Navigating Identity: Autism, Anorexia, and Gender Dysphoria

In this episode, the hosts dive into a thought-provoking analysis linking gender dysphoria, anorexia, and autism. They explore statistics and research to argue that gender dysphoria in the United States is a culture-bound syndrome similar to anorexia. The discussion delves into how autistic traits may contribute to these conditions, emphasizing the significant overlap and suggesting that societal acceptance of such identities is complex and potentially harmful. They highlight the emotional and social struggles faced by individuals with these conditions and propose alternative perspectives. An engaging and enlightening conversation sprinkled with personal anecdotes and cultural references.

Malcolm Collins: [00:00:00] Hello Simone! Today is an interesting day because I had a revelation as I was studying some data where, you know, sometimes I look at data I'll be like, hmm, that's weird. I've seen a number really similar to that somewhere else and I'm like Bring data. Bring data. Oh my God. Oh my God.

This explains everything. And I now feel like I have a much better understanding of what's causing the transgender phenomenon in the United States. Do tell.

Here's what Simone had to say at the end of this episode

Simone Collins: wow. I've now experienced a paradigm change. And I have a lot more empathy for people who have gender dysphoria

Malcolm Collins: What we are going to be arguing using data is that gender dysphoria is the same phenomenon as anorexia. Not a similar phenomenon, but literally the same phenomenon.

And as we read through this, we will both see what is causing the phenomenon. As well as why it is [00:01:00] specifically hitting the autistic population at such high rates and Yeah, i'll just jump right into it All right So the thing I was reading that first got me thinking this because it was like two statistics that overlapped and I was like that's weird Why do these statistics keep overlapping?

So statistic one was a scott alexander piece on

culture bound mental illnesses, specifically what a culture bound mental illness is, is it something like, in the recent episode we did, on the phenomenon in Africa or East Asia called Koro, where people think their penises are being stolen by witches.

And they, like, really believe this and there's lots of others that we're going to go over. But in the United States, one of the particularly best studied cases of a likely culturally bound illness, which will go over evidence that is culturally bound is anorexia. And when Scott Alexander was trying to judge because he said, yeah, but everything is like partly biological and partly culture bound.

So he and his piece was trying to judge how much is this, right? And he goes, well, I suspect that anorexia is [00:02:00] about 80% Culture bound and 20 percent biological. That checks out. I'm gonna be like, yeah, that, that checks out. Then at the end of the piece, he's like, now a lot of people reading this piece are probably thinking about gender dysphoria and the transgender phenomenon in the United States.

Is this a culture bound phenomenon? And his estimate, and I will note, Scott Alexander is a very, very, Pro trans person. Okay. And, but he also has like an incredible amount of integrity to be willing to say this because in San Francisco saying what he said is like walking down the seats was like the sign from die hard with a vengeance.

Oh, no, you're right.

In this scene. I imagine Samuel Jackson's character to be Scott Alexander's trans friends,

Trying to get him to take the piece down after it was first published. As I imagine quite a few, probably did.

Speaker: dial 9 1 1. Tell the police to get up here quick. Somebody's about to get killed.

Now you got about 10 seconds before those guys see you.

When they do, they will kill [00:03:00] you. You understand? You are about to have a very bad day.

Speaker 2: Tell me about it.

Speaker: Fellas! Fellas! Nature boy here hates

Malcolm Collins: This guy wrote a piece, arguing being trend is in large part of social phenomenon.

Speaker: Now, what are we going to do about that? Oh, s**t!

Back! Back up! Back the f**k up! Now!

Malcolm Collins: Like, I'm pretty sure he lives with transgender people, like, in the comments under the thing, I, like, I don't have any confirmation of this, if he's dated transgender people before, like, this is not, he's against transgenderism, he's just laying out the facts as he sees them, he says it seemed to be about the same as anorexia, about 80 percent cultural and about 20 percent biological, which, It's exactly what I'd agree with.

I actually might, I might put it above Scott Alexander here. I might say at 30 percent biological 70 percent cultural. When I look at things like endocrine [00:04:00] disruptors and the tide studies and stuff like that which you can read about in our other trans videos, but there is like evidence that males due to chemicals they're being exposed to, at least males, at least are, they really are turning the frogs gay.

Speaker 4: I don't like them putting chemicals in the water that turn the friggin frogs gay! Do you understand that? Turn the friggin frogs gay! Boo! Boo! Serious crap! Gay! Frogs! Friggin frogs! Boo! It's not funny! I'm gonna say it real slow for you.

Malcolm Collins: They really are showing less gender presentation as males due to biological reasons. But then I saw a separate statistic that linked these two things, which was really high rates of autism. And we'll go over this sounds like Wait, wait, wait, wait, wait. I'm noticing something here. So estimates of autism prevalence in anorexia populations range from 20 to 30%.

A study at the National Specialist Eating Disorders Service at Maudsley Hospital found that [00:05:00] 35 percent of women met the criteria for an autism spectrum disorder. We also know that autism and ADHD commonly co occur in a recent meta analysis that range from 63 studies between 40 and 70 percent with bulimia.

This was Rong et al. 2021. And then anorexia nervosa carries the highest mortality rate of any health disorder at a 10 to 20 Suicide or death risk from this is bernstein 2023 and martin et al 2015 All right So what I'm pointing out when I point out like the suicide risk here This is to say that even if transness is a culturally locked phenomenon That doesn't mean that these people are not experiencing something that is loud enough to get them to kill themselves and simone is a like sane logical person who you guys apparently like hearing her opinions She almost died of anorexia and she also happens to be autistic.

So, do you want to Do you want to talk to that at all before we go further here? [00:06:00]

Simone Collins: Yeah. When you're saying this, hearing it and you, you putting the pieces together, this does make a lot of intuitive sense. And I think it comes down to autistic people committing to the bit. And, and having, when they have a special interest, they just actually go all the way.

They just actually do it. Other people dabble. Autistic people go all the way, you know, there are train enthusiastic and then there are autistic train enthusiasts and you know, you know, like those are the ones are the train conventions. Those are the ones going to the train pilgrimage sites. And then, you know, you have people with eating disorders.

It takes a lot of discipline, like an inhuman level, you know, beyond the level of proper intuition or. You know, the human body has a lot of ways of resisting starvation, right? Like, it's pretty good at controlling for that. So I think you need something else super out of whack to be able to commit to that.

And it makes the same sense. Gender transition requires a huge amount of [00:07:00] commitment. And you have to be committed to the point of tone deafness. to getting there. And I think also framing anorexia as a body dysmorphia driven by a desire to look beautiful is misleading and may misstate what people think anorexia is.

They think anorexia is the pretty popular girl who talks about dieting when anorexia is often the very not pretty girl who looks like Skeletor, who is clearly not doing this to look good. It's commitment to the bed.

Malcolm Collins: Yeah, well, and I by the way, how, how light did you get in college when you were doing this?

Simone Collins: It was high school. I think the lightest I ever was was 98 pounds. I'm currently like 123 pounds, which is like the minimum safe weight I can have.

Malcolm Collins: I'm five foot eight and a half. Yeah. So, I would note here, that this also can help you understand something, which is [00:08:00] like, if, as a non autistic person, you will struggle to understand how a person with anorexia, who looks like Skeletor, can be standing there and being like, I'm too fat.

Like, but now, now in your head, you're like, Think about the autistic train enthusiast, you know, they don't understand how crazy they look when they're there talking to you about a whatever training. You're like, I do not. How do you not understand that? I don't care about this, but now think about the like, don't you have

Simone Collins: enough trains?

And they're like,

Malcolm Collins: Yeah, now think about this in the context of a trans person, which is like, wait, why, why won't everyone accept me? Like, why can't I be on women's sports teams? Why can't I, you know, like you, we need to go 100 percent with this. We can't be like, let's do this in a reasonable way where like, I'm not like an active impediment to other people living their lives, you know?

Simone Collins: Yeah. And then even, even the threat of death [00:09:00] as anorexia demonstrates with that high mortality rate you pointed out. Is not at all of interest or relevant. So this is very

Malcolm Collins: important here is this claim is not saying that they are Faking it or that they are imagining it or that they are Yeah, what we are saying is it's a culturally bound illness, but culturally bound illnesses are illnesses

Simone Collins: Yeah,

Malcolm Collins: so we're gonna keep going here a large scale study published in nature communications in 2020 Found that 24 percent of transgender and gender diverse respondents were autistic compared to five percent of cisgender participants The study analyzed data from 641, 000 participants across five data sets, including survey data, population studies, and online questionnaires.

Studies have found that the lifetime prevalence of eating disorders is also noticeably higher in transgender men, 10. 5 percent in transgender women, 8. 1 percent compared to 4 percent non autistic females, 0. 3% non autistic male. So just like astronomically higher.

Simone Collins: Wow.

Malcolm Collins: Now here is where the real breakthrough for me came from.

Okay. [00:10:00] This is going to shock you, so I decided to go and read more about from the perspective of like psychiatrists or psychologists who work with people who have anorexia, why autism might lead to that. And when I started reading their explanation, if you just replace these words like you change out the word eating with gender expression or you change out the word, you know, like, autism with gender dysphoria, you're going to be like, Oh my God, this is such a good explanation.

Really? Oh, can you read us some quotes? I'm going to go through.

Simone Collins: Oh!

Malcolm Collins: Lever and Goertz, 2016, found that up to 79 percent of autistic adults met diagnostic criteria for a mental health condition, including depression, anxiety, and eating disorders. We also know that many autistic individuals struggle to emotionally self rep.

regulate, use internal strategies to calm down like breathing, and co regulate, be soothed by another person, so they find other ways to self soothe or feel okay. [00:11:00] And one example is by eating or not eating. Sensory sensitivities are extremely common in autism, so much so that they form part of the standard diagnostic criteria, APA 2022.

Eating involves all five senses, and interception, or the capacity to sense internal body sensations, such as hunger satiation. It is perhaps unsurprising that eating disorders are overrepresented in the autistic population. So let's re read that. Your sense of gender identity involves all five senses and interception.

The capacity to sense internal body sensations, such as any of the things associated with gender dysphoria. Okay, let's keep going here. Unfortunately, many autistic individuals in our society experience loneliness. Perkinson et al., 2017. Bullying and abuse, Rumble, 2019. They may use restrictive eating patterns as a way of distracting themselves from these difficulties and numb the emotional pain.

As one autistic person nervosa said, I can get [00:12:00] engrossed in food and exercise and just forget about everything else. Okay, they may use gender dysphoria as a way of distracting themselves from these difficulties and numb the emotional pain. Yeah, going through a transition is, is, is

Simone Collins: physically, mentally, socially, it's, it's, it's, it will completely take over your life.

And so you don't have any room to worry. That's actually a really good point. And like I pointed out, for example, that having kids. It's an amazing anxiety combat tool because you simply don't have time or mental space to be tired or stressed or worried. Like you're just going to child maxing is a new transition.

Yes. Let's just let, can we, can we hijack this? Can we, but yeah, that, that makes a lot of sense. And that, that doesn't, yeah, absolutely. Controlling. The

Malcolm Collins: thing that people have noticed is that the pronatalist movement is like overwhelmingly autistic and that's the rumor. Oh my gosh, it is! Are

Simone Collins: we the new trans?

This is so exciting! It'd

Malcolm Collins: be [00:13:00] so fun if a bunch of autistic people are like spamming 20 kids because it's like their special interest. Let's do it! The Greater Replacement Theory

Simone Collins: is happening!

Malcolm Collins: The Hottest!

Simone Collins: It's happening!

Malcolm Collins: Okay, so. I mean, I think that's kind of why you're doing it, right? Like, you get really into pregnancy and you get into all the measuring and everything.

The measuring,

Simone Collins: the

appointments, making sure All the hormone shots and

Malcolm Collins: everything you have to do. Yeah, all the It's very similar to transition in a way. And she gets really actively distressed when she's not pregnant, especially right after a birth. You know what? Oh my god, I'm trans pregnant?

Simone Collins: Oh, you have, you have gender dysphoria when you're pregnant?

I have, I have fertility dysphoria. I have I have pregnancy dysphoria, gestational dysphoria. There we go. I mean, that's the thing that some

Malcolm Collins: trans people experience, right? You know, they, they want to be pregnant.

Simone Collins: That, that I, it, yeah, my heart goes out to them.

Trans woman to have a successful uterus transplant, ovaries and eggs included. [00:14:00] And I want to be the first trans woman to have an abortion.

Mrs. Garrison. You can't have an abortion. Don't you tell me what I can and can't do with my body! A woman has a right to choose! You can't get pregnant. But I missed my period. You can't have periods either. You mean, I'll never know what it feels like to have a baby growing inside me and then scramble its brains and vacuum it out? This would mean I'm not really a woman, it's, I'm just a, I'm just a guy with a mutilated penis!

Basically, yes. Oh boy, do I feel like a jackass.

Malcolm Collins: Conversely, they may use comfort eating to overcome difficult feelings associated with socializing. Many social occasions are paired with eating, socializing can be difficult and anxiety provoking for an autistic person. See, conversely, they may use gender displays to overcome difficult feelings associated with socializing. Many social occasions are paired with gender displays. [00:15:00] Socializing can be difficult and anxiety provoking for an autistic person. You see? It's all, it's all falling together for me here, okay? Eating disorders often begin in puberty. Just as the social world becomes more complex and the autistic person experiences more problems navigating changing social Expectations and trying to connect with their peers and quote unquote fit in they often feel very different from their peers and may become immense As a way of coping they may believe that they do not fit in socially because their body or appearance So seek to change them both it is common for teenagers to connect with peers through this common interest But an autistic teenager may be unable to connect with interests of non autistic groups You As they become more fascinated with eating disorder behaviors, they become accepted in a peer group that embraces this culture.

Some autistic teenagers will focus on dieting and appearance as a way of being included and build a sense of identity. All right, Simone, so let's reread that, but change a few things here. Oh boy. [00:16:00] Trans disorders often begin in puberty, just as the social world becomes more complex and the autistic person experiences more problems navigating changing social expectations and trying to connect with their peers and fit in.

They feel very different from their peers and may become immersed in gender transition as a way of coping. They may believe that they do not fit in socially because of their body. I'm not even having to change the words here because of their body and their appearance. So they seek to change them both.

Oh, It is common for teenagers to connect with peers through a common interest, but a autistic teenager may not be able to connect with the interests of non autistic groups. Again, I'm not having to change any of the words here.

Simone Collins: As they become

Malcolm Collins: more fascinated with gender transition and trans communities, they may become accepted in a peer group that embraces this culture.

Some autistic teenagers will focus on gender transition and appearance as a way of being included and build a sense of identity. It, the overlap is [00:17:00] so strong. Intense. And that's what was found in a different community that also has all of these over, other overlaps here.

Simone Collins: Yeah, yeah.

Malcolm Collins: Wow. So, to keep going here.

No, it's just like the entire thing reads like it's about trans individuals. But it, but it helped me understand it from this other perspective. Alternate perspective. But you know what I'm doing,

Simone Collins: I'm there. Then I'm replacing this with pregnancy and like pregnancy communities and fertility communities.

I'm

Malcolm Collins: like, Oh, hello. Can we create a disease in our culture around girls who want hot autistic girls who want to get pregnant all the time? This is the thing. People online are like, Oh, this is like a fetish. They're like, Oh, they must have a breeding fetish. And it's like, no, it's a special interest. It's so much worse than that.

It's about autism. It's about body dysmorphia, guys. Oh my God, if we could get, if we could get pernatalism categorized in the same way that like trans people get like special rights [00:18:00] and stuff like that that you as a pregnant person who is autistic and it's like your special interest, you've got to get all these special rights because now, you know, well, You know, you're a protected class, right?

It's, it's no longer a wholesome thing. It's a weird sex thing or a weird gender thing. And as soon as it's that, now we just need to embrace that aspect of prenatalism. Right.

Simone Collins: I will say here, you know, to all the, the hate watchers who I see the comments.

Malcolm Collins: Our comment section is like 95 percent votes on even our most hated videos.

Wow.

Simone Collins: Okay. Well, I guess I would say that there are people Who are they take umbrage to the idea of people having children for quote, unquote, the wrong reasons, like, because it's an autistic special interest to this being one example, right? Or for ideological reasons, instead of just loving children, I think, honestly, and this is something I've heard other very pronatalist people say.

You kind of have to have an ideological or logical or special interest reason to begin having kids because it's [00:19:00] really hard to get started. Then once you actually get to know them as people, you're having kids because they're amazing people. And you realize that one of the most meaningful thing you could ever do is create an amazing life for them and bring amazing, wonderful people into the world and give them the best possible life.

Okay. So you start out essentially doing it for the wrong reason or for a heartless reason, and then you start doing it for the heart. I just want to, I just want to point out that it's not wrong for someone to like use special interests or ideology or logic to get someone started, because you can't really, you can't show someone, for example, what it's like to be in love.

Until they're actually in love, right? You know, they have to get, they have to be interested in getting in love from a logical standpoint first, before it happens, or it just kind of happens naturally, you know, they, they fall in love by mistake, just like you might get pregnant by mistake and have kids by mistake.

I just wanted to comment on some very frequent [00:20:00] pointed remarks about, Oh, like, wasn't it terrible that pronatalists would be having children just because they think it's important to have children. This

Malcolm Collins: is the worst reason to have to moan. It's when we need to keep up the facade. Our children live a gray.

And dull and, and, and, and, and dreary existence. Yes. Look, look miserable Indy. I mean, look, we're, we don't eat our house in the winter. This is me wearing a warm winter coat inside, right? Like, yeah. And

Simone Collins: Indy's wearing a snowsuit. Cause of course she is.

Malcolm Collins: Clearly our, our drive towards extreme levels of temperance is where I'd say, I'd say with discipline to try to work on our internal discipline by, by not indulging in pointless.

Simone Collins: She's so sad. She's so depressed. Pro. I see it in her

Malcolm Collins: eyes. That's that her eyes. We did this episode on the, the, the girl who went and shot up at school. That's what she looked like. Same eyes. I see it, Simone.

Simone Collins: I see it.

Malcolm Collins: I see it. . [00:21:00] She knows, she knows she's a mistake. Just like that girl, her parents had her as a mistake.

Oh, I had

Simone Collins: for all the wrong reasons, and, oh, you're so not loved.

Malcolm Collins: Okay, so, Simone, hold on, I gotta continue here. Okay. I'm not gonna keep reading it both ways anymore, because, like, it just gets so comical at this point. Yeah. Sometimes, restricted eating can commence because the person seeks to remain asexual and androgynous.

Sometimes, puberty blockers can commence because Okay. Fearing change and disliking the body changes that start to occur during puberty. For example, the person may be afraid of becoming an adult, and the changes this will bring to their lives, feeling incapable of getting a job or living independently, is that they seek to stay in their childlike body.

Oh my god! What?! You see why, like, when I started reading this, I was like, oh my god, revelation moment. This is the same phenomenon. Yeah. Okay, we found that autistic people often [00:22:00] experience difficulties discerning the character or personality of others, including their own personality. They often define themselves in terms of their interests and knowledge, rather than in terms of personality descriptors of social roles, such as mother, daughter, or friend.

This difficulty with conceptualizing the self can lead to over reliance on a self identification in terms of physical appearance, including their weight, rather than their character and other personality traits. qualities here. We say, including their gender rather than their character or other personality qualities.

Because in reality, your gender should not be that important to you. Like to a normal person, like I'd say myself, if I woke up the other day and I was in a woman's body, I'd just be like, okay, I'll figure out how to make this work. Like, I wouldn't be like, oh my God, I need to transition back immediately.

And I, this was in the transgender world makes us a gender. And ironically, because both of us feel this way and ironically, a form of transgender, because Agender is a form of genderqueer, and genderqueer is a form of transgender, by I forgot the, the main organization that does [00:23:00] all of this one of the main pride groups or whatever.

So we are technically transgender by their own definition just because I don't, Understand why I would care if I was a different gender. I'm like, I've got to focus on the difference I'm going to make in the world. You would trounce as a woman. I'm just saying, I wouldn't know. I'm even like, it's funny.

Like I wouldn't even be distressed. I'd just be like, Oh, awesome. Like now I can try. And I'd be such a cute guy.

Simone Collins: Like, you know, like taking care of the house. You and I would make a great partner. If you

Malcolm Collins: change nothing about our personality and just the gender. Oh my

Simone Collins: gosh. I would watch the gender swapped AI movie of us that we will eventually create in like two years when that becomes possible.

Malcolm Collins: We become famous enough. There will be rule 34 part of us. That's where they do gender swap or no real city for that. They exist. There's part of it. And then there's rule. There's so many

Simone Collins: rules of the internet. One of the other rules

Malcolm Collins: is that there's gender swapped porn events. So eventually there's going to be gender swapped porn of us.

Anyway part of the international definition of autism is rigidity and thinking APA 2020. Once an autistic person has made a [00:24:00] decision, they can be very determined and stay with the decision despite data and persuasion to the contrary. Commit to the bit!

What? Commit to the bet. That's what they do. For example, the person may decide that their life is far easier and simpler if they follow the rules dictated by eating disorder and therefore are very reluctant to change. Yeah. Simone does this. She still follows the rules of eating disorder and I find this.

Can help you if you've ever interacted. I'm a functional anorexic. Okay? If you've ever interacted with a trans person and they're like, my life is better now. And you're like, yeah, but like, I knew you before this and it's clearly not like you're not as happy as you used to be. You. You have to spend all of this money every month on this.

You are not widely accepted. You know, a lot of people treat you with discrimination now that didn't treat you with discrimination before, like your life is. Objectively not better, but they're like, no, my life is better now. And it's the same way you're talking to an anorexic person. If you go to an anorexic person, they're like, no, you don't understand.

My [00:25:00] life, gosh, yeah. And if

Simone Collins: I'm thinking about how I felt when I weighed like 98 pounds as a five foot eight and a half woman, and people were like, you need to put on weight. I could imagine that's how it felt. When people are like, you're, you're not passing, like, you should just be a guy again. And this feeling of like, I am not crossing that line.

Yeah, I can feel that. And I, yeah, that, that makes, actually, that makes Gender dysphoria feel a lot more relatable to me. So this is really helpful that you're reading this to me. Thanks, Malcolm.

Malcolm Collins: Yeah, right? Like as soon as you, who is an autistic person, who diagnosed autistic who went through this and understanding this is really important for our family because this is something our kids are going to be exposed to.

You know

Simone Collins: it. I mean, Toasty's already showing all of my disordered eating.

Malcolm Collins: All of our kids are autistic so far that can or old enough to be diagnosed. And so, you know, how do. How could somebody have had off anorexia for you, given [00:26:00] that it's a culture, maybe we just need to make our culture so different from the culture around them that they wouldn't even think of it.

Maybe we make the way you relate to gender and sexuality in our culture so different that they wouldn't even think about it.

Simone Collins: No, see, I think that again, just the mere presence of a large family really solves this problem because again, let's go back to that part where they needed something to fill the void or the to drown out the chaos.

That was too noisy, that was so noisy, like a restrictive eating disorder or like gender transition that they didn't have room for social anxiety and a large family will do that. The responsibilities of being in a large family will do that. The chaos of being in a large family, I really think that I, and I'd love to see research on this.

If rates of both gender dysphoria and Anorexia and cutting and all these other, I would say, like, kind of related disorders are [00:27:00] lower when there are 5 plus children. And I really think the key is 5 plus children. And I don't, I would not say that Elon Musk's family counts because they have. Enough supplementary care where the kids aren't growing up in a highly constrained environment, like resource constrained and like cramped and chaotic.

Like, unfortunately they have been given too much space for anxiety to creep in. Through their privilege. Yeah, they're too privileged.

Malcolm Collins: We got a small house like this where you've always got other people in a room with you and you're always There's no room for the

Simone Collins: social anxiety. There's just no, like, you're, you're literally too tired and, like, fed up with it all to have room for social anxiety.

You give zero s***s at that point. Which is so beautiful! Like, the word that was used in Hannah's Children So it was something along the lines of, of having enough children to burn the selfishness out of you. And it really is burned away like a cleansing [00:28:00] fire. It's so cool.

Malcolm Collins: Simone, I love you, by the way.

You're fantastic in the way you talk about this. , next. There are other types of thinking that are characteristics of autism and may be a risk factor for developing an eating disorder. For example, black and white thinking. The person may think, if I am not thin, then I am fat.

And hold on, I'd note here that and sees weight as a dichotomy rather than a range of acceptable weights. So think about this in terms of gender presentation, right? They may be like, I'm a girl, but I like some boy things, or I'm a boy, but I like some girl things. And because of, instead of being able to be like, well, you can present your gender in a way that like, well, then it

Simone Collins: means that I'm a girl or it means that I'm a boy.

Exactly. Yeah. You have to, this is the systematizing part of autism where it has to be in the category. And that's why I'm pretty sure that Titan also is autistic because she loves categorizing. Oh my gosh. She'll just sit and sort her dinner for like an hour. Have you

Malcolm Collins: noticed that? No, [00:29:00] they can stick very rigidly to a single number on the weighted scale as being the only desirable number Even though that number puts them at a life threatening weight part of the rigidity of thinking it can be what we have called the And and this is what I I I know here.

Like with a trans individual you can be like But your suicide risk is super high now. Like, your mental health seems really poor right now. Like, why do you think this is a preferable position? And they're just like, because it is. Because it needs to fit. The thing needs to fit. And this is the only acceptable way of doing this.

Simone Collins: The risk of death has absolutely zero bearing. When I was 98, And I weighed in at 98 pounds. I was like, all right, so let's get to 97. All right. Good job. Let's keep going There was no there is no stopping point with these things and there is no concern About health or death.

Malcolm Collins: Yes and so in the past this is called the frank sinatra syndrome or the my way [00:30:00] Syndrome, once the person has decided on their beliefs about their weight, or you could say gender expression, the rules around their eating and exercise patterns, you could say their presentation they can be very rigid.

They are not open to other people's advice or opinions, even if these are based on scientific evidence. You know, I could have gone to you as papers on, you know, the correct weight ranges, healthy ranges. I could have said, why? Like, what's the point of this weight? And you'd be like I feel more comfortable this way.

You know, Imagine how bad anorexic would get as we as a society started accepting it, right? And we're like, pro Anna, for the win, pro You can't, you can't hate on someone for being pro Anna. Oh yeah, if we, if we

Simone Collins: defended people's right to continue to starve themselves. Like,

how dare you put her in a recovery home, she, she identifies, you

Malcolm Collins: put anorexic people in recovery home and they're like, this is like, you know, you're denying their identity.

Yeah. Transitioning gay people. Although

Simone Collins: you know, my, my dad, God bless his genius. [00:31:00] He, he somehow figured out how to do that. He, he enabled me to maintain my status as someone with a severe eating disorder and not die by giving me a food scale and a software program. Where I could track everything I ate and then all the calories I burned using fitness trackers or just logging.

And what I think that's like for, for gender dysphoria though, it would probably involve like giving other categories or I would probably like introducing different definitions of gender, possibly introducing them to like the concept of, of Louis the 14th's Brother whose name I'm forgetting. Oh, I, I, yeah, I actually love this idea.

Malcolm Collins: So you actually fix it by going

Simone Collins: You have to change the categories. Yeah, you have to be like, Oh, but you're, you're like, you're more likely, you are manifesting like, what was it? Louis Philippe? I can't remember his name. He was so badass. But you just have to be like, you have the wrong, sorry, you have misunderstood the categorization [00:32:00] system.

Actually, you're sub level A. B5 4. And

Malcolm Collins: parts of the community have basically done this. We're like, I'll meet people and we'll see them online who identify as trans, but have done literally nothing in terms of gender transition or anything like that. They're just like, Oh, I'm like category B7, subsection 15.

Fascinating. I think you're right. Yeah. And it's, it's a, it's a solution. Yes. And

Simone Collins: is always the right answer with children. Yes. And.

Malcolm Collins: One of the qualities of autism is the intensity of the interests a person develops and the pleasure that these interests bring. One of the reasons eating disorders can develop is because of an intellectual fascination with eating and its effects on the body, as well as the numbers involved.

For example, in terms of calories for different foods. Okay, I just have to, well, one of the reasons for gender transition can develop is an intellectual fascination with puberty and gender and its effects on the body, as well as the numbers involved. And I absolutely see this in the trans community, they're like, my numbers!

[00:33:00] Let's, let's share my numbers!

Simone Collins: Absolutely yes.

Malcolm Collins: They may enjoy exploring eating patterns, rules, and weight. They may keep schedules and spreadsheets or use apps to record progress. Entering numbers and seeking patterns can be very enjoyable aspect of their interest. The eating disorder practices become a source of enjoyment and they embrace being.

An expert in the eating disorder. Their expertise and commitment are admired by others within the eating disorder. Social media can be a way of sharing their knowledge and gaining dopamine through the number of likes achieved through their social media page. Is that not something we see with people going through transition?

Simone Collins: Nail on the head. Wow. I mean, done. I feel like the argument has been, has been presented. This is insane.

Malcolm Collins: Well, there was actually, I know you need to go soon, but for people to believe this, there's a few things we need to go into. We need to go into evidence that, because a lot of people will be like, wait, what's the evidence that anorexia is a [00:34:00] cultural phenomenon, right?

So just to read here, this is from Scott Alexander. Anorexia was mostly unknown in the west until becoming trendy in the mid 1800s. During that period, doctors reported a high prevalence of anorexia among quote unquote hysterics, but the fad ended after about 10 or 20 years and went back to being basically unknown.

In 1983, a famous singer, Karen Carpenter, died of anorexia, thrusting it back into national news, and suddenly lots of people in the west were anorexic again. Meanwhile, foreign doctors who trained in the west went back to their countries. A search far and wide for it and found almost nothing. The few cases they did see didn't resemble the typical Western version at all.

For example, one Hong Kong psychiatrist was able to find a woman who refused to eat out of grief when her boyfriend left her, but she didn't think she was fat or feel any cultural pressure to be thinner. And this doesn't appear like the this is like a self punishment thing. The absence of anorexia abroad was especially surprising.

Since anorexics tend to end up in the hospital with extremely noticeable malnutrition, that doesn't really mimic anything else. It's not [00:35:00] really possible to hide severe anorexia in the way you can hide severe depression. In 1994, Hong Kong got its own Karen Carpenter, a young girl died of anorexia setting off a national pandemic and many public awareness campaigns.

Near instantly, anorexia rate shot up to the same level as the West, with appropriate number of people presenting to hospital ERs with severe malnutrition. A study of the Caribbean island of, and this is not forbidden, this And in post here, one thing I'm going to add is a description of some of the alternate gender displays that you get in different countries.

Because trans people will point to them as trans just because they're a nonconforming gender display. Yeah. But they don't Actually, they, they point to like incredibly rigid social structures in these countries or, or tribes where like if a man takes on like a woman's job or is gay, they'll say, oh, he's actually a [00:36:00] woman.

That's, that's the way it often works. It's nothing like transgenderism in the West. It's nothing like, oh, I don't feel comfortable in my body or something like that. It's like, oh, well, that guy's a florist. So we, we treat him like he's a woman. And then you. female pronouns for him because that's a woman's job.

And you know,

Simone Collins: or

Malcolm Collins: that guy likes sleeping with guys and you know, women do that. So we used like a women, it's a tweak basically. That's, that's what you're seeing, you know, not this big effort to gender transition or anything like that.

You've got the FATF IAM of Simoa who are. If feminine males who are attracted to other males in the United States, this is not what we would call trans. This is what we would call a twink.

This is also seems to be the case of the MOOCs. of Southern Mexico. Which are again, just males who are a feminine and attracted to other males.

Twinkie sub gay males. That's what they are not trans.

Then you have the bug.

So people of Southern Indonesia. And they believe in [00:37:00] five genders and people will say, oh, , this, this one of the genders, the color. Maybe these are, , trans people. And so, , let's describe these individuals and see what you would classify them as in our society. They do not undergo any sort of feminization surgery or feminization practices. But they are males who are attracted to other males. And are predominantly involved in industries like wedding planning. , yes, it sounds very much like a trans now. That's a f*****g gay person.

Okay. That's a f*****g gay person. Trans people really seem to only exist within the urban monoculture,

In every one of these instances, the alternate gender identity that these individuals are assigned. Appears to be downstream of the gender they are attracted to. So if I am attracted to men, I am assigned a female gender. And if I am attracted to. Females. I am [00:38:00] assigned a male gender that is a very different than the Western version of transgenderism. I think too. Find a phenomenon that you could consider culturally analogous to the transgender phenomenon in the United States. You would need to find a culture in which individuals are considered the opposite gender from their birth gender. But are still attracted to the gender

their birth gender would be expected to be attracted to. I E trans women who are attracted to women or trans men who are attracted to men and you just don't see this anywhere else. I have found in history.

Or in any culture?

trans people only seem to really exist in large numbers in the urban monoculture. And we don't seem to be able to find the phenomenon really anywhere else. You will find cross-dressers throughout history, but they do not appear like the trans phenomenon of today where all of a sudden it's like, oh my God, I need to go through this.

I need to go through this. I need to be recognized for this, or I'm going to [00:39:00] kill myself. It's very much.

Oh, there's that weird guy or girl who likes dressing up as somebody else. Like that's, that's cool. Or, oh, a girl's dressing up as guys so that she can serve in the military or some other function that she wouldn't be able to serve as a woman, but not out of this, like obsession was being recognized. As another gender. That's a completely modern phenomenon.

If you're wondering why I'm not going into two spirit people. ,

It's because my read of the evidence that they're mostly a modern fabrication and didn't exist in wide numbers.

Across the native American cultures. However,

where they did exist. They typically meant one of two things. It was either when a man or woman held a job that was typically associated with the other gender. I E. If I was a man and I was a wedding planner, I would be called a woman in this tribe. And, , that is not a sign of gender flexibility. That is a sign of intense gender rigidity.

, or it was a way to talk about Twinkie, homosexual men,

Which as we have seen, it is not [00:40:00] uncommon for cultures to categorize as women. And to be honest, I kind of get it.,

I actually don't know of, of, of gender transition really exists that widely in any other culture.

I take that back. It does exist pretty widely in some middle Eastern cultures as a cure for gayness, but I'm pretty sure that no one would consider that the same phenomenon is what's going on in the United States. I E. If there's a guy who likes sleeping with guys. Well, you know, obviously if he's gay, he needs to be put to death, but you can fix that by turning him into a woman.

It also exists in the form of his rise. In, , India, Pakistan area. This is communities of. Born males who, if they are living in poverty or kicked out of their family. , go live in these communities where they are. , castrated or gender transition, whatever you want to say so that they can act as sex workers for other men. Again, not anything like you would think a modern, transgender individual, although the transgender community calls them transgender.

Calling [00:41:00] someone in poverty who was castrated, so they could be used for sex work. Transgender one to me feels incredibly offensive. , but to, , it would be sort of the equivalent of calling a cus. Trato transgender. If you're not familiar with Toronto is that's. , It's a historic thing in Italy, where they would castrate young boys who were very good singers so that they could continue to sing, , in the equivalent of a. , the high pitches.

And I want to be absolutely clear here, what we are not arguing.

Is that.

Fluid gender identity didn't exist. Historically, historically there is a wide range of gender presentation. What we're specifically addressing here is the modern phenomenon where somebody, all of a sudden starts obsessing over the ways that other people interpret their gender identity. And the way that they see their own gender identity and then enters the state where they feel like they're going to kill themselves.

If people don't start seeing their gender identity, the way that they want them to.

[00:42:00] This is why we did the episode on members, stealing witches, which is a culture bound illness, similar to anorexia or gender dysphoria in the United States. Because we can look at something like that as outsiders and have a laugh. But from within that culture's perspective, it is very real.

So real that some people end up killing their own babies over it. Accidentally of course, , or end up permanently dismembering their genitalium over it. , and so when we hear about this, we have a laugh at them. Because we don't have something like this was in our culture, but when they hear about something like gender dysphoria in our culture, they have a laugh at us.

Speaker 13: That a dumb question? No. No. It'll look like to if you want to become a lady, but your man, you have something wrong in your Something wrong. Something wrong in your family.

Speaker 12: Something wrong in you.

Malcolm Collins: And unfortunately this new understanding of what gender dysphoria [00:43:00] and transgender ism is, has moved me to a position.

Where I am. Maybe more antagonistic towards openly supporting any form of alternative gender identity than I was historically, because if this is accurate, it means that generally supporting this as a society. Is just as harmful as being supportive of something like the pro Ana movement. This is a movement that promotes anorexia. , in is made up of primarily anorexic people.

, And people will be like, but I feel better now in the same way that anorexic people, you know, as I said, I've had anorexic friends in the past and they were like, look, I feel better. I feel accepted. I finally feel comfortable in my body. And I'm like, as an outsider, Who has looking in on you and who has known you for a long time?

I can see that that's. A delusion. You were less happy now than you've ever been. This is, this is not healthy for you.

But if I tell you that you will cut me out of your life and stop talking to me.,

It's something anorexic people often do [00:44:00] to people who try to shake them out of it.

and if you look at it, The transgender person is, is listening to this. And they're like, yeah, but. I feel better now than I did historically. , and I'm like, well, I'm sorry.

I can just look at this statistics on trans individuals and see that the suicide rate goes way up. I can see that. , we even know from the Travis doc clinic, , that people put on. , do you have any blockers? , when you're put on puberty blockers, your suicide rate actually goes up. Now they were suppressing this information because their approach trans clinic.

I mean it's a community was a 50% attempted suicide rate. If you were aware that

didn't exist in other cultures, you'd be like, well, why are we making room for it was in our culture.

And my historic position was. Some real trans individuals probably exist, but a large part of the movement is social. , and I still hold this position. As I said at the beginning, I think about 30%. It's probably biological.

However the damage done by the social part of the movement is so severe. And so [00:45:00] demonstrable at this point. That I am beginning to rethink whether it is a net, good to society, to support trans individuals for the small faction that are real.

But I don't even know if it would really hurt those individuals because. I assume with the real trans individuals, they don't particularly care how other people see their gender presentation.

They just have preferences and thought patterns that match the opposite gender.

They would be okay with a society that just accepted more fluid forms of gender presentation. Whereas when we're talking about this new form of transness,

I w I guess I'd call it gender obsession. A overwhelming obsession with how you perceive your own gender and how other people are perceiving your gender. , because . That leads to a huge amount of suffering. And. These people are hurting.

And I think that this can be occluded from trans individuals because they, when they develop gender dysphoria, they begin to look at [00:46:00] the way a person's body looks. And stop looking at simple things. Like the way their eyes look. So take an individual like Elliot page

look at his eyes. Pre and post transition. Or look at Dylan Mulvaney is either look at really any public facing trans individuals, eyes pre and post transition. And you will notice post-transition. There's something like a spark. That has left them. And it's really, really sad to see.

And I think trans individuals don't see this because they're so focused on every other part of that person's body and gender identity. That they don't see that the person. Has become that anorexic person who is desperately trying to tell you and everyone else that they're genuinely happy and satisfied

Simone Collins: so yeah, that's wow. No, you've completely You've experienced a paradigm change. I've now experienced a paradigm change. And I have a lot more empathy for [00:47:00] people who have gender dysphoria because now I realize I didn't do, basically experience the exact same thing, but with Eating and pregnancy. Oh Well, now we've got

Malcolm Collins: to be more worried about our kids, you know?

No,

Simone Collins: we were already worried. We already knew that autistic kids were disproportionately But I, but

Malcolm Collins: I think that they're just, like, like, like, Modeled and aesthetic wise so similar anorexia and gender dysphoria.

Simone Collins: Yeah.

Malcolm Collins: And in terms of talking to individuals because I had a cousin who was anorexic, for example, and I just remember, you know, trying to talk to her about it.

You know,

Simone Collins: yeah, well, there is a logic, but you have to speak. Autism, fortunately.

Malcolm Collins: And she was likely autistic. We speak autism. And knowing you now and knowing her, she was like one of the only really fun people in my family. So I was always like, Oh, you know, she, she gets me because she, she broke the social norms more, but it was [00:48:00] likely because she was autistic.

Simone Collins: Maybe.

Malcolm Collins: So do you want to go over some other culture bound syndrome and do you have to head out?

Simone Collins: I really have to go both. Cause I have to change a poopy diaper. We might add

Malcolm Collins: these in another day.

Simone Collins: I know, I, I, I, We'll do a

Malcolm Collins: separate episode on different culture bound syndromes. These have been really fun episodes to record.

Simone Collins: Yeah, and this, we've already, we're 37 minutes in.

Malcolm Collins: Yeah. So, this will be a different episode. And I've got a life in Describe if you want to continue. Oh, go to the natalism conference.

Simone Collins: Use the, use the code Collins for a 10 percent off. We will be there. So many cool people will be there. It is going to be awesome.

It is an awesome,

Malcolm Collins: you can find your autistic husband. Yes.

Simone Collins: Annual autistic marriage market taking place Austin this March. It's going to be, so we got to make sure they do a

Malcolm Collins: dating market this year. We should talk with Kevin about that. Do we have to call set up by the way? I know I need to get one on the books.

Well, I just want to say, I, so also this, this was [00:49:00] weird, like shifting for you too. Right? Like when I read it, I was like,

Simone Collins: yeah, but it also, it, it, it helps me understand what we would need to do. Just like my dad found a way. To enable me to be a functional anorexic, one can easily enable someone to be a functional trans person.

By functional, I mean trans in a way where they're less likely to die. Just like I am I am, I have an eating disorder in a way where I'm far less likely to die. Yeah,

Malcolm Collins: and I think that this can also help trans people just in modeling the way that they come off to outsiders and the way that they can think about themselves.

So like, yeah. If you're a trans person and you've had a friend who suffered from anorexia before and you tried to talk to them about like, you're clearly hurting yourself, I know you say you feel better like this, but I've seen you [00:50:00] before this. I've seen you after this. This is not the thing. And then this person begins retreating more and more into pro ana communities.

You don't know what pro ana is. These are pro anorexia, anorexia supporting communities where they'll post like inspiration of like really sickly looking people. Thinspo.

Simone Collins: Yes.

Malcolm Collins: So it's called if you have a friend who's gone down that rabbit hole, that's how other people feel when they're talking to you.

No,

Simone Collins: this will help everyone understand everyone else. This is good. Okay. I'm going off to get my teeth cleaned and change a poopy diaper. I love you so much. And steak tonight. Wagyu. Let's do it. We didn't buy Wagyu ourselves.

Malcolm Collins: I'm not at that indulgent. I got it for Christmas. Okay. I got it for Christmas.

Simone Collins: Best Christmas present. Oh my gosh. Amazing. Thank you. Okay. Love you. Bye.

Malcolm Collins: Love you. Bye.

Speaker 11: There's snow on the window. There's snow on the window. Snowy cake. It's snowing. It's snowing. Isn't it pretty, Tyson? Yeah. There's so much. I make it all [00:51:00] to the house. It's snowing.

What do you see, Octavian? I see the Christmas tree. Are you happy? Yeah. Testy, are you happy? I'm sick in it. I'm sick in it.