s05e118 | Challenging Gender Medicine from Within, with Jamie Reed & Aaron Kimberly
Aug 24, 2023
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Former worker in a gender clinic, Jamie Reed, and LGBT advocate, Aaron Kimberly, challenge the rush to transition minors. They discuss the lack of evidence and its impact on youth health care. The speakers explore the importance of a supportive environment, share challenges in providing gender medicine, and advocate for more exploration of gender identity without solely relying on medical interventions. The LGBT Courage Coalition aims to rework standard practices and promote dialogue within the LGBTQ+ community.
The decision by the American Academy of Pediatrics to conduct a systematic review of the evidence marks a significant step in the evaluation of gender affirming care and its impact on transgender and gender diverse youth.
The podcast raises concerns about the medicalization of gender diversity in children and adolescents, emphasizing the need for a supportive environment while highlighting the lack of robust clinical evidence and potential harms of medical interventions.
Advocating for change in gender affirming care requires holding professional organizations accountable, building connections within the LGBTQ+ community, promoting open dialogue, and reforming healthcare systems to ensure evidence-based practices and the well-being of all individuals.
Deep dives
The American Academy of Pediatrics Reconsiders Gender Affirming Care
The podcast discusses the decision by the American Academy of Pediatrics to commission a systematic review of the evidence regarding gender affirming care. This decision marks a significant step as the AAP had previously been resistant to conducting such a review. The review will examine the evidence behind gender affirming care and its impact on transgender and gender diverse children and adolescents. The speaker expresses curiosity about the prompt for this decision and highlights the potential political biases that can emerge in systematic reviews. The outcome of the review could potentially reveal low-quality evidence supporting interventions but still recommend their continuation, as seen in previous guidelines from the Endocrine Society.
Problems with Medicalization of Children and Adolescents
The podcast explores concerns regarding the medicalization of children and adolescents under the pretext of gender affirming care. The speakers discuss the shift from viewing gender diversity as a form of mental illness to recognizing it as a normal part of development. They emphasize the need for a supportive environment that allows individuals to explore and understand their own gender identity. However, they express alarm over the lack of robust clinical evidence and the reliance on political ideologies in guiding medical practices related to gender diversity. They also point out the potential harms and unknown long-term effects of medical interventions such as hormone blockers and surgeries.
Challenges in Advocating for Change
The podcast delves into the challenges faced in advocating for change and holding professional organizations accountable. The speakers discuss the lack of accountability for organizations such as WPATH and AAP, despite the significant influence they wield in shaping policies and practices related to gender affirming care. They underscore the need to build connections among dissenting voices within the LGBTQ+ community and promote open dialogue. They express the importance of preserving trust within the community and avoiding a polarizing backlash, while calling for a moratorium on medicalizing children and adolescents for gender affirmation purposes. The speakers also highlight the necessity of reforming healthcare systems and increasing evidence-based practices in order to ensure the well-being of all individuals, regardless of their sexual orientation or gender identity.
Shift in Paradigm: From Clinical Practice to Activist Activism
The podcast explores the contrast between clinical practice and activist activism within the context of gender identity. The speakers highlight how clinicians and activists operate from different paradigms when discussing gender, with activists focusing on human rights and reducing barriers to care. This shift in paradigm can lead to unsafe practices in clinical settings, as clinicians are expected to provide services without questioning an individual's self-identified gender, even if there is a lack of gender dysphoria history. The podcast emphasizes the importance of considering clinical guidelines and evidence-based approaches in providing gender-affirming care.
Societal Integration and Middle Ground Solutions
The podcast advocates for finding middle ground solutions and societal integration in discussions around gender identity. The speakers highlight the need to engage in dialogue that transcends polarized viewpoints and promotes understanding. They argue for the importance of fostering societal acceptance of gender non-conformity and exploring ways to prevent gender dysphoria through societal changes. Additionally, they emphasize the value of evidence-based decision-making, acknowledging biological sex when necessary, and ensuring fair practices in areas such as sports and medical treatment. The speakers urge for open conversations, submission of diverse perspectives, and the creation of safe spaces for dialogue within the LGBT community.
Jamie Reed worked in a "gender clinic" and was shocked at the dearth of evidence and rush to transition minors that she saw—thus she stood up and spoke out. Aaron Kimberly has a similar story. Together they've founded "LGBT Courage Coalition" which is a group of LGBT adults that are working to rework standard practices in medicine, as well as public perception, of the so-called "gender affirming" model of youth health care.
