Agree to Disagree About Gender

In this episode of Agree to Disagree About Gender, I speak with epidemiologist Dr. Gideon Meyerowitz-Katz, also known as Health Nerd, about pediatric gender medicine, medical transition for young people with gender dysphoria, and what the evidence can and cannot tell us. The quality of evidence around pediatric medical transition remains highly contested. Some argue that the existing research is too weak to determine whether these interventions improve outcomes for young people, make outcomes worse for some, or help certain groups while harming others. Others argue that continued access is necessary despite uncertainty, especially given the distress experienced by many adolescents with gender dysphoria. Dr. Meyerowitz-Katz is an epidemiologist and science communicator who writes about evidence, public health, and how to interpret data. His Substack, Health Nerd, has more than 33,000 subscribers, and he has written extensively about pediatric gender medicine, including arguments in favour of continued access to care despite the limitations of the current evidence base. In this conversation, we discuss: • Why the evidence base for pediatric medical transition is so difficult to interpret • What randomized trials, observational studies, and systematic reviews can and cannot answer • Whether better data could resolve the debate • How researchers should think about benefit, harm, regret, and uncertainty • Why pediatric gender medicine has become so politically polarized • Why data alone often fails to persuade people on either side of the issue This is a conversation about evidence, uncertainty, values, and the limits of epidemiology in one of the most contested areas of medicine. Guest: Dr. Gideon Meyerowitz-Katz / Health Nerd Show: Agree to Disagree About Gender #PediatricGenderMedicine #GenderDysphoria #MedicalTransition #HealthNerd #Epidemiology #GenderMedicine #EvidenceBasedMedicine #AgreeToDisagreeAboutGender

Maia Poet joins us for Part 2 of our conversation about her theories of the interface between autism in natal females, the drive to transition and detransition, and how it informs her advocacy. We also discuss the evolution of her thinking on trans people, and her transition from a more adversarial to a more curious and collaborative approach Also, please check out Part 1 of our interview on our channel!

Maia Poet spent 12 years of her adolescence and early adulthood believing she had a male brain in a female body, and eventually went on to live in the male social role amongst Orthodox Jews, Palestinian Muslims and secular Israelis for five years. It took living through two wars in the Middle East for Maia to begin the journey of questioning the conclusion she came to as a 12 year old, and eventually to divest from it entirely. Almost three years later, she is now a public speaker and writer who reflects extensively on Substack about her experiences of transition, desistance and detransition with a focus on exploring the overlap of conditions like ADHD, autism and gender dysphoria at the intersection of research and lived experience. She hopes to bring awareness to the ways in which the systematic overlooking of autistic traits and experiences in girls early in life, leaves them uniquely unequipped to navigate the psycho-social and sensory challenges of puberty, and therefore more vulnerable to developing conditions like sex or gender dysphoria and eating disorders around adolescence. Maia sits down with Laura and Yvette about the impact of autism and neurodiversity on the experience of living with gender dysphoria. Her perspective is imformed by her own experience of growing up autistic before it was commonly recognized in natal females, her relationship to her body and how she developed gender dysphoria, and how she came to live in a male role as an adolescent and young adult in Israel

Karleigh Webb is a woman who wears a lot of hats on the field and off. She is a sports journalist with 33 years experience as a television sports reporter/anchor, producer and now as a contributing sportswriter to Outsports.com. She is also the a training coordinator and peer support operator for Trans Lifeline. Karleigh is also an avid cycling, runner, triathlete/duathlete and is in her fourth season of women's football playing for the Connecticut Ambush of the American Women's Football League. Karleigh joins us to make her case about why trans women belong in women's sports at all levels. We discuss the implications of trans women's participation in contact vs. noncontact sports, competitive vs. recreational, and on the role sports can play in creating a sense of belonging for trans women Needless to say, this becomes a source of vigorous debate for Laura and especially Yvette who is firmly protective of women's sports being for biological women. This discussion gets lively and contentious, but remains civil throughout, as we continue to model how to have impactful conversations about controversies in the world of gender

Sasha Ayad is a license therapist who provides counselling to families where a child is transitioning or is experiencing gender distress. Her focus is on how parents can continue to be part of their child's life and avoid estrangement and promote reconcilement, even when they are not supportive of medical transition She joins Yvette and Laura on Agree to Disagree About Gender to have a heartfelt discussion on these issues Sasha became interested in the sharp rise in teenagers who declare they are trans for the first time during adolescence. She questions the practice of medical transition for minors, and her clinical work focuses on developmentally appropriate, least-invasive-first talk therapy. Seeing a great need to help parents, Sasha began running parent groups in 2019 both online and through in-person retreats. She is the co-author of the book When Kids Say They’re Trans, and writes regularly on Substack. She recently launched a new project called The Metaphor of Gender: on this YouTube Channel, identity goes beyond the literal. She uses radical curiosity and surprising insights to help adolescents and young adults better understand themselves and skillfully navigate the real world.

In Part 2 of our conversation with Jonni Skinner, we focus on life after detransition: the challenges of re-integrating back into the male gender role after living for 8 years as a woman, staying positive despite facing hardships, his motivations to become an advocate for restricting access to medical interventions for minors, and on what his future might hold. Please take a moment to watch Part 1 if you haven't already

Jonni Skinner is a young man who spent 8 years of his adolescence and young adulthood living as a girl and young woman, before deciding to reclaim his identity as an effeminate gay man. He details how he came to believe that transition would be a better fit for his personality, his struggles with medicalization as a young person, and how he intends to face his future in his birth sex. Yvette and Laura touch upon why he tried to "trans away the gay", if he is now trying to "gay away the trans", and his advocacy for banning access to the type of care he beleives has left him permanently damaged.. We also discuss the intersection between identity and embodiment, what he envisions his life will be like going forward, and why he still has affection for the trans community. This is the first of 2 episodes, -please stay tuned for Part 2 next week

Jamie Paul is a writer based in Greater Philadelphia, founder of American Dreaming, managing editor at Queer Majority, and contributing editor at Bi.org. His work has appeared in outlets including Quillette, Persuasion, Areo Magazine, and Gazeta do Povo. His recent focus has been on documenting what he perceives as the excesses of "wokism", and on how these excesses have undermined the status and well-being of the populations who they were ostensibly advocating for. These can be found on his series "The Memory Hole Archives"" In his thesis, trans advocacy was no exception; trans activists once in control of influence within academia, government, the civil service, and in left-leaning society promoted a set of policies without the broader consent of the public leading to a backlash that threatens the ability of trans people to access the accommodations and concessions that once allowed many of them to flourish. Jamie joins Yvette and Laura to discuss his thesis in more detail, not out of hatred or contempt for trans people, but to act as the blue print on how trans advocacy can move forward in a more measured and pragmatic fashion

Dr. Kinnon MacKinnon is an Assistant Professor of Social Work at York University in Toronto, and is one of the world's leading researchers on the phenomenon of decisional regret around gender transition, desistance from trans identification and detransition from medicalization . Dr MacKinnon''s research seeks to better characterize and understand the different factors that lead to regret and detransition, and how this is influences by the changing nature of identity and the stigma associated with being transgender. His work is especially crucial, given how concerns about the rising rates of regret and detransition have provided a compelling rationale for restricting access to medical transition, especially for adults and other vulnerable adults. In this episode, we discuss the history of detransition, the reasons why it might be increasing, and how we can be providing better care and support of people who have detransitioned, or who may be considering not following through with an ongoing transition. Dr. MacKinnon also discusses his concerns about the encroachment of politics into medial care, and on how this may not best serve the needs of people exploring their gender identity

Zander Keig has seen a lot and changed a lot since he began his transition about 20 years ago. On this episode, we have an interesting discussion on what it means to be embrace masculinity, on his relationship with transness and queerness, and what's changed in the FTM community between his time in transition and today. We contrast the drive the both he and Laura shared, which was transitioning in an attempt to be more "normal" and to fit in better into broader society, as opposed to wanting to be gender non-conforming. This ironically, places his as a heterodox non-conformist among trans care providers Zander is a licensed clinical social worker and host of "The Third Space Podcast" where he interviews guests who take their own approacj outside of ideological alignments. He also co-hosts "The Umbrella Hour", featuring insightful, provocative, and inspiring interviews examining the lives of LGBT people from diverse vantage points

Ray Alex Williams is one of the more contraversial and fascinating characters in the online gender world. For 8 years, he lived as "Rachel", a radical progressive trans activist , going as far as writing a book about arguing for the legitimacy of trans-feminine identities as women. In 2023, he publicly announced his detransition and embrace of Christianity, quickly becoming a bête-noir to the trans activists he once identified with, which his regularly taking positions that sought to completely delegitimize the trans experience he had once embraced, while becoming a vocal proponent of autogynephilia being the primary driver of most male-to-female transitions Two weeks ago, Ray made a surprise announcement that he was no longer going to repress his desires, and posted a number of pictures of himself cross-dressed, stating he wished to re-embrace his desire for femininity while not re-transitioning and taking on a female identity. Along with this, he is promoting a more nuanced and balanced philosophy about trans identities and transition. Ray's circuitous life journey, his openness regarding gender expression, and his background in philosophy make for a very insightful and entertaining conversation. In this episode, Laura, Yvette, and I discuss autogynephilia and its role in motivating transitions versus autogynephilia being a consequence of innate feminine desire, the differences and commonalities between crossdressers and trans women, and his own continuing evolution of thought and his relationship to gender

Julie Rei Goldstein is a long-transitioned trans woman and voice actress who survived attempts at conversion therapy as an adolescent, which informs her advocacy to preserve access to gender affirming care for youth today. She is also notable for her detailed journaling of the numerous lawsuits filed by detransitioners against their care providers, and provides a trans positive perspective on the state of play of these cases On today's episode, we talk to Ms. Goldstein about her childhood and transition experience, focusing on why she believes there is no real difference between exploratory therapy and conversion practices, and on the limited evidence for their effectiveness. We also discuss our concerns about how the failure to make efforts to prevent young people whose interests are not best served through affirmation and medicalization may have created the conditions that led to an increase in regretful detransitioners We then discuss some of technicalities behind why many of these lawsuits are failing, and how the legal arena may not be the best avenue to seek remedies for perceived harms, and we offer suggestions for how the medical system and society can best meet the considerable needs of detransitioners and those who otherwise came to regret their transitions.

Karleen Gribble is an Australian breastfeeding and infant-feeding researcher whose work sits at the intersection of public health, emergency preparedness, maternal-infant care, and policy. She is affiliated with Western Sydney University, where her research profile lists work on breastfeeding, infant and young child feeding in emergencies, child protection, adoption, and sex and gender identity She joins us on the podcast to discuss the increasing use of desexed language like "chestfeeding" and "people with cervixes" in health care settings, and why she believes that this is confusing and alienating to women, and may lead to meaningful harm, even while attempting to be inclusive We also discuss the importance of accurate recording of birth sex in the medical records, and if there are ways to centre the importance of birth sex in health care decision making while respecting trans people's desire for privacy and dignity.

Dr. Quentin Van Meter is a pediatric endocrinologist who gained notoriety and national prominence as head of the American College of Pediatrics, a splinter group of pediatricians who split from the mainstream American Academy of Pediatrics originally over their endorsement of same-sex parents. During the 2010s, ACPeds, under Dr. Van Meter’s leadership, were one of the initial organizations to speak out in public and in the backrooms of government to make the case against pediatric medical transition from a clinical perspective, presaging the success of the current gender critical political movement.In particular, Dr. Van Meter expressed concern about how pediatric medical transition interrupts the formative role that puberty plays not only in sexual and reproductive development, but how it is necessary for the health of nearly every organ system of the body.On our show, Dr. Van Meter, Laura, and Yvette focus less on politics, and more on the medical side. We discuss his theories on puberty, whether it is important to go through a puberty that is in alignment with one’s sex (or will any puberty do), and on the stability (or lack thereof) of childhood and adolescent gender identity.

Jennifer Lahl is an experienced pediatric critical care nurse who is the founder of the The Center for Bioethics and Culture Network, which advocates for caution and expresses concerns surrounding the use of assisted reproductive technologies including in-vitro fertilization, artificial wombs and surrogacy. She is a recognized authority, having numerous national and international media appearances, and was invited to testify before the European Parliament and the United Nations to address issues of egg and womb trafficking, She has also expressed caution regarding the ethics and technical limitations of fertility preservation in young people who are undergoing medical and surgical interventions for gender dysphoria; interventions that are high likely to result in infertility or at the very least fertility challenges in young people who have a limited capacity to understand the implications of these interventions, and whose views on having biologically related children may change over time Jennifer joins Yvette and Laura for a spirited discussion on what makes children with dysphoria different that other young people (and their families) which seek these interventions. Show Notes: Here is the link to our paper on fertility preservation Resilience Health Network survey: https://resiliencehealth.network Ms. Lahl's paper on fertility preservation: "Fertility preservation: is there a model for gender-dysphoric youth" https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1386716/full?utm_campaign=imp_mile_2024_fall_en_aut-ww Mama's Minerals - New Mexico's largest woman owned rock & crystal retailer https://www.mamasminerals.com/

In our 12th episode, Laura and Yvette bring on Dr. Melanie Crites Bachert (prounounced BUCK-ert), a pelvic reconstructive surgical specialist whose practice has been primarily centered on women's pelvic health, and on repairing congenital abnormalities of the kidneys and the bladder. However, in recent years, she has become more vocal about what she sees as the unacceptable high incidence of urinary and vaginal complications experienced by trans men (natal women) on testosterone, who find their way into her Oregon practice. She expressed concern about hormone prescribers not appropriately counselling their patients about the consequences of hormone therapy, and on what she believes is an abdication of responsibility in managing adverse effects associated with therapy Dr. Laura and Dr. Crites Bachert engage in some vigourous but respectful argument about the benefits of gender care, how we engage with medical uncertainty, and on the the amount of weight we put onto the pain and the consequences of living with dysphoria

In our 11th episode, Laura and Yvette are joined by pediatric bioethicist Dr. Ian Wolfe, of the University of Minnesota. Dr. Wolfe believes that young people with gender dysphoria should be able to access care to medically facilitate a gender transition, and that there is a well-established ethical framework to support it. Dr. Wolfe shares his rebuttal to common concerns raised by gender critical advocates, while also acknowledging some of the limitations and missteps in pediatric medical transition. Dr. Wolfe also discusses his critique of the HHS report and the restrictive legislation that has been justified by the conclusion of the report, and the challenges with learning clarifying information where even research into the subject is considered unethical

In their second episode, Laura and Yvette have a heartfelt conversation about their concerns about pediatric medical transition. Laura is a trans woman who believes that access to medical transition can rescue some children from the horrors of dysphoria. Yvette has grave concerns about transition being a false promise of salvation from difficult and complicated childhoods. We have created this podcast because we believe it is important for well-meaning and empathic people who have arrived at different positions on contentious issues regarding gender to be able to have open and honest dialogue, and even more important for curious and caring people to hear

In their third episode, Laura and Yvette dig deep on Little vs Hecox, and West Virginia vs BPJ, two cases that will be argued in front of the Supreme Court today. Laura is a trans woman who believes that trans women should be allowed to play on teams with their female peers under certain conditions whereas Yvette believes women's team are the domain of biologic women. We also discuss the broader implications of these cases beyond the playing field, both in terms of how sex and gender are defined under the law, and the potential that this decision could be a gateway to broader restrictions on the trans community We have created this podcast because we believe it is important for well-meaning and empathic people who have arrived at different positions on contentious issues regarding gender to be able to have open and honest dialogue, and even more important for curious and caring people to hear

In this week's episode, Laura and Yvette sit down with Dr. Alex Byrne, the Laurance S. Rockefeller Professor of Philosophy at MIT. His most recent book is Trouble with Gender: Sex Facts, Gender Fictions. In that book, he provides a philosophical underpinning on a narrow definition of "man" and "woman", as well as justification for discarding the concept of gender. He is also one of the 9 authors of the controversial HHS Report "Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices", which supports the complete banning of access to medical and surgical therapies for children and adolescents with gender dysphoria, and even more contentiously recommends against any further research evaluating the potential efficacy of medical interventions. In this conversation, we discuss the challenges with applying a narrow definition of male/female and man/woman in the real world, whether this precludes treating trans people with respect, and what responsibilitis academics have when their positions are likely to be weaponized. In the second half, we shift our focus to the HHS report, talking about his hesitations with getting involved with the Trump and Kennedy-led HHS, on the secrecy surrounding the authorship, and on why he believes that further research in this area is unethical to pursue

Laura wants more data about the effectiveness of puberty blockers. Yvette has seen enough They disagree about most things, but they've agreed to talk about it In this episode, they do a comprehensive review of the recently launched UK Pathways Trial, which seeks to determine if puberty blockers have a role to play in the management of young people with gender incongruence. However, many question have been raised about its design, whether it is ethical, or whether it is even necessary. Plus stay tuned to the end for a special Easter Egg!

In Episode 6. Laura and Yvette sit down with investigative reporter Ben Ryan to hear his perspectives on pediatric gender medicine, his coverage of the 1st medical malpractice trial where a regretful detransitioner prevailed against her care team, and his sympathies towards the trans community.

In Episode 7. Laura and Yvette sit down with former Virginia National Guard Black Hawk helicopter plot, aspiring comedian, and trans infuencer Jo Ellis to discuss the impact and rationale of the US trans military ban, how conservatism shapes her approach to trans-advocacy, and on the transformative power of dick jokes

In our tenth episode, Yvette and Laura debate what responsibilities, and in what circumstances, a stealth or private trans person should be obliged to disclose their history of transition. We are joined by Dilan Esper (x.com/dilanesper), a Los Angeles based lawyer who is trans supportive, but who has challenged the trans community on its stridency in its advocacy We discuss this thorny debate in the context of San Jose State University former volleyball player Brooke Slusser, who described her experience with sharing an apartment with her teammate Blaire Fleming, who she did not realize at the time was trans. Later, co-host Laura muses on her obligations for disclosure as a physician who is often referred female patients who are looking for a woman physician

On this episode, sexologist Dr. James Morandini talks about the concept of autogynephilia, how it relates (and doesn't relate) to the drive to transition, and what we can do to help people recognize it as non-pathological human variation in sexual practice.

In this episode, Laura and Yvette welcome Jon M, an autism advocate and independent researcher who shares his experiences with living with gender dysphoria as a teenager, in whom it spontaneously and inexplicably remitted when he entered adulthood. He discusses this uncommon experience in the context of autism, and his relationship to religiosity, and provides insights on how we can better understand the natural history of dysphoria in natal males. Jon's Podcast (Christianity on the Spectrum) : https://christianityonthespectrum.podbean.com/ Jon's Substack: (Dispatches from the Autism Wars) (https://dispatchesfromtheautismwars.substack.com/ Jon's Essay on Teenage Dysphoria https://dispatchesfromtheautismwars.substack.com/p/i-had-teenage-gender-dysphoria

In this first episode, Laura and Yvette tackle one of the most contentious issues in the gender debate: Are single sex spaces for women born women only, or is there a way that trans women can be accepted. Laura shares her experiences of being welcomed and included in these spaces for the last 25 years, and why being told she no longer belongs feels like a threat to her dignity. Yvette talks about how these spaces are intended to be sanctuaries for violence, and in particular, from the men who are responsible for the overwhelming majority of violence and harassment of women. More importantly, Yvette and Laura seek to model how to talk about issues where there is a broad divide in opinion, without assuming the worst of intentions.