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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.
Tamara: Christine Jorgensen, the one
I mentioned before, that first one in
America that got outed , he won Woman
of the Year even though he was male.
This is insane.
A, a man who pretends to be
woman won Woman of the Year.
You know, I think women had only been
able to have their own possessions in
the UK for about 80 years, and here
we have somebody going, "Oh, great.
Okay, I'll have that too, thanks.
Now that you're allowed to have
things, I'll grab that from you."
Cheers for that.
Announcer: You must be
some kind of therapist
Stephanie: Today I'm welcoming
to the podcast Tamara Sears.
She is a British existential
psychotherapist with 20 years of
experience in private practice,
specializing in sex and relationship
issues, as well as a published
writer addressing censorship
in the counseling profession.
Today we're here to discuss her critique
of the American Psychiatric Association
featured in her recent Substack article,
The Unfolding Scandal of Our Time.
We're also going to discuss how
various psychological organizations,
professional bodies in both the UK and
the US have affected the state of the
counseling profession today, the way
that we deal with gender identity issues
as a profession, and we're even going
to discuss some of Tamara's even more
controversial ideas such as, uh, her
pushback on the term autogynephilia.
So I am excited to hear
what she has to say.
Tamara, welcome.
Thank you so much for joining me.
Tamara: Thank you.
I'm glad to be here.
Stephanie: So I saw this incredibly
thorough article that you published
on your Substack, and you gave this
incredibly detailed historical analysis.
I mean, you're halfway to writing
a book in this piece, covering some
of the same ground that, you know,
people like Helen Joyce cover in her
book on trans, of how we got here
over the past hundred years or so.
Um, and specifically throughout, you look
at the role of psychiatry and psychology
and how the counseling profession
has, has enabled or pushed back.
Um, so we're gonna cover
some of that ground today.
We're going to help listeners who are
wondering, how did we get here, understand
that knowledge that you've shared.
We're gonna talk about the changes in the
Diagnostic and Statistical Manual as well.
And as we were just discussing before I
s- hit record- Um, I am planning a series
loosely on the American Psychological
Association, which many of my colleagues
are, um, writing great sort of exposés on.
And you made the important distinction
there are actually two APAs.
So there's the American Psychological
Association, and there's the American
Psychiatric Association, and I
actually got those two mixed up when
I was like, "Oh, Tamara's gonna be
the first in a series on the APA."
Well, which APA, you asked.
So, um, so to be clear, uh, the APA
that we're gonna be focusing on today
is the American Psychiatric Association,
which is the party responsible
for creating the DSM, correct?
Tamara: Mm-hmm.
Correct.
Stephanie: I'm wondering where to start.
We wanna name the professional
organizations that we're talking about.
We wanna go over some
of those DSM changes.
We wanna go through some of the
relevant history, and we also wanna
expose what's going on now and
what does this mean for the future.
Which of those places would
you like to start, Tamara?
Tamara: So I think what's really
confusing for people is that this
seems to have come out of nowhere.
Um, but actually, as I kind of tried
to outline in my article, that this
has been building up, um, for, as
you point out now, over 100 years.
Um, it started- I'd argue in the late
1800s, um, before it was properly
started to be me- medicalized in the
1910s and '20s, um, before the 1930s.
You know, even the Nazi Party was
all over this, um, as an issue, which
helped, uh, fuel Nazi propaganda.
Um, and then, you know, traveling through
time I think is the best way to get sen-
get a sense of what it is sometimes,
because sometimes if you're looking
at things in a tiny snapshot, you sort
of let go and this doesn't make sense.
We need a bigger perspective to kind of
go, "Okay, this is now making more sense."
So that's why I did it.
Stephanie: And thank you for that.
I always say this on episodes when I'm
interviewing someone with a different type
of expertise or skill set than myself,
that I have a good mind for sort of ideas.
It, it…
I like to philosophize,
and psychology's my realm.
But when it comes to names, dates,
historical facts, all that kind of
stuff, I am so impressed by people
with skill sets like Tamara's.
And I think the fact that Tamara is
bringing this skill set of being able
to track what has happened historically,
tracking those details while also being
psychologically minded, is a huge gift.
I don't have that gift.
So, um, for our listeners, I'm
gonna be asking the dumb questions.
I'm gonna be asking the same questions
that you might be asking if you
didn't know anything about this.
And yes, I've done over 200 episodes,
and like half of them have covered
this topic with all kinds of experts.
You'd think I'd know a thing or
two by now, but my brain just
cannot retain that information.
So I will be asking some of those dumb
questions about the historical things.
And another thing that I think those
skills can bring, Tamara, is a view on the
future as well, because I've found myself
wondering lately, is this ever going away?
I, I guess I was approaching this
topic as if it's a wildfire that's
going to burn completely out someday.
It's, it's a pandemic that will
be over like lobotomies, as many
people have made that comparison.
But increasingly, I'm entertaining
the possibility that it's more
becoming endemic, that this, the
Pandora's box has been opened.
And so one thing I'm wondering is,
you know, maybe by the end of today's
conversation, I will get a sense
of, with your historical lens, which
direction you see this heading, whether
you see this becoming something that
eventually kind of burns itself out,
goes extinct, and we look back on it
with horror, or whether this sort of
idea that humans can change sex and
that it's a basic human right to choose
your gender, like if that is now just
part of the culture and not going away.
So I think your historical viewpoint
here should shed a lot of light on
where we're going in the future as well.
What are your thoughts on that?
Tamara: You're right that
this is not going away.
However, this is A, a very
interesting time because you know,
How do I, how do I respond to this?
Wars start from things like this, when
you have people that just become so
divided with different points of view.
And at the moment we have a situation
which we've never had before,
where people believe that they
can change sex and a whole Bunch
of other people who think we can.
And the, the sort of medical
scandal that's underneath it
isn't getting addressed at all.
'Cause I just think that most of
the reasons why people think that
we can change sex are actually down
to fraudulent medical practices, um,
where over time these euphemisms, um,
as Thomas Szasz, the, the, the psych-
the psychiatrist sort of said, the
abusive language, he referred to it.
You know, they have become embedded
in the psychiatric manuals, and every
generation that has then gone on has just
picked it up as if the arguments, oh,
they were settled decades ago, so, you
know, we'll just continue on as we were.
Without kind of tracking the corresponding
technology, advancements in, in technology
at the same time and how they're,
they're correlating, like the advances in
medicine, the advances in communication.
Um, and so as a result, I'm not sure
where we're gonna end up, end up on this.
What I can say with clarity though
is that historically, you know,
there are moments that we haven't
ended up anywhere good on this.
Whether we can band together this time
to stop it, um, before it goes any
further, that's something different.
But I th- I do think you're right
to sort of question, you know,
is w- what are we dealing with?
Is it just a, a, a fire that needs to be
put out like a, a virus or a pandemic?
My personal opinion is that i- in order
to really properly address it, it's
going to need a coordinated effort, um,
across nations, um, and there's gonna
have to be a mass education campaign,
um, in order to inform people of
exactly what's happened and what's done.
And just to let people know the
simple fact is humans cannot change
sex, and if somebody has told you
they can, they're lying to you.
Stephanie: I think it's a bold move
to bring up the role of Nazis here.
Because if I'm tracking correctly what
you've shared in your article, uh, there
was Magnus Hirschfeld was his name.
Mm-hmm.
And he was Jewish, and he, he was
one of the earliest experimenters
propagating these surgeries,
and the Nazis opposed him.
And, and this is exactly the sort
of thing that trans rights activists
use to paint us as Nazis, right?
As if anyone in opposition
to this is a, a Nazi.
So I think it's bold of you to, to go
there and almost lend our opposition
that fuel for strawmanning our position.
Tell us why you go there anyway.
Tamara: It wasn't intentional.
It's where the evidence led me.
Uh, as I was looking into it, um,
I became aware that- Hirschfeld was
operating in, uh, Germany at the time,
and I, I'd sort of seen some of the
reports of some of the more problematic
aspects of his experiments, which,
you know, the, uh, the, the trans
activists, you know, they're very
clearly hiding a lot of this information.
Hirschfeld, you know, they kind
of applaud Hirschfeld for, for
doing the things that he did.
But, you know, what Lili
Elbe, for example, you know.
Th- that man endured seven operations
and died of, of sepsis after
experiencing a, a womb implant.
And keeping in mind that, you know,
we don't know who the, the female was.
That's never documented.
So they're, you know, appropriating
body parts from women, implanting them
in predominantly gay men or this case
it was just one, um, and then who of
c- of course the body rejected it.
You know, these are very early medical
experiments that were of their time,
and even in their, in their time they
were actually really controversial.
As a result of doing it, and remember
it's at a period where, you know,
they were experimenting with things
like eugenics, um, which, you know,
now is like we don't do it, you know.
And Hirschfeld was a eugenicist.
Um, this is the man that, you know,
promoted the idea, was providing
transvestite certificates, as they
called them back in the time, so that
people who pretended to be the opposite
sex could be accepted legally as the
opposite sex even back in the early 1900s.
And so it's hardly surprising that, you
know, uh, that people were … You know,
Adolf Hitler referred to H- you know,
what he was doing as, um, you know,
m- making a mockery of the people and
referred to him as being a Jewish swine.
Even if Adolf Hitler's criticisms of the
experiments that Hirschfeld was conducting
on people, and keeping in mind he was
doing this on pre- predominantly gay men.
Okay?
Even if Hirschfeld's experiments
were unethical, you know, the fact
that H- that, you know, Adolf Hitler
was referring to that is correct.
The problem is that being a Jewish
male, Adolf Hitler then used the fact of
Hirschfeld being Jewish to justify racism
against a whole entire race of people,
rather than just identifying that this is
medical malpractice and this is unethical.
And so then this is being extrapolated
by many people as, oh, the Nazis said
it's wrong so, you know, everything
the Nazis have said is wrong.
But, you know, as the running
joke goes, well, the Nazis got
the trains running on time.
Um, I Was horrified to learn that,
you know, there's this narrative, this
history, and then delving into it to
sort of see exactly how Hirschfeld's
experiments had fueled Nazi propaganda.
You know, they'd used him as a,
you know, a, a Jewish person.
I, I just went, "This is awful."
You know, the historical, um, context
in all of this, which all of this
occurred, is actually more complicated
than, than this sort of good and bad,
goodies and baddies kind of narrative
that everybody's been promoting.
Stephanie: So walk us through some
of the professional bodies that have
been involved over the past 100 years.
Uh, you don't have to name all of them,
but, but the significant ones that you've
brought attention to in your article, uh,
in, in Europe and in the United States
and, uh, what their roles have been.
Tamara: So Hirschfeld, you know,
the way the story goes is that
Hirschfeld started the Institute
for Sexuality in Berlin in Germany.
Nazi Party closed it down, but prior to
the closing down, one of the students
that trained, um, with the institute,
uh, in 1914, he went to America, to
New York, and that was a, a guy by the
name of Harry Benjamin, which a lot
of people have probably heard by now.
And he started up, um, his practice
in New York, um, and in counseling
some of the people that, um, you
know, he may have m- Sorry, I've
just forgot how he came about it.
His first client I've forgotten the
name of But the point being that using
Hirschfeld's ideas, Harry Benjamin
then started sort of going, "Yeah,
you know, if you wanna pretend to be
the opposite sex, then, you know, we
can do surgery to facilitate that."
So he brought, he imported these
ideas from Hirschfeld into America,
um, and also referred clients
over to Hirschfeld as well.
One of the things that was really
awful about Hirschfeld's experiments
was what they were doing to gay men.
So in order to cure homosexuality, they
were transplanting the testicles, the
gonads, of heterosexual men, deceased
heterosexual men, and putting them
into homosexual men, and thinking…
Because they were onto this idea that,
um, you know, homosexuality must be
biological in fa- in foundation somewhere.
And so, you know, if all the male energy
comes from the testes, then if we just
transplant the heterosexual's testes
into the homosexual's testes, then
that should surely cure homosexuality.
Stephanie: I have to ask, w- with all of
these bizarre procedures, like you also
talked about the womb transplant, did
they even experiment on animals first?
Tamara: Yes.
Yes.
Stephanie: Okay.
Tamara: So Hir- Hirschfeld picked
up a lot of these ideas from, uh,
Eugen Steinach, and he was doing these
anim- experiments on animals first.
Um, I…
They were just horrific, and it's
because of Steinach's experiments that
Hirschfeld got his ideas from, and then
it transferred it from animals to humans.
Stephanie: I can't imagine
that they actually worked
very well on animals either.
Tamara: Why they thought they worked at
all is beyond my comprehension, but you
know, we're talking about the, the level
of knowledge that was very different back
in the early 1900s compared to the level
of knowledge that we have now, you know.
The, the advances that we've made
since then are quite considerable.
You know, back in the day, remember, they
They didn't even have e- electricity yet.
Stephanie: So is it fair to say for the
record that these so-called transsexual
operations began as an attempted
so-called cure for homosexuality?
Tamara: That's exactly
what I'm trying to say.
That's exactly what
they were intended for.
You know, the idea that we attend to
psychological issues by h- harming
a healthy body completely goes
against the Hippocratic Oath and the
first principle of do no harm, yet
that is what Hirschfeld was doing.
These men had psychological issues.
There were the occasional women,
but it was predominantly men,
predominantly gay men, and being a
gay man himself, uh, I, I don't…
It's a, it, it will never cease to
amaze me how Hirschfeld got caught up
in this without recognizing that, you
know, if you found a biological cause
for homosexuality, then, then that means
that they would sit there and, and try
and change the biology all the time as
if you're fixing people, whereas nowadays
we'd find that h- horrid, you know?
But back then, that made perfect sense.
Stephanie: It's quite ironic if you look
at the progression from then to now, the
fact that these experimental surgeries
with these obviously horrific outcomes
began as an attempted so-called cure for
homosexuality, and then you compare that
to where we are now almost 100 years
later, where we have these so-called
anti-conversion therapy bills, right?
Where it's the exact opposite,
where those of us who are
saying, "Let's not harm the body.
Let's treat this distress
holistically," now we're the
ones being framed as engaging in
so-called conversion practices.
It's quite ironic, isn't it?
Tamara: It's madness, isn't it?
It's utter madness.
Whereas the…
If you go back to the simple principle
of do no harm, um, then i- it's
very clear and straightforward that
no, these are psychological issues,
and we don't address psychological
issues with medical intervention.
So kind of moving on from there, um, one
of the students that trained under him
was a, a, a man called Harry Benjamin,
who in 1914 went over to, to New York
and created a practice over there,
and it's through him that he imported
a lot of Hirschfeld's ideas and the
surgeries after having studied and seen
what, um, Gorbach was doing, um, one of
the, the surgeons at the time, who…
Gorbach, I should mention,
Malcolm Clark has documented how
he then went on to do the, um,
hypothermia experiments at Dachau.
Um, although he was cleared at the
Nuremberg trials, Malcolm Clark
has questioned his involvement,
and he, he was also influential in
dismissing 2,000 Jewish surgeons
throughout Germany at the time.
Anyway, so, so Harry Benjamin, you know,
takes all of these ideas, all these
medical interventions that Gorbach and
Hirschfeld have been inflicting upon
these people and goes to New York and
starts encountering these people who
along the grapevine, all for whatever
reason, and he s- he says, "Oh, you
know, I know how to deal with this
You know, I've seen how this works for
people that makes them so much happier.
Well, yes, y- you know, um, you
could argue that, you know, there
are people who have argued that
suicide makes them happy, you know?
It, it's that thing where, you know, if
you have a purpose and you, it achieve
what you want, then you achieve your goal.
You kinda like, you know, would it…
Even if it's an illusion to destroy
yourself, there is a fleeting moment of
feeling empowered, which, you know, is a,
a psychological problem as anybody working
in this- these sort of areas will know.
Anyway, so, um, he ends up with
Christine Jorgensen, um, and is a, an
American GI, if I remember correctly.
And he, as a client, had s- all
these operations, six operations.
The press ended up intercepting a
letter between, um, him and his parents
where he was sort of talking about
it, and the press then reported that,
you know, marvels of medical science.
You know, a man is now a woman.
You know, you can change sex,
and that was where they…
The press were the first one who
to call it a sex change operation.
But as, uh, you know, other doctors
are pointing out now, such as Dr.
Mayer-Buen over here, you know, these are,
particularly on the earlier male ones,
are male genital mutilation surgeries
and female genital mutilation surgeries.
They're not sex change operations.
You know, that's a euphemistic term
that hides the me- medical horror of it.
And, uh, so then Harry Benjamin, you
know, s- uh, enlisted a, a surgeon,
um, and, uh, you know, an industry in
America pretty much sort of took off.
And that, you know, started,
you know, g- you know, gaining
traction 'cause everybody, you
know, found this new novel way.
You know, oh, you know,
it's a biological thing.
We've just gotta change
people's biology to match.
All sorts of narratives and stories
would then explode around it to
justify it or, you know, promote it.
And, um, the critics started piping
up, and, uh, the early ones were, I
think as early as 1963, 1964, where
they're kinda going, "No, no, no.
This is a, a medical solution
for a psychological problem.
You know, this is not what
we do in our profession."
These, of course, were ignored, and,
uh, the first gender clinics started
getting established all around America
offering, offering these, you know,
psychological assessments and surgeries.
And, you know, they, they decided,
okay, well, you know, we can't just
give them to everybody, um, so we have
to put, you know, stringent, um, tests
on there to figure out, you know Um,
if this is going to backfire on us.
And so Norman Fiske, you know, he
would select, um, candidates where
it was most likely to succeed.
So all the research that is done are
on sort of, you know, these really
individuals that have been sold the lie
that it's possible to se- change sex, and
if they're then happy with the outcome
of the lie, it's just, it's just this
circular feedback loop of insanity.
And, uh, then more and more, you know, of
these people that had had these operations
or, or the cross-dressing fetishists
that, you know, didn't wanna necessarily
modify their bodies, but, you know, there
was an industry being built up, so then
that permitted and justified them, um,
in, in able to go, "Yeah, yeah, look,
see, you know, it's just, you know."
I think, um, can't remember his
name off the top of my head, but one
of the guys, he says, "Oh, yeah."
Oh, Virginia Prince, that's it.
He says that, "Oh, yeah, you
know, sex is in the body, but
gender's in the mind," you know?
And this is in the first edition of
Transvestia that he was, um, publishing
when that sort of then had the print
medium reaching out to people to
sort of find anyone who's interested.
And of course, once you've got some people
that go, "Oh yeah, that's a good idea.
Why don't I do it?"
And it's a, it's a bit of a
self-perpetuating motion then.
Now, there are people that will argue
with me and say, "No, this has come about
because, you know, this is how I am.
I've always been like this."
But my question is, but if you didn't
know that this was an option, is this
something that you would've done?
You know?
If there are other ways, there
are other means to attend to
psychological issues, to attend to
it in a med- to a- in a medical way.
It has such a harmful impact upon
the body because of these very
high-profile cases and then the
celebrity surrounding these doctors.
The gender clinics, of course,
being very lucrative and, you
know, advancing human sexuality.
It wasn't until Janice
Raymond came along in 1979.
The critics had been brewing, but Janice
Raymond and her groundbreaking book, The
Transsexual Empire, that really tackled
the issue from a more feminist, uh, point
of view as to how this was detrimental,
um, to women and children particularly,
as more and more m- men were, you know,
pretending to be women and then demanding
and, you know, taking female spaces.
Christine Jorgensen, the one I
mentioned before, that, that first
one in America, um, that got outed.
He won Woman of the Year
even though he was male.
This is insane.
A man who pretends to be
woman won Woman of the Year.
Cons- forever do my head in, 'cause that's
the point where you, you know, women had
fought for so long to, for s- to gain,
you know, employment, gainful employment.
You know, at that point,
that was in the early '50s.
You know, I think women had only been
able to have their own possessions in
the UK for about 80 years, and here
we have somebody going, "Oh, great.
Okay, I'll have that too, thanks.
Now that you're allowed to have
things, I'll grab that from you.
Cheers for that."
And then, uh, yeah, so Janice Raymond,
she was the first one to really
spot the problems with how these
men were taking things from women.
Stephanie: And that was back in the '50s?
Tamara: No, that was in
1979, so a little bit later.
And Thomas Szasz, the psychiatrist who was
very influential, as a lot of therapists
will know, in the anti-psychiatry
movement, you know, he was very clear.
No, th- they're not changing sex.
You know, these are, are euphemisms to…
It's an abuse of language, you know?
Uh, and the language itself, Janice
Raymond even pointed out that, you know,
to call somebody a transsexual, it hides
the medical establishment, and it's im-
and they're im- and they're part in it.
Th- they're placing all the issues within
the psychology of the person that is, um,
claiming to change sex rather than the
medical industry that has, um, promoted
the lie that it's possible to change sex.
You know?
The, it's very, very insidious.
It's a very, you know,
it's abuse dynamics.
You know, the difference between somebody
abusing who's just hiding the abuse in the
abused and going, "Well, they wanted it,
so, you know, I had to give it to them."
It's just terrible thing that they did.
But anyway, um, so then Paul McHugh had
taken over the, the Johns Hopkins medical
clinic, um, the gender clinic there.
And, uh, no, he'd taken over the American
Psychiatry Association, sorry about that,
in 1979, and he closed down the clinic
which was started there with John Money.
And John Money, of course, being that
very controversial psychiatrist, uh,
that he believed that if you You know,
you can address, you know, bodily
issues with a psychological solution.
And that was the experiment
that he did on the Reimer twins,
which was a complete disaster.
You know, because he caught…
You know, one of the, the Reimer
twins had his penis cauterized, um,
in a botched circumcision operation.
Um, then, uh, he said, "That's all right.
Bring him up as a, a girl.
It'll be fine."
And you know, believing
that, you know, these are…
this wouldn't be an issue or problem.
And of course, eventually he committed
suicide, but not after going on Oprah.
So these are, uh, you know, and that
already you have this trail of how these
really problematic ideas have sort of
like twisted and turned all the way along.
Um, and it's those in positions of power
that have been facilitating it, that have
never, ever been held to account for it.
Thankfully in 1979, the, you know,
because of, um, Paul McHugh, um,
gaining- becoming the head of the
American Psychiatric Association, and
Janice Raymond's, um, work together
with the evidence that this, these,
uh, interventions don't help somebody.
Because the psychological issues that
they are bringing, you know, the reason,
the thing that they're fleeing from
in the first place is never resolved.
So, you know, these people are offering
this false hope, this illusion.
Now, this is the, the
solution to your problem.
And so these people kinda
latch onto it and go, "Great!"
you know.
"Let's have that and solve it."
But those original issues that, you
know, they were fleeing from in the first
place are still there, they still remain.
Which is what Paul Hugh-
McHugh identified…
Was it Paul McHugh?
Identified back in 1979.
And so they shut down, um, the clinics.
Um, unfortunately, yeah, a number
of them remained open, and,
uh, London being one of them.
Um, and you know, several in America too.
So instead of a kinda coordinated
worldwide effort that we kinda
went, "No, this is not acceptable.
This is not the way to do things."
Um, it con- kinda continued
to flourish in other places.
So now Harry Benjamin, um, you know,
he was, uh, uh, still promoting these
ideas and, um, he then connected
with John Money, and they used to
meet once a month on these things.
And he started the, uh, Harry
Benjamin, uh, what is it?
Gender…
God.
Stephanie: I forget what
the acronym stands for too.
Tamara: I know.
I- it's H asapBDIG.
I always know it as asapBDIG.
Harry…
Yeah.
Anyway, that one.
In, uh, 1977, and then he deci- you
know, he started specializing in these
people and, you know, scri- he had the…
With him and…
He adopted Norman Fiss'
gatekeeping approach.
Norman Fiss being a, uh, a
Stanford University professor.
And, um- They used his model, Norman
Fisk's model, in order to justify the
existence of Harry Benjamin, um, her
big deal, whereby it, it functioned as
sort of like a gatekeeping organization
where sort of only the most sort of hard
to reach, you know, the ones that were
really persistent, that kind of seemed
sane, that, you know, had to pretend
to be women and coerce their whole
family into accepting their delusion as
well, um, then they were the ones that
they said, "Okay, you know, then you
can go and do these, these surgeries,
have these procedures, and this will
turn you into the opposite sex."
Now, these days, of
course, we, you know…
Well, I say these days.
10, 20 years ago , the idea
that you could change sex.
You know, these operations I think
should've been shut down and more focus
been given to this prior to this point.
I genuinely think that it wasn't,
because a lot of the men that were
going for these surgeries were gay, and
this has been a huge stain, I think,
on gay history, that the rest of us
haven't supported the gay community
to fight back against these things.
And instead of i- these men accepting
just being gay, you know, ins- in
dealing with the homophobia, they just
went, "Okay, well, the way out of it
is to go and have these surgeries and
to be a transsexual, and then I can
be accepted in a heterosexual world."
And, you know, I have a lot of
sympathy for what these men must have
been going through at times, 'cause
it was a very homophobic period
when these surgeries were created.
And I h- have to say, at that time, it
was more pref- more preferable to pretend
to be the opposite sex than to be gay.
Well, you know, it wasn't…
When was it?
1967, I think, in the UK was when
it was finally, um, accepted,
and that was a part of…
Was it 1967?
Can't remember that
off the top of my head.
I might have my date wrong on that.
You know, homophobia at that
point was incredibly taboo.
So in order to be in the world, a
lot of gay men would pretend to be
the opposite sex, um, just so that
they could circumvent the police.
Um, you know, there was…
It was a common, a, a common theme.
So- But that doesn't account for the fact
that then, you know, there are a lot of
heterosexual men that would, you know,
develop sexual fetishes in relation to
women's clothing or, uh, the misogyny
associated and the bullying associated
with, you know, pretending to be women.
And so it's then sort of the conflation
of these two differing groups where
they got all mixed up and tied together.
Um, and the original heterosexual
transsexuals, they were-- or
transvestites even, you know,
they were very, very homophobic.
They didn't like, you know…
They were like, "No, no, no, we
don't-- we're-- we don't do that."
The-the-their magazines, you know, so
many of them, they're-they're-they're
talking about how they are so completely
separate from the gay rights movement.
And yet once the gay rights movement
started to sort of gain traction and
get more acceptance, then it was sort
of like, "Well, actually, no, no, no,
we are part of the gay rights movement."
So, uh, so, um, they sort of jumped
on the back of these sort of gay men
that had sort of slowly been accepted
and didn't have-- necessarily have to
pretend to be the opposite sex anymore.
But anyway, that's aside,
uh, some of the politics.
But these men coordinated, um,
different groups, um, the Beaumont
Society being one of the huge ones.
Um, and over time, they created Gires,
Press for Change, and they would go on
to become, uh, campaigning organizations,
uh, and try and ensure that laws were
changed, um, in order to facilitate this.
Any debate, you know, it's
just a mission creep for them.
They just want to shape the world, um, in
their image, which is a rejection of the
sexed body, which It's never gonna wash.
So they closed down a lot of
the gender clinics in 1979.
Um, and John- Johns Hopkins being one.
Uh, John Money, I think was, if I remember
correctly, was running it at the time.
And it, it sort of settled down.
The London clinic was still open, um,
as were some of the American ones.
And then as a result, it sort of slowly…
and this networked amount of men,
it slowly just sort of, the numbers
just started increasing over time.
And so that meant that by the time
the, the 1980s, the early '90s came
about, there were a lot more people.
And then you had, uh, the situation
like, uh, the Mitchfest Women's
Festival, where, uh, you know, some
of these men, these post-operative
transsexuals who, you know…
And then, oh, it's an…
There's so much to tell sometimes.
I need to slow down.
My brain did one of those twings where
it goes, "Oh, I wanna go this way.
I wanna go that way."
Stephanie: Happens to
me all day, every day.
You're doing great.
So what happened at Mitchfest?
Tamara: So what happened at Mitchfest
is that some of the former patients
of these psychiatrists and sexologists
that, you know, some of which had had
operations, had, uh, decided that because
they were now women, these men decided
that they were entitled to go and be a
part of the Mitchfest Women's Festival.
Of course-
A lot of women, particularly a lot
of lesbians, had a problem with that
because these men were demanding to
be included as being lesbians now.
And, uh, so a, a fight kind of en- en-
ensued, which is really interesting
because this is what these men do.
They kind of insert
themselves, demand something.
And then what was a, a united female
space where females were all united
around being female then got split,
divided by the females who were like,
"Okay, no, no, we believe these men are
women, so we have to include them in."
And, you know, the other
ones were like, "They're men.
We're not including them in."
You know, it's a classic divide
and conquer, um, sort of situation.
And so fights ensued, you know.
But eventually this, the women's
festival, Mitchfest Women's Festival
closed down precisely because of
this issue, but in two thou- 2015.
But this debate rolled on
and on and on for years.
Um, and a lot of the people that…
There's a, a great account of it by,
um, a woman on X called Hat Pin Woman.
Um, if anybody's interested in reading
about it in detail, she's done a
great historical analysis of it.
But this is what these men do.
They, you know, they demand to be
treated as women, so they take the,
the accolades, the Woman of the Year.
Then they sort of go, "Right, we
want to come into your space, so a,
a women's festival just for you."
Well, you know, men start going
into women's festivals, then it's
no longer a women's festival, is it?
One of the, the men involved in
that sort of camping, they called
it Camp Trans, out the front of the
Mitchfest Women's Festival, was a,
a man by the name of Ricky Wiltse.
And, uh, he was very much
connected with, uh, Mr.
Phyllis Frye and Then later on, Mr.
Martine Rothblatt, who, um, others
have documented as the being the
billionaire that many will know, um,
behind a lot of the funding today.
But back in the early '90s, he
was one of the ones that was
camped outside demanding to be in
women's Mitchfest Women's Festival.
They kinda cottoned on that, you know,
just doing these grassroots things is
not really the way to change things
and, and figured out that the way to
tackle it, to, to sort of force the
issue, was to go and campaign at the
American Psychiatric Association.
And so they were out there picketing.
Was it the American Psychiatric
Association or the American
Psychological Association?
I'm pretty sure it was the
American Psychiatric Association.
Anyway, they were out there picketing,
making the claims that, "No, no, no.
We're saying we know
exactly what we're doing.
You know, this is not…
There's nothing wrong with this.
You know, the, the…
Everything's normal.
This is great."
Those on the board of the American
Psychiatric Association, um, were
starting to listen to them a lot
more, such as, uh, Jack Dresner.
Uh, he was one of the ones that
would ended up interviewing, um,
Riki Wilchins in 2002, and which
all of this is documented in
all the various academic papers.
And, um, in it has Riki Wilchins',
you know, ideas of how no, you know,
this is a, a human rights issue.
Um, you know, he was the f- one of
the early ones that was claiming,
"No, it's our human rights to
pretend to be the opposite sex."
He wanted it included under human
rights framework, um, rather than…
So you can see this sort of gradual
shift from like, "Hey, this is
like a medical and psychological
issue," but, "No, no, no.
We, we…
Under our human rights, we, you
know, we're entitled to do this now."
Stephanie: Just so interesting the way
that you highlighted that moment in time
where they went from camping outside of
the lesbian music festival to, "No, no,
no, no, we gotta, we gotta aim higher.
We gotta go for the big fish.
We gotta … So what are we gonna do?
We're gonna set our sights on the APA."
Tamara: And they did it, and they
started lobbing them continually.
Um, uh, Jack Dresner init- initially said
to Riki Wilchins that, you know, "You're
better off trying to get the insurance
companies if you want change to…
you know, because you'll never
get the American Psychiatric
Association to change their position."
And yet, that's exactly what happened.
And Jack Dresner was a part of the team
that put through the changes in the DSM-5,
um, that accepted that, you know, this
was not a, a what, what they call it?
A, a sort of disorder or psychiatric
illness, um, and instead was some You
know, in order to remove the stigma from
it, they called it gender dysphoria, which
is a familiar term for everybody now.
Stephanie: Is this a good time to
turn towards the various DSM editions?
Tamara: It might be.
Mm-hmm.
Stephanie: All right.
Let's talk about that.
So for the non-therapists in the
audience, can you explain what the DSM
is and the different times that it's
been changed, some of what drives that?
Tamara: The DSM is the Diagnostic and
Statistic Manual that's created by the
American Psychiatric Association that
has, since its inception, been very
controversial, um, because it diagnoses
what it believes are psychological issues.
Um, and It's based upon a, a
medical model of diagnosis, which,
uh, you know, in psychology and
psychiatry and psychotherapy, uh,
part of what we've all been fighting
about since then has been whether
something is biological and medically
founded or if it's something else.
Um, and of course, being a
psychotherapist, I'm more of
a, "No, it's something else."
You know, there are psychological issues
going on, whereas the psychiatrists,
uh, have been traditionally more focused
on everything being sort of biological
in some way, whether it's in the
brain or it's the body or something.
Um, and so hence why the Diagnostic
and Statistical Manual has a very
medical, um, bias and framework on it.
So these psychological issues
would then be diagnosed using this
medical framework, and the DSM…
I can't off the top of my head,
I'll have to look it up, the
various changes of the iterations.
It changed from, you know, starting
off as sort of, um, you know,
transsexualism, and then they
sort of went, "No, we're gonna…"
John Money and Richard Green sort of put
in a gender identity disorder, and then
they changed that to gender dysphoria.
And when they did this, when they
eliminated the, the sort of like the
difference between an adult and a
child, this new term encapsulated both
adults and children as having the same
psychological condition called gender
dysphoria, and that was done in the DSM-5.
But the iterations had been going
on prior to that point, where they
were kind of getting rid of…
It was just, if you track it through, you
know, the softening in the language and
the blurring of the boundaries between
the two is really apparent, and I think
it was a really-- it's one of the worst
things in history that the American
Psychiatric Association ever did when it
removed the distinction between adults
and children, 'cause this is a failure of
child safeguarding in the highest order.
Stephanie: Let me add for context that
another aspect of the tension between
the medical model and the way that
especially existential and psychodynamic
therapists tend to think about this
issue, well, on family, family systems
therapists especially as well, is That
there is the struggle for legitimacy,
and then there's the struggle for
insurance coverage and reimbursement.
So many therapists can absolutely
sympathize with patients'
desires to have their insurance
cover their services, right?
We are also patients, and we would
also rather pay a $20 copay than a $200
out-of-pocket rate for our own services.
So that's a completely
understandable dilemma.
I'm speaking as an American therapist.
I'm not sure how it's different in the
UK, but that's, that's a big piece of
what it is here, is that in order to
be taken seriously, especially when
it comes to insurance reimbursement,
insurance reimbursement is always about,
um, procedure codes, diagnostic codes.
Things have to be labeled and
quantified in a certain way.
There has to be a diagnosis
and a treatment plan, and the
treatment has to fit the diagnosis.
And so a lot of the role that a, that the
DSM plays is in codifying all of that.
And so it really is a double-edged sword
for a therapist because on the one hand
it grants us this legitimacy, it grants us
this ability to bill patients' insurances.
And at my previous job before I went
into private practice, we were contracted
with as, as many insurance panels as
we could get with, and that allowed
us to treat all kinds of patients.
You know, working class people who
would not be seeing a therapist if
it cost $200 an hour, but who can
utilize their in-network benefits.
That is such a big piece of the puzzle.
Um, and it also medicalizes these things
that are actually quite subjective,
that there are no biomarkers for.
You know, a lot of the discussion we'll
be having on future episodes about the
American Psychological Association has
to do with this side of things as well.
Um, like my friend Sowad Abrewy, who's
doing some great work exposing the APA,
argues that, you know, th- we don't have
any official diagnostic markers of any
of these conditions, and furthermore,
if you go to 10 different therapists
telling them the exact same thing, you
will walk away with, well, at least
five different diagnoses, maybe not 10.
So that's a little bit of context
for, for listeners as well about
some of the politics behind this.
And so back to the DSM
changes, um, it was tw-
Tamara: Even before moving on, I just
wanna add to what you've just said
about that, is that- We, there's a lot
of people that think you need to get
rid of the DSM-5 or the DSM entirely,
and, you know, as you point out, you
know, there are reasons, economic
reasons why it exists, you know, in
order to track and measure things.
I think there are other reasons
that it should exist as well,
but not in its current form.
You know?
There are some psychological issues
that we need to be able to recognize
and in law, um, have a status.
We need to define them so that then when
they come up, we can then intervene.
Y- you know?
So if, um, you know, I think
Pyromania being a case in point.
You know, if somebody develops this,
you know, uncontrollable fetish or
pass- passion for f- you know, obsession
with, with fire, and he then becomes
or she becomes a problem or an issue
for the rest of us if they're going
around burning things, you know?
Now historically, if that person
gets diagnosed with something,
then, you know, under the…
You know, these are the, the industries
or the, uh, not the industries, the, the
frameworks that have been established that
give, um, permission for their detention,
either for their own safety or for the
safety of the general public as well.
And there are many issues
like this, you know?
Those with, um, really
problematic psychiatric issues.
You know, sometimes if they are really
violent, you know, we do need to have a
way of detaining them, and unfortunately
sometimes they need to be medicated.
They need to be sedated in order to
give them the space and the calm down.
There are huge debates as to whether this
is appropriate or not, and all of those
debates I think are perfectly valid.
The problem is at the moment because
of the censorship, we, we no longer
have them, and instead we have
soundbite debates on social media.
But a more, a proper debate needs to be
had about these very problematic issues.
And whilst the DSM has been effective
in managing some of these really
sort of extreme and problematic
people, it, it sort of encroached
over time onto more normal things
like, you know, just feeling sad or,
or anxious or grieving or something,
um, and needing a, a code for that.
And so that becomes a bit of a problem.
So I just wanted to add that in there.
Stephanie: On that note, when we talk
about things like how a diagnosis
affects how someone is treated legally
for their crimes, that gets into
the incentives and disincentives
for having various diagnoses.
And, and that really complicates things.
Whether it's, um…
I mean, there, there are a number of
ways that getting a diagnosis is not just
about having clarity about what's going
on with a person psychologically and what
they need, but it's also about how this
or that diagnosis can shape this or that
thing that they care about in their life.
Um, how having a diagnosis
can affect whether a person
is able to get life insurance.
Having a diagnosis can affect how a person
is treated by the judicial system or
how long they are hospitalized if they
are hospitalized against their will.
All of these kinds of things, uh
You know, what to speak of stigma,
what to speak of secondary gain
from diagnoses being popularized.
You know, uh, with the population I work
with, it's parents of trans-identified
youth who I coach, and so I get a lot
of, of pictures into those young people's
worlds, and I see some diagnosis shopping
according to what their friends have You
know, the more impressionable, the more…
The, the ones with dependent
personality traits, for example.
You know, suddenly my friend's on
lithium, so I wanna be on lithium.
My friend's on this, so I wanna…
Right?
And, like, it's obviously not that
straightforward because if, if someone
actually said and thought such things out
loud, it would be a little transparent,
but that's the underlying logic.
So I just wanna add that incentives
and disincentives piece makes it
really complicated, and patients
will put pressure on therapists, and
therapists are not good at saying
no . You know, patients will pressure
therapists: "I want this diagnosis.
I don't want that diagnosis."
Um, and, and it's, it's hard not to
be swayed by that, especially when
you know you have something like a
patient's medical record in your hand.
You have their potential future
insurance situation in their hand,
potential legal situation in your hands.
You, you almost feel guilty and
obligated to do what they want.
Tamara: Which reminds me of how
Riki Wilchins was arguing that,
um, they they didn't want the
diagnoses back in the day because
they couldn't get health insurance.
Because they had a psychological
condition, they couldn't get
health insurance, and so that's
why they wanted to eliminate the
diagnoses in the di- in the DSM.
Stephanie: And now it's the
exact opposite, isn't it?
It's, "I want the, I want the diagnosis
if the diagnosis is required for the
so-called treatment that I have in mind."
And you can get whiplash trying to
follow any individual's narrative,
what to speak of the collective
narrative about this, because one
moment it's, "Don't pathologize us.
You don't need a diagnosis.
Anyone who says they're trans is
trans, regardless of gender dysphoria."
Like, one moment that's the
narrative, and the next it's,
"This is a medical condition.
Treating our condition
is a human rights issue.
Treating our condition precisely the
way we say it should be treated," right?
Even though that goes against
longevity, against health span.
Yeah, there's a lot of politics here.
Tamara: There is a lot of
politics here, and I, and the…
I doubt, you know, we could sit
there and try and sort it out,
but I, I doubt we're gonna do it
today on, on one podcast, I think.
Stephanie: No, we're just naming some
considerations for our listeners to
chew on, and I'm sure that's plenty.
How do we get back to your narrative?
You were in the middle of
something, and we went on a tangent.
Tamara: So, um, where were we?
We were talking about how they were
lobbying, um, the American Psychiatric
Association, and then yeah, the American
Psychiatric Association caved in and,
uh, a change, instead of the insurance
codes changing, the psychiatric
conditions changed instead, and that
was when they wrote gender dysphoria
in because it was less stigmatizing.
Stephanie: Okay, so tell us
about that shift from, uh…
By, by the way, fun fact, I was
in grad school from 2010 to 2013.
And the DSM-5 was released in
2013, the year I graduated.
And so when I studied
psychopathology, it was…
We were working with the DSM-4,
and it was, "By the way, th-
the, all this is about to change.
And so you're, you're
gonna have to relearn it."
Um, and so I think anyone who went
to school around the same time
as me or right before Is still
habituated to thinking in s- in
terms of some things from the DSM-IV.
Like for example, uh, social communication
disorder was added in the DSM-5, right?
It went from having autism and Asperger's,
right, to autism spectrum disorder.
We take out Asperger's partly because of
the Nazi association there too, I guess.
Like, that's some of the
politics there as well.
And then their social- Mm-hmm
… communication disorder gets added.
I have not seen anyone adopt that.
I mean, every now and then.
I mean, here it is 13 years later
since the DSM-5 was published, and I
have not seen people diagnose social
communication disorder when it easily
might actually be the most fitting.
They're still diagnosing autism instead,
or they're not diagnosing at all, or
they're diagnosing social anxiety.
So there are some, some things I
think that have been slow to change.
I don't know if you've seen the
same or different from the UK.
Tamara: I'm in psychotherapy, so
I don't tend to track it so much.
Stephanie: Okay.
But tell us about that shift.
So, um, I was just giving that
context, uh, that little window
into my experience, right?
The, the DSM-5 came out in 2013, and this
is where we see the shift from DSM-IV's
so-called gender identity disorder,
and a distinction between adults and
children, to, uh, DSM-5 gender dysphoria.
Now, there is still a separate
section, right, children and
adolescents versus adults.
Those are separate sections in
the DSM-5, but some of, some of
the guardrails have broken down.
Uh, you say it's supposedly
less stigmatizing.
So tell us about that shift from
your perspective, because you
view that as one of the most
destructive things that's happened.
Tamara: If you're going to pretend
to be the opposite sex, you know,
that is already a lie, and it has been
documented through time that, you know,
these people that seeking out some of
these surgeries, that have been lied
to that these surgeries change sex.
Um, they also lie quite a lot in
order to access these surgeries.
So Norman Fisk, who created the term
gender s- dysphoria, had documented
back in the 1960s, I think it was,
how these people would, um, uh, kind
of, um, tell their families what to
say, um, in order for them to then
pass the test, the stringent test,
in order to, to get the surgery.
So they were coaching everybody.
You know, we'd probably use the
term grooming now, but that,
back then they were sort of
referring to it as, as coaching.
The idea that a male going for adult
psychosexual issues which he's trying
to escape from, and latching onto this
lie that, you know, the medical fa-
fraternity has offered as a solution.
The idea that what he's doing is the same
as a child experimenting with wearing
his mother's shoes is absurd But because
of a lot of these men, they do lie, and
they like to rec-con their history in
order to give the illusion that they've
been doing it since they were kids.
So they will sort of create this narrative
of being this adult, "Oh, I remember
doing this when I was a kid," in order
to give this idea that it's this sort
of one continuous, continuous, uh,
development from childhood into adulthood.
Now, in some respects, they may have
started messing around and playing with
different clothes at, at, at a young age.
And, you know, if puberty c- you know,
came on, then, you know, there are all
sorts of things that could be happening.
But the, the males that were retconning
their history then sort of helped to
create-- they push onto children the
idea that, you know, this, this, the
reason why an adult needs to do it is the
same as the reason why a child does it.
And this is what the, the change in
the DSM 5 in eliminating the dist-
distinction between adults and children,
uh, didn't do, didn't account for.
Um, so instead it gave the illusion
that it's just sort of this one
long developing arc when it's not.
Stephanie: So I presume part of
what you're talking about here
is sexual motives, um, as well as
Not saying that this is the
case for all of them, but, um,
more antisocial motives as well
Tamara: Stuff that's not about kind
of, you know, we were talking earlier
about not being accepted for being gay
or, you know, just having a, a fixation
on an- on a object or something.
This becomes something very
different, where it's sort of, um…
I tend to think of it more…
I think the psychoanalysts back in the
day, they, they were kinda onto something
when they referred to it as the, the
sadism and the masochism involved in it.
You know, there- that, that has
completely been lost in the dialogue
around these phenomena now, um,
and other really problematic
narratives have taken their place.
'Cause sadism and masochism at
least, they give you the words that
describe an abuse of inequality.
You know, you kinda let go of this one
person that has more power than the other
one, male and female, adult and child.
Whereas when you start using terms
instead like autogynephilia, it
eliminates those differentials.
Stephanie: Ah, okay.
So now we're starting to get into your
critique of the term autogynephilia, and
into some very important psychological
territory, because sad- sadism is real.
And, uh, and I agree that the, the
way things are worded in the DSM and
in much of the culture is kind of
whitewashed, um, and trans-identified
people are cast in the victim role.
So, um, there's, there's ignorance
of the aggression and some of
the, the other motives there.
Let's take a quick break, and when we
return, we'll get into that territory.
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Tamara, one of your most controversial
takes is that you disagree with the
use of the term autogynephilia to
describe what we use it to describe.
And that is a term I use,
um, just pragmatically.
It's a, it's a term a lotta
people are familiar with.
Um, so I haven't thought too deeply,
I suppose, about, about why not
use it or what else we could use
in its place, but this is something
you have put a lot of thought into.
So tell us why you disagree
with the use of the term.
Tamara: First of all, it, it doesn't
differentiate between adults and
children, um, which gives rise to the
concept that a child can, you know,
a- be an autogynephiliac in some way.
Um, and as we sort of have been
discussing, a lot of these men
like to create a history that
they're sorta helpless victims
that can't do anything about it.
What a great way to do that than by
claiming that there is a, a sexual
orientation that was established in
adolescence that they can't control.
Um, and, um, as a result, you
know, it's a sexual orientation
and, or, and/or a fetish.
Whatever they call it, an erotic
preference of sexual orientation, I
think, is what Anne Lawrence called it.
Um, Doc- Anne Lawrence, I
should point out, is a, a man.
Unfortunately, we have a lot of people
telling youngsters that they, you
know, if they have any adolescent
ideas about anything, that, you know,
a male sex drive at adolescence, it
goes hey- it goes ev- everywhere.
But it then kind of- they sort of impose
this meaning upon these things that
could be very innocent, very innocuous.
Um, you know, just like kind of a, a
child that's been bullied and thinks,
"Oh, I'd rather be a, a woman or
something, you know, then I wouldn't
get pic- picked on," or you know.
I remember one instance of a, a,
a guy, a, a, a young teenager who,
whose father would call him a sissy.
"Stop being a sissy."
And so then it was sort of like, "Well,
I'll go and be a sissy," you know?
And that can be empowering.
Um, and as a result, kind of
find sexual arousing over it.
You know, this then gonna gets
labeled as being autogynephilia,
rather than, um, looking at the
psychological issues that are going on.
And as we sort of mentioned before, the
problems with diagnostic categories, it-
particularly for psychological issues,
if you're telling somebody that they
have this thing that's embedded in, you
know, that is, um, got some foundation
in biology, for example, in particular,
then people are gonna sit there and
think they have no agency over it.
You know, they're going, "Okay,
you know, I have this thing.
It's called autogynephilia.
I can't do anything about it.
I've just gotta manage it."
This is really problematic,
um, particularly when you're
pushing it onto children.
So we've got adult men pushing
these adult concepts onto children.
I, before I go for- forward on this,
so I want to talk about the history
of the term and how it came about.
So it was develop- it was, um, uh, Ray
Blanchard is, uh, w- the sexologist who,
who coined the phrase, and, uh, he, he
decided that the previous terminology
was inadequate, and so he decided he was
going to follow the logic of pedophilia.
Pedophilia is the love of a
child To create this term, the
love of yourself as a woman.
So this is the, the ancient Greek
word translates to love of a child.
So his initial paper talked about how
he's, you know, he's basically following
pedophilic logic, treating people as
objects in order to create this term.
That's the other problem with the term.
It just treats people with ob- as objects.
You know, gay rights movement was
never about objectifying people.
Um, you know, it was very much
about working and building alongside
heterosexuality and going, "No,
we want our own, um, community.
We're not about, you know, being
psychopaths and objectifying
people," 'cause, you know, it's only
psychopaths who objectify people.
They were very keen on building their
own loving relationships and, uh, this
completely elim- eliminates all of
that by kind of going, "Oh, it's…
Yeah, I get aroused by the
idea of myself as a woman."
Like, as if woman is just an object but,
you know, this sexual attraction lands on.
It's just insane.
Anyway, so, so you've got the
pedophilic logic in there.
Um, and then it wasn't until
a couple of years after
Blanchard coi- coined the term.
You know, it was…
It never took off originally as
a term, and it wasn't until a man
who now goes by the name of Dr.
Anne Lawrence found it.
He was working, I think, as…
in the medical profession in some way at
the time, and he found it in some sort of
dusty corner of some library somewhere.
Had an a-ha moment and
kind of went, "That's it.
That's- that explains everything that
I- I'm- I've been thinking and feeling."
And then from there, he then
underwent and obtained these body
modification sur- surgeries to
pretend to be the opposite sex.
It wasn't until a male who wanted
to act out his psychosexual issues
found this and then took it on board.
He then started extensively promoting
it as a concept that the idea took off.
That in itself was really
problematic in my opinion.
Don't know about you.
Stephanie: Hmm.
Well, certainly if it's treated as a-
an immutable sexual orientation, and
if people who use that term are sort of
piggybacking off the gay rights movement.
We know, we know the trans rights
movement is predatory and, um,
parasitic by nature, um, in a way
that mirrors the typical parasitic
lifestyle of a person with, let's say,
narcissistic personality disorder.
So we see that connection.
And certainly, right, if autogynephilia as
a term is used in a way to argue that this
is, you know, I was born this way, right?
Rather than this is an indicator of
a part of me That has not developed
the capacity for mature, healthy love.
Um, and it's also strange
the philia part, right?
Because like you say with pedophilia,
I think, um, you know, the idea that
molesting a child is loving them, that
is, uh, obviously very faulty logic.
And so you make the distinction that, um,
th- it's not, it's not really about love,
it's about objectifying and dehumanizing,
um, someone else so that they become
used for this sort of sick gratification.
So, um You know, I definitely agree
that it would be preferable if the
terminology revealed the narcissistic
and antisocial qualities, um, that
are inherent in that way of thinking.
Because it's, um, even the concept
of love of the idea of oneself as
a woman, even that concept, it's
blatantly narcissistic, right?
Love of oneself, right?
The, the sexual desire being misplaced
from an I-thou relationship where
human sexuality at its peak is the
flourishing and ultimate fulfillment,
mature relational capacity.
Um, you know, o- obviously many,
many people in the world, including
many people who have nothing to do
with anything so-called trans, um,
have not reached their full potential
when it comes to mature love.
Um, and that's, that's
an ideal that I hold.
Uh, it's not the reality of the
world, but I, I still think it's
a- an ideal worth striving for.
Um, a world in which we, we're able
to love each other at the highest
level, in which sexual intimacy is
treated as the ultimate fulfillment
of that with one very special person.
You know, of course we fall short
of that ideal, but there is such a
selfishness, to say the least, um,
rooted in this sort of self-fixation.
And we, we do know, and have known
for some time, that there's tremendous
overlap between what is often called
autogynephilic behavior and narcissistic
and antisocial personality disorders.
We already know that.
Um, it's not popular to say it.
You know, then I think you were
also talking about that sadistic
element before the break as well.
Tamara: That's exactly where
I was gonna bring it in next.
That term, that saying it's love of
yourself as a woman and getting an a-
arousal from that, that hides that very
sadistic or masochistic, um, relationship
that's actually going on here.
'Cause men, you know, they, they
have often-- they get a kick out of
the, the exploiting the, the power
differential between men and women.
You know, that's why we're into
now talking about, you know, the
masochistic side of it would be the
things like, um, the sissification
fetishes, you know, where you're
being belittled and diminished on
the fact that you're being a woman.
The masoch- uh, that would
be the masochistic side.
You know, the sadistic is sort of when you
get to bully somebody by, uh, you know,
for example, pretending to be your wife.
You know, what a great way to bully
somebody is when you parrot them.
You know, kids sort of like when
they tease somebody, they just sort
of start mimicking them, don't they?
It's a, it's a bullying technique.
You know, and that can be arousing,
you know, for many men if they follow
it through and sort of succumb to it.
Stephanie: It's a really good point.
Tamara: And that term hides
both of those phenomena.
Stephanie: I think as a
society, m- and I'm not just
speaking about American society.
I s- I assume all, you know,
Western English-speaking countries
are fairly like this, that at this
particular point in time, the typical
sexual ethos is pretty libertarian.
Um, there's this, you know, uh,
f- consent is the bottom line.
It's the end-all be-all of mainstream
sexual morality, and it's, you know,
and it harm none, do as you will, right?
It's all about freedom and
who am I to tell someone else
what to do with their body?
Which, like, fair enough, as a principle.
I personally think that's an
incomplete sexual ethos, um- Agreed
to say the least.
But- I agree … but I'm just sort of
anchoring that at this point in time,
Western society has a libertarian sexual
ethos, and I think that is part of the
sort of fertile breeding ground for the
pathology here, is that the average person
who's a, a decent person who's part of the
culture and tuning into that libertarian
sexual ethos and just kind of going
along with it because they're agreeable
feels like, "Who am I to question?
Who am I to…"
I, I hate this saying, but I'm
gonna say it because that's what
it is, to yuck someone's yum.
For, for those who are just
listening, Tamara just rolled
her eyes really hard at that.
Tamara: That's Gayle Rubin.
So never quote Gayle Rubin at me.
Stephanie: Okay.
I don't know where these words come from.
I don't, I don't-
I don't know.
I'm just seeing the culture- … and
making my observations.
But I think that's, that's part of
what is being exploited in, like,
fair-minded, pro-social people is who
am I to tell someone else that they
shouldn't enjoy something if I can't
directly point out exactly concretely
how it's harming other people?
And then people like you and
I come along and we're like,
"Actually, it is harming people.
Here are the ways it's harming people."
But, you know, by then they're just so
far in that, that we're the bad guys.
Tamara: Yep, that is the problem.
And, you know, then you have situations
which is, you know, where, uh, I don't-
I've had clients come to me dealing
with issues as they're getting their
head around the fact that they have
strangled somebody in sex, and they
didn't feel comfortable doing it.
Uh, and, you know-- or the other one,
somebody-- a female has asked for it
thinking that that's the thing to do and
the, and the male's been uncomfortable
but feels like he can't say no.
You know, there's all sorts of,
you know, dynamics, problematic
dynamics that have come up by this
extreme libertarian point of view.
That's also been fueled by porn
as well, very largely I would
add in, um, where, you know, it,
it, it, it has no parameters.
And so it sort of, as Jo Bartosch
and Rob Jessel have said in their
book, Pornography, it sends mixed
messages to, to men particularly
that, you know, whatever y- because,
you know, you can watch anything
sexually on porn, and that's okay.
But then you go out in the real
world, and you're kind of, you
know, you're not allowed to do that.
It's, it's not consistent.
You know, there's- Uh, that's a problem.
Um, one of the things I wanted to go back
to with the autogynephilia conversation
though is that as I mentioned earlier,
we know that Norman Fisk even documented,
you know, that people would coach, um,
you know, their families, all sorts
of people on, on what to say in order
to, for them to, to access surgeries.
The autogynephilia narrative is a really
convenient one for, uh, you know, all
these people online to sort of like be, be
learning the same script from each other.
"I have this condition.
I-- this is what I've gotta
do in order to maintain it."
And, you know, when you've got Michael
Bailey and Kenneth Zucker, you know,
even identifying it as a route to medical
intervention, it's not very difficult to
see how that then becomes a coordinated
script in the back channels where they're
going, "If you just say this, then you can
get the hormones and surgery on insurance.
Even if you just want hormones
but don't want the surgery,
this is how you can do it."
Stephanie: I didn't realize the
term was being used in that way.
I think, um, I've seen it used more in
gender-critical spaces, whereas the--
most parents I talk to, their sons would
not use that term themselves, and if
the parents used the term, they-- the
sons would find it quite offensive.
So it's interesting to hear
about this other side of it.
Tamara: Whereas I'm a- I'm aware of,
you know, for- Reddit forums where
they're sort of talking about…
Y- you can see it.
It's the same script.
"Oh, yeah, you know, since
I had it as a kid, you know?
Started off doing with my sister's panties
or something, and then it, you know?"
And it's the same script that they all
keep ta- And when-- I've got a thing
where, I don't know, it must be a really
nerdy thing because when I sort of hear
the same script, I kinda go, "Hang on."
That's so similar to the
way somebody else said.
And not in a, in a personal way.
In a it hits the same markers
in a conversation kinda way, and
I'm like, "Oh, that's a script."
Stephanie: What language do you think
we ought to use instead to point to
this phenomenon, the male sexual fetish?
Tamara: Yeah.
I think going back to transvestic
fetishism, um, and pointing to that
is probably more accurate, um, 'cause
you-- the transvest- transvestitism
is the cross-dressing, um, and the
fetishist is when the compulsion
becomes obsessive You know, so that
distinction is a little bit more helpful.
But I'm not an ex-- I, you know,
I, I say I'm not an expert.
Um, I feel like I would like
more people to discuss this
properly, um, and to figure it out.
But that would be the, one of
the first places to propose.
But these terms, they
cannot include children.
They just cannot, 'cause then it's,
we're delving into pedophilic logic,
which is, again, you know, there are
now All sorts of pedophile advocacy
organizations claiming that pedophilia
is an innate sexual orientation, um,
and it comes in a childhood adolescence.
Children are not pedophiles.
You know, child-on-child sexual
assault is not pedophilia.
And they're claiming that if you are
a child, you know, sexually assaulting
another child, then you have pedophilia,
and this is, you know, something, a sexual
orientation that will stay with you.
It's very, very different.
Again, it's that adult logic pushing
it onto a child and to a child's
experience, and it doesn't account for
the difference, um, in, you know, y-
in philosophy, as you know, we call
it the epistemological standpoint.
You know?
They're very different.
Stephanie: I think a place where, where
we run into trouble is that those of us
who would advocate for child safeguarding
and for these kind of boundaries that
you're describing can easily end up
sounding like we're arguing that youth do
not experience any sexual desires until
they're adults, and that's not true.
We know that's not true.
We know that adolescence is a, a
powerful time of sexual and romantic
feelings, and this is really
uncomfortable territory to discuss.
It's unfortunate that so many young
people are finding the places that they
can go are the places with the worst
influences and, and the most inaccurate
depictions of sexuality as well.
Um, you know, for example, I've heard from
parents who say that their kid identifies
as asexual, and then they describe the
kind of media that their kid is consuming.
And I wanna say, if I grew up
consuming that same media, I would also
identify as asexual because I would
be so horrified and so creeped out.
And there are so many people discussing
and promoting and depicting sexuality
in ways that are actually very
unsexy, that are crude, that are
offensive to feminine sentiments.
Many of these girls do not recognize
how feminine they are because of
their internalized misogyny, their
devaluation of their own feminine traits.
They identify as boys.
They do not recognize how feminine
they are in, in ways that I think
are perfectly wonderful and natural,
and that includes their sexuality.
Um, you know, if you compare, like, '90s
TV shows versus 2020s TV shows depicting
adolescents and young adults navigating
crushes and dating and things like that,
I, I've been watching these side by side,
and in the '90s it was much more following
the pace of your typical adolescent girl
developing intense romantic feelings,
and there's the crush and the long
drawn-out will they, won't they, and
oh my goodness, did he look my way?
Are we gonna hold hands?
Are we gonna kiss one day?
Um, versus 2020s depiction of
sexuality in the media is so
unrealistic to female nature.
Now, it might be realistic to
what's actually happening on college
campuses with the hookup culture,
but the ways that the girls and
women are depicted as reacting
emotionally to that is so unrealistic,
because they're acting like guys.
They're not acting like the way that girls
are actually affected psychologically
when they're having casual sex.
So, I just think that the messages are so
screwed up that young people are finding.
A lot of these girls, another thing, and
I'm just gonna touch on it briefly, is,
like, the, the anime and manga and the,
the femboy and the boy-on-boy depictions
that are sold to the adolescent girls
who think they're boys are ironically
very female-type relationships, right?
They're full of romance and sweetness
rather than just the kind of hookup
culture that is actually more found
in young gay men, um, even though
it's supposedly young gay men
that are being depicted in these,
like, comics and things like that.
So, so here's the thing, right?
Like, as adults, as healthy adults,
we naturally feel wary to broach
the subject of adolescent sexuality,
because heaven forbid we cross that line
into territory that imposes anything
on a young person or that reads as
pedophilic or anything like that, right?
So those who actually should be talking
about adolescent sexuality, right, those
who care, who want appropriate safeguards
in place, who understand the psychological
and rela- relational motives, are
hesitant to discuss adolescent sexuality
because we're the ones saying, "Protect
kids from pedophiles, from creeps on
the internet," and so we're not talking
about how adolescent sexually, sexuality
actually works, and then adolescents are
getting their messages about sexuality
from people who don't care about
safeguarding, who are interested in
grooming them and depicting things that
are designed to desensitize them to their,
their innate feelings and responses.
Tamara: I agree that, um, I probably
take issue with the adolescent
sexuality framing, but, um, I agree
that there hasn't been, um, helpful
information provided and age-appropriate
information provided for any time.
What part do you take issue
Stephanie: with?
Tamara: Again, it's such a loose term.
It's like, you know, a child is under
18, and between 16 and 18 is when, you
know, we have age of consent rules.
Um, but they are all still children,
and sometimes adolescence, it
sort of blurs that boundary a bit.
Stephanie: I think we're d- I think we're
depicting the dilemma in real time, right?
Because your instinct as a responsible and
thoughtful person is to draw those lines.
And, and my- that's
exactly my point, right?
Is that if I say adolescent
sexuality, you go, "Hold on.
Wait a minute.
They're children."
Tamara: W- w- you know, what are we,
what are we defining here, you know?
Stephanie: We're defining adolescents
having Romantic and sexual curiosity,
interest, crushes, and feelings.
And, you know, to get into
uncomfortable territory,
adolescents can and do masturbate.
They can and do look at pornography.
They can and do get into relationships.
They can and do have underage sex
Tamara: On the pornography
issue, though, I would argue
that they have their attention
exploited by pornography because-
Stephanie: Oh, absolutely
…
Tamara: you know.
It, it's- Yeah … not that
they are into it so much.
But yeah, you know, it's, uh,
that's a big conversation.
I'm not sure that we've got…
I'm like, I'm
Stephanie: sitting here going- No,
we don't have time for that right
Tamara: now.
Stephanie: But I think, but I
think, I mean, the re- like, this
feels uncomfortable because it
should feel uncomfortable, right?
And it, and that's exactly what
I'm talking about, is that those…
the, the adults in the room who
are saying, "Protect children
from exposure to pornography,"
yes, yes, yes, yes, yes, right?
But at the same time, that is also a
factor, adolescents seeking to explore
their natural curiosity in exactly the
places that we would worry about most
Tamara: Which brings me to sort of going
back to some of the history of what's
happened, is that when social media came
about, um, in that sort of, what was it?
The late noughties, early
2010s, around that period.
A lot of, you know, youngsters were,
you know, accessing the internet.
You know, they were
encountering sexual content.
And one of the things that in my research
that really astounded me, there's a,
a paper called Tr- Tumblr Was a Trans
Technology, and that's quite a paper,
where it documents how the, um, adults
were on there sort of sharing, um,
their descent into medical addiction.
When, uh, the company got bought
out by Yahoo or- and the changes
leading up to that, they, uh, decided
to ban the transgender hashtag.
And so instead of So then, you know, the
transgender ha- hashtag would only be
available to adults, not to children.
But in order to get round that, they just
shortened it to trans, and that's how the,
the trans concept just sort of came about.
From that point,
everything was just trans.
There was no distinction between
transsexual and transgender.
It all just became trans.
Stephanie: You unearthed so many
fascinating nuggets in your research.
I'm aware of the time.
I'm-- and I'm thinking, like,
what feels most important?
I mean, of, uh, of course I'm drawn
to thinking about the future, like
where do we go from here, or what,
what perspective does all this
research and all this knowledge about
the past give us about the future?
But I also feel like we left many
kinda threads open and incomplete.
So what do you feel most drawn to?
Tamara: There's one more one I
wanna tell you about first, 'cause
there was some-- in 2012, Mr.
Janet Mock, M-O-C-K was his name,
um, and he started up the hashtag
on Twitter called Girls Like Us.
And, uh, then in 2013,
the-- he was invite-…
That hashtag went viral, by the way, and
that came to the attention of John Stryker
at the Arcus Foundation, um, who invited
him on the board the following year in
order to promote cross-sex impersonation.
So there's a lot of billionaires
that have been pushing this.
So this is not a bottom up sort of…
You know, it's not a, a grassroots,
um, thing that's emerged.
It's very much been pushed from the top
down, from the medical establishment
and from, you know, problematic
billionaires, um, going, "Yeah, yeah,
there's a lot of money to be made in this.
Let's go."
And this is a real problem when
it comes to children and child
protection as well, 'cause we're in
new territory here, particularly as,
you know, it's very difficult for
nation laws to be able to address that.
And this is what's so interesting
about the DSM-5, 'cause when, um…
I should mention that, um, uh,
going back to HBIGDA, so they, the
Harry Benjamin Gender Dysphoria
Association, that one, uh, they, uh…
In 2007, uh, the former
patients that, you know…
The organization was originally, um,
started up by the sexologists, and it was,
uh, the clinicians that handled it all.
In 2007, that organization was
taken over by one of their former
patients by the name of Ms.
Stephen Whittle, a, a British
woman who, um, takes cross-sex
hormones and presents as male.
At that point, the sexologists, the
psychiatric fraternity lost control of
the organization to their former patients,
and then they-- that organization
then changed its name to WPATH
And as a lot of people now know that
WPATH is the problematic organization
that has been de- discredited, um, by the
WPATH files, um, and things like that.
WPATH tried to lobby
the American Psychiatric
Association, um, for the DSM-5.
They failed, and instead they went over
and lobbied the World Health Organization
to change the ICD, which is what up--
'cause, uh, although the DSM-5 is
predominantly used in America, many other
nations around the world use the ICD,
International Classification of Diseases,
ICD-11, at the World Health Organization.
So now we've got these men have
infiltrated an international space
so- that bypasses nation laws.
This has not happened before.
Not, not, not like this.
Sorry, men and women.
I think I just said men, but at this point
we're talking about w- men and women.
It started off with men, but now
w- it's female enablers as well.
As far as how to address it goes,
unless it's addressed at that level,
this is going to keep rumbling on.
This is going to continue 'cause
the tap hasn't been turned off.
Stephanie: What's your
message to therapists?
I know you've advocated for therapists
pushing back against how this
is infiltrating our profession.
Tamara: Psychotherapy is in a unique
position compared to, um, psychologists
and psychiatrists, um, where we don't
have the same constraints, and we are
against the medical model, you know.
So we are-- we have always
stepped-- stood apart from it.
And so I do think psychotherapists have
a crucial role in pl- in putting pressure
on these organizations and, um, being
able to effect a change that perhaps
psychologists and psychiatrists can't.
Um, I would hope that psychiatrists
and psychologists would find a way
and, you know, I have every faith in
their ability to be able to do that.
But I think at the moment,
psychotherapists have more freedom to
be able to speak out about this than
some of the people that have kind of
relied u- upon this from the inside.
Stephanie: What do you think
psychotherapists can and should
do if it's within their personal
and professional capacity?
Tamara: I th- I think all of
us, everybody, psychotherapists,
psychologists, psychiatrists, should be
amending these at organizational levels
at the American Psychiatric Association
and at the World Health Organization.
Um, all of us need to be
addressing this collectively.
But I'd also like to hear other people's
ideas, um, on how to do this 'cause
I, you know, uh, this is, you know,
I can only document what's happened.
But how to move forward, you
know, that's something that needs
to be collectivized together.
I think the way that we should finish
it off is that we can change this.
You know, people feel like it's
insurmountable at the moment.
It's just 'cause it seems like there's
a lot of problems, but it is doable.
You know, there are ways through it.
What I would like to see happen is the
censorship in the professions, all of the
professions, to stop 'cause that is what's
really fueling a lot of the problems.
And I think that what these people
don't understand is, and they probably
hate me saying it, but a lot of
us are fighting for them as well.
It's like they're, they are struggling
with issues quite obviously, and
they've been failed as well, you
know, whether that be psychosexual
issues or family issues or, um,
you know, self-esteem issues.
You know, they have been failed by
our entire profession, and the failure
of leadership in our profession to
address it, um, by shutting down and
censoring is as much of a crime as what
the, you know, board of the American
Psychiatric Association did in my opinion.
'Cause that failure of leadership
then left everybody else
going, "Well, what do we do?
How do we do it?"
I think it's a matter of all of us
being more informed, getting back on the
boards of all of these organizations,
and stopping the censorship in the
publications, reclaiming all of the
entire industry, and in educating
and informing each other a lot
better and working together again.
I miss, I miss working
with other colleagues
In a broad spectrum way, you know?
I have my, my circle of
colleagues, but, you know.
Mm.
Instead it's the whole
industry is being siloed off.
"No, you're this way, you're that way."
It's like, no, we need to get
back to going have the civilized
debates and discussions.
Stephanie: I think that's
a wonderful message of
encouragement to other therapists.
Thank you so much.
Tamara Sears, British
psychotherapist, it's been a pleasure.
Um, where can people find you?
Tamara: So I'm on X, tamarasearsuk,
and on Substack as well, tamarasearsuk.
Stephanie: And, uh, is your
practice taking patients?
Tamara: Uh, I do take clients.
I'm a psychotherapist.
My website is, um, www.tamarasears.com.
Stephanie: Thank you
so much for joining me.
It's been a pleasure.
Tamara: Likewise.
Thank you.
Stephanie: Thank you for listening to
You Must Be Some Kind of Therapist.
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And of course, please remember,
podcasts are not therapy,
and I'm not your therapist.
Special thanks to Joey Pecoraro for
this awesome theme song, Half Awake,
and to Pods by Nick for production.
For help navigating the impact
of the gender craze on your
family, be sure to check out my
program for parents, ROGD Repair.
Any resource you heard mentioned
on this show, plus how to get in
touch with me, can all be found
in the notes and links below.
Rain or shine, I hope you will step
outside to breathe the air today.
In the words of Max Ehrmann, "With
all its sham, drudgery, and broken
dreams, it is still a beautiful world."