00:01:10.000We will not embrace the ideas that have destroyed countries, destroyed lives, and we are going to fight for freedom on campuses across the country.
00:02:01.000So, Dr. Blanchard, I have several questions, but I suppose one that I think you could help with as we begin here is that you seem to have you suggest that there are two different types of male to female transgenders.
00:02:16.000Can you describe what those types are?
00:02:19.000The one type, the type that most people think of when they think about gender identity disorders, are you could think of them as extremely effeminate homosexual males who've kind of gone the additional step and have made moves to obtain surgical and hormonal procedures that would allow them to present as the opposite biological sex.
00:02:45.000And that is what people think of when they think of transsexuals usually.
00:02:49.000The homosexual type of transsexual who is either starts out as an extremely feminine male or an extremely masculine female, and they just go the additional logical step, you might say.
00:03:04.000And that kind of makes sense to most people.
00:03:07.000The other type, however, which I think accounts for the majority of biological males who are now presenting as women are not homosexual at all.
00:03:18.000They start out as boys who are not observably effeminate.
00:03:23.000And they usually start out with either cross-dressing in their mother's clothes or sister's clothes or some clothing that they borrow or steal from somewhere, which is accompanied by sexual excitement and masturbation.
00:03:41.000I'll tell you what I call these types later, what I call the second type later, but I want to point out this is not just my brainstorm.
00:03:49.000Clinicians have been describing these different types of male to female transsexual, well, since the beginning of the 20th century, so over 100 years now.
00:04:00.000And I sort of basically gathered up all the previous clinical observations, systematized them, and gave a label to the relevant phenomenon.
00:04:11.000What I call this second type of transsexual is their autogynophiles.
00:04:16.000I know that word is unfamiliar to people.
00:04:55.000But, you know, I'm open to being proven wrong.
00:05:00.000I have no aspiration to control this line of research forever until the day I die and have final say on what people can or cannot conclude.
00:05:08.000But I personally think that the autogynophilic type of transsexualism doesn't really have an exact counterpart in biological females.
00:05:18.000So just curious about this, and I don't know the answer.
00:05:22.000You're using the term transsexual, not transgender.
00:05:27.000Can you just tell me, is there a difference or is it just kind of a more of a technical point that isn't that big of a difference?
00:05:34.000Well, nowadays, the definition of words changes like once a week.
00:05:39.000So who knows what the woke community approve as a terminology for transgender is transsexuals.
00:05:49.000Now, I use the word transsexual because I'm old and because nobody can stop me.
00:05:54.000And I think we could talk about a spectrum of gender dysphoria.
00:06:01.000There is a genuine spectrum of people who have occasional desires to be the opposite sex up to men who are troubled by this periodically until you get to the most extreme form of autogynophilia where people are just obsessing about wanting to be the opposite sex all the time.
00:06:22.000So for me, transsexualism is the most extreme degree of gender dysphoria.
00:06:28.000So let's define the terms, gender dysphoria.
00:06:31.000I got picketed and protested this last semester, doctor, because I said gender dysphoria.
00:06:46.000I would define it as, of course, this applies to both males and females, the desire to present as the opposite sex, the desire to be regarded by other people as the opposite sex and to be treated by other people as the opposite sex.
00:07:03.000And finally, the desire to have some or all of the anatomic features of the opposite sex.
00:07:25.000Oh, it's certainly not a new phenomenon.
00:07:28.000One of the most important sex researchers of all time, Magnus Hirschfeld, wrote about it in 1910.
00:07:36.000I think Klaf Debing had also mentioned a few cases that were obviously in this ballpark earlier than 1910.
00:07:44.000One of the first entire books about a post-operative transsexual was published around 1933.
00:07:51.000That was the book that the movie, what was it called, The Danish Girl, was based on.
00:07:57.000So people have known about this stuff for a long time.
00:08:00.000So the amount of young people that are, let's just say, identifying as trans or could be diagnosed with gender dysphoria is increasing.
00:08:11.000Do you think that there is a social component to this?
00:08:15.000Or I'm asking, is there a way where people that might have a pre a predisposition towards gender dysphoria can be prompted towards that line of thinking?
00:08:32.000What I've been talking about up to this point are what we might call the classical syndromes of gender dysphoria slash transsexualism.
00:08:42.000That is the homosexual type, which applies to both biological males and biological females, and the autocytophilic type, which applies only to biological males.
00:08:53.000The phenomenon you're bringing up, which has been called rapid onset gender dysphoria, and is predominant among teenagers, this is a new thing.
00:09:06.000And what I haven't, I've never worked with or done research on this phenomenon of these rapid onset gender dysphoria kids, but I certainly know people who have, such as Lisa Lippman.
00:09:22.000And my impression is that these kids are a mixed bag of some who would, who probably are the same type as the classical syndromes of gender dysphoria, plus a bunch of other kids who are a mixture of personality disorders and kids having adjustment disorders to adolescence, a lot of attention seeking,
00:09:46.000just a kind of mixed bag of personality disorders and adjustment problems.
00:09:58.000The community that attacks me, the trans activist community says it's how people naturally are.
00:10:03.000You're not allowed to ask that question.
00:10:05.000I would beg, I would just challenge it and say there's probably some social elements to this that are nudging people or encouraging people towards identifying towards that.
00:10:18.000If there's research to back it up, I'd be curious to have that.
00:10:22.000But it certainly seems as if the amount of, just, for example, in America, clinics that offer gender affirming care or what we would call, you know, medical intervention for 12 or 13, 14 year olds, there's hundreds, hundreds of these clinics, and only a couple existed 20 years ago.
00:10:40.000This is Charlie Kirk, and we're saving babies at pre-born.
00:11:42.000So, doctor, let me put forward a situation that is happening quite a lot.
00:11:48.000And I would like your expertise on how you think it should be handled.
00:11:50.000Let's say a 14-year-old starts to tell their parents that they're really a girl or they're really a boy.
00:11:58.000How should generally, with obvious understanding that there could be elements that need to be discovered in the process of treatment, but generally, how should that be handled?
00:12:07.000With hormone blockers, puberty blockers, or is there another proven way to be able to treat 14, 15, and 16-year-olds that might be wrestling with or struggling with gender dysphoria?
00:12:20.000Okay, what you've posed are actually two different questions.
00:12:23.000What I would do with regard to, let's say, 13 or 14, I think the first line of attack, clinically speaking, is to help a child or adolescent accept their anatomic sex and make a satisfactory adjustment to the body that they were born with.
00:12:43.000Only if that is a total failure, should anything else along the lines of transition be considered?
00:12:53.000Not that sex reassignment should be prohibited in all cases.
00:12:59.000I think it should be allowed for adults for whom every other form of treatment has proven unusable, useless, ineffective.
00:13:10.000But for kids, I think the first line of treatment should be try and adjust to the sex that you are.
00:13:17.000And the great majority of them who have cross-gender behavior from early childhood will end up as gay men or lesbian women.
00:13:27.000And I think that that outcome can be helped to be an ordinary gay man or lesbian woman as opposed to somebody who is dependent on medicine their whole life.
00:13:39.000I think it can be helped by appropriate treatment.
00:13:51.000No, I don't think that there is high-quality medical research to show that there are treatments that can be applied that will correct gender identity confusion in children or adolescents and automatically put them on a different path.
00:14:08.000I'd like to believe that that's how it works, but I think I'd be lying if I said, oh, yeah, we have all these great studies.
00:14:14.000Does the would the people that argue in favor of surgery and hormone blockers for 12, 13, 14 year olds?
00:14:21.000Do they have robust research peer-reviewed that supports their position?
00:14:27.000Well, peer-reviewed and robust are two different things.
00:14:30.000I mean, you can get peer reviewers who are sympathetic to the point that the submitting author wants to make and it'll sail by just fine.
00:14:41.000No, there isn't high-quality research.
00:14:44.000It's very, very difficult to do high-quality research in this area because, you know, if you don't give the patients what they want or what their parents want, they'll just go someplace else.
00:14:55.000You know, you're not in a situation where you can say, okay, tough for you, but you're going into the control group and this next patient who comes along is going to get early hormones.
00:15:06.000You can't do it because they'll just go someplace else.
00:15:09.000And so your earlier opinion is basically very heterodox against this idea of gender affirming care.
00:15:18.000Do you think that should be the standard operating procedure, if you will, to affirm one's identity?
00:15:25.000You've said it, you answered the question earlier, but let me ask it differently.
00:15:28.000How is it then without research backing it that that is now the predominant way of treating 14, 15, and 16 year olds with gender dysphoria?
00:15:38.000There are fashions in medicine and fashions in psychiatry as there are fashions in other areas of life.
00:15:46.000I mean, people are idealizing medicine if they think that everything that doctors do is based on some firm foundation of clinical research.
00:15:56.000Psychiatrists have gone off the deep end before with trendy ideas, like back in the day when, oh, what was it?
00:16:06.000Satanic ritual child abuse was all a thing.
00:16:11.000I forget the exact dates now, but for a while, you know, satanic ritual child abuse was everywhere.
00:16:18.000And there were a number of psychiatrists who bought into this.
00:16:21.000You know, just because a bunch of psychiatrists are presently endorsing a particular treatment doesn't really mean that that's the best possible treatment.
00:16:30.000Another example would be prefrontal lobotomies, for which the originator, I think, got a Nobel Prize.
00:16:54.000And people message me, Charlie, how do you get sleep?
00:16:56.000I sleep great because I get the magnesium I get.
00:16:59.000And look, unlike other magnesium supplements that might be giving you only one or two forms of magnesium, magnesium breakthrough contains all seven forms of magnesium designed to help calm your mind, help you fall asleep, stay asleep, and wake up refreshed.
00:17:13.000Over 75% of the population is magnesium deficient.
00:17:16.000And what most people don't know is that even if they're taking a magnesium supplement, they're deficient because they're not getting all seven forms.
00:17:23.000Not only does magnesium breakthrough help you sleep better, it also calms your mind and allows you to feel grounded and relaxed during the day and especially before bed.
00:18:56.000That's a very good question, because obviously in previous times, a lot of people did go untreated because they saw no options.
00:19:03.000I think that probably they just suffered through their lives.
00:19:07.000I mean, people, a lot of people have mental disorders that give them significant distress and probably damage their quality of life, damage it beyond what any of us would want to accept for ourselves or our families.
00:19:25.000So they hang in there and they get to the end of their lives.
00:19:28.000However, Sometimes they might, you know, like engage in surreptitious cross-dressing or other surreptitious activities as a kind of as a kind of release.
00:19:39.000But I think that they just got through as best they could.
00:19:43.000Once it became apparent that, or I shouldn't say once it became apparent, once the culture changed in such a way that it became thinkable for a grown man to leave his wife and children and pursue life as a female, then more of them began thinking about it as a possible alternative for themselves.
00:20:05.000And so you started this field, I think, in the 80s or 90s.
00:20:57.000I mean, I have been under, I've been constantly vilified online since 2003 when Mike, a professor at Northwestern named Michael Bailey published a book called The Man Who Would Be Queen, and he based a lot of the book on my work.
00:21:15.000He was viciously attacked by trans activists who tried everything to get him fired from his job at Northwestern.
00:21:23.000Nothing that bad happened to me, but since that, since the publication of that book, that was when my work got exposed in a major way to trans activists, and they weren't liking it at all.
00:21:35.000So as I said, I've been vilified constantly for the past 10 years.
00:21:40.000Just to kind of inform our audience, what do they attack you most on?
00:21:59.000Yeah, I'm going to answer that question, but I want to back up like three feet and say, what am I not being attacked for?
00:22:09.000I never had a blanket opposition to people undergoing hormonal or surgical sex reassignment.
00:22:15.000My position 30 years ago and my position now is that surgical and hormonal sex reassignment are the best treatment we have now for carefully selected adult patients for whom all other forms of treatment have been ineffective and who continue to be wretched.
00:22:37.000So I'm not being attacked because I opposed gender transition.
00:22:42.000I'm being attacked because of what I had to say about the nature of gender dysphoria.
00:22:49.000Activists resented two related points that I made and which I believe are absolutely true.
00:22:56.000One is that there is more than one type of transsexualism.
00:23:00.000Now, this is not an original thought with me.
00:23:03.000When I came to the field in 1980, there was a confusing plethora of different classification schemes for gender identity disorders.
00:23:14.000What my work consisted of was deciding which of these are basically different syndromes and which are superficial variants of one of the two basic syndromes.
00:23:26.000And that's where I got to the idea of in males, the homosexual type and the autogynophilic type.
00:23:32.000The trans activists hate, absolutely hate that I made a distinction between different types of transsexual males.
00:23:41.000I think, I mean, I'm trying to now get into their heads.
00:23:46.000I suspect that among the autogynophiles, there's a lot of envy of the homosexual type because they're more effortlessly feminine and they often pass better.
00:23:57.000So I think that's one possible reason why they don't like the distinction being made between homosexual male to females and autogynophilic male to females.
00:24:07.000So they hated my typology just because it was a typology.
00:24:12.000Related to that is the fact that I said, okay, gender identity disorder is not a sexual preference per se.
00:24:21.000Gender identity disorder is not a paraphilia.
00:24:24.000It's not a sexual deviation, but it's related to sexual deviations.
00:24:30.000Wherever there's a serious gender identity disorder, it's either preceded or accompanied by a sexual deviation, a paraphilia.
00:24:40.000So that the one group, the erotic anomaly, let's call it, is homosexuality.
00:24:47.000And for the other group, the erotic anomaly is autogynophilia.
00:24:51.000And they hated that because they wanted to think of gender identity as something that descends from the heavens, like the grace of God, and not as something that grows out of an erotic preference.
00:25:07.000So that's the other reason that they despise me because I said, no, gender dysphoria, transsexualism is not a sexual perversion, but it is a complication or something that develops out of an anomalous erotic preference.
00:25:27.000If I were, I would guess the reason why they find that objectionable, and you could correct me, is because then you're implying that treatment, not affirmation, actually is the first line to address it.
00:25:42.000Because the trans activists that I've dealt with, they never want, they want complete and total mandatory acceptance and affirmation of their own perception, right?
00:25:54.000Where the way that you're articulating it, it could be interpreted by them as saying, well, are you trying to tell me that you're going to want to talk to me about being anatomically consistent with my biological reality?
00:26:10.000Is that why they find that so objectionable?
00:26:11.000Because it seems like such a technical point, but when you think deeply about it, it's actually a big, big threat.
00:26:17.000They could call it conversion therapy or something of the sort.
00:26:26.000So it's possible to be correct, but incomplete.
00:26:30.000I think that the autogon, first place, the people bitching about autocynophilia are not the homosexual male to females, but the autogynophilic male to females.
00:26:41.000And I think there's two reasons why this bothers them.
00:26:45.000One is that, you know, it's important to their mental economy to think of themselves as being in some sense really women.
00:26:54.000And so they don't want anything said about themselves, which challenges their view of themselves as being in some essential mystical way really women.
00:27:05.000You have to remember these guys, some of them, have done some pretty drastic things in pursuit of this idea.
00:27:12.000Divorce wives whom they might have still actually loved, risked alienating children, who in many cases do become permanently alienated.
00:27:20.000So there's a lot of investment in this idea.
00:27:23.000I'm really just like any normal woman.
00:27:26.000And normal women don't usually talk about being sexually excited at the mere thought of being a woman.
00:27:34.000So then they don't like autogautophilia, number one, because it's inconsistent with their self-concept.
00:27:40.000Number two, and I think this is kind of realistic.
00:27:43.000You can sell the public on the Cinderella story of transsexualism.
00:27:48.000You had this poor, wretched little kid who everybody was mean and blah, blah, blah, blah.
00:27:53.000And then they grew up like the ugly duckling or Cinderella and they got to express their true selves.
00:27:59.000And all of a sudden, everything was wonderful because they got to be true to themselves.
00:28:04.000This is easy to sell to the general public.
00:28:12.000If it weren't a simple story, it wouldn't have been a popular story with children for 200 years.
00:28:17.000If you get into autogautophilia and you're not prejudiced against autogautophilic transsexuals, and I'm not, you know, but it's a much more complicated explanation.
00:28:27.000You have to explain, well, we have here this phenomenon which starts out looking very much like a paraphilia and is always accompanied by sexual excitement, but somehow over time, it changes its nature and it becomes more like an obsession that is present in the patient, even when the patient isn't sexually excited.
00:28:50.000So, you know, it's a less desirable way to sell transsexualism to the public than the Cinderella story of now that I'm true to my real self, everything's great.
00:29:02.000That's perfectly said because that is the talking point, is that it's true to my real self.
00:29:08.000And you're also introducing a variable that, well, you actually, it might not be as much an identity issue as it is, you actually are getting off on potentially sexually the idea of you cross-dressing or wearing female clothing or whatever.
00:29:26.000There's so many questions I hear, Doctor.
00:29:27.000And do you think some of these people that are suffering from gender dysphoria from your experience, are they sometimes suffering under other mental issues, depression, anxiety, schizophrenia, bipolar disorder?
00:29:44.000Or is that those things don't always come in combination together?
00:29:49.000Well, I think that, you know, what psychiatrists would call comorbidity, which means the presence of two or more psychiatric conditions at the same time, that applies to all sorts of psychiatric conditions.
00:30:00.000Anybody can have more than one psychiatric condition at the same time.
00:30:05.000Whether transsexuals have higher rates of other mental disorders, probably that's true among the ROGD adolescents.
00:30:16.000And we probably have more data on that than on other classes of patients.
00:30:24.000I want to play a piece of tape here from the Boston Children's Hospital and get your reaction, Dr. Blanchard.
00:30:32.000So most of the patients that we have in the GEMS clinic actually know their gender, usually around the age of puberty, but a good portion of children do know as early as seemingly from the womb.
00:30:41.000And they will usually express their gender identity as very young children.
00:30:45.000Some, as soon as they can talk, they might say phrases such as I'm a girl or I'm a boy or I'm going to be a woman or I'm going to be a mom.
00:31:13.000Now, I think I want to make it clear to you that child and adolescent gender disorders are not my specialty.
00:31:20.000At the hospital where I worked, there actually were two separate independent gender identity clinics, one for children and adolescents and one for adults.
00:31:28.000And they really didn't overlap that much in function.
00:31:33.000And so I'm always reluctant to comment in detail on gender identity disorders in children and how they should be treated.
00:31:43.000But I will say one thing because it's a general point and it applies perfectly to this business of early transition and early medical procedures for children and adolescents.
00:31:56.000Whenever you make a clinical decision, you can make a mistake.
00:32:03.000You can make a mistake and not give treatment to a patient who would have benefited from it, or you can give a treatment to a patient who is harmed by the treatment and would have done better without the treatment.
00:32:21.000Now, these two kinds of errors are not symmetrical in their negative consequences in terms of children.
00:32:31.000If you're confronted with a, let's say, I don't know, 12-year-old and you decide that you're going to argue against them transitioning.
00:32:43.000It could be that in reality, to some omniscient observer, to some God of the universe who knows everything, if that patient had been given help in transitioning, they would have done well and everything would have been fine.
00:32:59.000So there is that kind of error, but that kind of error can be corrected.
00:33:04.000If the patient doesn't transition at 12, well, they can transition at 16 or 18 or 21.
00:33:14.000Now let's consider the other kind of error.
00:33:16.000You have a 12-year-old whom you put on puberty blockers or for whom you recommend mastectomy or some other surgery at the earliest opportunity.
00:33:26.000And there are places that kids can get this quite young.
00:33:29.000And it turns out that that was an error in the opposite direction.
00:33:33.000This kid would have done better without surgery.
00:33:41.000So the two kinds of errors, the false positive and the false negative, are not equal with regard to the potential for disastrous consequences.
00:33:51.000That's why to me, you don't even have to know anything about gender dysphoric children specifically to be able to say, hmm, what are the kinds of clinical errors we can make here?
00:34:02.000And what are the consequences of the two different kinds of clinical errors?
00:34:05.000And I think anybody with their head screwed on would say, well, let's make the kind of error that can be corrected later and not the kind of error that is permanent and unfixable.
00:34:20.000I mean, if there's even a small percentage chance that you're wrong, you're doing irreversible damage.
00:34:26.000And I mean, I've met these people, doctor, of people that were 12, 13, 14 that were administered these drugs, and now they are 25, 26, 27, and they say, I don't feel the way I did when I was younger.