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A podcast at the intersection of psychology and culture that intimately explores the human experience and critiques the counseling profession. Your host, Stephanie Winn, distills wisdom gained from her practice as a family therapist and coach while pivoting towards questions of how to apply a practical understanding of psychology to the novel dilemmas of the 21st century, from political polarization to medical malpractice.
What does ethical mental health care look like in a normless age, as our moral compasses spin in search of true north? How can therapists treat patients under pressure to affirm everything from the notion of "gender identity" to assisted suicide?
Primarily a long-form interview podcast, Stephanie invites unorthodox, free-thinking guests from many walks of life, including counselors, social workers, medical professionals, writers, researchers, and people with unique lived experience, such as detransitioners.
Curious about many things, Stephanie’s interdisciplinary psychological lens investigates challenging social issues and inspires transformation in the self, relationships, and society. She is known for bringing calm warmth to painful subjects, and astute perceptiveness to ethically complex issues. Pick up a torch to illuminate the dark night and join us on this journey through the inner wilderness.
You Must Be Some Kind of Therapist ranks in the top 1% globally according to ListenNotes. New episodes are released every Monday. Three and a half years after the show's inception in May of 2022, Stephanie became a Christian, representing the crystallization of moral, spiritual, and existential views she had been openly grappling with along with her audience and guests. Newer episodes (#188 forward) may sometimes reflect a Christian understanding, interwoven with and applied to the same issues the podcast has always addressed. The podcast remains diverse and continues to feature guests from all viewpoints.
211. Mia Hughes-
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[00:00:00] Mia Hughes: The crucial part of Deps Psycho Pathologization that I think most people miss [00:00:05] is because they framed the trans identity as healthy when clearly [00:00:10] it's the result of a psychiatric condition. But they reframed this [00:00:15] mental illness as a perfectly healthy identity, which is dangerous in and of itself [00:00:20] because anyone who is suffering from a mental illness is not well served by [00:00:25] everyone pretending that they're perfectly healthy.
[00:00:27] Mia Hughes: But the other crucial part is when they reframed [00:00:30] it as healthy, they made it not only possible to celebrate it, but because [00:00:35] trans activism is so aggressive in its approach, they made it [00:00:40] mandatory that we celebrate it. Wpath shifted that they forced everyone to [00:00:45] celebrate it, and I believe. That's what triggered the social contagion.
[00:00:49] Mia Hughes: Then the [00:00:50] idea lands into the minds of young people. And these young people are not identifying as [00:00:55] having a psychiatric disorder. They're not identifying as having gender dysphoria. They're not [00:01:00] identifying as having autogynephilia, they're identifying as [00:01:05] trans and trans is the healthy identity.
[00:01:09] SKOT: You must [00:01:10] be some kind of therapist[00:01:15]
[00:01:15] Stephanie Winn: today. I have the pleasure of welcoming back to the show, Mia Hughes, who I like to think of [00:01:20] as Mia phone book Hughes on account of my favorite comment from our last episode where someone said I [00:01:25] could listen to her read the phone book. That when, in addition to being a [00:01:30] brilliant, uh, thinker, she's also very pleasant to listen to.
[00:01:32] Stephanie Winn: She probably needs no introduction for [00:01:35] many of you. But, uh, Nia Hughes is the. Director of Gen Spec [00:01:40] Canada, a senior fellow at the McDonald Laurier Institute, and a [00:01:45] writer and researcher on all things, uh, gender scandal. So, Mia, [00:01:50] welcome back. It's so great to see you again.
[00:01:52] Mia Hughes: Thank you for having me. Lovely to see you too.
[00:01:54] Stephanie Winn: I had the [00:01:55] pleasure of finally meeting you in person at the Gen Spec Conference in Albuquerque in [00:02:00] 2025, and you gave this brilliant talk on a topic. You've been [00:02:05] working on a series of papers on the, uh, idea of trans as an [00:02:10] extreme overvalued belief. Let's dive into it. What do you mean by that?
[00:02:13] Mia Hughes: Yes, so when I [00:02:15] introduced this in Albuquerque, it was, for me, it [00:02:20] was the end point of about two and a half years of deep thinking [00:02:25] into this one particular psychiatric concept.
[00:02:29] Mia Hughes: And then I, and then I [00:02:30] throw it into my Albuquerque talk without really understanding that most [00:02:35] people have never heard of the extreme of value, belief, and that it was going to [00:02:40] take far more explaining than I initially realized. So [00:02:45] what it, I'll start with the very basics of what this concept is. [00:02:50] And it's a psychiatric concept that long neglected, for [00:02:55] some strange reason, it started out as the overvalued idea, [00:03:00] and it was coined, the term was coined in 1892 by a German [00:03:05] psychiatrist, Carl Verica, and the overvalued idea [00:03:10] received a lot of attention in British psychiatry, but almost none in American psychiatry.
[00:03:14] Mia Hughes: So I think [00:03:15] that's the problem. And what it describes is one [00:03:20] all consuming idea that overtakes a [00:03:25] person's entire life and drives them [00:03:30] towards some kind of pathological behavior. They're either causing harm to [00:03:35] themselves or they're causing harm to others, or both in some cases. And so I. [00:03:40] I had been reading about trans for a long time, probably [00:03:45] about four years, and you've got all these diagnoses all throughout the, [00:03:50] the history of this disorder being recognized by psychiatry.
[00:03:54] Mia Hughes: You've got [00:03:55] transsexualism, transvestic, transvestic, fetishism. [00:04:00] You've got gender identity disorder, gender dysphoria, all kinds of [00:04:05] diagnoses that never really, nobody ever really knew what they were treating. And [00:04:10] nobody ever really, there's no clarity to these diagnoses at all. Nobody's really getting to the [00:04:15] cause of it, and I was trying to make sense of the diagnosis when I [00:04:20] came across Dr.
[00:04:21] Mia Hughes: Paul McHugh calling trans transgender [00:04:25] identification. An overvalued idea just in passing in this [00:04:30] paper about multiple personality disorder actually. So Paul Mke is obviously [00:04:35] the, the man who shut down John Money. He was psychiatrist in chief at Johns Hopkins. [00:04:40] Very respected psychiatrist and an excellent scholar.
[00:04:43] Mia Hughes: And he just throws into this paper [00:04:45] that trends as an overvalued idea. And that's how I ended up there because I'm like, oh, what's that? [00:04:50] That sounds interesting. And I went into the papers. And so the [00:04:55] overvalued idea, it's just a psychiatric classification in [00:05:00] that it separates trends from delusion and it separates [00:05:05] trends from obsession.
[00:05:06] Mia Hughes: And that's, I think, the crucial [00:05:10] differentiation that we're working with here because. Many people think that a trans-identified [00:05:15] person, a man who thinks he's a woman, is delusional. But in the [00:05:20] actual psychiatric classification, a delusion is idiosyncratic. [00:05:25] It's individually held only You believe that aliens are communicating with you [00:05:30] through the radio.
[00:05:31] Mia Hughes: No one else around you shares that belief or affirms that belief. [00:05:35] So you, you can see that trans doesn't fit into that classification at all because [00:05:40] everybody is affirming this man as a woman, and we're all pretending that there's such a thing as a male [00:05:45] woman. And then obsession. I know that you and I are gonna have a lot to talk about here [00:05:50] because it can't be considered an obsession because an obsession is something that is [00:05:55] ego dystonic, which means it's, it's experienced as.
[00:05:59] Mia Hughes: [00:06:00] Distressing and the, the, the thoughts or the beliefs are, are [00:06:05] experienced as kind of repugnant and unacceptable and in conflict with who this [00:06:10] person thinks they really are. And so they fight against those beliefs and they, they, [00:06:15] they act upon them with, you know, obsessive compulsive disorder. The person will do their [00:06:20] rituals or whatever, but they're fighting against it and they're finding it distressing.
[00:06:24] Mia Hughes: So again, [00:06:25] everybody, I'm sure can tell that trends doesn't fit in there. And the crucial [00:06:30] part about the overvalued idea is that the individual. [00:06:35] Relishes, it experiences it as a true, [00:06:40] authentic expression of their most deepest nature. They, they relish it, they cherish [00:06:45] it. They, they, they embrace it completely.
[00:06:48] Mia Hughes: And so obviously [00:06:50] that makes, so, that makes sense with trends. That is the way these people are experiencing their trans [00:06:55] identities. They're not, they're not finding them distressing and they're not fighting against them. [00:07:00] They're very much rel relishing them and acting upon them. And so [00:07:05] I'm talking about overvalued ideas, but I should explain why in my [00:07:10] talk, I use the term extreme overvalued belief.
[00:07:13] Mia Hughes: And that's because. [00:07:15] So it was an overvalued idea for decades, probably for about a century [00:07:20] until nine. Well, nine 11 comes along and Paul McHugh actually [00:07:25] takes the concept of the overvalued idea and applied it to the [00:07:30] terrorists and, and think about it, it does make perfect sense. He's like, [00:07:35] these terrorists were very much, their minds were [00:07:40] dominated by a very rigid belief, and they acted upon it, and it was a [00:07:45] true expression of their authentic self, and they absorbed it from the culture in which they [00:07:50] lived.
[00:07:50] Mia Hughes: And so Chu was the one who took the overvalued idea and [00:07:55] applied it to a cultural belief. A [00:08:00] belief that is reinforced by a culture or subculture that comes to [00:08:05] dominate a person's mind and propels them in that sense [00:08:10] towards atrocious acts of mass murder or. Acts of [00:08:15] violence. And so that was the turning point for the overvalued idea concept.
[00:08:19] Mia Hughes: From [00:08:20] that point on, it became, uh, of interest to [00:08:25] forensic psychiatry and then a forensic psychiatrist to hear a man [00:08:30] used it to analyze, oh, what's his name? Anders Breck. You know the man who [00:08:35] the, the mass murder in Norway. Terrible act [00:08:40] of mass violence in Norway. This, this man who had been very, very [00:08:45] active in white supremacist neo-Nazi internet, [00:08:50] echo chambers, came to believe that he needed to save Norway [00:08:55] from.
[00:08:56] Mia Hughes: Immigration from, from being invaded. [00:09:00] And so he committed an act, a terrible act of mass murder in the [00:09:05] service of that belief. So then we get Tehir Aman. He coins [00:09:10] the term extreme overvalue belief and he's written a book called The [00:09:15] Extreme Overvalued Belief, and it details acts of mass violence [00:09:20] lone wolf.
[00:09:21] Mia Hughes: Acts of mass violence that are propelled by political [00:09:25] beliefs. But when you read his book, and this was the aha moment for [00:09:30] me, this was when I felt like I'd cracked the code. I read his book and I'm like, goodness me, this is like reading about [00:09:35] trans, the, not that I'm saying trans identified people are in any way [00:09:40] violent, uh, but if you read the way he defines an extreme [00:09:45] overvalued belief, it is a rigidly held, non delusional [00:09:50] conviction that is shared by others in your culture or [00:09:55] subculture that is amplified until it consumes the individual.[00:10:00]
[00:10:00] Mia Hughes: And then the individual it comes to dominate their life. They relish it, [00:10:05] they cherish it, they act upon it, and then they take it to an extreme [00:10:10] where they are. Acting pathologically. Now, to [00:10:15] me, I framed it in my Albuquerque talk. The trans identified person [00:10:20] is not going out and co shooting people or, or being violent towards others.
[00:10:24] Mia Hughes: [00:10:25] They are seeking extreme self harm. They are, they are seeking [00:10:30] from surgeons and from doctors medical interventions that do [00:10:35] terrible harm to themselves. But because they are in the service of [00:10:40] this belief that they, they cherish and they experience as a complete and true [00:10:45] expression of their deepest, most internal nature, they don't [00:10:50] realize that they're pursuing something pathological.
[00:10:52] Mia Hughes: They think they're pursuing life [00:10:55] altering, lifesaving, ethical medical care.
[00:10:58] Stephanie Winn: Well, that's a brilliant, uh, [00:11:00] explanation you've laid out there for us, front and center, the history of the [00:11:05] terminology, the way it connects to other things, and it makes me think of how. [00:11:10] The human mind is such a fascinating thing.
[00:11:13] Stephanie Winn: Um, [00:11:15] I put a lot of emphasis on neuroplasticity in my parent coaching work and in my [00:11:20] course because it's fascinating because so much of the problems and [00:11:25] the solutions here hinge on it. And because late adolescence, early [00:11:30] adulthood is a time of tremendous neuroplasticity. And so when I hear you [00:11:35] describe what you call the extreme overvalued belief and how it maps onto [00:11:40] trans, I think about the meaning making system that a lot of these [00:11:45] young people have.
[00:11:46] Stephanie Winn: Um, this idea enters the picture [00:11:50] that has a lot of allure. It has an emotional pull. It feels like it solves a [00:11:55] problem. And one thing parents frequently get wrong about this is they. They [00:12:00] tend to assume, in my experience at least talking to parents who have trans-identified youth, they [00:12:05] tend to assume that the kid has more insight, more psychological insight than they really [00:12:10] do about, oh, why do you feel this way?
[00:12:12] Stephanie Winn: Or things like that. And, and I explain to [00:12:15] people at least once a week that, that they don't have psychological insight and you [00:12:20] don't have to have psychological insight in order for something to have a powerful emotional pool on you in [00:12:25] order for an idea to be very appealing because of the emotional impact [00:12:30] it has on you.
[00:12:30] Stephanie Winn: And all this can be going on well beneath the surface of conscious awareness. So, [00:12:35] you know, a person's plagued by a problem, a potential solution [00:12:40] appears, they may not have psychological insight into the emotional pull that it has on [00:12:45] them, but then now there's an incentive to map [00:12:50] everything that happens to them.
[00:12:52] Stephanie Winn: To this and, and it can snowball [00:12:55] because of that neuroplasticity, because of our ability to form associations. [00:13:00] Every feeling connects to trans. Just like when I was [00:13:05] counseling someone with a food addiction, um, you know, if I'm happy, I celebrate by [00:13:10] eating. If I'm sad, I comfort myself by eating. If I'm angry, I suppress my anger By eating, you know, [00:13:15] everything connects to food if that is a person's drug of choice.
[00:13:19] Stephanie Winn: Similarly [00:13:20] with trans, I had a bad day for any reason. I had a [00:13:25] distressing emotion. I had a glimmer of hope. I, in whatever happens, I [00:13:30] connect it to this particular. Meaning making system, and then it becomes a self-fulfilling [00:13:35] prophecy.
[00:13:35] Mia Hughes: It does. I mean, I, I agree that these kids, the, [00:13:40] well, I would argue that no one in the grips of this belief understands that they're in the grips [00:13:45] of a belief, and that is by definition what these beliefs are.
[00:13:48] Mia Hughes: The individual doesn't [00:13:50] recognize them as being a psychiatric disorder, but particularly [00:13:55] the kids, because they're just kids, they don't, the, the adolescents, [00:14:00] adolescents don't understand anything. They think they understand everything. They don't actually understand [00:14:05] anything, really, and so that's the particular danger.
[00:14:09] Mia Hughes: That's why [00:14:10] before we hit record, I was saying I really feel as though I've cracked the code [00:14:15] because everything can be explained using this framework [00:14:20] and. What the real danger to these kids? Yeah. They don't [00:14:25] have the, the cognitive maturity. They don't have the life experience and they, and they're [00:14:30] in that period of identity fluctuation, diffusion.
[00:14:34] Mia Hughes: They're not [00:14:35] really sure who they are yet. And then the trends [00:14:40] overvalued belief, the extreme overvalue belief is thrust upon [00:14:45] them because the entire. Movement. The [00:14:50] entire trans activism movement is the extreme overvalued [00:14:55] belief. It has been forced from a tiny subculture, a [00:15:00] fringe group of strange doctors and a few individuals.
[00:15:04] Mia Hughes: It's been [00:15:05] that this overvalued belief has been thrust into the mainstream and [00:15:10] not just thrust into the mainstream, but then forced onto young people [00:15:15] who are still in this fluctuating stage of identity development. And it [00:15:20] does, it does look as if it's the solution. And you're right, once [00:15:25] they adopt it, because they're looking for a, an [00:15:30] explanation for why they feel so bad.
[00:15:31] Mia Hughes: And once they adopt the belief, [00:15:35] once it, it lands in their mind and it just lodges and stays there, then [00:15:40] they can interpret everything through. The lens of [00:15:45] that belief, which is typical of all of these overvalued beliefs. They, they, they just, [00:15:50] they dominate the mind. So if you can, if you've got one belief lodged in your mind, [00:15:55] and it is now central to your very core identity, [00:16:00] of course you're going to, you're going to interpret every experience [00:16:05] through the lens of that belief, because it is the most central part of who you are right [00:16:10] now.
[00:16:10] Mia Hughes: But the, the very, very dangerous thing about this one, [00:16:15] not only is it obviously forced upon young people via [00:16:20] education, media, social media, every single angle basically. And it's, [00:16:25] the belief is elevated to this sacred identity that one, you [00:16:30] cannot question, and two, you actually must celebrate. Don't question it and absolutely [00:16:35] celebrate it.
[00:16:35] Mia Hughes: But at the same time, uh. Lying in weight [00:16:40] is an entire field of medicine, completely guided [00:16:45] by this belief. You see, the entire field of so-called gender [00:16:50] affirming care is built upon the trans overvalued belief, [00:16:55] which I think actually I've got ahead of myself here because I don't think I've [00:17:00] defined the trends overvalued belief yet, have I?
[00:17:02] Mia Hughes: Which I should do. I will [00:17:05] say we, there's a lot of, I'm worried, there's a lot of things not of [00:17:10] projects that I'm working on, one of which is a research project into what [00:17:15] beliefs, what, what beliefs these people hold that drives them towards medical [00:17:20] transition, but condensing it into its simplest form. The, the, the [00:17:25] trends overvalue belief is I [00:17:30] am trends.
[00:17:31] Mia Hughes: My trends identity is healthy. And I [00:17:35] need medical body modification in order to live [00:17:40] a authentic, an authentic, happy life. [00:17:45] That is what I've condensed it into its simplest form. Now, I've [00:17:50] already interviewed a whole bunch of people, is uh, the kind of like a pilot, a test [00:17:55] project for my, for my actual research.
[00:17:57] Mia Hughes: And I got plenty of other [00:18:00] answers. The other variance of this, because it's difficult. The I am [00:18:05] trends. 'cause then these people are like, okay, but everyone has a different understanding or there are many [00:18:10] different understandings of what I am trans means. And so for some people it [00:18:15] was, uh, they believed not so much that they were actually born [00:18:20] in the wrong body, but that they would be happier living as a [00:18:25] member of the opposite sex.
[00:18:26] Mia Hughes: They were not adequately masculine. [00:18:30] So they would be happier living as a woman. They were not adequately feminine. [00:18:35] So they would therefore be happier living as a man. And what, what unites all of these [00:18:40] different beliefs is that they ultimately drive the person [00:18:45] towards seeking hormonal and surgical body modification [00:18:50] as the road to happiness.
[00:18:52] Mia Hughes: So that's the trends overvalue belief. But [00:18:55] think about it, the crucial part to me [00:19:00] is an overvalue belief is [00:19:05] experienced as healthy. And so that's what we are right now doing in this [00:19:10] mad era of trans activism. Wpath trans [00:19:15] activism has des psycho pathologized trans identities, which means [00:19:20] they are presenting trans identities as healthy.
[00:19:23] Mia Hughes: That's the core of the [00:19:25] overvalued belief. And then going hand in hand with this, trans identities are [00:19:30] healthy, is. Medical body modification is a human right. [00:19:35] Okay. That's the overvalued belief. That is these people are [00:19:40] singularly focused on obtaining the hormones and surgeries that they [00:19:45] believe are the only road to.
[00:19:47] Mia Hughes: Authenticity and happiness, and it's [00:19:50] just been transformed into a civil rights movement and [00:19:55] then pushed onto young people who are still in a stage of identity development and [00:20:00] they are just having it lodged in, it just lodges in the minds of some. And then the [00:20:05] entire field of gender affirming care, likewise, is built upon this extreme [00:20:10] overvalue belief that one, trans identities are healthy.
[00:20:13] Mia Hughes: So you cannot [00:20:15] try and help the person overcome their desire, their their trans [00:20:20] identification, because that's conversion therapy. And two, you must [00:20:25] provide the medical interventions that the belief demands because that's [00:20:30] a human right. And if you don't provide those interventions, then you are violating the [00:20:35] human rights of your patient.
[00:20:36] Stephanie Winn: Out of all the brilliant things you just shared, [00:20:40] one piece I can pick up on next is. How this [00:20:45] creates a problematic incentive structure. When there is that [00:20:50] extreme overvalued belief and that is deemed healthy and [00:20:55] dessy pathologized, then we have [00:21:00] actual health and this definition of health pulling into [00:21:05] completely opposite directions.
[00:21:07] Stephanie Winn: So as long as we're operating from a belief [00:21:10] system that, that the mind and body are one, and that something that's [00:21:15] harmful to the body is gonna be harmful to the mind and vice versa, [00:21:20] then we have a coherent value system that allows us to make [00:21:25] decisions that make sense. But you use the word [00:21:30] health, right?
[00:21:30] Stephanie Winn: That the idea with the overvalue belief is that [00:21:35] trans, the trans identity is healthy. And while we know [00:21:40] that, that the. Implications of that identity. [00:21:45] Literally shorten lifespans, increase the risk of all cause [00:21:50] mortality, right? So, so the definition of health there becomes [00:21:55] split and polarized so that it's pulling in two different directions.
[00:21:59] Stephanie Winn: I think we [00:22:00] could even go further than to say that it's thought of as healthy. It's thought of as the only thing, right? It's thought [00:22:05] of as so synonymous with the identity of the individual that to [00:22:10] question it is to question their right to exist. That's where we get a lot of the hyperbolic [00:22:15] histrionic language, and I think it has to be structured that way in [00:22:20] order to survive.
[00:22:20] Stephanie Winn: Because if we treat it as anything less than [00:22:25] that, then we do have to question the health outcomes of these decisions, [00:22:30] right? If we treat this as a choice, then we have to question if it's the healthiest [00:22:35] choice. But if it's. Framed in, in as a life or death [00:22:40] matter, well then it's better to be alive and to exist even if your lifespan is 10 years [00:22:45] shorter and you have Alzheimer's at 50 than it is [00:22:50] to not get to be yourself.
[00:22:52] Mia Hughes: Yeah. It's a totally [00:22:55] different world, and that's the most important part, I think, to understanding all of this [00:23:00] because it, it can seem so completely insane and so completely [00:23:05] mad what they're doing unless you're able to understand the world that they live in. [00:23:10] And so yes, for them, and this is, I I was just reading, [00:23:15] actually I'm reading the Dutch approach, Alex Bakker, the, so it's [00:23:20] this individual transitioned in the, the Dutch, [00:23:25] the early, early days of the Dutch protocol and has written the history of, [00:23:30] of the, the Dutch.
[00:23:32] Mia Hughes: Starting this whole mad experiment. And there's a [00:23:35] wonderful quote in there, um, because the medical ethics side of this [00:23:40] has its ori origins in a Christian hospital. And the individual [00:23:45] who was tasked with presenting to the ethics board, I'm talking in the [00:23:50] seventies here, says something like, you know, the, in the [00:23:55] Christian world, in, in Christian thinking, the [00:24:00] soul or the psyche is more important than the body.
[00:24:04] Mia Hughes: And [00:24:05] therefore if the person's soul or psyche is causing them so [00:24:10] much distress and you can't fix it, then you should [00:24:15] operate on a healthy body. You should cut into a healthy body. 'cause that's what they're debating at the [00:24:20] time. Should we cut into healthy bodies? And so you can see they're [00:24:25] prioritizing psychological.
[00:24:28] Mia Hughes: Wellbeing [00:24:30] and they had basically given up at that point. They're like, there's nothing we can do for these people. [00:24:35] Their psychological suffering is so terrible that the only ethical [00:24:40] justification is to cut into these healthy bodies. That's the [00:24:45] way that they were framing harm. Harm in that world is not [00:24:50] cutting into the healthy bodies harm in our world or the, certainly the world that I live [00:24:55] in is cutting into healthy bodies and it all stems from the fact that they just gave up.[00:25:00]
[00:25:00] Mia Hughes: There's nothing we can do for these people. We can't help them psychologically, so we're just gonna, we [00:25:05] have to help them medically. I would argue that that is because one, they didn't in [00:25:10] the 1970s, they didn't understand autogynephilia, so I think [00:25:15] everybody had an idea that. Erotic motivations [00:25:20] were behind the, the trans identities of many of these men.
[00:25:24] Mia Hughes: Not [00:25:25] all of them, but many of them. But they didn't understand [00:25:30] Autogynephilia at the time. And on top of that, they weren't seeing this as an [00:25:35] overvalued idea because this was just not even something they were considering. So [00:25:40] they weren't approaching it in the right way. I'm not entirely, I have to say, I'm not [00:25:45] entirely convinced that you can talk [00:25:50] someone.
[00:25:50] Mia Hughes: You can psycho therapeutically guide someone out of autogynephilia. [00:25:55] However, I think. I, do all of your viewers know what [00:26:00] Autogynephilia is? Should I explain it?
[00:26:01] Stephanie Winn: I mean, some people might be listening for the first time.
[00:26:04] Mia Hughes: [00:26:05] Right. So Autogynephilia is a paraphilia in which a man is aroused by the [00:26:10] fantasy of becoming a woman, like having breasts, a vagina, being [00:26:15] treated as a woman.
[00:26:16] Mia Hughes: There's the transvestic side as well, dressing as a woman, but it's [00:26:20] largely about medically embodying a female body, like becoming [00:26:25] a woman and having female body parts and bodily functions. And so that drives most [00:26:30] men, or did certainly in the 1970s when they were having these ethical discussions. [00:26:35] But it wasn't the, the, the typology wasn't outlined until [00:26:40] 1989, so they, we really didn't understand what was going on.
[00:26:43] Mia Hughes: These men, [00:26:45] arguably, you can't talk them out of this. Erotic [00:26:50] urge, you know, it's probably quite difficult to do so, but I would argue that at [00:26:55] least, at the very least, trying to help them manage their [00:27:00] erotic desires rather than just simply [00:27:05] giving them the medical interventions that the, the erotic desire demands, [00:27:10] trying to help them manage it is a more ethical, [00:27:15] less harmful way to deal with it.
[00:27:18] Mia Hughes: But it, [00:27:20] it all comes down to how you define harm. And, and again, there is this angle of [00:27:25] all along gender medicine, as you know, has been built on, give me [00:27:30] what I want or I'll kill myself. I don't know if I can say that, if you bleep it out, if I can't. But [00:27:35] this, this threat of, at the very least, if you don't gimme what I want, I will harm [00:27:40] myself, is is the basis of gender affirming care, so [00:27:45] called.
[00:27:45] Mia Hughes: It is the idea that. If we do not do [00:27:50] this for these individuals, they will cause themselves harm. So therefore, [00:27:55] cutting into the healthy body is the least harmful approach and therefore it is [00:28:00] their human right. But I argue that that's not a healthy way to approach [00:28:05] any field of medicine and that everybody needs to just calm [00:28:10] down, take a step back, and, and I think rethink [00:28:15] the entire way that we approach care for all of the [00:28:20] individuals who seek this medical treatment.
[00:28:22] Stephanie Winn: Mia, you described an [00:28:25] attitude of sort of helpless, frantic [00:28:30] incompetence on the part of an unspecified group of individuals, and I'm really curious [00:28:35] who that group is. The ones who said, well, these patients are suffering so badly and [00:28:40] there's no other way to help them. The ones who, who gave up essentially and says, just, just [00:28:45] give the patients what they want.
[00:28:47] Stephanie Winn: Who are these people? Because I have some thoughts about them. [00:28:50]
[00:28:50] Mia Hughes: Who are the individuals who gave up?
[00:28:52] Stephanie Winn: Yeah.
[00:28:53] Mia Hughes: When I was talking, I was talking about [00:28:55] the Dutch in the 1970s, so this was the turning point [00:29:00] as far as I can see in the 1950s, 1960s, [00:29:05] that was mostly going on in the, in the us, John Money, Robert Stoller, Harry Benjamin, [00:29:10] all the rest of them.
[00:29:11] Mia Hughes: And they definitely viewed [00:29:15] cutting into healthy bodies as harm. That was, that was they. [00:29:20] Nobody was really very comfortable. Sending these men [00:29:25] along to have their penises chopped off. It was, it was viewed, surgeons had problems with it [00:29:30] ethically. It was a bit, you know, horrifying for most people. And then it was the Dutch, [00:29:35] it was the Dutch in the 1970s.
[00:29:37] Mia Hughes: They were, they were [00:29:40] doing, they started this experiment. The, they can't find any surgeons, medical [00:29:45] ethics boards are like rejecting it. No, you can't cut into healthy bodies. They were going simply on [00:29:50] that. That was the phrase, it's, it's harm. You are not allowed to cut into a healthy [00:29:55] body That's a violation of medical ethics, which I think most people still to this day would agree [00:30:00] with.
[00:30:00] Mia Hughes: But then in this, in this ethical debate that they were having, [00:30:05] someone came along, was it. Ooh, I can't remember his name. It's gone [00:30:10] completely outta my mind. Someone came along and presented to the ethics board this idea that the [00:30:15] soul, the psyche is more important in a Christian sense, and if the [00:30:20] soul and the psyche are so tortured because of a mismatch [00:30:25] with the body than the ethical thing to do is cut into the body.
[00:30:29] Mia Hughes: And I [00:30:30] think that is just them giving up. They, they weren't, they weren't helping these [00:30:35] largely paraphilic men get over their sexual desires. So they just [00:30:40] gave up and said, okay, we'll just start cutting into the healthy bodies. And of course, that's the Dutch, [00:30:45] that the, it starts there with adults and they do this to adults, but then it's just a short [00:30:50] stepping stone, isn't it?
[00:30:51] Mia Hughes: To doing it to children. So that really is the [00:30:55] origins of the entire medical scandal as we know it in the, the pediatric [00:31:00] sense.
[00:31:00] Stephanie Winn: When I'm thinking about. This Dutch group, I'm wondering what, what [00:31:05] were the professional backgrounds of the people who were coming together to have these dialogues? Because I'm [00:31:10] thinking about it from the standpoint of a therapist, for example.
[00:31:13] Stephanie Winn: You know, how many [00:31:15] of the people arguing for this, well, there's nothing else we can do to help [00:31:20] these people. They're so distressed. Just, you know, do what they do, what they say they want from [00:31:25] us. Um, I mean, it sounds interdisciplinary, right? It sounds like [00:31:30] some of the people involved in this conversation were on the [00:31:35] clinical psychotherapeutic side of things.
[00:31:37] Stephanie Winn: Some of them were on the medical. This is the [00:31:40] whole scandal is, is rests upon the intersection of those two fields and the [00:31:45] intersection being handled quite sloppily. But I'm just thinking from a, from a [00:31:50] psychotherapeutic standpoint, what this points to about the [00:31:55] importance of personal insight [00:32:00] and, uh.
[00:32:01] Stephanie Winn: Training on transference and counter transference dynamics [00:32:05] because, uh, as therapists, we are triggered to feel a lot of [00:32:10] different things toward our patients. Sometimes we feel, we feel helpless, incompetent, [00:32:15] impotent, even powerless, uh, frustrated. And [00:32:20] a good psychodynamic training, uh, teaches the therapist [00:32:25] to, uh, reflect on that as clinical information, learn from it, be able to [00:32:30] discern what is sort, sort of my stuff, right?
[00:32:33] Stephanie Winn: What is, oh, I'm [00:32:35] feeling this way because this is part of my psychological makeup. What [00:32:40] is something that the patient is sparking in me? Because the patient tends to spark this feeling [00:32:45] in people. Um, how can I learn from this? How can I process this? [00:32:50] Right? And so our most frustrating cases, uh, can [00:32:55] really teach us a lot.
[00:32:56] Stephanie Winn: But what I hear happening in that space, when I [00:33:00] imagine. Mental health professionals having a voice in that conversation of saying, [00:33:05] uh, we can't do anything else to help just give them what they want. Is, is that, feels like unchecked [00:33:10] countertransference, to me, that feels like a therapist not having good emotional [00:33:15] boundaries, not being able to differentiate and self-reflect on the experience of [00:33:20] frustration, bewilderment, helplessness, and fear that the patient is sparking in [00:33:25] them.
[00:33:25] Stephanie Winn: And that feels like an ethical failure.
[00:33:28] Mia Hughes: You know, I'm just looking [00:33:30] because, well, the book's right there. If you, if you don't mind, I can go get it. I [00:33:35] think he was a plastic surgeon. I think it was a surgeon. [00:33:40] Presenting to his ethics board. You see, the reason [00:33:45] why I like the Dutch approach, it's a difficult book to get your hands on.
[00:33:48] Mia Hughes: A lovely [00:33:50] lady gave it to me when I was in Belgium actually. Um, the reason I [00:33:55] like it is because it's the stories of the doctors and the psychologists and the [00:34:00] endocrinologists and the surgeons. It's the human element. And that is what we all [00:34:05] kind of lose when we are talking about this. Because we focus on the, the, what I [00:34:10] believe is a medical crime.
[00:34:11] Mia Hughes: We focus on what they're doing and the scandal [00:34:15] without. Understanding the human beings. That all kind of [00:34:20] crossed paths at just the right time with just the right ideas, with just [00:34:25] to make this medical scandal possible. And if I'm not mistaken, the guy who [00:34:30] was presenting to the ethics board was a plastic surgeon, [00:34:35] but then you, you have, it's the Netherlands 1970s, so you've got [00:34:40] the political momentum, the moral enthusiasm of the [00:34:45] time.
[00:34:45] Mia Hughes: They're all swept up in this, and it's an extremely progressive nation. [00:34:50] So I guess I can't really apply any motives [00:34:55] to this person, but there is the possibility as well that. [00:35:00] He was swept up in the, the enthusiasm for the experiment, the [00:35:05] challenge, the, the possibility of being on the cutting edge of this new, exciting [00:35:10] field of medicine.
[00:35:11] Mia Hughes: So the motivations of each of the human [00:35:15] beings in this medical scandal, and there have been so many, are [00:35:20] all fascinating to me. It's totally fascinating to me. But if I, I [00:35:25] do think it was a plastic surgeon, a surgeon presenting to his board. There [00:35:30] were psychologists involved, very few, and that's the other thing that you've gotta understand is [00:35:35] this is a very, very, very fringe field of medicine.
[00:35:39] Mia Hughes: [00:35:40] Almost no one will touch it. They can't find anyone to care for these [00:35:45] individuals. And the idea is out there because at the same time, they're doing [00:35:50] media, they're talking to the press, they're going on television shows to promote [00:35:55] the idea that some people are transgender and that they need these medical treatments.
[00:35:59] Mia Hughes: They're [00:36:00] doing that to help their patients. But every time they do that, there's even a quote in there. The [00:36:05] guy who manages the whole sentence, he says the whole, the whole, um, clinic, he says. [00:36:10] Every time a trans identified person appeared on [00:36:15] television, the phone was ringing off the hook for the next few days because people had saw it and they're [00:36:20] like, oh, that's, that explains what I'm feeling.
[00:36:22] Mia Hughes: I need this medical treatment too. [00:36:25] So they're doing the media promotion to, to [00:36:30] increase acceptance of trans-identified people, but they're also contributing to the social [00:36:35] contagion. But at the same time, nobody in the medical world will go near [00:36:40] this 'cause they all find it repulsive and absolutely abhorrent.
[00:36:43] Mia Hughes: And so then they're [00:36:45] trying to, within their, their hospital increase. [00:36:50] Acceptance of these procedures that they themselves really believe in [00:36:55] and, and so that's why they're coming up with these, in my mind, that's why they're coming up with these ideas of the [00:37:00] soul, the psyche. It's more important, and I, I do think that they're all [00:37:05] swept up by the belief, by the idea, and quite possibly by [00:37:10] the idea that this can make them famous in some way.
[00:37:14] Stephanie Winn: [00:37:15] Yeah, it is. It is fascinating to speculate about the motivations of the [00:37:20] different people involved, because with the surgeons, like you say, there's the excitement of, [00:37:25] you know. Being the first to do something, feeling like a [00:37:30] pioneer feeling. The, the, the thrill, the challenge [00:37:35] of the procedure of, of getting better at something that they've been practicing their whole life.
[00:37:39] Stephanie Winn: And, [00:37:40] and this might be someone, you know, very low and empathy, right? We know [00:37:45] like statistically surgeons are more likely to be sociopathic, uh, [00:37:50] in terms of just their, their brain structure. Um, and then I can [00:37:55] speculate of course about the, the psychotherapist, whether it's the, the lack of insight [00:38:00] into, um, the transference countertransference [00:38:05] dynamics, whether it's also that excitement of, oh, do I have that rare [00:38:10] special patient, right?
[00:38:11] Stephanie Winn: The, the sort of excitement of, oh, this novelty, [00:38:15] this rare condition. Am I going to be one of the ones who's on the cutting edge of. [00:38:20] My field. And in the same way that it has that glimmer, I think for certain parents [00:38:25] who've dropped the Kool-Aid, right? Not listeners of this podcast, but on the other side of that [00:38:30] issue, oh, do I have the special trans child, the magical trans [00:38:35] child,
[00:38:35] Mia Hughes: and isn't there also, I think there might be in many [00:38:40] cases, and you've kind of sensed it with the Dutch at the beginning, it's.
[00:38:44] Mia Hughes: I am a [00:38:45] good person. Look at how much better I am because I can [00:38:50] accept these, these people for who they are. Like I am. I'm [00:38:55] so much more enlightened than these Philistines over here. You [00:39:00] know, I'm, I'm good person because I can accept this and we just need to bring [00:39:05] everyone, everyone just needs to catch up to me and my colleagues.
[00:39:09] Mia Hughes: And that's still [00:39:10] going on in Wpath now to this day. They still, they're still on this righteous quest. They still [00:39:15] see themselves as being the good progressive people, and it's just the, the [00:39:20] transphobic bigots that they have to convince and then they'll catch up and then [00:39:25] everybody will support them. It doesn't, I can understand with the Dutch way [00:39:30] back when, I suppose, because it was all new and the harm was, the harm was there [00:39:35] though.
[00:39:35] Mia Hughes: And that's the thing that, that. Is distressing to read is [00:39:40] it's very, very clear that many of the patients that they saw were not [00:39:45] helped, were not doing well, and yet still they carried on. But if you're still, uh, in [00:39:50] 2026 convinced that you are a good person and the [00:39:55] rest of the world just needs to get over their bigotry and accept trans-identified people for [00:40:00] who they are, of course you are, you are, you are in the service.
[00:40:04] Mia Hughes: You are acting in the [00:40:05] service. You're an ideolog, you're acting in the service of a, a belief and, and [00:40:10] reality. You're not in touch with reality. You've, you've kind of, you've gone into an [00:40:15] extreme area,
[00:40:16] Stephanie Winn: and I think it's even darker because on some level, they know they'll [00:40:20] never get everyone over to their side.
[00:40:22] Stephanie Winn: And so as long as there's another side [00:40:25] combined with that self-righteous mentality, then there's, well, we're, we're better than them. [00:40:30] Right? And, and the more extreme. Evidence we have [00:40:35] of how these things are obviously not good for physical help, the [00:40:40] more distorted the mental ideas have to become, to [00:40:45] continue justifying the destruction of the body.
[00:40:49] Mia Hughes: Well, [00:40:50] I think it just ricochets off them. I think I, I like to think of the belief [00:40:55] as a kind of protective sphere around these people. And so if there's [00:41:00] any evidence of harm, it really doesn't even enter their [00:41:05] mind. It just ricochets off. And that's, we've seen this in, in true believers. So [00:41:10] throughout history, in every mass movement that has occurred, it's, it's not unique to [00:41:15] trends, it's just we're, we're, we're, [00:41:20] it's our job.
[00:41:21] Mia Hughes: That's what we do all the time, is highlight the harm and show the harm. So [00:41:25] it's, it's so. It's a, a fascinating thing to witness. I [00:41:30] think I, I think of the individual with this protective sphere around them. The, the belief [00:41:35] protects them, but think of the entire. Wpath WPATH [00:41:40] exists inside a a, a fortress and, and really truly nothing [00:41:45] penetrates, no systematic review is ever going to sway wpath.
[00:41:49] Mia Hughes: The cast report is [00:41:50] not gonna do anything. Forget any high quality evidence outta Finland. [00:41:55] Forget it. It doesn't mean anything to these people. It doesn't even make it inside. And if, [00:42:00] if by any chance, you know, the C cast report did manage to penetrate [00:42:05] it, got in, and then they produced this insane statement because they read the cast [00:42:10] report just entirely through the lens of their belief.
[00:42:13] Mia Hughes: And it's just transphobia. It's [00:42:15] just the work of right wing bigots who infiltrated the NHS or something like that. So [00:42:20] forget trying to win this, defeat them with evidence. You can't [00:42:25] defeat ideologues with evidence because the evidence means nothing to them.
[00:42:28] Stephanie Winn: Let's take a quick [00:42:30] break and when we return, we'll talk about your campaign to.[00:42:35]
[00:42:35] Stephanie Winn: Re psycho pathologize the trans identity. [00:42:40] Your trans identified kid won't listen to reason, because reason isn't what they [00:42:45] need right now. They need a parent who knows how to communicate in an empathic [00:42:50] yet strategic manner. ROGD repair gives you over 120 [00:42:55] lessons in the psychology and communication tools that actually work when normal [00:43:00] parenting doesn't.
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[00:43:29] Stephanie Winn: But I think in order [00:43:30] to do so. We need to talk about how it's been desy [00:43:35] pathologized by groups like WPATH and other trans advocacy groups, [00:43:40] and that really makes no sense when you consider all the similarities that the trans [00:43:45] identity has to things like anorexia, obsessive compulsive [00:43:50] disorder, body dysmorphic disorder.
[00:43:52] Stephanie Winn: Um. I know you mentioned [00:43:55] when you were describing trans as an extreme overvalued belief, um, but even [00:44:00] extreme acts of violence can be connected to this concept. So let's talk about [00:44:05] the psychopathology part.
[00:44:06] Mia Hughes: Yeah, it's a really important part. It's to me, [00:44:10] after years and years of studying this social contagion, medical scandal, I came to the [00:44:15] conclusion that the core of it is [00:44:20] dessy pathologization.
[00:44:20] Mia Hughes: And that is, I took that word, I didn't, I didn't make that up. I took [00:44:25] that word from wpath, the World Professional Association for Transgender Health, which [00:44:30] of course I've been writing about for years and many times in my [00:44:35] writing I had cited the pivotal moment in 2010 [00:44:40] when WPATH released its Des Psycho [00:44:45] pathologization statement, and that is they declare.
[00:44:49] Mia Hughes: They just pull [00:44:50] this idea out thin air, but they declare that trans identities are [00:44:55] a healthy variation of human existence. They actually say, I think they word it [00:45:00] gender diversity, and that's the sneaky thing about these people. They never say [00:45:05] what they really mean because of course, gender diversity is a [00:45:10] healthy variation of human existence.
[00:45:11] Mia Hughes: So most people are like, oh yeah, okay, that's fine. [00:45:15] Some people are more masculine, some more feminine. There's a whole range of [00:45:20] gender expressions out there, but that's not actually what Wpath [00:45:25] meant with their 2010 deps psycho pathologization statement. What [00:45:30] they meant was. Identifying as a member of the opposite sex [00:45:35] and seeking and obtaining hormonal and surgical [00:45:40] body modification is a healthy variation of human [00:45:45] existence.
[00:45:45] Mia Hughes: That's what they really meant. What that is, is [00:45:50] truly, you can trace it to the extreme over value belief it is. They are, [00:45:55] I'm gonna go back to the late 1990s, and this [00:46:00] is when WPATH was called Hida, the Harry Benjamin International [00:46:05] Gender Dysphoria Association. And Hida in its early [00:46:10] days, was a group of definitely [00:46:15] fringe doctors who were trying to help individuals who [00:46:20] wanted this medical treatment, who, who believed themselves to be members of the opposite sex and believed that [00:46:25] they needed this medical treatment.
[00:46:27] Mia Hughes: But then in the 1990s, trans [00:46:30] activism is really starting to gain strength and [00:46:35] trans-identified activists. Began to join Habig dda. And we know that [00:46:40] this is true. You can see it in the or you can see it in the way Habig changes. [00:46:45] Its its approach to formulating standards of care. Its [00:46:50] messaging. But we also know it because Dr.
[00:46:52] Mia Hughes: Steven Levine was one of the original [00:46:55] members of Habig dda, or early days members of Habig, and he [00:47:00] saw it with his own eyes. So he said early two thousands, he was [00:47:05] at one of their annual conferences. And the way he words it, and I love [00:47:10] it, he says there were a lot of cross dressed men in the audience, [00:47:15] and when people were on the stage.
[00:47:18] Mia Hughes: Speaking about [00:47:20] how to diagnose, how to treat, presenting scientific [00:47:25] presentations. These cross-dressed men in the audience would heckle them [00:47:30] because they were, they were saying things that the men [00:47:35] did not believe aligned with the true nature, that they felt that, you know, [00:47:40] they felt that they were women.
[00:47:41] Mia Hughes: And so. Allowing these trans-identified [00:47:45] activists into Heda is what transformed the [00:47:50] organization from something like pursuing science [00:47:55] to an organization that is predominantly guided by activism. [00:48:00] But you've got to understand who those men were. They [00:48:05] were men who were complete their, their lives, their [00:48:10] minds were totally dominated by the belief, the extreme overvalued belief that one [00:48:15] trans is natural and healthy.
[00:48:16] Mia Hughes: So yes, they are women, they are, they are women. They're not, [00:48:20] they don't have a psychiatric disorder. That's the crucial part of this belief is you [00:48:25] believe that you are a member of the opposite sex. You, the, [00:48:30] these individuals get really upset at the mere suggestion [00:48:35] that their identity could be related to a psychiatric [00:48:40] disorder.
[00:48:40] Mia Hughes: They get really upset at the suggestion that their identity is in [00:48:45] any way pathological, and they also get really upset by [00:48:50] anyone who tries to prevent them from [00:48:55] obtaining the hormones and hormones and surgeries that their [00:49:00] overvalued belief demands. They are on this. They have tunnel vision. They are [00:49:05] fixated, and they are on this trek where nothing can get [00:49:10] in their way.
[00:49:11] Mia Hughes: And so this is who populated [00:49:15] Heda, and then it turned into WA as soon as WA [00:49:20] rebranded. It was guided entirely by this [00:49:25] belief that trans is natural and healthy, and medical body modification is a human [00:49:30] right. And because that was the guiding principle inside the [00:49:35] organization, they then launched Des Psycho Pathologization, which is just, [00:49:40] it's just taking the belief and turning it into an, an [00:49:45] entire campaign, an entire political campaign.
[00:49:47] Mia Hughes: So they announced in [00:49:50] 2010 that trans is natural and healthy, and then they make it their business [00:49:55] to ensure that this de psycho pathologization campaign, [00:50:00] um, is embedded into the entire field of gender medicine. First of all, they [00:50:05] succeed in getting it into the American Psychiatric Association because [00:50:10] at the time, the diagnosis was gender identity disorder.
[00:50:13] Mia Hughes: So the [00:50:15] identity is the disorder. It can't have that because the identity is healthy. [00:50:20] So they deps psycho pathologize. They turn it into gender dysphoria [00:50:25] with the diagnosis of gender dysphoria in DSM five, the [00:50:30] identity is healthy and it's the distress that you feel [00:50:35] because you have this healthy identity that doesn't match your body.
[00:50:38] Mia Hughes: The distress is the [00:50:40] disorder. But then think about what that means. That means the only possible way to [00:50:45] treat the disorder is to medicalize the body, to bring the [00:50:50] body in my in, in line with this healthy identity that you just [00:50:55] so happen to have. That's des psycho pathologization. Then [00:51:00] from there, of course they, they go to the World Health Organization next.
[00:51:04] Mia Hughes: That [00:51:05] was the diagnosis was gender identity disorder as well. They [00:51:10] transformed that in 2018 in the World Health Organizations [00:51:15] International Classification of Disease. Version 11, they turn it into gender [00:51:20] incongruence, which is also des psycho pathologization. It's just [00:51:25] you, you, your, your body and mind don't match, and therefore you should have medical [00:51:30] intervention.
[00:51:30] Mia Hughes: That's, that's the diagnosis. And so it all, [00:51:35] the, the crucial part of de psycho pathologization that I think most people [00:51:40] miss is. Because they framed the trans identity as [00:51:45] healthy when clearly it's the result of a psychiatric [00:51:50] disorder. It's a, it's a psychiatric condition, but they [00:51:55] reframed this mental illness as a perfectly healthy identity, which is dangerous [00:52:00] in and of itself because anyone who is suffering from a mental illness is not, is [00:52:05] not well served by everyone pretending that they're perfectly healthy.
[00:52:09] Mia Hughes: But [00:52:10] the other crucial part is when they reframed it as healthy, they made it not [00:52:15] only possible to celebrate it. But because trans activism [00:52:20] is so aggressive in its approach, they made it mandatory that we [00:52:25] celebrate it. So we had, you know, Laverne [00:52:30] Cox, Caitlyn Jenner, I am Jazz. Those were just a tiny few. We [00:52:35] all of a sudden trans-identified celebrities.
[00:52:38] Mia Hughes: So individuals who [00:52:40] have this psychiatric disorder and have medicalized their bodies as a result [00:52:45] of this psychiatric disorder were then thrust into the mainstream. They're, they're [00:52:50] on the cover of magazines. They're celebrated, they're, they're elevated to [00:52:55] almost a sacred status, and everybody is just, you know, forced to go along with this.[00:53:00]
[00:53:00] Mia Hughes: That is, that could only happen. Because they [00:53:05] deps psycho pathologized. It, it, it's impossible. If we were still grounded in [00:53:10] reality, if we still recognize that this was an actual psychiatric disorder and it it [00:53:15] requires ethical psychotherapeutic care, then nobody would be [00:53:20] putting these individuals on the cover of magazines.
[00:53:23] Mia Hughes: But because WPATH [00:53:25] shifted that they, we, they forced everyone to celebrate it. And I [00:53:30] believe that's what triggered the social contagion. Because the moment [00:53:35] we are celebrating it, and we're teaching kids in schools, that some people are trends, and I [00:53:40] am jazz is telling kids that, you know, you can be born with the boy brain, a girl [00:53:45] brain, and a boy body and all the rest of it.
[00:53:47] Mia Hughes: Then the idea lands into the minds of [00:53:50] young people and these young people are not identifying. Think about it. They're not [00:53:55] identifying as having a psychiatric disorder. They're not identifying as having gender [00:54:00] dysphoria. They're not identifying as having. [00:54:05] Autogynephilia, they're identifying as trends. And trends is the healthy [00:54:10] identity.
[00:54:10] Mia Hughes: So the harm that Dessy Pathologization [00:54:15] Unleashed is, is almost immeasurable in my mind. All of it to [00:54:20] all of its stems from Dessy, pathologization. And bear in mind that all of those [00:54:25] social contagion, kids who are exposed to this messaging then fall [00:54:30] into a medical world entirely guided by wpath, [00:54:35] guided by Dessy Pathologization, which means they're not being seen [00:54:40] as having a psychiatric disorder.
[00:54:41] Mia Hughes: They show up at the gender clinic, they say, I am [00:54:45] trans. And everybody in the gender clinic says, yes you are. And that's great. And they [00:54:50] affirm it, and then they provide the medical interventions that the trans identity [00:54:55] demands. So when I gave my talk in [00:55:00] Albuquerque, I simply. I tracked, well, I, I [00:55:05] outlined Des Psycho Pathologization, I explained the harm of it, and then I announced [00:55:10] that Gens SPECT was officially launching its Psycho [00:55:15] Pathologization campaign.
[00:55:16] Mia Hughes: Of course, it's just a play on w [00:55:20] path's wording. I just, and very deliberately, so I understand that perhaps it [00:55:25] was a bold thing to say. And, and believe me, the response was, um, [00:55:30] it was, it was quite, uh, it, it was not well received, let's [00:55:35] just say that. Um, but of course the reason I chose the word re psycho [00:55:40] pathologization is deliberately to show that we are turning [00:55:45] back all of the harm that Wpath Des Psycho Pathologization campaign has [00:55:50] done.
[00:55:50] Mia Hughes: And I stand by it. However, trans activists lost their [00:55:55] minds, of course. Um. That's, that was in no way a [00:56:00] surprise perhaps the, the, the ex, the, the, the lengths that they went to or the, the, the [00:56:05] extreme things that they said. Even that wasn't really that surprising. But there were lots of [00:56:10] calls for extreme acts of violence against Gen Spec members and [00:56:15] such.
[00:56:15] Mia Hughes: That is when they respond in that [00:56:20] way. I will say that that is actually exactly how you would expect [00:56:25] individuals who are. Consumed by an extreme overvalue [00:56:30] belief, that's exactly how you would expect them to react. Because like I [00:56:35] said, one of the defining features of anybody who is, whose mind is [00:56:40] dominated by an extreme overvalue belief is they really, really [00:56:45] respond viciously to anyone who suggests that their identity [00:56:50] is pathological instead of, you know, innate and healthy.
[00:56:53] Mia Hughes: And they also, [00:56:55] they, they react very aggressively towards anyone who they perceive to [00:57:00] be trying to step in the way of them obtaining whatever [00:57:05] goal their belief demands. In this case, it is the medical interventions. But I will [00:57:10] say that people on on so-called our side also responded. Some [00:57:15] people responded quite negatively to my talk and that was.[00:57:20]
[00:57:20] Mia Hughes: Because of my use of the word re psycho pathologization. However, I [00:57:25] still stand by it. And that's because to psycho pathologize [00:57:30] something in, in one part, in, in one [00:57:35] community, that is, it's a dirty word, I suppose. And it comes outta the Antip [00:57:40] psychiatry movement of the sixties and seventies where they viewed [00:57:45] all diagnosis as being oppression.
[00:57:49] Mia Hughes: [00:57:50] You know, it's, it's discrimination or it's oppression. Even schizophrenia or, [00:57:55] or really, really severe mental health issues. They viewed all of it as being a tool of [00:58:00] oppression and therefore get rid of all diagnoses. I'm not, I don't belong to that [00:58:05] world and I didn't realize anyone on so-called our side did belong to that world, but apparently they do.[00:58:10]
[00:58:10] Mia Hughes: I was using. To psychopathology in its [00:58:15] neutral clinical sense. And that means recognizing [00:58:20] something as a mental disorder in order to understand [00:58:25] it and ethically treat it and help the person understand themselves [00:58:30] and overcome to the best of the, the therapist's ability, [00:58:35] help them overcome whatever is troubling them.
[00:58:37] Mia Hughes: I didn't realize that it was going to cause [00:58:40] so much controversy on, on my people I would consider on my own [00:58:45] side. So that was the reason why I chose the word psycho [00:58:50] pathologization. And since then we have [00:58:55] yet to be published, but we've been working on a series of papers. [00:59:00] Explaining what we mean by trends as an extreme over value, belief, and [00:59:05] explaining why psycho pathologization is [00:59:10] necessary.
[00:59:10] Stephanie Winn: I wanna talk for a moment about the DSM five and the term gender [00:59:15] dysphoria. 'cause you talked about the shift where, uh, in previous DSMs it was, uh, gender [00:59:20] identity disorder, right. And DSM five that came out 2013, which is the same year [00:59:25] that I graduated from my, uh, graduate program in counseling psychology.[00:59:30]
[00:59:30] Stephanie Winn: And, uh, as you said, now the push in the ICD 11 [00:59:35] is gender incongruence. So for people who are, like, what's the DSM versus the ICD? So the [00:59:40] DSM is specifically the psychiatric listing. I hate it when people call the [00:59:45] Bible. It's more like the dictionary or the encyclopedia of, [00:59:50] uh, the current understanding of psychia psychiatric [00:59:55] diagnoses, which is obviously heavily politicized.
[00:59:59] Stephanie Winn: Very [01:00:00] influenced by culture, by the pharmaceutical industry. It's, it's a work in [01:00:05] progress, right? I, I would like to do an interview soon with my friend, SOAD Dreezy, because I [01:00:10] know that she's been keeping track of the latest developments toward the DSM six. Right? [01:00:15] So the DSM for listeners is the Diagnostic and Statistical Manual of Mental Disorders.
[01:00:19] Stephanie Winn: [01:00:20] The ICD is the International Classification of Diseases. So it's much broader. It's, it's what doctors [01:00:25] use. And so all of the DSM diagnoses and codes are within the [01:00:30] ICD, but it's a different, much broader classification system. So the ICD is [01:00:35] on the 11 now, where gender incongruence is a term. The [01:00:40] DSM is still on the five released in 2013 where it's, [01:00:45] uh, gender dysphoria.
[01:00:47] Stephanie Winn: And so the shift, as m is [01:00:50] pointing out towards the idea gender incongruence is the most d [01:00:55] psycho pathologized, because it's just saying, oh, your mind and body don't match. And it's not, let's [01:01:00] fix your mind. It's let's fix your body. But I did wanna talk a little bit about the DSM five because it, [01:01:05] it was released at an interesting time in the unfolding [01:01:10] of all of this, and it's actually not clear in the DSM [01:01:15] five what they expect therapists to do about this.
[01:01:17] Stephanie Winn: Um, you know, yes, it says [01:01:20] preference for activities and styles of dress and things [01:01:25] associated with the opposite sex. There's very little to no mention of the [01:01:30] sexual component of that. Um, like you say, the [01:01:35] distress is definitely defining criteria, but that's also the case with anything in the DSM. It [01:01:40] has to cause clinics, uh, excuse me, clinically significant distress or functional [01:01:45] impairment or both in order to meet criteria.
[01:01:47] Stephanie Winn: Um, but if you go out to read [01:01:50] the description of gender dysphoria, the, the narrative component in the DSM. It doesn't [01:01:55] say therapists should or shouldn't do this or that. It's very [01:02:00] neutral. And the rates, the prevalence statistics given are obviously [01:02:05] old. Like the numbers are just intuitively when you read them.
[01:02:08] Stephanie Winn: Those are like numbers [01:02:10] from, you know, 20 years ago. Um, and then it [01:02:15] says, well, some people choose to medicalize this and become transgender, blah, blah, blah. But does it [01:02:20] say, as a therapist you should write a letter encouraging that. Does it say as a [01:02:25] therapist you, you should explore, you know, what this might have to do [01:02:30] with childhood trauma or with paraphilias or with obsessive compulsive deter it.
[01:02:34] Stephanie Winn: It [01:02:35] doesn't say any of that. And I just, I think that's really interesting. And the, the other thing I will put a [01:02:40] little bit of a fine point on is the term dysphoria itself and how it's used now by the [01:02:45] youth because. Uh, like Mia is saying, a lot of them, they don't say, I have [01:02:50] dysphoria. They say I'm trans, but some of them do say I have dysphoria.
[01:02:54] Stephanie Winn: And [01:02:55] again, going back to that idea of the extreme overvalued belief in their meaning making system and how they're [01:03:00] using their neuroplasticity in this chapter of life, anything that goes wrong, anything that [01:03:05] doesn't feel good, that gets labeled my dysphoria and that gets painted in [01:03:10] contrast to the concept of euphoria, the gender euphoria that I anticipate I [01:03:15] will have.
[01:03:16] Stephanie Winn: And that to me feels like just a, a hacking of our [01:03:20] motivation and reward system. Before we started recording Mia, you had mentioned that, uh, when you [01:03:25] talk about cracking the code and your, your research and your writing, you describe feeling [01:03:30] a sense of euphoria associated with cracking the code. And I thought, well, that makes sense.
[01:03:33] Stephanie Winn: I know that feeling that [01:03:35] that dopamine, that, oh, I'm on the right track. I'm discovering something. [01:03:40] And it's like, that's actually what dopamine is meant to do for you. It's meant to reward. [01:03:45] Meaningful effort. It's meant to reward progress toward goals, but it [01:03:50] can also really easily be exploited. So if we think about all the pleasurable feelings that we [01:03:55] get out of doing things like meaningful work or building something or, or becoming [01:04:00] enlightened on a path of, of genuine intrigue, imagine that's the [01:04:05] same feeling, that's the same motivational system that is being hacked in [01:04:10] these kids where anytime they get so-called [01:04:15] properly gendered as opposed to misgendered, right, then they, they feel that little [01:04:20] euphoria, right?
[01:04:20] Stephanie Winn: And it's the placebo effect because they've, they had that extreme overvalue belief. [01:04:25] They've, they've convinced themselves that's what they need in order to be happy. But this is what I mean when I talk about [01:04:30] neuroplasticity. I mean, if that is how you are using your brain. Reinforcing it over and [01:04:35] over, it does become true for you.
[01:04:36] Stephanie Winn: It becomes a self-fulfilling prophecy, and that's why it's so [01:04:40] hard to treat it at this point. So people like Mia and uh, everything downstream of [01:04:45] the work you're doing, we have our work cut out for us, helping these people [01:04:50] untangle all the mental knots that have been tied here.
[01:04:52] Mia Hughes: It's true. I mean, when I said [01:04:55] euphoria, I wasn't joking.
[01:04:57] Mia Hughes: It's when I've been, 'cause I, [01:05:00] because I wrote my whole thesis out into one giant document and as I added [01:05:05] things in and I thinking through all of these areas, I. Every time something slotted [01:05:10] in, it felt like a eureka moment where I just go running through the streets and excitement. [01:05:15] However, the, the euphoria that these kids are chasing, it's artificial or it's, [01:05:20] it's in the future, they build up in their mind that this next medical [01:05:25] treatment is going to bring the euphoria and maybe it does for a short time.
[01:05:29] Mia Hughes: 'cause the mind is very [01:05:30] powerful and you've just, you, you have achieved a goal that you fixated [01:05:35] on and you really believe, yeah, you can create feelings of euphoria, but [01:05:40] it's usually short-lived.
[01:05:42] Stephanie Winn: Are you a freethinking therapist looking for [01:05:45] like-minded community? The Association for Mental Health Professionals is a [01:05:50] sanctuary for holistic critical thinking counselors and therapists who want to stand firm in our [01:05:55] values and reclaim our profession from ideologues.
[01:05:58] Stephanie Winn: A MHP offers its [01:06:00] members a blog and podcast, monthly webinars, and an annual. Each fall [01:06:05] in Texas, visit Association for mental health [01:06:10] professionals.org to join a growing number of like-minded therapists who want our profession back. Alright, [01:06:15] now back to the show.
[01:06:16] Mia Hughes: So Mia, you were saying that in your paper on [01:06:20] re Psycho Pathologization,
[01:06:22] Stephanie Winn: you compare [01:06:25] how we're handling gender dysphoria.
[01:06:27] Stephanie Winn: With how we're handling [01:06:30] anorexia and body dysmorphic disorder.
[01:06:32] Mia Hughes: I think it's the strongest [01:06:35] comparison to help people, like framing trends is an extreme overvalue belief. I [01:06:40] understand that this is a brand new framing and it's taking time for people to understand, [01:06:45] but it can help. When I was reading the literature on, they [01:06:50] were all overvalued ideas back then.
[01:06:52] Mia Hughes: That was the, the concept that people were [01:06:55] using repeatedly. I came across anorexia, [01:07:00] and so in the paper that I've written that has yet to, we've yet to find [01:07:05] a, a journal to publish it, but we're, we're just coming to the end of writing it. [01:07:10] We, I drew the, we drew the comparison between anorexia and it really works well [01:07:15] because anorexia is also a disorder of overvalued idea [01:07:20] in the sense that.
[01:07:22] Mia Hughes: It's usually a, an adolescent girl [01:07:25] or a young woman, and she, the, the idea that [01:07:30] she holds, the belief that she holds is typically something along the [01:07:35] lines of she is, um, one cannot be too thin, [01:07:40] thinner is better and one cannot be too thin. And that fits into [01:07:45] the culturally approved narrative, right? Because [01:07:50] we all, we, we do still live in a culture where thin is considered.[01:07:55]
[01:07:55] Mia Hughes: Better and, and fat. To be fat is considered shameful. There's no doubt about [01:08:00] that. Look at, you know, any popular culture, look at any television show, [01:08:05] movies, whatever. Even with fat positivity movements, we still, we still [01:08:10] live in this world where we value people who are thin over people who are fat. [01:08:15] And so the anorexic just takes that belief to the [01:08:20] extreme.
[01:08:20] Mia Hughes: I mean, in the ICD, we were just talking about the ICD, the World Health [01:08:25] Organization's classification. Anorexia is classified as a disorder of [01:08:30] overvalued idea, and it is the fear of flabbiness. So an [01:08:35] anorexic just absolutely detests any body fat of any [01:08:40] kind, and it becomes this all consuming belief. This, this belief [01:08:45] dominates her mind.
[01:08:46] Mia Hughes: Nothing else. There's nothing else in her life. It's all about [01:08:50] restricting food. Making sure that she doesn't eat anything that [01:08:55] could possibly add even an a, a tiny little bit of body fat, [01:09:00] compulsive behaviors, exercising and, and restricted eating, [01:09:05] obsessing over food. But the crucial part of anorexia is that [01:09:10] she experiences this belief as ego, syn, tonic.
[01:09:14] Mia Hughes: So we're right [01:09:15] back to that term, which is crucial for the overvalued idea or the overvalued belief. [01:09:20] She experiences her desire to be emaciated and, [01:09:25] and no body fat whatsoever as a true expression of who [01:09:30] she is. She doesn't see herself as having a mental disorder in her and [01:09:35] anorexia. An anorexic is not going to show up at a psychiatrist's clinic.[01:09:40]
[01:09:40] Mia Hughes: Asking for help to overcome her anorexia. She [01:09:45] relishes it. She cherishes it. She think she thinks that she is, she typically thinks that she [01:09:50] is better than everyone else and has this warped view that other [01:09:55] people are looking at her and they're, they're jealous and they wish that they could be as thin as she [01:10:00] is.
[01:10:00] Mia Hughes: And so that's why the comparison works really well, [01:10:05] because it's the anorexic family who typically convince her [01:10:10] to go and get psychiatric support. And she will fight against [01:10:15] anyone who tries to make her gain weight because she does not see [01:10:20] herself as being ill at all. And so. [01:10:25] I, when I, when I thought this through, I realized [01:10:30] gender affirming care, so-called the entire field of gender [01:10:35] medicine, is the equivalent of the anorexic showing up at [01:10:40] the eating disorder clinic.
[01:10:41] Mia Hughes: And, and, you know, saying that she's too fat and [01:10:45] she, she needs to lose weight. And the clinic saying, yes, you are too [01:10:50] fat. Here's your treatment, it's ozempic, here's your ozempic. [01:10:55] And then the amazing thing about gender affirming care, the, the field of [01:11:00] gender affirming care is that the way they measure whether or not [01:11:05] these medical interventions are the right thing to do is by self-report.
[01:11:09] Mia Hughes: We all [01:11:10] know that all of the studies in gender medicine. Are not [01:11:15] long-term studies measuring life situation, objective [01:11:20] outcome, how the person is functioning in life. It's self-report. They give these people the [01:11:25] medical treatments that they want and then at the end they say, are you happy? So that's the equivalent of [01:11:30] your anorexic showing up at an eating disorder clinic, being [01:11:35] given liposuction and ozempic.
[01:11:37] Mia Hughes: And then at the end of it, all of the [01:11:40] studies are asking her if she's happy. Now, of course, [01:11:45] she's happy, the disorder that she has propels her towards this. [01:11:50] This behavior, this pathological dangerous behavior to [01:11:55] lose as much weight as possible. And if you give her the drugs and the [01:12:00] whatever, the, the treatments that help her achieve that goal, you are going [01:12:05] to make her very happy.
[01:12:06] Mia Hughes: She, her health will be destroyed, she will be emaciated and [01:12:10] on the brink of death. But if you ask her if she's happy, she will absolutely say she is happy. [01:12:15] That is exactly what is happening in gender medicine. They [01:12:20] take the pathological desire, which is hormones and [01:12:25] surgeries. That is the key symptom of the trends.
[01:12:28] Mia Hughes: Overvalued belief is the [01:12:30] desire for these drastic irreversible medical interventions. [01:12:35] And then they give the individual the very treatments that the [01:12:40] key symptom. Demands. So the treatment and the symptom are [01:12:45] exactly the same. They're one and the same. And then they measure their success by [01:12:50] asking the individual whose mind is completely dominated by this idea, [01:12:55] are you happy?
[01:12:56] Mia Hughes: And because we, we know 99% of [01:13:00] them say, yes, I am happy. The entire field of gender medicine says [01:13:05] then we're doing the right thing. Everything is perfectly fine. The, the madness [01:13:10] of it, when you compare it to anorexia, which everyone can see, is [01:13:15] clearly a pathological disorder. But the point of psycho [01:13:20] pathologization, the point of framing trends as an extreme overvalue belief, and the [01:13:25] point of comparing it with anorexia is to show.
[01:13:29] Mia Hughes: That, as [01:13:30] I said in my talk repeatedly, the madness lies in society. The [01:13:35] madness, the individuals, they are, they are just, they are possessed by an [01:13:40] idea. They have, they're in the grips of a belief and they need help. The true [01:13:45] madness is how we as a society and the medical world [01:13:50] particularly respond to the individuals who are now completely [01:13:55] possessed by this idea because instead of trying to help them, we give them the exact [01:14:00] pathological desire.
[01:14:02] Mia Hughes: We, we fulfill their path, pathological [01:14:05] desire. So the, the i, I suppose I'm pathologizing [01:14:10] society. That's what the point of psycho pathologization [01:14:15] is, is we all have to recognize we have to, one, stop [01:14:20] celebrating. This identity is healthy. We have to stop pretending that these medical [01:14:25] interventions are ethical, medical care, and a human [01:14:30] right, and we need to, it doesn't mean like I know I'm accused of all [01:14:35] kinds of stuff.
[01:14:35] Mia Hughes: They accuse me of trying to exterminate trans identified people. They accuse me [01:14:40] of genocide and all of this, but actually this [01:14:45] group of people will still exist, but we will understand them better. The [01:14:50] people treating them will understand what it is that they are treating. [01:14:55] The people who have the idea will understand what it is that they have, and [01:15:00] all of society will have a better understanding of what is going [01:15:05] on with this group of people and will stop mindlessly celebrating it [01:15:10] without understanding it.
[01:15:10] Mia Hughes: I think I've just remembered what it was. I forgot earlier. It was [01:15:15] because you said the therapists have a really hard time with. [01:15:20] These individuals who show up very much in the [01:15:25] grips of the belief. And that's a key part that is in the paper that I wrote, is [01:15:30] for the, when the person shows up [01:15:35] seeking help, first of all, the trans-identified person, like the anorexic, the [01:15:40] trans-identified person is not presenting to a healthcare professional or a mental [01:15:45] health professional because they want to overcome the trans identity because they don't [01:15:50] realize that they have a pathological condition.
[01:15:52] Mia Hughes: They think that the trans identity is healthy, [01:15:55] and they are showing up because they want the medical interventions and the, [01:16:00] the field of medicine is set up such that they can expect to obtain [01:16:05] them. That's, that's just where we are. Like if you, if you identify as trans, look, this is [01:16:10] this entire field of medicine.
[01:16:12] Mia Hughes: The problem I think, therapist, the [01:16:15] frontline faces is by the time the person, uh. [01:16:20] Presents to a clinic. They are already very [01:16:25] much in the grips of the belief. So Carl Veer, who first outlined the [01:16:30] overvalued idea, he makes very clear that a. The [01:16:35] best hope that you have of loosening the grip of this idea is in its earliest [01:16:40] stages before it totally dominates the person's life.
[01:16:43] Mia Hughes: And he, he uses the [01:16:45] phrase countervailing perspectives. You have to, it's the job of [01:16:50] anyone around this person to introduce countervailing perspectives to [01:16:55] show why the belief is either false or harmful or dangerous or whatever. [01:17:00] But the problem that the therapists you guys face is by the [01:17:05] time the person presents for care, the belief has fully and completely [01:17:10] cemented into the mind.
[01:17:11] Mia Hughes: And once that happens, it's very [01:17:15] difficult, as I'm sure I don't need to tell you to take the young person or to take the, the [01:17:20] whatever age person, get them off course and get the belief to loosen its grip. [01:17:25] It's very much about just planting ideas, gently [01:17:30] present different. Beliefs, [01:17:35] different alternative perspectives, these countervailing perspectives that Verna talked about.
[01:17:39] Mia Hughes: [01:17:40] And so by, by redefining trends in this way and introducing [01:17:45] this whole framework, I want to be clear that I am in no way suggesting, oh, I've [01:17:50] solved the problem. I've saved them all. I haven't in any way whatsoever. It's [01:17:55] just a different way of viewing the trans-identified person. And it [01:18:00] hopefully will give therapists and everybody in the, the medical world a [01:18:05] different way of, uh, a, a way to understand these people and [01:18:10] perhaps help them in a less destructive way.
[01:18:13] Stephanie Winn: I think there's a range of [01:18:15] how dug in patients are when they arrive in the therapist's office. [01:18:20] And um, in my line of work, I'm uniquely suited to hear [01:18:25] all manner of stories. You know, second and third hand stories about. [01:18:30] How one of my client's kids' therapy is going. And of course, I'm perpetually [01:18:35] disappointed in my colleagues, you know, when, when I hear from a, a parent [01:18:40] who really thought that they did their due diligence and screening to [01:18:45] find a therapist who would be neutral, who seems [01:18:50] to have a more, uh, nuanced psychological understanding of these things.
[01:18:54] Stephanie Winn: And [01:18:55] then, uh, you know, time and again, I just keep hearing these [01:19:00] therapists eventually cave in. Uh, or I [01:19:05] hear that they do something naive. So a common mistake that I hear [01:19:10] about is encouraging the parents to quote [01:19:15] unquote compromise on pronouns or something like that. And, and to [01:19:20] me, that shows me that. The therapist has not had enough [01:19:25] experience in this world that you and I are in to recognize that [01:19:30] the ante will keep upping, that the goalposts will keep shifting.
[01:19:34] Stephanie Winn: That this is not a [01:19:35] satiable beast. This is not a, a, a situation that's [01:19:40] amenable to compromise. As you pointed out very early in our [01:19:45] conversation today, social transition leads to medical transition because [01:19:50] again, those neural pathways are being confirmed over and over again that [01:19:55] this is who I am, this is how I must be seen and treated in order to be myself, in [01:20:00] order to be okay, in order to be happy or move on with my life.
[01:20:04] Stephanie Winn: [01:20:05] And that becomes, again, a self-fulfilling prophecy. Um, as [01:20:10] I shared in, I think what will be the previous episode to this one coming out, [01:20:15] um, my personal read on the finished study, I talk about things like the [01:20:20] untested hypothesis and the body as a hotel room, right? So by those two [01:20:25] things, I mean, essentially.
[01:20:27] Stephanie Winn: That the young person is suspending [01:20:30] self care, suspending anything that would help them settle into their [01:20:35] body and grow confident as they are today because this belief system that they [01:20:40] hold gets in the way of them doing so. Right? If you were to get comfortable in your [01:20:45] body the way it is now and accept being recognized as the sex you are, you are, it would mean you're not [01:20:50] really trans or you don't really have gender dysphoria and that defines who you are, right?
[01:20:53] Stephanie Winn: So again, the [01:20:55] incentive structure here is just so whack, but my commentary on the [01:21:00] therapist is, you know, I do hear these stories where. A parent thinks that they [01:21:05] found a therapist who is going to serve their family well, and then the therapist [01:21:10] ends up revealing themselves to be quite naive because they're trying to negotiate with the parent as if they, you know, if you [01:21:15] just give in on pronouns, they'll come around.
[01:21:17] Stephanie Winn: Right? And it's like, that's not how [01:21:20] this works. If you've seen what these kids are like. And that's [01:21:25] why I teach parents that my motto with therapist is guilty until proven innocent. You just have to be kind [01:21:30] of paranoid towards them in today's climate. But I, I really do see [01:21:35] a broad range and I, I see therapists getting it wrong the other way around too, where [01:21:40] sometimes a parent will tell me about a therapist that their kid was seeing before the [01:21:45] gender issue ever came up.
[01:21:46] Stephanie Winn: They were seeing them for some other reason like divorce or something like that. [01:21:50] And then the gender issue comes up. The parent is hesitant to take the [01:21:55] kid away from a therapist they've been working with for years who they have a good relationship with. And the [01:22:00] therapist takes it too far. The kid's actually in a place of uncertainty, but the [01:22:05] therapist jumps to, oh, well then you, you must, you know, go further with [01:22:10] this.
[01:22:10] Stephanie Winn: So that's a, you know, that's a conversation for another time. My [01:22:15] critique of all the things I hear of therapists and I, I, you guys do have a hard job. [01:22:20] You do have a hard job, my colleagues, but there's so many ways to get it wrong.
[01:22:24] Mia Hughes: There [01:22:25] is, I mean, I just hope that by, if [01:22:30] everyone can understand what these pathological beliefs are, [01:22:35] how they function, how their ego, syn, tonic, how the kid does not see, or the young person does not [01:22:40] see that they have a psychiatric disorder, and how countervailing perspectives [01:22:45] can loosen the grip of the belief.
[01:22:47] Mia Hughes: But never in a direct [01:22:50] confrontational way that will just cause the person to further entrench or likely just cut you out of their [01:22:55] life. Um, then hopefully just understanding, first of all, [01:23:00] I think it's just understanding what you're dealing with and I think the, the extreme overvalue [01:23:05] belief does bring clarity to this in a way that no [01:23:10] other classification has so far.
[01:23:13] Mia Hughes: But IJI, I think as well, [01:23:15] something that I haven't brought up is, 'cause I was just talking about countervailing perspectives [01:23:20] that jumped into my mind is when Verica [01:23:25] described this overvalued idea in the, you know, the late [01:23:30] 19th century. Obviously he could never have imagined. [01:23:35] The world in which we live. So like there's definitely, there's the [01:23:40] extreme acts of violence where they're in these internet echo chambers and they're, you know, the [01:23:45] beliefs are being fortified and amplified, and then it just kind of lodges into one [01:23:50] mind and then, and then this person acts.
[01:23:52] Mia Hughes: But there's something [01:23:55] exceptional about trends in that for most of [01:24:00] the, well, for the 2010s, I would argue wider society [01:24:05] functioned like an internet echo chamber. Because trans activism [01:24:10] forbid anyone from deviating from this extreme overvalue belief [01:24:15] that trans is healthy and medical interventions are a human right because of the [01:24:20] climate of fear.
[01:24:20] Mia Hughes: And because trans activism created a society-wide [01:24:25] echo chamber. Many of these young people who got sucked [01:24:30] into the vortex of this belief. There were no countervailing perspectives [01:24:35] anywhere. But I do feel enormous hope now we're in [01:24:40] 2026 and the countervailing perspectives are there, like I've talked [01:24:45] to Detransition who say, well, one, there's a social contagion of [01:24:50] detransition and just that they are encountering a detransition and they [01:24:55] realize that, that this person is exactly like them.
[01:24:57] Mia Hughes: It's the same social mechanism that [01:25:00] tragically drew them all then in the first place when they encountered a, a lost, confused [01:25:05] teenager online saying, I'm trends. Now they're encountering [01:25:10] detransition who are the same as them again, and, and drawing them outta the social contagion, [01:25:15] outta the medical scandal.
[01:25:17] Mia Hughes: But I also think that [01:25:20] because people are now not afraid of trans activists in the same way, of [01:25:25] course the debate is on, the countervailing perspectives are out there. And Detransition [01:25:30] have said they listened to turfs. That's what caused them to detransition. They [01:25:35] just, like, they encountered turf narratives.
[01:25:39] Mia Hughes: Uh, they [01:25:40] encountered the gender critical side. And at first they thought it was [01:25:45] transphobic and terrible, but it lodged in their mind. And then eventually the [01:25:50] idea started to, the belief started to loosen its grip and they realized what [01:25:55] they had been a part of. So I think I, in, I feel [01:26:00] hopeful that countervailing perspectives that were forbidden for so long.[01:26:05]
[01:26:05] Mia Hughes: Which is just reality from reality is, is now permitted. We can [01:26:10] all talk about this. And that is going to, on the one hand, help draw people out [01:26:15] from further medical harm and on, on the other hand, prevent innocent [01:26:20] people from falling into it in the first place.
[01:26:22] Stephanie Winn: And for the parents in the audience, [01:26:25] just noticed that Mia didn't say that they listened to their [01:26:30] parents who were raging turfs, uh, and that, that they said, oh, you're [01:26:35] right.
[01:26:35] Stephanie Winn: Mom and dad, um, detransition, who listened to turfs, came to [01:26:40] appreciate those outside perspectives in their own time, in their own way. [01:26:45] Um, you know, you have to be very mindful of the developmental [01:26:50] stage that they're in and the function that the trans identity serves in their process of developing [01:26:55] autonomy.
[01:26:55] Stephanie Winn: And one of the things I regularly work through with my clients. [01:27:00] Is, uh, letting go of the naive fantasy that your kid's gonna say, [01:27:05] dad was right. Mom was right. That's not how this is gonna go. Right. [01:27:10] You are not the best messenger of these countervailing [01:27:15] beliefs. And as, as Mia pointed out, um, earlier. [01:27:20] The best stage for intervention is early before the beliefs have completely set and [01:27:25] integrated with, and taken over every aspect of that person's like.
[01:27:28] Stephanie Winn: And again, that [01:27:30] wedge needs to be sort of gentle and from the side, rather than directly [01:27:35] attacking something that that person perceives as fundamental to their identity and [01:27:40] their value as a person. So if you are a parent, uh, just know that what we talk about on this [01:27:45] podcast, I say this almost every single episode, what we talk about on this podcast is for our [01:27:50] information, for our understanding of the situation.
[01:27:52] Stephanie Winn: It's not necessarily always [01:27:55] that our approach to communicating about these issues on this podcast is the way that you should [01:28:00] talk to your kids about that. If you have a child in this, uh, you've probably already heard me [01:28:05] advertise my program for parents, but RGD Repair is where you will learn [01:28:10] specifically what communication techniques you can use as a parent that respond to your [01:28:15] child's psychology and that take your family system into account.
[01:28:17] Stephanie Winn: So I just wanted to. Add that note. If [01:28:20] you're a long-term listener, you've heard me say that in all my recent episodes just because the things we talk about [01:28:25] here are not going to be well received. If you take that exact same [01:28:30] message and try to have that conversation with your kid, or heaven forbid, try to play an episode of my [01:28:35] podcast for your child and your bought into this, it's not gonna go the way you hope.[01:28:40]
[01:28:40] Stephanie Winn: That's why we have a whole separate curriculum for learning how to talk about this in your [01:28:45] family.
[01:28:45] Mia Hughes: I'd be interested to know what you think about this. 'cause this is something I've been [01:28:50] just, it's in my mind. I read Hadley Freeman's Good Girls. [01:28:55] So Hadley Freeman, the journalist, had severe anorexia all throughout adolescence [01:29:00] and spent I think like six years in and out of psychiatric care.
[01:29:04] Mia Hughes: [01:29:05] And there's a really interesting part, 'cause I'm always thinking about. What, [01:29:10] what, how do we loosen the grip of the ones who are already in there? How do you loosen [01:29:15] the grip of this belief? And as the detransition have told me, many of them, they [01:29:20] just allowed, they watched one Peter Ian video, and then they just let it [01:29:25] sit in their mind.
[01:29:26] Mia Hughes: And eventually they sought out more, or they listened to a turf and they [01:29:30] thought she was transphobic. But the, the idea lodged in their mind, and the Hadley [01:29:35] Freeman, because it's anorexia, it's a parallel world, but it's very similar. She said [01:29:40] that she was interviewing one of the experts who said very often [01:29:45] the, the overvalued idea, the overvalued belief [01:29:50] loosens its grip.
[01:29:51] Mia Hughes: Definitely not because you're directly targeting it, but the [01:29:55] person in the eating disorder ward, the anorexic who's starving herself, would [01:30:00] overhear the nurses talking on a Friday afternoon about their plans for the [01:30:05] weekend. And gradually the, the, the, the woman would think. I wanna have [01:30:10] plans on the weekend.
[01:30:10] Mia Hughes: I wanna have a life beyond this. And that was the first crack. The [01:30:15] belief, there's a crack in the belief, and there's another world out there. There's a real life that you could [01:30:20] have if you just let this belief go. For Hadley Freeman, I think she says, one of the [01:30:25] cracks, one of the major cracks for her was there was a 30-year-old [01:30:30] anorexic at the, the table having a complete meltdown, like a, [01:30:35] like a toddler over how much butter was on her toast.
[01:30:39] Mia Hughes: And Hadley [01:30:40] Freeman had this, I don't wanna be 30 years old and having a tantrum over [01:30:45] toast. And the belief there was a crack, a major crack in this belief that I need [01:30:50] to starve myself. I cannot have an inch of fat on my body. And so. [01:30:55] It's not directly challenging the belief, but do you think [01:31:00] that, and I know that they also tell parents, parents are not to focus on the, on [01:31:05] the anorexia with their child.
[01:31:06] Mia Hughes: They're to just almost pretend that it doesn't exist and just [01:31:10] act normal and it's no big deal. Because if you focus on it and if [01:31:15] you aggressively attack it, you entrench the belief and you entrench your child. [01:31:20] So what's the, is there a similar, is there a way that parents [01:31:25] can be those nurses talking about the weekend or the, the, you know.[01:31:30]
[01:31:31] Mia Hughes: Put cracks in the belief without the, the young person [01:31:35] knowing. What do you think?
[01:31:35] Stephanie Winn: Yeah, absolutely. I mean this is, this is what I specialize in, right? This [01:31:40] is, this is the conversation I have all week long. And I think that there are far more than those [01:31:45] two options. And I think a lot of people come to me when they have tried [01:31:50] either or both of those two options, right?
[01:31:52] Stephanie Winn: One option being to directly attack the [01:31:55] belief oftentimes in a way that is quite naive to the [01:32:00] function that that belief serves in that young person's life. And then [01:32:05] no surprise that it doesn't go well, right? So that's one option. Another option is to [01:32:10] completely ignore it, like you say, and just, uh, as many people say, [01:32:15] focus on the relationship, fix, you know, nurture the relationship, which I definitely [01:32:20] believe in, but what does that mean?
[01:32:22] Stephanie Winn: A lot of times people come to me because they've been trying to do [01:32:25] that, and that's looked like being conflict. Avoid. Kicking the can down the road, [01:32:30] walking on eggshells, enabling bad behavior, [01:32:35] um, tolerating things that are not helping shape their child's [01:32:40] character development. And just hoping the issue will go away.
[01:32:44] Stephanie Winn: And [01:32:45] oftentimes, you know, these parents, they've done their research, they've read all the same things you and I have. Maybe not all the same things, but, [01:32:50] but they're like, well, gender dysphoria resolves on its own if you just leave it alone. It's like, yeah, [01:32:55] well that, that study that was from a, a time and a different [01:33:00] cultural environment, it's not gonna go away on its own in our current cultural [01:33:05] incentive and disincentive system.
[01:33:07] Stephanie Winn: So, you know, I, I don't [01:33:10] think that nurturing a relationship or, you know, not [01:33:15] directly targeting the issue has to mean total conflict. Avoidance has to mean codependent, [01:33:20] um, dysfunctional, you conflict avoidant [01:33:25] relationships. I think. Sometimes working on the relationship [01:33:30] without directly targeting the belief, but without not targeting it either, [01:33:35] is really a matter of slowing down attuning to what's happening and picking up what your kid is putting [01:33:40] down.
[01:33:40] Stephanie Winn: And that's why I describe ROGD repair as an emotionally intelligent approach [01:33:45] to parenting your way through this. Because if you're slowing down and attuning to what's [01:33:50] going on, kids are giving you all of these moments, right? There's, there's a [01:33:55] moment that they snap at you, or there there's a flash of [01:34:00] fear or a flash of guilt or some emotion, right?
[01:34:03] Stephanie Winn: And what are you [01:34:05] doing with that moment? Can you stop and acknowledge, okay, I saw that. Do you [01:34:10] wanna talk about it? Or, uh, I teach parents to make [01:34:15] empathic guesses. People rely on questions too much. They [01:34:20] think, uh, you know, that's the other advice. Oh, just ask what does that mean to you? Why do you [01:34:25] feel that way?
[01:34:25] Stephanie Winn: Why do you think you feel that way? No, those aren't good questions. I mean, I do have a lesson in my [01:34:30] course on using what and how questions rather than why questions. 'cause those are less [01:34:35] likely to provoke defensiveness. But when you're asking questions, you're letting the kid lead and [01:34:40] you are overvaluing their insight.
[01:34:43] Stephanie Winn: You're overestimating [01:34:45] their insight. So what I do with my clients is we do the heavy lifting as the [01:34:50] adults, and if you go through my course and you take their homework really seriously and you do the exercises [01:34:55] in my program, you're basically mimicking the coaching process. You as the adult, as the [01:35:00] mo, more emotionally intelligent person here, you do the heavy lifting of figuring out what this means to [01:35:05] your child, mapping out their psyche, figuring out their association so that you can make [01:35:10] intelligent empathic guesses so that you can reframe what they're saying in a way that [01:35:15] they feel heard, that you just interpreted it a slightly different angle.[01:35:20]
[01:35:20] Stephanie Winn: And, and, and that's the process by which you gradually untangle these knots in the brain. And [01:35:25] that's what I teach parents to do.
[01:35:26] Mia Hughes: That's putting the crack. So that's your way of, of [01:35:30] putting, it's all about just putting little cracks in the belief. And then [01:35:35] for some it's really fast, it just crumbles. And for others it can take years and years and [01:35:40] years.
[01:35:40] Mia Hughes: But the doubts and the incoherencies, the [01:35:45] inconsistencies, it all starts to add up. And eventually, Stella's got that lovely analogy, [01:35:50] adding pebbles to a bucket. I love that. Eventually the, the, the accumulated [01:35:55] weight of the pebbles outweighs the whole, the belief hand.
[01:35:57] Stephanie Winn: And let me add a really important [01:36:00] piece of this that I don't, I don't ever want anybody to miss this piece.
[01:36:03] Stephanie Winn: It's about the [01:36:05] part of your child that wants to desist. It's about helping the [01:36:10] part of them that wants out of this. There is a part. [01:36:15] So it's not about the cracks that you wanna put in, right? So if you're [01:36:20] a raging feminist turf and you're so angry about men in women's prisons, like, [01:36:25] I get it. Okay, I'm, I'm with you.
[01:36:27] Stephanie Winn: Okay? But if that's not the [01:36:30] area of cognitive dissonance that's most accessible for your child, figure out [01:36:35] what is. Well, thanks for inviting me to talk about my work. I, I, I was talking about my work. Um, [01:36:40] Mia Hughes, it's so good to have you. Thanks so much for coming back on the show. By the way, I forgot to mention this [01:36:45] at the beginning, but if you're still listening and you want more of Mia's lovely phone book [01:36:50] reading voice, um, to put you to sleep, perhaps put you to sleep while learning about gender [01:36:55] issues as she originally appeared on my podcast on episode 107.
[01:36:59] Stephanie Winn: And I will link to [01:37:00] that in the show notes. Um, so Mia Hughes, where can people [01:37:05] find you and all the things that you're up to?
[01:37:08] Mia Hughes: I am only active [01:37:10] on Twitter XI suppose I should get used to calling it, but I can't. Um, [01:37:15] at underscore Crimea River, that's the only social media I have. Although I did [01:37:20] just launch my substack.
[01:37:21] Mia Hughes: I suppose I should plug that. It's the same Crimea [01:37:25] River Mia spelled MIA. And there's one essay on [01:37:30] there, which is a very personal one about my time in Taiwan and about [01:37:35] change and the importance of open futures. I'm a co-host of Beyond [01:37:40] Gender with Stella Iman and Brett Alderman. So you can find beyond gender on [01:37:45] YouTube.
[01:37:45] Mia Hughes: My Canadian writing is on my MLI, my McDonald Laure [01:37:50] Institute page, and then I write for Gen Spec too and keep a lookout for my [01:37:55] academic paper, which I am convinced will get published somewhere, but [01:38:00] I think it's going to be a bit of a lengthy. Process there.
[01:38:03] Stephanie Winn: Thank you so much for joining me. It's been a pleasure.[01:38:05]
[01:38:05] Mia Hughes: Thanks for having me.
[01:38:07] Stephanie Winn: Thank you for listening to you [01:38:10] Must Be Some Kind of Therapist. If you enjoyed this episode. Kindly take a [01:38:15] moment to rate, review, share or comment on it using your platform of choice. [01:38:20] And of course, please remember. Podcasts are not therapy and I'm not your [01:38:25] therapist. Special thanks to Joey Rero for this awesome theme [01:38:30] song, half Awake and to Pods by Nick for production.
[01:38:34] Stephanie Winn: For help [01:38:35] navigating the impact of the gender craze on your family, be sure to check out my [01:38:40] program for parents, our OGD Repair. [01:38:45] Any resource you heard mentioned on this show plus how to get in touch with me can all be found [01:38:50] in the notes and links below rain or shine. I hope you will step [01:38:55] outside to breathe the air today in the words of Max Airman.
[01:38:59] Stephanie Winn: [01:39:00] With all its sham, drudgery and broken dreams, it is still a beautiful [01:39:05] [01:39:10] [01:39:15] [01:39:20] [01:39:25] [01:39:30] [01:39:35] [01:39:40] world.