Listen now | Dr. Julia Mason is a board-certified pediatrician and fellow of the American Academy of Pediatrics. She’s a graduate of the University of Illinois with both her masters in nutritional science and her medical degree, and she completed residency training in pediatrics at Children's Hospital, Los Angeles. She currently runs a busy practice in Oregon where she now deals with an ever increasing number of gender dysphoric adolescents–many of whom are dealing with neurodevelopmental challenges or psychiatric comorbidities.
Oh my goodness, this was an incredible episode. I had a long and boring drive to do but when I put this podcast on, the time just flew!
I was absolutely engrossed in listening to this conversation. I found it fair and balanced and (of course as ever with your podcasts) factual. I like how you mention specific studies/papers/essays - it adds so much credence to the discussion and it so often lacking these days in debate. I also agreed wholeheartedly with the points you were making about data collection for a study that was used to inform policy (sorry I can’t remember the exact details) but it reminded me how’s important it is to stringently check the data collection strategies used for what I am reading.
I was also shocked to hear about the citation of conversion therapy in a paper you mentioned, that turned out to be about gay conversion therapy and not trans conversion therapy at all. So as my country aligns itself to ban trans conversion therapy, I worry deeply about what this means for the treatment of distressed youth, and whether they will be put on a medical pathway they do not need. I had heard about the doctors/therapists who have gotten into trouble for merely asking questions of their patients. Another therapist that comes to mind is Stephanie Winn, whose podcasts I listen to.
I work with children and young people and I worry for a lot, so this topic struck particularly close to home for me.
"historical" conversion therapy, no. He did not beat or physically torture his patients. But he did tell parents to throw away all of their kid's toys, told parents to discipline their children for cross-gender behavior, and forced social and other situations on children that should never be done. Is this conversion therapy? I don't think the children involved care whether this conversion therapy is "historical", Im sure it wasn't pleasant and it created some issues for them to work out later. Zucker himself has gone back and forth in regret for his therapy methods at times showing remorse.
No, Tavistock did not get shut down for these reasons. It was a centralized location for the NHS that could not keep up with demand. The typical wait time in the UK for a patient seeking gender counseling or care is over 4 years. The Cass report said that one centralized location could never meet the demand. They also said that because the demand was so high, and patients had waited so long, caregivers felt pressure to rush patients through, knowing that their next apt might be years away. There were no resources for follow-up. Basically, it was failing on nearly every level. Affirmative care models always include exploratory, but Tavistock did not have the means to follow through on appropriate care. After the NHS published proposed interim guidelines, a new response was created by the Cass report saying that most people misunderstand affirmative care, just like you're doing now. https://cass.independent-review.uk/publications/
Affirmative care just means respecting pronouns and giving some breathing room to a patient while they work out how they got to their identification, explore past traumas, etc. It doesn't mean a rubber stamp and pat on the back and passing them on through. Yes, that has happened, but it's by irresponsible therapists with no training or education on the subject. So the UK is going to train people on best care practices and treat GD patients using local doctors and therapists. They may adopt a watchful waiting approach or a hybrid of affirmative care and watchful waiting. They will study results, and track the best outcomes and yes, child transition is still an option for rare severe cases which is all anyone wants. And thank you but no, I cannot do your show. I am far too personally invested in this subject and get too emotional when debating it and that does not play well in a public forum. I know my limitations But if you're looking for people with alternative points of view, I might be able to help connect you with people that are better equipped to handle a public discussion than me. Thanks.
I would really appreciate any and all referrals to join me in the show - especially those with alternative views to the many clinicians I have interviewed thus far.
As mentioned earlier, I do not have a personal agenda - nor does an agenda follow in the ethos of T30.
Thanks again for your sincere and appreciated comments.
Joey, I had hoped that you might be someone that was truly objective. And after listening to yet another anti-trans activist platformed by your substack, I'm wondering if I'm not wasting my time. With all due respect, it's becoming an echo chamber and you have more talent than to waste your time doing the same thing that hundreds of others are doing too. In a conference with local doctors and therapists of the rise in GD, we wanted to represent all sides of the discussion. When looking for a medical doctor to conference in on Zoom to discuss hormones and puberty blockers, we discussed different doctors to bring in. Julia was one of them, but when we discussed it in length the 2 pediatricians shook their heads and when pressed, they said "Julia has an exaggeration problem."
And she does, so let me counter some of her exaggerations and outright disinformation:
1. Littman’s study interviewed parents not TG patients and used the same online anonymous survey methods used in the USTS study that Julia discredits. This is why it was discredited and why trans people cannot trust the results.
2. Zucker was dismissed for conversion therapy. Canada settled the case as a political move and later said that they made the right decision in letting him go. Zucker’s methods are not endorsed by any therapeutic organization and are condemned by many. Here is a link to the actual methods he suggested in the last few years which involve blocking and disciplining your child for any cross-gender behavior or dressing. 4thwavenow.com/2017/12/07/gender-dysphoria-is-not-one-thing/ > The paper is co-authored by Michael Bailey and Ray Blanchard.
3. The story she tells about the daughter of the immigrant is a lie. The daughter was not taken from her mom for not using correct pronouns. She was taken because of extensive abuse by the deeply religious mother, a severely transphobic and hostile woman who tortured her daughter to the point of suicide because of her identity.
4. Julia claims that conversion therapy does not exist. This is a complete fabrication. It not only exists, it's thriving. Conversion therapy on kids is thriving mostly under religious protections and it's not hard to find at all.
5. Affirmative therapy always includes exploratory. Those therapists that do not do so are committing an ethical violation and are acting on their own accord. No guidelines call for affirmation without exploratory. There will always be those that can lie their way to referrals. It makes no sense to compromise the freedoms of others because of these rare bad actors.
6. Kids that advance to hormones from PB's is 97%, not 99%. Only children with severe gender dysphoria are prescribed PBs. It would make sense that most of them would go on to hormones as this group has the highest persist percentages anyway.
7. The child from Sweeden she mentioned was put on PBs too long (3+ years). They were not monitored like they were supposed to be, checking calcium levels, etc. the problem was determined to be the lack of follow-up from the clinic and not the PBs themselves. There has been no evidence to show that any long-term bone density issues are common with the use of PBs.
8. Julia implies that there is no benefit in shortened height in transwomen who transition before puberty. This is an outright lie. Transwomen who transition at or before puberty will be on average 4-6 inches shorter than if they went through male puberty, but still, remain statistically taller than a natal female. They will also grow proportionally female with a leg, hip, and waist ratio that resembles a natal female.
9. Helena, the detransitioner in Julia’s story was an ADULT. She had severe mental health issues and lied her way into gender care. There is nothing you can do to stop this that won't unfairly take away medicine from people who need it. The moral of that story is, to tell the truth, because no one can save you from yourself in a free society.
10. Cost of a PB implant is not 10’s of thousands of dollars. It’s $4500.
11. People who use parts of their colon for vaginoplasty do not end up with a colon that "smells like poop" as Julia says. This is ridiculous. It's tissue. Tissue does not inherently smell like poop. (Cant believe I have to say this). How can she be a doctor? Nearly everything she said about transition results is atypical or an exaggeration. How do I know? I went through it all.
12. Let's use some common sense. If doctors were really telling kids they are transgender if they exhibit cross-gender behavior, wouldn't we have a bigger problem on our hands? Right now there are 75 million children in the US and only 4000 transitioners. Do the math. What is that percentage? Is it really as big of a problem as you think? To date, there are only a few minor detransitioners and they were all adolescent identifiers and female, so this claim made by Julia is a lie meant to fearmonger and drive anti-trans legislation like that we see in Texas.
SEGM is listed as a clear source and they have consulted on multiple bans across the nation. Combine this with the fact that every time a ban is implemented, Julia goes on social media and does some victory laps (when she is not trolling transpeople). So her claim to not support bans is a total lie.
14. If you're wondering why after 3-5 years of constant anti-trans activism, Julia is not listened to? It's not because she is a brave warrior on a crusade against the goliath of trans people (cant believe anyone believes that). It's because, out of all the prominent anti-trans activists, Julia has a big problem with the truth and what she says cannot be trusted.
Do you want to come on the show and talk this through? I am genuinely attempting to understand the complexity of this controversial topic - and I have no personal agenda.
One example I would LOVE to chat about is Dr. Kenneth Zucker. We have pulled public records on this case, and Zucker did NOT perform historical Conversion Therapy, e.g. the nonsense used on gay people to talk them out of being gay. What he did employ was broad based therapy as a foundation of a much more involved diagnosis of Trans - unlike much of the "Start at the Conclusion" ideas that were part and parcel to The Tavistock Clinic being shut down. To wit: https://segm.org/UK_shuts-down-worlds-biggest-gender-clinic-for-kids#:~:text=The%20UK's%20National%20Health%20Service,NHS%20Trust%20which%20houses%20it.
I would enjoy having you on the show if you would be so inclined.
Thanks again for your time and obvious energy and passion on this subject.
Oh my goodness, this was an incredible episode. I had a long and boring drive to do but when I put this podcast on, the time just flew!
I was absolutely engrossed in listening to this conversation. I found it fair and balanced and (of course as ever with your podcasts) factual. I like how you mention specific studies/papers/essays - it adds so much credence to the discussion and it so often lacking these days in debate. I also agreed wholeheartedly with the points you were making about data collection for a study that was used to inform policy (sorry I can’t remember the exact details) but it reminded me how’s important it is to stringently check the data collection strategies used for what I am reading.
I was also shocked to hear about the citation of conversion therapy in a paper you mentioned, that turned out to be about gay conversion therapy and not trans conversion therapy at all. So as my country aligns itself to ban trans conversion therapy, I worry deeply about what this means for the treatment of distressed youth, and whether they will be put on a medical pathway they do not need. I had heard about the doctors/therapists who have gotten into trouble for merely asking questions of their patients. Another therapist that comes to mind is Stephanie Winn, whose podcasts I listen to.
I work with children and young people and I worry for a lot, so this topic struck particularly close to home for me.
Thanks for another excellent podcast!
Thank you, T. J. I’m doing my best to bring research and data to a very emotional and controversial topic. So your kind words mean a lot.
Have a wonderful Holiday season.
"historical" conversion therapy, no. He did not beat or physically torture his patients. But he did tell parents to throw away all of their kid's toys, told parents to discipline their children for cross-gender behavior, and forced social and other situations on children that should never be done. Is this conversion therapy? I don't think the children involved care whether this conversion therapy is "historical", Im sure it wasn't pleasant and it created some issues for them to work out later. Zucker himself has gone back and forth in regret for his therapy methods at times showing remorse.
No, Tavistock did not get shut down for these reasons. It was a centralized location for the NHS that could not keep up with demand. The typical wait time in the UK for a patient seeking gender counseling or care is over 4 years. The Cass report said that one centralized location could never meet the demand. They also said that because the demand was so high, and patients had waited so long, caregivers felt pressure to rush patients through, knowing that their next apt might be years away. There were no resources for follow-up. Basically, it was failing on nearly every level. Affirmative care models always include exploratory, but Tavistock did not have the means to follow through on appropriate care. After the NHS published proposed interim guidelines, a new response was created by the Cass report saying that most people misunderstand affirmative care, just like you're doing now. https://cass.independent-review.uk/publications/
Affirmative care just means respecting pronouns and giving some breathing room to a patient while they work out how they got to their identification, explore past traumas, etc. It doesn't mean a rubber stamp and pat on the back and passing them on through. Yes, that has happened, but it's by irresponsible therapists with no training or education on the subject. So the UK is going to train people on best care practices and treat GD patients using local doctors and therapists. They may adopt a watchful waiting approach or a hybrid of affirmative care and watchful waiting. They will study results, and track the best outcomes and yes, child transition is still an option for rare severe cases which is all anyone wants. And thank you but no, I cannot do your show. I am far too personally invested in this subject and get too emotional when debating it and that does not play well in a public forum. I know my limitations But if you're looking for people with alternative points of view, I might be able to help connect you with people that are better equipped to handle a public discussion than me. Thanks.
Hey again Sunshine,
I would really appreciate any and all referrals to join me in the show - especially those with alternative views to the many clinicians I have interviewed thus far.
As mentioned earlier, I do not have a personal agenda - nor does an agenda follow in the ethos of T30.
Thanks again for your sincere and appreciated comments.
Have a wonderful Holiday season.
Joey, I had hoped that you might be someone that was truly objective. And after listening to yet another anti-trans activist platformed by your substack, I'm wondering if I'm not wasting my time. With all due respect, it's becoming an echo chamber and you have more talent than to waste your time doing the same thing that hundreds of others are doing too. In a conference with local doctors and therapists of the rise in GD, we wanted to represent all sides of the discussion. When looking for a medical doctor to conference in on Zoom to discuss hormones and puberty blockers, we discussed different doctors to bring in. Julia was one of them, but when we discussed it in length the 2 pediatricians shook their heads and when pressed, they said "Julia has an exaggeration problem."
And she does, so let me counter some of her exaggerations and outright disinformation:
1. Littman’s study interviewed parents not TG patients and used the same online anonymous survey methods used in the USTS study that Julia discredits. This is why it was discredited and why trans people cannot trust the results.
2. Zucker was dismissed for conversion therapy. Canada settled the case as a political move and later said that they made the right decision in letting him go. Zucker’s methods are not endorsed by any therapeutic organization and are condemned by many. Here is a link to the actual methods he suggested in the last few years which involve blocking and disciplining your child for any cross-gender behavior or dressing. 4thwavenow.com/2017/12/07/gender-dysphoria-is-not-one-thing/ > The paper is co-authored by Michael Bailey and Ray Blanchard.
3. The story she tells about the daughter of the immigrant is a lie. The daughter was not taken from her mom for not using correct pronouns. She was taken because of extensive abuse by the deeply religious mother, a severely transphobic and hostile woman who tortured her daughter to the point of suicide because of her identity.
4. Julia claims that conversion therapy does not exist. This is a complete fabrication. It not only exists, it's thriving. Conversion therapy on kids is thriving mostly under religious protections and it's not hard to find at all.
5. Affirmative therapy always includes exploratory. Those therapists that do not do so are committing an ethical violation and are acting on their own accord. No guidelines call for affirmation without exploratory. There will always be those that can lie their way to referrals. It makes no sense to compromise the freedoms of others because of these rare bad actors.
6. Kids that advance to hormones from PB's is 97%, not 99%. Only children with severe gender dysphoria are prescribed PBs. It would make sense that most of them would go on to hormones as this group has the highest persist percentages anyway.
7. The child from Sweeden she mentioned was put on PBs too long (3+ years). They were not monitored like they were supposed to be, checking calcium levels, etc. the problem was determined to be the lack of follow-up from the clinic and not the PBs themselves. There has been no evidence to show that any long-term bone density issues are common with the use of PBs.
8. Julia implies that there is no benefit in shortened height in transwomen who transition before puberty. This is an outright lie. Transwomen who transition at or before puberty will be on average 4-6 inches shorter than if they went through male puberty, but still, remain statistically taller than a natal female. They will also grow proportionally female with a leg, hip, and waist ratio that resembles a natal female.
9. Helena, the detransitioner in Julia’s story was an ADULT. She had severe mental health issues and lied her way into gender care. There is nothing you can do to stop this that won't unfairly take away medicine from people who need it. The moral of that story is, to tell the truth, because no one can save you from yourself in a free society.
10. Cost of a PB implant is not 10’s of thousands of dollars. It’s $4500.
11. People who use parts of their colon for vaginoplasty do not end up with a colon that "smells like poop" as Julia says. This is ridiculous. It's tissue. Tissue does not inherently smell like poop. (Cant believe I have to say this). How can she be a doctor? Nearly everything she said about transition results is atypical or an exaggeration. How do I know? I went through it all.
12. Let's use some common sense. If doctors were really telling kids they are transgender if they exhibit cross-gender behavior, wouldn't we have a bigger problem on our hands? Right now there are 75 million children in the US and only 4000 transitioners. Do the math. What is that percentage? Is it really as big of a problem as you think? To date, there are only a few minor detransitioners and they were all adolescent identifiers and female, so this claim made by Julia is a lie meant to fearmonger and drive anti-trans legislation like that we see in Texas.
13. Despite what she says publicly, her organization, SEGM, was instrumental in the policy of hunting down trans families as they are doing in Texas now. Here is the proof: https://texasattorneygeneral.gov/sites/default/files/global/KP-0401.pdf
SEGM is listed as a clear source and they have consulted on multiple bans across the nation. Combine this with the fact that every time a ban is implemented, Julia goes on social media and does some victory laps (when she is not trolling transpeople). So her claim to not support bans is a total lie.
14. If you're wondering why after 3-5 years of constant anti-trans activism, Julia is not listened to? It's not because she is a brave warrior on a crusade against the goliath of trans people (cant believe anyone believes that). It's because, out of all the prominent anti-trans activists, Julia has a big problem with the truth and what she says cannot be trusted.
Hello Sunshine,
Do you want to come on the show and talk this through? I am genuinely attempting to understand the complexity of this controversial topic - and I have no personal agenda.
One example I would LOVE to chat about is Dr. Kenneth Zucker. We have pulled public records on this case, and Zucker did NOT perform historical Conversion Therapy, e.g. the nonsense used on gay people to talk them out of being gay. What he did employ was broad based therapy as a foundation of a much more involved diagnosis of Trans - unlike much of the "Start at the Conclusion" ideas that were part and parcel to The Tavistock Clinic being shut down. To wit: https://segm.org/UK_shuts-down-worlds-biggest-gender-clinic-for-kids#:~:text=The%20UK's%20National%20Health%20Service,NHS%20Trust%20which%20houses%20it.
I would enjoy having you on the show if you would be so inclined.
Thanks again for your time and obvious energy and passion on this subject.