150 - The Consumerism of Gender-Affirming Care with Leor Sapir
Feb 16, 2024
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Leor Sapir, an expert in gender-affirming care, joins Sasha and Stella to discuss the consumerism of gender-affirming care, bans on gender-affirming care in the US, fostering of narcissism, and parallels with the recovered memory craze from the 1990s.
The current consumer-driven model of gender-affirming care dismisses the role of therapists and promotes patient responsibility, potentially inflating entitlement and reinforcing narcissistic tendencies in patients.
The golden mean fallacy in reporting on gender-affirming care fails to consider the lack of robust evidence and conceptual frameworks supporting transitioning children, highlighting the need to delay decisions until adulthood to avoid potential harm.
Deep dives
Gender Affirming Care Shifts Responsibility to the Patient
The podcast episode explores the concept of gender affirming care and how it places the responsibility on the patient, even at a young age. The episode highlights that this approach dismisses the role of the therapist and promotes a consumer-driven model of care. It is noted that therapists may act more like coaches or facilitators, helping the patient assert their identity in different domains of life, rather than engaging in traditional therapeutic processes. The episode emphasizes the potential dangers of this approach, including the risk of inflating entitlement and reinforcing narcissistic tendencies in patients. It calls for a reevaluation of the role of therapists in gender-affirming care and the need to balance patient autonomy with professional expertise.
The Problematic Golden Mean Fallacy in Left-Centered Reporting
The summary criticizes the golden mean fallacy often observed in left-centered reporting on gender-affirming care. This fallacy seeks to position a middle ground between extreme positions, suggesting that it is the correct approach simply because it is in the middle. However, the summary argues that the middle ground is not necessarily true or correct based on evidence and conceptual frameworks. It asserts that the current evidence and framework for pediatric gender medicine are not robust enough to support transitioning children and that the best approach is to delay these decisions until adulthood, highlighting the potential harm caused by rushing into affirming interventions.
Regulation of Gender-Affirming Care through State Bans
The episode delves into the topic of state bans on gender-affirming care and its implications. While acknowledging that such bans may create inflammatory reactions and potentially lead to a black market for hormones, the summary argues that regulatory intervention is currently necessary due to the medical establishment's promotion of harmful practices and the lack of self-regulation within the field. It discusses the polarization of politics, creating a tendency for individuals to align their opinions with their respective party's stance. The summary emphasizes that legislations and regulations in medicine are not uncommon and underscores the importance of finding a balance between patient autonomy and responsible regulation.
Parallels Between Gender-Affirming Care and the Recovered Memory Craze
The podcast episode draws parallels between the current gender-affirming care movement and the recovered memory craze of the 1990s. It highlights similarities in the unfalsifiability of theories underlying both movements, the reliance on symptoms to determine cause, and the focus on therapeutic outcomes over the truth of the patients' experiences. The summary also touches on the potential dangers of suggestibility and projection within therapy sessions, as well as the impact of cultural trends on therapeutic practices. The episode suggests that understanding the historical context and pitfalls of the recovered memory craze can provide insights into current gender-affirming care controversies.
Join Sasha and Stella in welcoming Leor Sapir back to the show. In addition to hearing his analysis of the recent New York Times piece by Pamela Paul on youth gender medicine and detransition, listen as they explore comparisons between gender medicine and consumer-driven cosmetic practices, bans on gender-affirming care in the United States, the fostering of narcissism, and parallels with the recovered memory craze from the 1990s.