Gender: A Wider Lens

Marcus and Sue Evans both worked as clinicians in the Tavistock Centre in London for many years. Noticing red flags since the early 2000s, Sue was the first whistle-blower in the Tavistock Centre and Marcus resigned as its governor because the concerns raised by therapists, parents, and managers were systematically dismissed. Marcus and Sue have recently released their book Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults. They join us to discuss the tasks of adolescents, family dynamics, and how important it is to explore questions about gender dysphoria as part of a more holistic approach to clinical care because nobody yet has all the final answers.Links:Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young AdultsAuthors: Susan Evans and Marcus EvansFiringthemind.com/product/9781912691784/  “Freedom to Think: the need for thorough assessment and treatment of gender dysphoric children” by Marcus Evans Cambridge.org/core/journals/bjpsych-bulletin/article/freedom-to-think-the-need-for-thorough-assessment-and-treatment-of-gender-dysphoric-children/F4B7F5CAFC0D0BE9FF3C7886BA6E904B “First do no harm: A new model for treating trans-identified children”Quillette.com/author/susan-evans/ Interview with Marcus Evans:  Quillette.com/2020/01/17/why-i-resigned-from-tavistock-trans-identified-children-need-therapy-not-just-affirmation-and-drugs/ Sue Quoted in the Guardian:  Theguardian.com/society/2020/mar/01/families-divided-tavistock-nhs-gender-clinic-judicial-review-goes-ahead An overview of the Judicial Review and court decision about puberty blockers Transparencyproject.org.uk/bell-v-tavistock-in-the-high-court-an-explainer/ Extended NotesHow did Sue get into gender dysphoria?Being involved in this work for many years now, Sue was concerned that children were being medicalized too quickly.It is clear that there needs to be more research in this area and the subject needs to be understood more before we prescribe children with puberty blockers.How did Marcus get into gender dysphoria?In 2006, Sue and Marcus were raising clinical concerns about the effects of puberty blockers. It was tough. Their opinions were unpopular.Marcus retired in 2018 and became a staff governor. He received a letter from 10 parents that were concerned that their children weren’t psychologically examined properly for their gender dysphoria. They felt the whole process was too rushed.After digging deeper into the issues, Marcus felt he had to resign because he disagreed with how his organization was handling the issue. He was terrified his career This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

Sasha and Stella continue their series which peers behind the curtain of depth work with gender-questioning clients. Today, they weave in philosophy and psychology to discuss the importance of authenticity, happiness, and connectedness. They also explore the value of art in the slow evolving process of an emergent Self.Links:The Catcher in the Rye: https://www.goodreads.com/book/show/5107.The_Catcher_in_the_Rye  The Bell Jar : https://www.goodreads.com/book/show/6514.The_Bell_Jar  Taxi Driver: https://en.wikipedia.org/wiki/Taxi_Driver  The Scream: https://en.wikipedia.org/wiki/The_Scream  Raised by the Village (with Stella O’Malley): https://www.rte.ie/tv/programmes/1076971-raised-by-the-village/ External Locus of Control: https://link.springer.com/referenceworkentry/10.1007%2F978-1-4419-1005-9_250#:~:text=Definition,luck%2C%20chance%2C%20or%20randomness.    Extended NotesHow do you “break the ice,” as it were, with a gender-questioning teen? Sasha and Stella noticed that a lot of these children don’t have “joy” in their lives.What does it mean to be authentic?So many teens feel different from others and they feel like no one else understands the feelings they’re going through.A lot of gender-questioning teens are asking very common existential questions. It often shows up everywhere, really.Sasha often likes to ask what are some of the common triggers to her client’s gender dysphoria. The answers are very interesting and insightful.Going from a child body to an adult body is very jarring.If a child is experiencing same-sex attraction, therapists really need to slow down in this process and explore.Everybody says they’re pro-LGBTQ, but they just don’t want it for themselves.There is a lot of bullying going on in schools when someone is gay or a lesbian — a lot of bullying.It’s one thing to say you’re okay with it, but it’s quite another to be experiencing same-sex attraction physically.Sasha works a lot with helping her clients find their own voice that’s not a reaction towards their parent’s wishes.When parents are so adamant about what the “right thing” is for their children, the children end up doubling down even further.Sasha loves to do these “gender timelines” to help the child see how their views change over time.Stella really likes to go “behind the label.” Yes, they’re calling themselves certain things, but let’s dig deeper as to why.Some children also have a hard time accepting their very “ordinary” selves.Let’s explore internal vs. external locus of control.Young people have been sold this idea that they can control how other people perceive them.Stella likes to encourage her clients to develop their own sense of style. Not develop a style based on “what they think it means to be trans.” What her clients come up with is often very freeing.Stella is also curious to understand whether medications are suppressing libidos and this means young teens feel like they have to... This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

After the therapist has laid the foundations of therapy and established a trusting relationship, the process moves into the middle stage. This is the meat of the therapy! In this episode, Sasha and Stella explore the dynamics that can elicit change in the individual. They consider the curious vs. fixed client, self-esteem issues, broadening the client’s focus, and how to speak meaningfully about gender in therapy.Links:The Importance of an Unhappy Adolescence: Youtube.com/watch?v=zcUI1Hk0GRU&feature=emb_title Gender Care Consumer Advocacy Network: Gccan.org Extended NotesWhat’s the true job of a therapist when a parent brings their gender-questioning teen in for counseling?Timing is important when approaching therapy. Both Stella and Sasha keep phrases and viewpoints their teen is saying in their back pocket to bring up for exploration at another time.If you’re not careful, it can turn into a “gotcha” moment for your client. You want to avoid that.Teens have very harsh inner voices and, as therapists, it’s important to look into this in a gentle way.A lot of adolescents understand the importance of their mental health, which is why they’re so critical of themselves when they don’t have happiness. It’s a vicious cycle.Whenever there’s an outburst, people might be dismissive and say, “Oh you should talk to your therapist about that.” Although true, there are better ways to reassure a child that their emotions are perfectly normal.Parents don’t like to reveal some of the bad things that happened to them throughout their life, but sharing some of these experiences with their children really humanizes them.When you don’t divulge information, you make your relationship colder. By sharing information and life experiences, you create a deeper friendship.People love to throw out diagnoses left and right, but sometimes these are just children going through normal teenage things.Stella shares an interesting pattern that happens with her clients when they go from gender distress to seemingly being fine, and then back to gender distress.As a therapist, it’s important to position yourself as someone who explores unknown questions together with your client.It’s important to think big picture and dive into what else is going on in their life and not just focus on the teen’s specific gender issue.Teens have reported that social media causes a lot of distress and time wasted. Too much time on these platforms causes them a lot of mental health issues.As therapists, it’s also important to show the client how they can find their strong voice and say no to things that aren’t serving them or causing them distress.What is the sexual self? How do you define it?Therapists need to not hurry this process. A strong relationship can develop over years and so there’s time to explore challenging subjects pieces at a time.The political narrative around puberty blockers is not matching what Stella and Sasha are seeing in their clinic, is it because they have a more biased cohort?This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:Rethinkime.orgLearn more about our show: Linktr.ee/WiderLensPod This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

This is the first episode in a short series which takes listeners behind the scenes of a gender exploratory therapy process. Although there has been plenty written about Gender Affirmative Therapy, very little has been written about a concept often described as Gender Exploratory Therapy. Sasha and Stella discuss the specifics of establishing a therapeutic alliance when a person is questioning their gender identity. They describe different strategies involving issues such as names, pronouns, clothes and hairstyles and reflect on the different stages of therapy, which they’ll discuss in subsequent series episodes.   Anastassis Spiliadis: ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties  https://journals.sagepub.com/doi/abs/10.1177/1359104518825288   Sasha Ayad: How do I work with gender questioning teens: https://gdworkinggroup.org/2018/11/12/how-i-work-with-rogd-teens/   Sasha Ayad, Stella O’Malley and Lisa Marchiano: ‘Effective Relationships and Clinical Relationships’ https://youtu.be/Sy1VuuN6V2g    This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

In today’s episode, we begin to answer some of the many questions sent to us by listeners.Can we be born in the wrong body? Do parental role models influence children to reject or seek transition? What is the impact of a trans partner on a teenagers’ sexuality? How do siblings of trans people experience these changes in the family?Listen in to see if your question was answered and how Sasha and Stella plan to explore these topics in future episodes.Links:TED Talks — “Own Your Face” Happiness isn’t found in your appearance: Youtube.com/watch?v=QbxinUJcLGg&feature=emb_logo“My Philosophy for a Happy Life”:Youtube.com/watch?v=36m1o-tM05g&t=1sMy Left Foot Film: Imdb.com/title/tt0097937/ The Crying Game: Imdb.com/title/tt0104036/Dr. Lisa Diamond: Youtube.com/watch?v=m2rTHDOuUBw&t=5sExtended NotesThank you so much for sending your questions! Let’s talk!Born in the wrong body? How is that different from those with disabilities?What does it mean to be in the “wrong body”? Stella and Sasha discuss.You cannot let yourself be defined by your disability or your abnormal face.Stella asks some interesting questions about people who undergo drastic cosmetic surgery.Is it the new normal to just drastically change your appearance?Sasha shares interesting cosmetic surgery trends that we’re now seeing in our society.How do you really know you’re born in the wrong body vs. just being unhappy with your body?Next question! This listener’s teenage daughter is dating a girl that identifies as a boy. This mother has some questions on what this all means.This listener is curious if her parenting style has had an impact on her daughter’s rebellious tendencies to reject her own gender identity.It’s normal for a daughter to not be a carbon copy of the mother.Don’t blame yourself for your daughter’s gender identity.Parents often put their own needs on the backburner when they have a child.Next question: How do you talk to siblings about their gender dysphoria?Birth order is important. Was the child who is transitioning older or younger? This can affect siblings differently.Parents are trying so hard to give their resources to their trans child, but siblings are sitting on the sidelines keeping their questions to themselves because they see how much conflict this is giving everyone.Listeners share some of their favorite episodes, and even ones they’ve shared with their children.Sasha and Stella share some upcoming episodes that they have in the works right now!This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:Rethinkime.orgLearn more about our show: Linktr.ee/WiderLensPod This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

“Lauren” is a 32-year-old lesbian who has moved with ease across the gender spectrum over the course of her lifetime. Lauren offers a positive story about how being gender non-normative and having a complicated gender experience can be a pleasant and interesting experience. Cautioning against the heavy and urgent discussions about medicalizing gender expression, Lauren wonders if we can become more playful and even joyful about gender?Links:Lauren’s Blog: Theanxiousskeptic.wordpress.com/ Extended NotesA little bit about Lauren and her experience with gender.The way our society is handling trans children is completely different from when Lauren grew up.Lauren feels a bit betrayed by the LGBTQ community.What was Lauren’s childhood like?How did Lauren’s family deal with her and her older sister’s masculine gender?Can you be gay and Mormon?Lauren was always the good child and her older sister was the problem masculine child. So it threw everyone for a loop when they found out Lauren was a lesbian, and not her sister.When Lauren dressed in drag, she felt much more comfortable in her own body.Men’s clothing was just easier to understand and when Lauren took on a more butch persona, it was a lot easier for her to date.Lauren was a butch lesbian for about 10 years before switching back to a more “feminine” look.In Lauren’s mind, being butch is almost like a third gender.At one point, Lauren identified as trans.The trans community has really affected the way lesbians see themselves. Lauren knows several people in same-sex relationships who have identified as trans at one point in time in her friend group.When it came to having children, how did Lauren and her wife decide who should have a child?A lot of Lauren’s friends who were butch were transitioning, either to a more feminine persona or trans. And she felt like she could not grieve this sense of loss. She just had to be happy for her friends.When random people were shouting slurs at Lauren and her wife, it only really started to bother her as she got older and was going to become a parent.What’s it like being a mother?Eleven-year-olds are being asked if they want to preserve their fertility. It’s crazy.Lauren has gone through many different gender identities and went on to have children. She gets fired up and passionate when young children are forced to “choose.”We have to think about the long-term well-being of children and teenagers first. Not our politics.Can we be more playful with our gender? Why do we have to always pick a side?This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:Rethinkime.orgLearn more about our show: Linktr.ee/WiderLensPod This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

Continuing the discussion about the new type of boy who is seeking to transition, we speak to Angus Fox, author of a series in Quillette. Angus explains why he thought it so important to earn the trust of parents who participate in clandestine meetings about their gender dysphoric sons. We discuss the role of systematic thinking in ROGD boys and the encouragement of their female friends to transition. Angus also provides his insights as a gay man remembering his own challenging boyhood.Links:Angus Fox (2021) — “When Sons Become Daughters: Parents of Transitioning Boys Speak Out on Their Own Suffering” Quillette.com/author/angus-fox/Angus Fox — Part II Quillette.com/2021/04/06/when-sons-become-daughters-part-ii-parents-of-transitioning-boys-speak-out-on-their-own-suffering/ Angus Fox — Part III Quillette.com/author/angus-fox/ Extended NotesHow did Angus get into this field and get interested in gender dysphoria?What are some of Angus’s biases?So many parents are blindsided when their child comes out as trans.The counselors and therapists are partly to blame.Angus conducted a survey to see what parents thought was influencing their children to become trans.What did Angus uncover after conducting this extensive research?These boys are often bright, socially behind, and very online.Angus noticed that a lot of these boys were playing particular RPG games and it gave them a false illusion of what the female aesthetic really was.These very intelligent boys, who often have intelligent answers to things, are giving parents very strange and almost immature answers as to why they want to become a woman.Predatory men online could be further exacerbating the problem.How do these boys end up relating to their own sexuality?We’re seeing a rocketing number of people who are saying they’re bisexual.What benefits do these gender dysphoric boys get by joining a girl clique?Why are young women so obsessed with dressing up their new toy?So many families are just lost and don’t know what to do.Want diversity and inclusion? You should see these groups. They’re diverse and they’re all worried about their child.When you talk to de-transitioners, they all have a level of wisdom about who they are and what they want.Did Angus see a connection with autism in his surveyed group?What kinds of reactions are mom and dad having when it comes to having a trans teen?Children are taking fewer and fewer risks in our environment. As a way to rebel, they’re taking risks on their bodies and their personal identity instead.Angus is curious about the child birth order and where trans children fall under. If they have a big family, small family, and where are they in the birth order, does it impact their identity?This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:Rethinkime.orgLearn more about our show: Linktr.ee/WiderLensPod This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

Many presume that ROGD only impacts girls, but there is a significant number of boys who appear to show the hallmark traits of Rapid-Onset Gender Dysphoria. Not quite fitting in with Ray Blanchard’s classification of homosexual transsexualism or autogynephilia, these boys tend to be softly spoken Mommy’s boys, highly intelligent and hyper-ruminative. Many prefer to remain safe at home in their bedrooms and become fixated on medical transition. In this first of two episodes, Stella and Sasha introduce some of the different ways that gender dysphoria can manifest in boys.Links:Ray Blanchard (1989). “The classification and labeling of nonhomosexual gender dysphorias.”  Archives of Sexual Behavior. 18 (4): 315–334. doi:10.1007/bf01541951. PMID 2673136. S2CID 43151898.Blanchard R (August 2005). “Early history of the concept of autogynephilia.”  Archives of Sexual Behavior. 34 (4):439–446. CiteSeerX 10.1.1.667.7255. doi:10.1007/s10508-005-4343-8. PMID 16010466. S2CID 15986011.Michael Bailey (2003). The Man who would be Queen. Wikipedia.org/wiki/The_Man_Who_Would_Be_QueenAnne Lawrence — (2013).  Men Trapped in Men's Bodies: Narratives of Autogynephilic Transsexualism. Springer Science+Business Media. ISBN 978-1-4614-5181-5.Angus Fox (2021) — “When Sons Become Daughters: Parents of Transitioning Boys Speak Out on Their Own Suffering” Quillette.com/author/angus-fox/Donna M. (2021) — “You’re not trans, you’re just weird” Newdiscourses.com/2021/03/youre-not-trans-youre-just-weird/Kellie Jay Keen Minshull — “The locker-room has a lot to answer for” This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

Hyper-active, inattentive, immature, and impulsivity are just some of the common traits associated with ADHD. These may not have an obvious link to Gender Dysphoria and yet gender variance is found to be 6.64 times more likely among individuals with ADHD. We discuss how ADHD manifests in girls and boys, how society responds to ADHD traits, and how this interaction can lead to gender-related issues.Links: ADHD and Gender DysphoriaSciencedaily.com/releases/2014/03/140312103102.htm Girls and ADHDVerywellmind.com/adhd-in-girls-symptoms-of-adhd-in-girls-20547 Travel Programs for Adolescents/Teens/Young Adults:Adolesco.org/Habitat.org/Semesteratsea.org/Volunteerhq.org/coronavirus-update/ Elle Palmer: How my Personality Influenced my IdentityYoutube.com/watch?v=H8FrT2M44Co&feature=emb_logo Richard Branson: ADHD: The Entrepreneur’s Superpower Forbes.com/sites/dalearcher/2014/05/14/adhd-the-entrepreneurs-superpower/?sh=11f9010459e9 Michael Phelps: How swimming saved Michael Phelps: An ADHD Story Additudemag.com/michael-phelps-adhd-advice-from-the-olympians-mom/ Gabor Maté (2000) Scattered: How Attention Deficit Disorder Originates and What You Can Do About It Drgabormate.com/book/scattered-minds/Extended NotesA lot of diagnoses are flying around and it’s easy to go, “yeah, yeah.”What is ADHD? How do you define it?It’s hard to force yourself to focus when you’re really uninterested in something.ADHD is actually a good thing and it was used for our survival.When society/school tells these children they’re slow or that they’re not performing well, it can really perpetuate a lot of negative self-talk and make the problem worse.Stella can see how a lot of children with ADHD have been impacted with how poor or low self-esteem.Has ADHD always existed or is this just the byproduct of our environment?Since ADHD kids have a hard time tracking the details, they might be seen as silly or slow.Do ADHD kids seem shyer because of how many times people tell them to “stop” doing things or being who they are? Stella and Sasha wonder what kind of personality they’d truly have if they were just “free to be.”ADHD kids try their best to structure themselves and they can also end up being really obsessed with goals.Once these kids have their minds set on something, they become hyper-focused on achieving it. Even if it means it’s not 100% what they want.Social media is made for an ADHD person.How do ADHD traits show up in boys and girls, especially those with gender dysphoria?A lot of successful people have ADHD. it’s a great... This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe

This last year of lockdown has been a strange and unsettling time for many. We have heard reports of gender issues escalating rapidly and we have also heard accounts of people leaving all thoughts of gender identity far behind. The impact of our restricted lifestyle on our mental health is explored and some strategies that might help in these difficult times are suggested. Stella and Sasha give listeners from around the globe shout-outs and audience members are invited to request future show topics and to share their burning gender questions.Links:Msnet thread: Mumsnet.com/Talk/womens_rights/3952739-The-effect-of-lockdown-on-transitioning-teen-girlsStella O’Malley, The Journal, “Young people have suffered so much this year — they need our support”: Thejournal.ie/readme/wellness-stella-omalley-5252594-Nov2020/Stella O’Malley, Irish Independent, “We must confront painful truth: we are facing into a mental health crisis”: Independent.ie/opinion/comment/we-must-confront-painful-truth-we-are-facing-into-a-mental-health-crisis-40031671.htmlStella O’Malley, Sunday Independent, “Locked in by Covid for almost a year, the kids aren’t all right”: Independent.ie/opinion/comment/locked-in-by-covid-for-almost-a-year-the-kids-arent-all-right-40088973.htmlConnect on Twitter: @Widerlenspod & FacebookExtended NotesHow has the lockdown affected people with gender dysphoria?Some clients spend months watching transition videos on YouTube.The internet is a very influential place. Get your children off of it!Stella has noticed that young people are really scared of life.Sasha remembers being afraid to step outside after the lockdown. She’s an adult, imagine what it’s like for young people!What is Ireland like right now?What does life look like for the rest of the world? Let Sasha and Stella know!Everyone is isolated right now and Stella is seeing a lot of relapses happening. Everything from eating disorders to gender.We’ve gotten through worse! But by saying that you are denying our current experiences.We know the mental impacts war and famine have on our wellbeings that last a lifetime, but what about isolation?Children are still developing and not being able to see any of their friends; both Sasha and Stella are curious what kinds of long-term effects this will have on our society.There are intense despair and loneliness happening right now with our children.Stella shares some observations she’s had with both her introverted clients vs. extroverted clients.Sasha shares why the lockdown made her decide to move to a different location.Stella was worried that her children were spending too much time on the screens. She needed them outside.The irony is despite being on their phones all the time, young adults are under-stimulated.What have been some of the pros of the lockdown?Shoutout to the listeners! Thank you for... This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.widerlenspod.com/subscribe