in w basically how this forum works is somebody shows up and they post an original it's usually a case study about a specific patient. So in the harm section, uh there's one like a very distressing part is the the the iatrogenic harm of s testosterone in females. And so somebody shows up and they've got a sixteen year old girl who was in the ER with pelvic inflammatory disease. She's

been on testosterone for a few years. She's got vaginal and uterine atrophy. She's bleeding. She's all sorts of terrible, terrible symptoms that are the result of the medical treatment. Otherwise she would be perfectly healthy. And so this this person comes in and they're like, I don't know what to do, what what if have you seen this before?

And as you see time and time again in the forum, a whole chorus of people come along and they share anecdotes. So they will so won't somebody medical will come along and say, Oh, I had that and I tried this. And somebody else will say, I saw one patient with that and I tried this.

And y be you can see that it's experimental in the fact that nobody shows up saying, Oh, this study, here, read this, this will tell you what to do or this is the guideline from Standards of Care Eight, this is what you have to do. because nobody knows what to do, because it's all entirely experimental. But the crucial part in like this this thread and it plays out in all of them is a bunch of trans identified females show up and they say, I had that and this is what I did.

And to me, that's when the conversation i even if these were real medical professionals, which I do not believe they are, I think they're more activist clinicians than real doctors, but even if they were real doctors, and even if they did care about the the health and well-being of this sixteen-year-old girl and or like her. They now can't say anything because they are in the presence of a person who has made that medical decision for herself and is dealing with the consequences of it.

There's no open debate and discussion about whether testosterone is safe for females, whether it is a good idea to use it as the first and only line of treatment and for, you know, dismissing psychotherapy altogether. You can't have that conversation because you're in the presence of someone who's made that medical decision for themselves. So what the files to me show is

On the inside, I mean we know that they're act you you really don't end up with a eunuch chapter. I'm sorry to keep going on about the eunuch chapter, but you don't end up with a eunuch chapter if you're not a bunch of activists. But the files and uh when you see what's going on on the inside, you really, really do see how activist led all of the patient care is.

because of the conversations that are going on on the inside, that there's not open debate and discussion like there should be in any real medical organization. Mm. Yeah. Or that they have bleeding after sex. And it's very hard for a clinician imagine to come in and say, Well, that clearly isn't an ideal solution. Let's try something else. You're you're effectively stifled. You you know what I mean? So you you're you're left to go, Hm, we could try that.

That th that you know, uh I it's very interesting when we've moved from kind of client centred to client led care, and this is a very good example of it. And I think we we we as an industry, and I'm talking about medical and therapeutic, we've kind of lost our way because we did start getting led by clients and patients rather than being centred. And when we centred them, you know, I do think it's important that clinicians can speak

freely to each other, sometimes without patience. I think there's real value in that. For really kind of um pressure testing and critical analysis of of any kind of treatment path. But this idea of always centering patience within it and now we've moved to client led, so now they're they're leading the way. I just think actually theoretically and and and practically speaking it's not a good move. And I'm saying that for for all sorts of things. This idea that, you know, any conference with

that might be is is a conference about addiction should have addicts leading the way. It's not necessarily true. The lived experience has been kind of glorified. And I mean I think there's a place for maybe separate conversations where providers and patients can come together and patients are given kind of a forum to air their concerns or share their experience.

If the entire model of guideline development is based on centering patient preferences and patient experiences, you're dealing with something different. And in addition to that, we're, you know, this is something Carrie Mendoza always raises, like what are we actually treating? Because if you have, let's say, a patient population of people who suffered from a heart attack. There was like a tangible and concrete event that they experienced.

You know, yes, clinicians and physicians need a separate space, you know, aside from the patients to talk, but there might be value in hearing from the patients. When we're talking about something as esoteric and subjective and individual and personalized as somebody's felt sense of gender. Th that certainly cannot be the driving force of the treatment model.

And it's all all of the people in there who have modified their body on the basis of that internal s sense of gender, whatever they have got a very powerful interest in medical transition being the right the the only approach and the right approach because they have to have made the right decision for themselves.

So again, if they if these are the people who are shaping the conversations on the inside, and there's actually when you talk about the standards of care, there's a really interesting video of Marcy Bowers. in twenty eighteen and it's quite it's quite um interesting to watch. It's the Be Bold speech. So Bowers, have you seen it? Bowers is at the twenty eighteen W Path.

conference in Argentina, I think. And he's talking to, I don't know if it's just the Standards of Care AI committee or if it's a wider audience. And he's basically telling the Standards of Care Ape committee to be bold. And there's a really interesting line in it, you know,'cause he's asking for them to get rid of gatekeeping, get rid of the the need for surgery the referral letters.

um lower the age limit for surgical intervention for adolescents. But he says a really interesting thing and it's something like, I have been talking to members Especially transgender members of our group and they all say that gatekeeping is unnecessary and it's it's discrimination. And it's like there's the problem right there, that th he's talking to the transgender members and they are the ones that they don't like gatekeeping'cause they just want

access to medical intervention on demand, but then that's being applied to the adolescent chapter and to the to the younger people who would really benefit. I mean, I think everyone would benefit from a whole lot more gatekeeping. And um a lot more attention to the the concept of experimental. If you're going to if you're going to treat

Anybody with experimental drugs. I see it, you know, I saw it with You know, Alastair who who worked with me and he he was put on an experimental treatment for cancer, but he had to sign this and sign that and it was so scientific because they're gathering data when they're on experimental and this is for very serious

stage four cancer. But as well as that, Helen Joyce helped myself and me and you know, we had a kind of a team that were kind of helping kind of with the P or I suppose for want of a better phrase around the W path files and She made a very good point about her dad and effectively I think it's something like he had a hip operation

And then ten years later had a another operation and they went in a completely different you know, they might have gone in the side the first time and then in the back the second time. Because medical advances are happening very, very fast. And so doctors are used to the concept of experimental, we're trying this, this is getting better results. Key point. It's getting better results because we are following this diligently. And that is the gaping hole.

right in the center of the gender industry. The loss to follow up, we do not know. We don't know. Forty percent lost to follow up, twenty five percent lost to follow up. We haven't really collected the data because we're not really asking the right questions. We have some very, very happy people who are advocates for it, but this isn't as clinically, forensically, scientifically um followed up population. That to me is the centre of the issue. Well of many. Many of the issues.

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Mia, I think it's very interesting. You've told me before, but I'd love other people to hear. How did you come to be involved in gender? I knew you and Sasha knew you through your your tweets. How was it that Michael Chellenberger decided that you were the person to work with him on the W Path Files? Could you tell us the lead up and then the event of that?

Right. Do you want me to go back to my my first moment when I discovered gender and then take it from there? Yeah, yeah. Okay. Okay. It's um it's kind of a good story. So I was a bit woke prior to December nineteenth, twenty nineteen. I have to confess that I was a little bit woke because I immigrated to Canada, you know, I was living in Asia, I had my first child in Asia, met a Canadian, moved to Canada.

And so everyone that I met here was typically on the left and that means woke in Canada. And, you know, I was a mother, I was a stay at home mother, I had three children, I was busy being a mother, getting no sleep. breastfeeding children, like of making sure that they don't die each day and and all that stuff, you know, I was preoccupied. I didn't have time to think about politics and think deeply about anything. So

I was aware of this whole trans women or women thing. I thought it was odd, but I went along with it to be kind. And then on tw December nineteenth, twenty nineteen, JK Rowling tweeted in support of Maya Forstetter. Um Maya had lost her job for saying men are not women, basically. And JK's tweet, I should remember it, but I don't, but it was gorgeously worded, it seemed perfectly reasonable. I read it, I was like, Yep, that seems fine, all is well.

And then I saw people in absolute meltdown, being so viciously awful to her, calling her a turf, calling her a transphobe. And so I thought that Uh I didn't understand what the problem was and I actually asked woke friends in my real life and they were also calling her a turf and a transphobe. I even remember that day somebody shared that absolutely hilariously named Scientific American article stop using phony science to justify your transphobia just.

Like all of it was baffling, but what what I what I understood on that day was that we were supposed to believe that trans women were women. Like actually believe it, real like women just like th us. And that was nonsense to me. That was utterly absurd. So I uh I I continued reading all of these threads. I saw lesbians in in battle with trans activists over the concept of the male lesbian.

And I just thought this is so completely absurd. A male lesbian, I had never heard anything more stupid in my life. And shortly after that I discovered what was happening to children. Within days it became apparent children were being taught that they could be born in the wrong body. Adolescents were having healthy body parts amputated.

And so that was the that was when th I as soon as I discovered that I couldn't look away, this was just a crime of unimaginable proportions to me. I just couldn't understand. how it was happening. So I started tweeting about it and this is not the Twitter account I have now. Like so many before me, I got suspended in the pre-Elon days.

And so I started tweeting about it and then it was not long after that that I came out in my real life and it was, you know, all hell broke loose in my real life when, you know, this I came out as a turf.

And so anyway, b th the the reason because of the scandal, because of the the the scandal in pediatric gender clinics, it didn't make any sense to me, so I turned to history. because I like I was reading uh I turned to m past medical scandals, reading about those to try and help make sense of the current medical scandal.

And it really helped. It helped to see how catastrophically wrong things have gone in the past. And just, you know, you can take the framework of any past medical scandal and pretty much just plonk it on this one, add a few crazy elements, and and it's the same thing. So after I got suspended, and it's kind of funny because I got suspended, I built my account up to a few thousand, and then I got suspended.

And I w waited about a month or something for my appeal. And in that month I had no Twitter. I didn't have Twitter sucking all my time. So I was really reading. I was reading s read so many books and all sorts of stuff. And when I came back I I just changed my approach to Twitter and I instead of just the sort of angry tweeting and the the like just just single tweets, I started to write thread.

about everything that I'd read now, about the social contagions, about the medical history, comparing and th what to what's happening now and That's how this account grew much faster than the other one did. It really this account just exploded. And so I ended up uh based on a Twitter thread, I ended up working for the post millennial, covering gender full time. And then last And you were you a teacher when this was happening?

Oh right. Okay. So I was actually at this point this is COVID, I was home schooling with you. You were at home with the kids. So I had been a home I had been a stay at home mum for nine years. I did I made it back into the workforce for about eighteen months. COVID hit, I lost my job and then I home schooled my kids. So at this point I'm home schooling.

And it was all very perfect timing, like the basically the the morning of my children's first day back at school when I had said to my husband, Okay, this is it, I'm gonna put them back in school and then I'm gonna look for a job. The very morning while I was down at the bus stop putting my kids on the school bus, the editor of the postmillennial sent me a DM on Twitter offering me a full time job covering gender.

Wow. So that's what I did. And then last February I wrote a Twitter thread, another it's always a Twitter thread. I wrote a Twitter thread about apotemnuphilium, it's which is the psychiatric condition, you could call it a paraphilia, in which people want a healthy limb amputated or sometimes like it can be both legs, it can be one leg, it can be an arm. And I the thread was a thought experiment about imagine a world in which a powerful a potem nophile lobby group

su succeeds in convincing society that a potum nephile rights is the next civil rights movement, just like the trans rights movement did. And then you see a social contagion of kids wanting their healthy limbs cut off and we're all supposed to celebrate it. Imagine surgeons advertising their their amputation services to kids on TikTok, like you know, the one in Florida who advertises her mastectomies. And so the thread went viral, which was a surprise. It's always a surprise to me.

And this this guy called Michael Schellenberger showed up in my DMs offering me a job that day. And I don't think he'll mind me saying, but I didn't know who he was. So the the thread was going viral and it was really stressful for me. I find this kind of thing very stressful. It's like an overload of adrenaline and dopamine or something.

So I do recall looking at his Twitter account and I could see he had hundreds of thousands of followers, but I had somehow missed his involvement in the Twitter files. I was aware of the Twitter files, but I had somehow missed his involvement in So I turned him down. That day I very politely, you know, thank you, but I already have a job kind of thing.

And thankfully he was persistent. He came back and we had this idea of combining a whole bunch of my threads into a big essay and we did that and it was great. And so eventually I went over and I was writing I worked for Michael full time and almost right away he got the W path files, the first batch from the whistleblower. Which we tried to turn into a series of articles for public because that's where I was working at that point.

But it didn't work, it was just too much information. We couldn't do the files justice. So then he moved me over to environmental progress and we worked well I worked on this the big, big think tank report. And it it really is a book, I think, in many ways. I th I think it would be it I think of any any uh bright and savvy publisher out there, I think it's it's it's a book that's pretty much written, in my own view.

It does feel as though I wrote a book, certainly. Yeah. We want to take a moment to thank our sponsors, Gen Spect and Therapy First. GenSpect is an international organization committed to fostering a healthy approach to sex and gender. The team and members of Gen Spect strive to promote high-quality, evidence-based care for gender non-conforming individuals.

GenSpect is pleased to offer a non-medicalized approach to gender with their recently published Gender Framework, and they continue to hold conferences around the world. Visit Genspect.org to learn more. Therapy First is a non-profit worldwide professional association of mental health providers who view psychotherapy as the appropriate first-line treatment for gender dysphoria. Therapy First supports psychotherapists working with gender dysphoric youth and young adults.

And offers public education on mental health and psychotherapy. Visit therapyfirst.org. Now back to the show. Well you go through four specific medical scandals from the past to try and elucidate, you know, some some ideas about how we got here with pediatric gender medicine. Can you maybe pick pick one and tell us a little bit about it just so that listeners who are becoming familiar with the pediatric gender thing can hear, Oh, like something similar has happened before. Pick one.

Sure, I mean the four are lobotomies, ovariotomies, apotemnophilia, the one that I was just talking about, and then the experiment to correct supposedly the height of tall and short children with hormones.

My favourite of the case studies is ovariotomy. Um I chose those particular four because I think elements of each can be combined into what we are now seeing. I see now this scandal as being the super scandal because it combines elements of all of those four. So but let's talk about ovariotomy because it's my favorite. Uh this was this was the worst medical scandal of the nineteenth century.

And this was uh so they were removing the healthy ovaries of women for basically all forms of madness by the end, of all sorts of mental health issues. And so this was a time before antibiotics and before surgical cleanliness. So approximately thirty percent died. And we're talking about a hundred thousand women, they estimate. Oh my god. It was based on an entirely pseudo-scientific idea called reflex theory, and the idea was that.

An organ in the body could create symptoms in a distant organ in the body. They were all connected somehow. And so what would w th it was basically the so the ovaries were affecting the brain in women and they They first of all the surgeons I think were very You know, they were on something of a quest and Because they had developed these new surgical techniques and they were eager to try them out in whatever place they could.

And we're talking leading surgeons at the time. We're not talking just a few cranks over on the side. We're talking leading surgeons at the time. It is the nineteenth century, so they can be somewhat forgiven. But the part that I really like about it is the fact that the women at the time imbibed the narrative of reflex theory, and they began the women who were in distress, women who were dw in an unhappy place and struggling, began to fixate on their ovaries.

as the source of their mental distress and then they were the ones who were showing up and asking the surgeons to remove their perfectly healthy ovaries. And then even some of them will will would say afterwards that they were cured. That they and one there's one that's really similar to now in that you know, one of the women says, I don't even think I would be here if I hadn't, you know, if I hadn't had my ovaries removed. It saved my life, which is so similar to these young women now.

Because again, it's based entirely on a pseudoscientific idea and it actually was not beneficial at all. Of course, there was no there was no link between the ovaries and and a a woman's mental illness. But because they were convinced it would work, the power of the mind placebo, it it worked for them and they were satisfied.

I I wanna ask you something about this because I mean, anyone who's been following my work knows I've been saying that this is a medical scandal and I've written about lobotomies and things like that. So I I am there with you. But I kind of have this other thought in my mind about the Inherently sexual nature of gender dysphoria. And particularly when you think about the male fantasy of becoming a woman.

That is a documented phenomenon that has happened kind of organically outside of the contemporary culture-bound syndrome piece. And I think that that desire for some men to embody womanhood was the original driver behind the Harry Benjamin Society. Like th there is a thread of a real, let's say, condition.

that has woven its way through this entire history of trans medicine. And of course with the addition of queer theory and this kind of patient led stuff, all the things we talk about, it's blown up into something very different. You know, do you think that that's do you think that's a fair comparison? Because

I suspect that with the the scandals we're discussing, those things are long gone. And the desire for women to get their ovaries removed is also, as far as I can tell, long gone. But I don't think we will ever reach a point where some adult males don't want to become women. So I don't think transmedicine is gonna follow the same path as the other medical scandal.

Oh the Could I add something uh else to that point though,'cause th there is a a couple of other points. When you look at the Harry Benjamin Soci um HBIGDA, the H Benjamin Association You know, pre that, you know, Reed Erickson was born a female.

and, you know, um was a millionaire back in the sixties, and inherited and born a female, became a a a male, uh Rita Erikson turned it to Reed Erickson in nineteen sixty three and you know, through Harry Benjamin's quackery for want of a better word, because it was absolute snake oil salesman as far as I can see, uh Harry Benjamin.

So there's something about the very fixated, very rich person who can get very far. So Reed Ericsson started the EEF, which is the Erickson Educational Foundation, which is the precursor This is like nineteen sixty four, which was very well funded.

And it was really v uh extraordinary how much how far they went. So I I think to add, while I totally agree with you, Sasha, there is one or two other elements that I also would be interested in what Mia's take is, which is The the desire for some doctors To be God's You know, to create things. And um if somebody has money to fund it, how far from ethics these doctors will go? I think that's underestimated in all this.

So first to to your point, Sasha, the the The four scandals that I chose are each one deals with a particular element of today's scandal. So the ovariotomy one was deliberately well it was just comparing Basically the R O G D, teenage girls and young women. who have these this this cohort of young women and girls who have imbibed the narrative of the modern trans rights movement.

coalesce all of their mental distress into a fixation on removing the healthy breasts and and very much uh and often can go down to the the uterus and the ovaries as well. And so that's the comparison that I'm drawing because I think one of the biggest problems we have here is all of these disparate groups who are lumped into

people suffering from gender dysphoria or transgender people even. And so for me, yeah, your average auto gyneophilic man has got nothing at all in common with the girl who is in distress and who has fixated on her ovary uh on her breasts or on her ovaries or whatever. And so these are...

These are two very different groups. Autogynophilia, I mean, I didn't really address it too much in the report, but if I'm going to put it anywhere I'm putting it with the apotemnophilia case study because it's totally separate. And I do believe

Sure, we probably had some sort of autogynophilia. The presence of autogynephilia can probably be documented for a very long time. I'm no expert, but I do think that Perhaps it's something that is only really present in times of abundance and and sort of affluence because I don't know that m I men they're weird and stuff, but I don't know that men and their fetishes

are really a thing in times of war and famine. Maybe they are, maybe they're still they've still got their thing going then, but I think probably, yeah, autogynophilia in in certain forms has been present and could be documented over a long time, but That's not who I'm talking about when I'm talking about ovariotomy. It's, I think, I don't know that it comes across in the report. Like there's a little subheading under each.

case study to say this is what I'm comparing. I'm taking just this one part of today's scandal, I'm comparing to this past scandal. And that's what I mean when I say

you can combine all four of the scandals that I put in the report, elements of you can put them all together and you've got today's super scandal. So I don't know that we're I also don't know that we're ever going to be There I think there will always be, particularly now that we've unleashed this upon society and this this medical treatment exists.

And as long as this this hormonal and surgical medical treatment exists, there will be autogynophilic men who will fixate on it and obsess over it and desperately desire it. And and it will become su it is an obsession, a compulsion. And so I don't know that I see a way that we get past that, but I do see a way, I do I hope very much that we get past this.

ROGD or for want of a better term, all of these young these teenage girls and young women who are getting sucked into just the the social contagion angle of it and the Or or the the gay the gay young people who uh just feel like their life

w now is better as a trans person. I mean, th the ROGD and the gay sometimes of course there's overlap. Of course I work with girls who seemingly are ROG D but actually are lesbian, but But of course, yes, I you were saying like you do see a way, hopefully, out of it for those populations that are not, let's say, the autogynaphilic male. Right, because I I don't know that autogynophilia is a social contagion. I did read um

it was a piece by a detransitioner who br introduced me to the concept of rapid onset autogynophilia, which was I I I brought it up with Michael Bailey and he was like not buying it at all. He doesn't think so but I don't think we're looking at I don't know that we have a social contagion of autogynophilia. Lord help us if we do, but um I think

I if I'm I can go off on a tangent here and can I talk about Ian Hacking? Yeah. So Ian Hacking i was a Canadian philosopher. He died not very long ago and his work was absolutely brilliant. If you wanna understand what's going on now, you can't go wrong with reading Ian Hacking. And so he has this idea of the the th so there are transient mental illnesses, mental illnesses that arise at a certain time, in a certain place, they spread and then they disappear.

And he has this l lovely metaphor of the ecological niche of a transient mental illness, where you need a certain set of cultural factors to be present at the same time for one of these mental illnesses to land in the ecolog uh ecological niche and then just flourish.

And so if you're talking um rapid onset gender dysphoria or this this current epidemic of gender dysphoria, the the cultural factor of the modern trans rights movement with its really powerful messaging about gen everyone possesses a gender identity, the fact that you're being bombarded with it in your schools and in on social media and it's coming at these young people from every single angle in society.

That is one factor for its ecological niche. And then there's another, you know, it has to be observable, which it's the most observable. possible mental illness you could ever have. You know, they've got their flags, they've got their pronouns, they've got the physical changes to their body and and it's a very observable thing for the contagion to to take hold. It has to provide release and sure it provides them with release from female puberty, it r provides them with

their misery, it promises them, you know, that they're gonna be happy and strong and confident men and so they of course they're jumping into it. And then it also the medical world has to legitimise it. That's the fourth factor. Those are the four. But his idea is that you just like any like any ecological niche for any species, if one factor disappears the transient mental illness as well will also disappear. And so when if and when we can ever get past our

Fascination with trans rights. If we can abolish the whole idea of gender identity, if we can get all of this thi if we can get this poisonous lie out of schools and if we can get

everybody to come back to reality that, you know, there is no such thing as a gender identity. Yes, this is a complex mental health issue, and if you have it, you deserve some sort of help, but Forget this this this messaging that seduces all of these young g teenage girls and young women who are in a place of distress and are

making sense of their lives through the lens of the modern trans rights movement. So I do have hope that if we can shift beyond this cultural moment, it should disappear the the but I don't I'm not talking about autogynaphilia here. How how would hacking um understand, let's say, the arrival of anorexia and the way it stayed, and the arrival of bulimia and it stayed, and then the arrival of self harming?

as a phenomenon among sp you know, that started among teenage girls. And has remained as a coping mechanism. Exactly. You see, I don't think those aren't actually ver they're not really transient. Th there are some that that like w for hacking he's talking about uh he wrote m largely about multiple personality disorder. If we wanna get a go there, we can um hysteria in Freud's time, fugue in the the nineteenth century.

So we are talking the type of mental illness that that just attaches itself to a particular cultural movement or a particular cultural moment. And then when that cultural moment is over, the the mental illness disappears. The trouble with bulimia and anorexia is they were never really attached to any

particular moment in the culture. They they were we've got the he another concept of his is this semantic contagion where the naming and describing of a condition creates the means by which it spreads. It's no coincidence that

the bulimia contagion that started that was in the nineteen eighties and nineties started with bulimia's inclusion in the DSM three in nineteen eighty, the exact same thing with multiple personality disorder. Once it's named and described And it's just it's unleashed and it's sometimes very it's very difficult to rein in bulimia and anorexia because it's simply body image. It's so just simply women looking at themselves and and and not measuring up and and uh and internalize

Mm. Have you read uh Ethan Waters Crazy Like Us? Of course. He talks about this, and I I thought it was really interesting that. the eating disorders per se really had a very different flavor when they existed in kind of rural China until some, you know middle you know, middle or upper class wealthy girl in Hong Kong fainted in the street from being malnourished and then they brought in American journalists or American psychiatrists or something like that to explain it.

And they explained eating disorders from the DSM, the US DSM perspective. Which actually wasn't an accurate description of the girl who fainted. But then of course, lo and behold, this news story spread, and then all of these wealthy young women in Hong Kong were developing a an Americanized version of an eating disorder. So it it's really interesting the way our our narratives around a condition can create more of that flavor of the condition. I mean, that's what we're seeing with gender.

Yeah, it plants the idea. I mean that that that girl tragically died on a busy Hong Kong street. She actually collapsed and died. And yeah, they had I mean there was they they did have something that would have resembled anorexia in some form prior to that event. But exactly we we export all of our mental what we consider to be mental disorders were now because of the global society we are exporting

them all around the world and yeah, like they triggered a contagion, right? They triggered a contagion in Hong Kong. because with the best of intentions they were trying to prevent such an event from occurring again and what they actually ended up doing was describing the condition and planting the thoughts into the minds of all of these vulnerable women women and girls.

What do you as we wrap up the kind of main portion here, what do you think the impact of the WPATH files and the report will be moving forward? Because, you know, we've had It's been it's been released in the last, I would say, two weeks, and we've had lots of media coverage, but more so in Britain and Europe and we've had a f some coverage here in the US, but what do you think the impact of this report is going to be?

It's difficult to say. I mean we're getting we're still getting coverage. There's been I to me, because my expectations were probably low, lower, I just think it's incredible how much coverage it's had. And the only impact I would hope that it just People see W Path for for what it really is. It's uh this is like I th I cannot take any credit for yw yw yw yw yw yw yw yw yw yw yw yw yw

That that's been in the works for years. They've been looking at the evidence. They've been examining everything that's been going on in this issue and and they made the announcement right after the WPAT files. So, I mean, it's very difficult to know what the impact will be because it's very difficult I think these things are much slower than many people think. The the the we we've put it out there now.

plain and clear, in in no uncertain terms, that this is this is not a medical or scientific group and this is not a group that any real medical association or health authority or anyone should be listening to. very difficult to know what's going to happen, what people are going to do with that information. And this type of thing takes It can take a very long time for a professional association or even a local health authority to to reverse course that that to to

They may look at it, they may think, goodness me, that this is we we thought this group was a real medical group and now we're like not so sure. But there aren't these fast knee-jerk reactions in in i it's a very lengthy process. I hope. I just hope people are reading it. And I d uh particularly in Canada. I'm always talking about Canada because that's where I live, but

Coast to coast we follow W Path. Coast to coast we think W Path is a real organization. And so the the problem is where we where the coverage where we needed coverage the most we got the least coverage so far. I mean Canada we only got a couple of articles so far. But I still think even without the coverage, I still think people are paying attention. I still think Twitter is a very powerful

uh platform and I do think that people will be reading it. It's just hard to tell what impact it's gonna have right away. Yeah. There's one uh one one campaign got expire inspired from the W Path Files, which I think is really powerful. Um the parents and Gen Specter kind of they've kind of united. There's an awful lot of organisations I kind of grouped. and they're writing to their local clinic

to inform them that the WPATH files have revealed that this is not a medical organisation or a scientific o organisation and they don't actually know the harm. Well, they now know the harm that's been done. And therefore, so each parent like from all let's say twenty five different organisations around the world

all the parent groups are all writing to their clinics to inform them you've got the W path standards of care on your website. This is now a discredited organisation with discredited guidelines. Um what do you intend to do with this? We you know, and we look to, for example, the NHS um as a leading light, along with Sweden, Finland, France, Denmark and other countries. So uh we've touched on the W Path files in lots of different ways with the medical scandals and

the different procedures that are are are not scientific or or or medically necessary. I think what's probably been most shocking, and myself and yourself, me have spoken about it extensively,

is the extraordinary procedures that are not known in nature, such as, as I mentioned earlier, the phalloplasty preserving vag no, the phallus preserving vaginoplasty, the minimal depth vaginoplasty, the nullification, um the um do you want to speak a little bit about these procedures that are being recommended by W Plat, this this purported international best practice organisation?

Yeah, so in the files, those are the most bizarre conversations. This is like the the final chapter of my report is W Path has no respect for medical ethics. And it's basically this is where you see it the most, that this is it's a very dangerous combination the with the non binary surgeries of you've got basically queer theory in the operating theatre is b by the way I look at it. So They're in the files you've got these these non these surgeons who perform non-binary surgeries.

And they're talking in there about, you know, one of them is saying how comfortable he is with the the this these surgeries where the man can keep his penis and have a surgically created vagina, where a woman can keep her reproductive organs and have the

the the appendage made out of her forearm sewn onto her groin. There's all bizarre things going on. Like he even talks about mastectomies with customized scars and stuff, and then someone in there weighs in to say, Yeah, we're creating bodies that don't exist in nature. And I just think there can be no greater violation of the Hippocratic Oath than this Uh this it's not even an experiment because nobody is

monitoring the best way to create a second set of genitals. The the nullification, there's no nobody's tracking this. What's the safest and most effective way to nullify a body? Like that that means no outer sign of any any sexual organs, like, you know, smooth, sexless bodies like mannequins. We have gone so far beyond anything that could be called ethical medicine at this point. And it all stems from WPATH taking its turn for the ideological and practicing P political activism

but w in the operating theatre. And so the the non-binary chapter of WPATH Standards of Care 8 is a shopping list of extreme body modification. That's all it is. And typical of W PA few. Everything is medically necessary if the patient so desires. You know, it's it's entirely okay, the client. identifies as non-binary and wishes to have a second set of genitals. It's medically necessary because they want it and that's it.

And it plays out in the real world. This is not this is the you know, we have got the most baffling case ongoing here in Ontario. And it is the case of a man who identifies as non-binary and ha goes by she her pronouns and he wanted he wants to keep his penis and have a surgically created vagina. And so he applied to the provincial health insurance and they said, No, we're not covering that. And he appealed basically the the the appeal, the basis of his appeal, the argument is that.

To force a non binary person to go through binary surgery is a form of conversion therapy under our conversion therapy ban which passed a few years ago. And W PATH's non binary chapter is quoted all the way through not only his argument but the appeal board ruled in his favour, and they ruled in his favour because W PATH says that these surgeries they I think they call them individually customized bodies.

They are medic uh this these surgeries are medically necessary healthcare for people who identify as non-binary. So

But what's really interesting in the files, in these conversations where you're reading them and you think, what am I reading? These people, what are they talking about? and nobody in there co well, all that goes on in those conversations is people policing each other's language. What language should we use to talk about these types of surgeries that create bodies that don't exist in nature?

some little activist, you know, the surgeon is talking about how comfortable he is doing all these crazy surgeries, and a little activist member comes along and uh sort of uh t tells him off for using cis heteronormative language and that you can't call them non standard because what if they're gonna become standard and You don't have to be non binary in order to have these surgeries, so you can't call them non-binary surgeries either.

And nobody is talking about the ethics of it. There's not one person in there that says Is this the right thing to do? Should we? Should we be creating a second set of genitals? Is there any ethical issue with us taking these perfectly healthy bodies and creating I I can't even I mean whether the the h the long term health implications of

These surgeries m are enormous and yet nobody is nobody is talking about that. They're just policing each other's language and they're just and they're talking about the autonomy, the right to. If you want it, you should have it. That's it. There's no there's no greater indication that this is a med this is a group that has totally lost its ethical compass and has no concern whatsoever for this patient cohort that it claims to

Serving. We're gonna shift gears and take this into our listener community. I have a lot of questions about that because I I suspect that we're in the realm of something like You know. boundaryless. Cosmetic Sexual surgery or Something along those lines. And I'd love to also talk with you about WPath's response to the files and to all of the media attention. So

For now, I mean, obviously, we'll link to environmental progress and all of your work there and the report. Is there anywhere else? And of course, your amazing expert. Formerly Twitter profile. Is there anywhere else that you want to send people before we shift gears? No, I think that's that's uh that's all of it. Okay. It's been great to have you here for the full episode. Thank you so much for joining us, Mia. It's been a pleasure. Thank you. Thanks. Thanks, Mia.

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