 So what does it mean to be a woman? Is there a fundamental biological script that we are overriding, or merely social expectations that we are shunning? Well, there is a God-awful confusion between sex and gender. Sex, we used to think of sex, we used to believe that sex is biologically determined by something called gametes, certain type of sex cells. We've honestly and firmly and sincerely believed until well into the 1960s that sex is exclusively determined by gametes, in a sexual differentiation process during the pregnancy, and that people are born either men or women, either male or female, I'm sorry. So sex is about being male or female. Today we know a lot more, and we know that about 2% of people are born with an indeterminate sex. We also know that hormonal cascades, hormonal developments in later life can absolutely change one's sexuality and psychosexuality, to the point that one has gender dysphoria, which is a bad name, a bad label, it should have been sex dysphoria. So we know that someone can be born as a man, but having been exposed to certain hormones in the womb and later on in life, etc., etc., he can definitely feel that he's a female, he's born male, but he can feel that he's a female and vice versa. So there is the concept of sex fluidity. Regrettably it is hyped beyond measure, but it does exist. I also see nothing wrong in adolescents experimenting with sexual identities. Sooner or later, all adolescents settle on a single sexual identity. Now this sexual identity can be punch sexuality, can be bisexuality, it doesn't have to be male or female. We have about, I think, 8 or 9 sexual identities nowadays, which are recognized and recognizable and documented in literature for thousands of years, by the way. So I don't see anything wrong in an adolescent experimenting. Actually, adolescents had always experimented with homoeroticism and homosexuality. Even in the 1940s, even in the 1920s, even in the 19th century, people, when boys were growing up, they were experimenting with homosexuality. It was a well-known documented phenomenon. So people experiment as adolescents and then they settle on a single, usually lifelong identity and there is type constancy after that. So sex is largely dependent and largely determined biologically on birth, but people can transition and there is sexual or sex fluidity. And in adolescence, it might even be a good idea to encourage people to explore the whole range until they can conveniently and safely and comfortably settle into a single sex kind of role. So this is sex. While sex in something like 90% of the cases is determined at birth and is stable across the lifespan, gender is a completely different thing. Now remember, sex is male-female. We have sex in all the animal kingdom, male and female. Well, all the advanced organisms have sex, definitely mammals have sex like male and female. Sexual reproduction is the favorite strategy in nature. If we ignore, for example, protozoa and microbes and so on, if we talk about evolved complex organisms, sexual reproduction is by far the favorite strategy of nature. We transfer genes, usually onwards, intergenerationally, using sexual reproduction. So this is sex. And one could say pretty safely that sex is fixed. At the margins, there are people who are fluid and they can transition from one sex to another, but sex is a pretty fixed thing. Not so gender. Sex is male-female. Gender is men-women. Men-women is a social-cultural construct. It has no foundation, no real strong foundation in biology. It so happens that people with vaginas were assigned the gender of women and people with penises were assigned the gender of men. But there is no biological foundation to decide that a specific gender role should forever be assigned to someone with a specific set of genitalia, or that a specific gender role should be universal across all periods of history in all societies, all cultures and all geographic regions. Actually, this is counterfactual. It's not true. Gender roles, there are like thousands of gender roles throughout history in various cultures, societies, periods, etc. Gender roles are inverted in northern Albania, which is a highly traditionalist and conservative country. There are women there who are considered to be men and treated as men. Gender roles are inverted in many, many tribes in Africa, in Latin America, in the Amazon, etc., etc. Many primitive early societies had inverted gender roles, including passages in the Bible. Gender is not a fixed thing. Gender is a social convention, essentially, and the outcome of upbringing. To start with, as Butler had noted, gender is performative. It's a performance. Gender is what men do, how they act, including in sex. Gender is what women do, how they act, their choices, including in sex. So sex underlies gender and kind of integrates with it in some way, but as a performance. When people grow up, they are being consistently told, girls don't do this, boys don't do this. This is the way you should behave, to be a man, to grow up and be a man. This is the set of actions, choices, decisions, body language, etc., that you should adopt. It's a stereotype, it's a role, and people are brought up to perform these roles. So gender is performative. Gender is also the outcome of socialization. Society wants us to perform specific roles. For example, there was a period in human history where society valued children very much, especially, for example, during the colonial times, when they needed surplus population to take over colonialism. So during that period, 17th, 18th, and 19th century, women were encouraged to stay at home, reproduce, and raise children. Society needed it. Men were encouraged to be disposed of and laden, aggressive, and so on, because society needed soldiers. Societal needs shape and determine gender roles. Today, for example, society needs women to be promiscuous. They need them to not have committed relationship. Society needs women to not have committed relationship. Society needs women to postpone, delay marriage, and not have children. Why? Because society wants women to be, to integrate in the workforce, to integrate in the workforce, and to become consumers. The overriding need of society today is to equate gender roles, to create a unique gender, where everyone, regardless of genitalia, is a consumer and a producer. Now, children get in the way of this. Family, families, marriages, committed relationships, intimacy, they get in the way of profits, and income, and consumption, and production, which are the ultimate values. They are the gods of today. They are the idols of today, money, the bottom line, profits. So these are the values of today. So gender roles today had shifted to reflect these social preferences. Similarly, gender roles reflect dominance, submission. Men are supposed to be dominant. Women are supposed to be submissive. Now, everyone in the monastery will tell you this is a natural and biological way of things. That's utter, unmitigated nonsense. In numerous species, it is the female who is super dominant, and the male who is submissive. There's nothing in nature that preordains this. Nothing in the biology of men and women determines who will be dominant and who will be submissive. Yes, men have higher muscle mass. They have more muscles. Women, by the way, are better adapted to post-modern society and its exigencies and demands. But men for a very long time, during the agricultural and early industrial revolution, men had leveraged their muscles to dominate society and exert control over women, subdu, subjugate, and submit them. But this is a historical accident. Had we started with the industrial revolution or the information revolution in ancient Babylon, we would have had a matriarchy. Men would have been nothing. They wouldn't be dominant. They would be submissive. And indeed, in many societies throughout history, there were matriarchies. Women were in control. They were dominant. In quite a few societies to this very day, women married multiple men. Today in the West, 43% of primary breadwinners, the providers, those who bring the bread home, those who bring the money home, they're women. 43%. And about half of all children are raised in single parent households, majority of which are women. So dominance and submission is a socially imposed interpretation of what it means to be a woman and an integral underlying foundation of gender roles. Then there is the issue of gendered personality. We are taught to become gendered. Part of our identity formation is our gender. It's not like you're an accountant. Your identity is not that you're an accountant. Your identity is that you are, I don't know, a man, a woman. So gender, masculine, feminine is an integral part of your identity, unlike, for example, your profession or your academic accomplishments or degrees or whatever. And so we are taught from an early age that this job, this job, it's a job of being a man, this job of being a woman, this job of being a father, this job of being a mother, this job of being a masculine, this job of being feminine. These are jobs. These are absolute jobs. We are taught that these are the only jobs that are part of our identity. If you later become a PhD, that's not part of your identity. If you become an accountant, that's not part of your identity. But if you are training to be a man, that's part of your identity. If you are about to become a mother, that is part of your identity. We took a set of jobs, a set of employment opportunities, a set of, and we made them, we made them a part of our identity. And they are not. They should not be. That you're a man or a woman should not be a part of your identity because that is a societal imposition in accordance with society's needs, not your needs. Now you may feel comfortable being a man or a woman. No problem with that. But just try to not feel comfortable and you will see the societal backlash against, for example, transgender transsexual people. So masculine and feminine are narratives, societal narratives, that tell you that you can't have a complete and whole identity if you don't have a gender. Even though a gender is total fiction. It's a job. And finally, there's the issue of boys and girls. We can't ignore the fact that women raise both boys and girls. Children, regardless of their genitalia, are raised by women. Now that creates, that creates an asymmetry in the way boys and girls are raised. Naturally, naturally women have more affinity to girls, even if they don't admit it, even if they are totally infatuated with their boys rather than their girls. It's still, studies have shown that women raise girls differently to the way that they raise boys. For example, they are much more emotionally open and empathetic with their girl children than they are with their boy children. Gradually boys are learned to separate from the mother, not only in a good way, but in some ways, in some dysfunctional ways, in some not so good ways. They learn, for example, boys learn, for example, that to express one's emotions is unmanly. Now men today are softer, they're more effeminate. In other words, they had adopted some elements of the feminine gender role. But still they're very averse to expressing emotions, crying in public, admitting to vulnerabilities. They're much more averse than women. There is a mountain of studies of this. And why are they averse? Because that's the way they had been brought up by their mothers. The mother broadcasts to the boy, to the boy child, the mother broadcasts, I'm much closer emotionally to my girl than to you. And the boy takes this on board and he understands that he shouldn't burden his mother and impose on her his emotions. Because she reserves her emotions to the girl, not to him as a boy. Now this has been documented and observed and actually it constitutes one of the arguments in modern feminism. And theoretically the presence of a male, the presence of a father should balance this, but he doesn't. He doesn't because women monopolize the formative years, zero to six, absolutely monopolize. Psychodynamically the father has an extremely limited function before the age of six. And this is the critical age where we get all the messages that tell us how to be, who to be. So our identity formation, these are the critical years. We become who we are. We have identity diffusion well into age 21. But the figments, the elements of our identity, we acquire these in the first formative years where mommy is in charge to the exclusion of daddy. And boys get a different treatment, bordering on discrimination. Even if they are loved and adored and admired, they're loved and adored and admired in a way different to girls. It could well be one of the main reasons for the current gender wars and the problems between men and women. This is my commentary on the questions. I wish to thank my client for raising them. I hope I provoked your thoughts as she had provoked mine. Thank you for listening. Men, women, males and females. During this forced vacation from my YouTube channel, what else can I contemplate but gender dysphoria, transgenders. And today we are going to discuss two topics, much shunned, much censored, much feared, much suppressed. The first one is the phenomenon of transgenderism. Is it a form of social contagion? Also, we are going to touch upon narcissism and how it may be connected to transgender phenomena. But first and foremost, is it communicable? Is it, as some conservative thinkers say, and some scholars, is society a social pressure, pure pressure? Is this a vector of transmission, so to speak, of transgender inclinations? That's the first question. And the second question is detransitioning. How widespread is it? And what does it teach us about the transgender phenomenon? First of all, before we proceed, I've been saying repeatedly in numerous videos, there is a huge difference between sex and gender. Sex is a sign that birth, and it's usually based on visible genitalia. It's a sign by the delivery in doctor. Gender is learned. It's acculturated. It's socialized. It's performative. That's why we call it gender role. People with specific sex organs, secondary or primary, can choose a gender which is non-conforming, a gender which does not conform to their genitalia or other sex parts. So gender and sex are two totally different issues. And here starts the major confusion. Gender dysphoria is actually very often about sex, not about gender, or not only about gender. It should have been called appropriately sex dysphoria, or sexual dysphoria, or something containing the word sex. But it's called gender dysphoria. It's been called gender dysphoria for like forever, for decades. And this created God-awful confusion. Both sexuality and gender are fluid. Even sex itself, which is supposedly a biological determinant, even that is fluid. It can be changed. But gender definitely is fluid. Gender roles. Sexual orientation is fluid, and very often changes over the lifespan. So there's a lot of fluidity and plasticity built into sexuality, gender, and even sex. And the confusion is so massive that we all stumble in the dark, talking at cross purposes, not being able to communicate meaningfully. And whenever communication fails us, whenever language breaks down, emotions erupt, especially negative affectivity, emotions such as anger, fear of the unknown. So today, I'm going to do my little best to contribute to throwing sunlight on some of the more convoluted and dark alleys of this debate, if you can call it debate. It's more like a skirmish or a squirrel. My name is Sam Vaknin. I'm the author of Malignant Self-Love, Narcissism, Revisited and Former and Current Professor of Psychology and Finance. Having dispensed with this, let's delve right in. Moira Shilaji, I hope I'm pronouncing her name correctly. Moira Shilaji is the President of the American Academy of Pediatrics, AAP. And she released no fewer than two statements, one on August 22nd last year, 2022. This statement was published in the Wall Street Journal of All Places. The other statement followed three days later on the 25th of August, 2022, and it was in the form of an AAP daily briefing. Presumably she was just trying to clarify the Wall Street Journal widely misunderstood statement that she had released. She was trying to clear the air because the debate has become vicious and pernicious and poisonous and aggressive to the point of violence and very often spilled into violence. And a lot of the debate revolves around the question or the issue of, is gender dysphoria a clinical entity? Is it a real thing? Is it a true condition similar, let's say, to cancer or tuberculosis or schizophrenia? Is it a disorder? Or is it just a choice? Is it a lifestyle or is it dictated by biology? And what's the contribution of biology? What about society and culture? How do gender roles interact with underlying biological sex and how do the two put together create sexuality? None of these questions, believe it or not, have clear answers. So she referred to two papers and the two papers dealt with a very, very difficult, ornery question. Can gender dysphoria be learned? Is it mimicked? Is it the outcome of exposure to other gender dysphoric individuals? It's as if gender dysphoria was some kind of epidemic, contagion with an infectious agent, a pathogen. So the two papers were published, the first one was published in 2018. At the time there was a health expert working in Brown University and they hypothesized, they proposed the existence of a condition called rapid onset gender dysphoria, ROGD. The lead author, a woman, described rapid onset gender dysphoria as a social contagion, or at least one of the reasons for ROGD was supposed to have been social contagion. When the paper was published, it ignited a firestorm. There was criticism from every segment of the population, not the list of which from the transgender community. And of course immediately the paper was withdrawn and suppressed and censored and eliminated and burned at the stake and shredded, which is what many of you would like to do to me. Okay Shoshanim, was this paper published in 2018, was it supported by any research? The truth is not really, and the even bigger truth is, there's no research about transgender issues. The topic is so sensitive, is so politically incorrect or politically correct depending on which side of the walk movements you are, that academics stay away, they shy away from it. We don't have any data as to transgender phenomena, including surgical interventions, gender affirming care, nothing, we know nothing about any of this. We haven't followed up on people, we don't have outcomes, we don't have analysis, absolutely nothing. And that's because some of the findings may unsettle the transgender community, or may unsettle the conservative wing of the intellectual life in the United States, which is increasingly more vociferous and may I say unduly aggressive. Four years later, 2022, there was a second paper published in the August issue of Pediatrics. The authors of the paper attempted to test the hypothesis of rapid onset gender dysphoria. And more specifically, they tried to ascertain or to measure the possible social contagion. Now just to remind you, social contagion simply means if you're exposed to gender dysphoric people, you're more likely to become gender dysphoric yourself. This is the vector of social contagion. Now we have many, many phenomena which involve social contagion. Mob psychology is an example, the behavior of crowds. In many, many cases, we communicate behaviors to individuals via collectives, or via social structures and social institutions, including peers, for example. So 2022, the study was published. And it was more substantial than the 2018 paper. They checked the birth ratios between 2017 and 2019, the birth ratios of transgender diverse individuals to female sex at birth individuals. And the idea was to see if there is a decrease or an increase in adolescents who self-identify as transgender diverse. In short, they established a benchmark, how many people were assigned female sex at birth, and then they followed up on these people trying to see how many of them outed and declared themselves to be transgender diverse, how many adolescents identified as such. So the first thing they found, which is not surprising at all, is that people who identify as transgender or transgender diverse, they're subject to bullying, victimization, and the suicidality among these people, among these youth, is much higher when compared with cisgender peers. That came as no surprise to anyone. The authors concluded that actually their findings were, and I'm quoting, incongruent, incongruent, not supportive of the ROGD hypothesis. In other words, their findings did not show any social contagion. And the reasoning behind this was it is so difficult to be transgender. You pay such a high price socially, you're victimized, you're bullied, you're ridiculed, you're shunned. The price is so high that it's very unlikely that you will try to emulate or imitate someone who is gender dysphoric. On the very contrary, you will try to keep away. So this was the 2022 conclusion. So what can we make of these two studies, which seem to contradict each other? There is a general perception that there is an increase in prevalence of gender dysphoria. And this may be not entirely true. Perhaps the prevalence and incidence haven't changed, but what has changed is that people are more compassionate, more educated and more accepting. So it is less challenging to out yourself, to come out and acknowledge and admit and confess that your gender dysphoric, especially in youth among the young people. So are we, is the debate over? Can we now say safely that there is no social contagion? The transgender community and population, they feel very threatened by this idea of social contagion. Because if there is social contagion, and if it is considerable, then the whole transgender issue is nothing but a fad. It's a fashion. It's not real. It's not a clinical entity. It doesn't reflect any biological or psychological, true, veritable, verifiable processes. If on the other hand social contagion is very minimal, if at all, then we are talking about a real phenomenon. And unfortunately, there are no answers. We don't know. The samples are too small. The methodology is questioned and academics are afraid. They're terrified. They don't dare to touch this issue. We must study this. Because if gender dysphoria is social contagion, especially among peer-sensitive adolescents, in other lessons we know that peers are the main socialization agents. Peers teach you everything you know about sex. Peers exert pressure on sexual identity and sexual orientation and to a large extent form it. Peers have a huge role in gender formation, gender role formation and sexual identity. If there is social contagion, we can put a stop to it. And we should even put a stop to it. If, however, social contagion is minimal, one, two percent of the cases, then we should revert to the opposite pole. We should afford and we should provide gender-affirming care. We should help youth to transition because then transgender is a real phenomenon. And here's the breaking news. We don't know yet scientifically if gender dysphoria is a real thing. We have no studies, no rigorous studies at least, which support either side of the debate conclusively. And that is a shame and a disgrace in 2022. In the meantime, because there's such a paucity of studies, such a dearth of data, everyone and his dog has a stake in the debate. Psychology, psychiatry, psychoanalysts, medical doctors, transgender, their families, their friends, conservatives and liberals. Everyone is throwing his or her head into the ring and it's a melee. It's a mess. It's a wrestling match rather than an informed medical debate because it boils down to a medical issue. It involves not only the mind, it involves the body. We find, for example, a month ago, February 15, we find a series of announcements by Italian psychoanalysts and they oppose the use of puberty blockers for gender dysphoria. The debate started in January when the Italian Psychoanalytic Society issued a call to the Ministry of Health signed by the president, the president, Thanopoulos. Great name. I don't know what he's doing in Italy. Okay. So the document expressed, I quote, great concern about the use of drugs that block pubertal development of minors diagnosed with gender dysphoria. And then there was a list of warnings based on the idea that, and I'm quoting again, the ongoing trial circumvent careful scientific evaluation. And the document calls for rigorous discussion. I can't agree more. I fully agree. I agree with all these things. There's no serious scientific study of the issue and we need to become serious about it and we need to go rigorous. So what do we base today? What do we base our diagnosis on? There's no real science. There are no major studies. There are no big samples. There's no follow-up on what is happening to individuals having transition. What do we base all this on? Well, believe it or not, we base it on claims. People come and say that the agenda dysphoric and that's where it begins and that's where it ends. There's no way to carefully and critically evaluate social identity in progress. The document says, only a minority of children who state that they do not identify with the agenda confirm this statement after puberty. Suspending or preventing psychosexual development while waiting for the maturation and definition of the child's stable identity is in contradiction with the fact that this development is a central factor in the process of identity definition. That's a very convoluted and long way of saying children have no clue as to what their gender or sex is. End of story and quite true. We acquire this determinants of identity only in mid-adolescence, not earlier. So children can't make these decisions and can't report truthfully about their inner states because these inner states are in flux. They're not stable. They're not firm and they're definitely not lifelong. The statement by the Italian Psychoanalytic Society continued, even when the declared gender dysphoria in pre-puberty age is confirmed during adolescence, the developmental arrest won't result in a body that is different from a sexual point of view from the original one. The sexual development of the body, even when it contradicts the internal orientation, allows an erotic fulfillment that a blocked or manipulated body does not offer. So here it's more debatable. Many transgender people report that they're pretty happy with the new bodies they have. And this biological determinism, you're born with genitalia and the genitalia determine your gender and how you function in society and basically your fate. That belongs in the 1930s and 1940s. There's no place in post-modern society on the one hand. So it's not true to say that once gender orientation becomes clear to the individual in adolescence, transitioning to a different kind of body would be unsatisfactory. That's not true. That's not supported by anything. And the overwhelming vast majority of transgender people report exactly the opposite. And so a large number of professional social societies in Italy countermanded the letter of the Psychoanalytic Society and they published an open letter. So Italian Society of Endocrinology, the Italian Society of Pediatrics, so pediatric endocrinology, diabetology, andrology, sexology, pediatric psychiatry, national observatory of gender identity. Most of a host of societies and associations spring to the rescue kind of. And they confronted the Psychoanalytic Society and that included the Society of Psychiatry, National Order of Psychologists, et cetera, et cetera. And so they said the text describes the treatment with hypothalamic blockers in adolescence with gender dysphoria as an experimental treatment. But it is not. In fact, the therapy is approved in many countries in the world, Italy included. And there are very favorable opinions by bioethics committees all over the world. And so these Italian societies and associations of professionals, they wrote, such medical treatment is reserved for carefully selected cases following multidisciplinary and personalized evaluation. We agree that the scientific data available to date confirm the gender identity reaches stability only at pubertal age during adolescence and not in pre-pubertal age or in childhood. Therefore, as widely documented in international recommendations, hypothalamic blockers can be prescribed only when puberty is already underway, which is the way it should be all over the world, including in the United States. Transgender adolescents are very vulnerable. They have much higher rates of depression, anxiety, suicide risk, distress. It's a conflict between one's feeling of oneself, one's experience of oneself, and one's body in a way the body is perceived as a strange or alien or even as a traitor, there's a sense of betrayal sometimes. And these associations continued in their open letter to say, follow-up studies show that treatment with puberty blockers can significantly reduce behavioral and emotional problems and reduce suicidal risk as well as improve overall psychological functioning in adolescence. And so there's a debate not only in the United States, even in a way more traditional society like Italy. The psychoanalytic society of Italy is right in saying the following. I'm quoting, There are no rigorous carefully collected and independently controlled data, nor studies on the difference in terms of suicide between allegedly transgender kids who take the drug and those who do not. Dysphoria often coexist with mental disorders such as depression, eating disorders, or autism spectrum disorders. We need a differential diagnosis, but few people deal with it. That is the core of the problem. The problem is there is a surge of adolescents including sometimes children who claim that they don't feel gender-wise. There is a discrepancy between their gender roles as assigned by society mainly and their sex as determined by their genitalia at birth. And they would like to transition to create conformity, to create a strong association or correlation between equipment and its use or change the equipment, change the genitalia and other sex organs and so on and so forth in order to reach such a conformity. But so the problem is not this. There is clearly a phenomenon. The problem is we don't know enough. We have no information. We have no data about anything. Literally about anything. Is it socially communicable? What's the influence of peers? We never conducted a study with a control group. How about are there any biological determinants that can be identified? I don't know, hormones, something. Is there a correlation? Is there intergenerational transmission, for example? What's the effect of puberty blockers? There's no follow-up. Can you believe this? There's no follow-up that I'm aware of as to what happens to transgender people having undergone interventions and treatments. And so this debate is not going to end until we bravely tackle the issues that I've mentioned without fear and without censorship. And one of the main issues we need to study is something called detransitioning. Detransitioning is when transgender people regret the decisions they've made. Now if you dare to mention the word detransition or the word regret, meaning on any of the forums of transgender people, you will be castigated, chastised, drawn and quartered, burned, and your ashes spread on all five oceans of the globe. These words are taboo, forbidden, verboten, nichts, don't say them. It's as if there's no such thing. Transgender people essentially deny that there is such a thing. And the academic cohort that is, dare I say, financially invested in the transgender industry because it became a cottage industry. This academic cohort equally denies detransitioning, the very existence of detransitioning. But the truth is detransitioning exists. And there is a huge debate because there are no studies. Whether detransitioning constitutes 2% of the transgender population or is it closer to 35%? I refer you to studies by Dr. Kenan McKinnon. So transgender people, let's be clear. The majority of transgender people are happy, content and egocintonic with their decisions. But there are transgender people who have undergone interventions and treatments including surgical treatments and regret it and are unhappy about it. This phenomenon is real. It exists. People who have detransitioned or regret their decision to transition, they don't dare to speak out. They feel ashamed. They don't want to endanger the transgender community by providing weapons and arguments to the opposite side, to the conservative camp. So they keep mum, they keep quiet. They feel stupid. They feel that they've made the wrong decision and no one likes to own up to making wrong decisions. And so it's as if you're not allowed to speak about these experiences. People who detransition deserve the same supportive care as young people who wish to transition. Detransitioning can even happen because gender identity is fluid. I keep telling you, it's all in flux. And so we need to be compassionate about these people and we need to study them. Because studying detransition can shed light on the mechanics and the dynamics and the etiology of transitioning. In short, if we study why people regret transitioning, we're going to learn a lot about transitioning. The decision making that goes into transitioning, the emotions, the cognitions, the causation, what causes transitioning, the connectivity to gender and or sex, et cetera, et cetera. I think detransitioning is a rare opportunity to learn the truth about gender dysphoria, transgender phenomena, and so on and so forth. I don't think they should be shunned. Detransitioning is rare. They're not absolute figures, but many authorities say that it's something like 2%. And so these cases are perceived to be isolated and dangerous to the transgender community. So ideology and politics trump, excuse me for the word, trump science. Like you're not supposed to study because there's a campaign going on. There's an agenda here. There's a battle, a war, and you don't ask questions. You don't cast doubts when a war is going on. You're patriotic and you do your duty and you shut up. And that is, of course, very wrong. It's very wrong. Gender-affirming care is a necessity in my view only in late adolescence. Detransitioning is also a necessity. We need to be tolerant of a two-way street. Never mind how slack the traffic is either way. We need to allow people to make choices even after they have made choices. Transitioning shouldn't be a dead end, an irreversible course of action. Transitioning should never be irrevocable. And so we need to study this. And the shocking truth is, I know you're not going to believe me, but the shocking truth is, there are no large-scale studies tracking people who receive gender care as adolescents. None. There are no studies that ask adolescents who transition. Are you satisfied with your treatment now that you're much older? You receive gender-affirming care when you were 13 and then you went through interventions in your 20s and now that you're in your 40s, are you happy with it? Are you satisfied? Have you done the right thing? No one. They've been a series of studies and they had severe limitations. Some of them focused on people who received treatment as adults, not adolescents. Some followed patients for a short period of time. Others lost track of like 80% of the patients and so on and so forth. McKinnon says there's a real need for more long-term studies that track patients for five years or longer. Many detransitioners talk about feeling good during the first few years of the transition and after that they may experience regret. Dutch researchers reported the results of a study which supposedly is the biggest study ever. It was a study of transgender youths and they reviewed prescription drug records and so on. The Dutch found that 704 out of 720 adolescents who started on puberty blockers before taking hormones continued with the treatment after four years. 16 discontinued. So this sits well with the 2% rule, only 2% regret the decision. This also would indicate that we are not dealing with social contagion. If 98% of youth who transitioned and were treated received gender-affirming care were treated with puberty blockers and so on. If 98% of them are happy with their decisions, satisfied, continued treatment after four years, that couldn't be merely pure pressure or social contagion that reflects some real need, some real urgent desire to transition. And so regret is rare. No one says it's not rare, but even rare phenomena teaches a lot about the rule. Even small minorities edify us about the dynamics of majorities. So we need to study this. Dr. Malian van der Loes, which was the lead author of this study, she says it's important to have evidence-based medicine instead of expert opinion or just opinion at all. And she's right. Science is not about opinions. Science is reliable evidence. Frequencies, tests, control groups, what the heck is going on? How can such a much disputed, most hotly disputed area, ethical debate in modern life, ethical dilemma remain so virgin in terms of scientific studies? And they say we cannot, there's a clinical psychologist, Edwards Leeper, and he says we cannot carry on in this field that involves permanently changing young people's bodies if we don't fully understand what we are doing and learn from those we fail. We need to take responsibility as a medical and mental health community to see all the outcomes. Part of the problem is that de-transitioning is ill-defined, like many other things in sexuality, in the study of sexuality. De-transitioning for those who transition socially may be another changing name, preferred pronouns, dress, other forms of identity expression. So that's de-transitioning. For those who receive medical treatment, de-transitioning typically includes halting hormone therapy. So not all people who stop treatment, for example, report that they regret transition. So this is a complex phenomenon de-transitioning. We have to separate the emotional side from the executive side, decisions to stop receiving treatment from the social side. Some people just stop receiving hormone therapy when they've achieved certain physical changes with which they're comfortable. They go midway. Some are unhappy with the side effects of hormones. Some are unable to cope with long-standing social stigma and discrimination and so on and so forth. We need to go deep and first and foremost we need to create terminology, a dictionary common to everyone. We don't have an argument in physics about what is energy or what is a black hole. It should be the same here. There shouldn't be arguments about what is gender, what is dysphoria, what is de-transitioning. For example, patients who had their ovaries or testes removed no longer produce hormones that match the gender assigned at birth. And so what's happening with these people? We know that they have a medical price and so on and so forth. How do they perceive this medical price, side effects and so on? Are they angry? Are they happy? Is it worth it and so on? Early van den Buusche, an author of a study in Germany, says many respondents describe experiences of outright rejection from the LGBT plus spaces due to the decision to transition or to de-transition. So this intolerance should stop. On the one hand, the transgender community must open itself up and allow diversity and allow different voices to interact. On the other hand, science should take gender dysphoria a lot more seriously and study the phenomenon time and again, rigorously, until we finally can tell the world and the adolescents who seek our help. What the heck is going on? What is this entity that we are dealing with, clinical, biological, social, peer pressure? What? And what would happen to them statistically? Should they choose different courses of treatment? I know no other field in medicine so neglected, so infantile and so primitive after 40 years. It's a shame. Time to move on. Welcome back and thank you for joining us. This part of the show is where we look at mental health matters and all things to do with psychology. Stay with me because I'm just going to read out something that came out in the census. The transgender and non-binary people have been counted for the very first time in the 220-year history of the census for England and Wales. It revealed that 262,000 people identify as a gender different to their sex registered at birth. Now, the England and Wales census also recorded sexuality for the first time with 1.5 million people aged over 15 or 3.2%, identifying as gay or lesbian, bisexual or other sexual orientation. The charity Stonewall, which has long called for the inclusion of gender and sexual identity questions, described the results as an historic step. Canada has also recorded similar figures. Now, a lot of people, I have to say it's, I don't include myself in this, but a lot of people will be asking why is LGBTQ plus why is it so prominent? Why do we keep hearing about it? I've heard people on this station and callers into many other stations say, why do they seem to be so many LGBTQ or transgender or why is this such a thing at the moment? Well, one reason is because people feel that they can talk about it more easily. That's not to say there aren't significant barriers and discriminations, but that's one issue. Is there anything else into the equation? Well, this is a question of my next guess, I'm thrilled, thrilled, thrilled to have. I know he got a huge response last time he was on the show from Israel. Dr. Sam Vaknin, a professor of clinical psychology. Sam, welcome back. I mean, our last talk, I can't tell you how interesting was. Love it. Love it. So, gender wars and the emergence of a uni gender. As I said, I mean, so many people are saying, why is this a thing? What's going on? What is your take on this? This is part of a historical process. The two world wars created a shortage of males. And then capitalism has transitioned into a paradigm of eternal growth, constant growth, continuous growth, which required the introduction of women into the workforce and also as consumers. Of course, we only have 24 hours a day. And if you spend your time at the workplace and then spend even more of your time consuming, then you have less time left for family, intimacy, marriage, and so on so forth. And there has been a tectonic shift in the way genders interact and team up to reproduce and to perpetuate the species. This is one of the greatest revolutions in human history in my view. And the outcome was the emergence of what I call the uni gender. The uni gender is a sex genderless person, someone who identifies less with social constructs such as gender stereotypical male or stereotypical female and identify much more, for example, with a career or with a lifestyle or with a sexual preference or orientation, rather than with gender gender was an organizing principle. Gender is performative. It's a social construct. It's actually a script. It's a form of acting. And so now we have different other scripts. So studies by Lisa Wade and many other scholars are showing that women are defining themselves as masculine, while men didn't complete the transition from masculine to feminine. This is a very old distilled revolution. Women have become men, but men have remained men. End result, we haven't seen the end. So let me when you say that when you say that that's taking it away from the social construct of what a man does and who he is and what have you because before up until recently. We had all sorts of, as you say, a script for what men were identifying by what they did their jobs, their roles in the family, etc. and likewise with women. With the erosion of that with both sexes having, you know, with a lot of crossover. If you take yourself away from those constructs from those definitions like a man puts out the rubbish and doesn't what have you. You then become what floating between the two, because what I find is interesting in many African societies before colonialism before invasion and all this before slavery, because the tribe had to work together to get the harvest in. They couldn't, you know, one lot do one thing and one lot do another. Everyone had to work together. The constructs of of male and female that we have in the West that we recognize. They weren't like that. And so you had many quote unquote genderless people that you looked at and you couldn't I readily identify as being a male or a female because people enveloped both sides just to just so the tribe could exist. Then along comes faith and religion and what have you and says no men do this women do that. But it's something that existed centuries or you know hundreds of years ago. And you're saying now it's it's coming back if you like it's coming to the West. Yes, what's happening now is not that the genders are exchanging scripts. It's not a swapping of scripts. It's a conversion. Not on a single gender and the gender is masculine. Everyone is becoming masculine, regardless of genitalia. Now, the construct of gender had emerged originally when people began to create surplus wealth. So when we started to do capitalism and prior to industrialism and prior to urbanism, we had hunter gatherer societies. When we started when we transitioned to agriculture, following the agriculture revolution, we started to generate surpluses, surpluses accumulated as wealth, and you needed to you needed to transmit this wealth from one to the next. And to do so, you needed to control reproduction, you needed to be sure that your child is your child and not someone else's child. And to do to accomplish this certainty, you needed to imprison women, essentially to imprison women to sequestered. And this is when gender gender roles emerged, culminating in the Victorian era. And of course, the emphasis is is not so much on reproduction. There are numerous mechanisms for transmitting wealth. Everything is contractual scripts of fluid sex is fluid, etc, etc. So there's no need for the old constructs, such as family, such as marriage marriage that declined by 50%. That's 50% from 1990. And one of the institutions we're getting rid of is gender. However, it is very unfortunate that we have converged on a single gender that is toxic. Both women and men. Why? Why is it toxic? Because women have adopted a male role model, which is psychopathic, narcissistic, aggressive, bullying, disempathic. Women did not adopt a male role model, which is hardworking, altruistic, empathic, loving, compassionate, caring and protective. Women are emulating and imitating the worst conceivable men. And men are doing the same. So we have a toxic convergence. The uni gender is toxic. So why is that? Why is that? Is it because it's still seen as all of those negative values that you talk the narcissistic one, the aggressive ones are still seen as the tools of power? Is it because being male or being seen as being more male or having more quote unquote male qualities is seen as the path to having power and control? Men have not become more feminine. Men have remained stereotypically masculine, almost a caricature of masculinity. Women have transitioned to toxic masculinity rather than men. Men have remained stuck there. So we have a situation where everyone agrees that values such as ambition, callousness, ruthlessness, suppression of empathy, competitiveness, and so on and so forth, everyone agrees now. Men and women alike agree that this should be the guiding light. This should be the northern star of one's life. Today, two and a half times more people say that they would prefer a career to a relationship lifelong. 38% of people in the United States are lifelong singles by decision. So we have created a masculine world which is a caricature of what real healthy masculinity is. And then we have adhered to it male and female alike. And this is the unigender. It's a toxic, sick, pathological construct. Now what about gay men then? A lot of people would say that, and it's a generalization I know because, you know, but a lot of people would see very gay of you like very camp men. Let's say camp because, you know, you could be camp and not gay, but very camp men as having what we see as female qualities. Or is that just the guys? Is that a caricature of female qualities? Many women would tell you that the best thing that could happen is having a gay friend. Someone you can trust without the constraints of sexual expectations and even sexual assault. Because sexual assault is on the rise. Sexual practices are heavily influenced by pornography. And these practices have entered the daily sexual practice of the vast majority of young people under age 35. Sex today is a ritualized form of extreme aggression. There's nothing there anymore. Really? I mean, there are people like Andrew Tate. I don't know if you've heard about that influence as Andrew Tate. And then there's the incel, you know, the whole incel movement as well, which is women hating, feminine quality hating, if you like, and promotes violence against women and what have you. But I mean, many of us would see that as something that's fringe. But let's just come back to the previous point that when with gay or very camp men, then where do they lie in all of this? Do they not have more quote unquote feminine qualities or is that a guy's feminine and feminine and masculine, as I said, social constructs. So of course, a guy can be feminine. A guy can be feminine without being gay. Femininity is simply a set a list of traits and behaviors which denote, for example, enhanced empathy, caring and connectivity, rather than aggression and competitiveness, which are stereotypically masculine. But gay gay men aside, I don't see any other enclaves of femininity, even among women. And when I said that sex is ritualized aggression, regrettably, it's also among the gay community. Sex in general is becoming way more aggressive. For example, the incidence of choking on sexual dates has quintupled in the past 10 years alone. Anal sex had replaced vaginal sex as the main practice and anal sex is very painful to women. So there's an orgasm gap. Women experience orgasm six times less than men in most sexual encounters, which are not committed, which are not in committed relationships and so on and so forth. Sorry, Sam, just because we're talking in a day, we've got to be slightly less graphic. But do you think that's because of the rise of, and you mentioned pornography, and we talked on this show about many young people learning about sex through pornography. But coming back to the role of the roles of men and women and what you're saying about women becoming more, you know, taking up the negative qualities of being masculine. Is that the way you see it? That's the way it's going to go. That's the way it is. Is it a fad? Is it a tide? Or is it this is what's happening to humanity that we'll see more and more and more? It's interesting that I'm just thinking of apparently there are more when it comes to actually, and that's another issue about people who say I'm not born the sex that I am, if you like, and having, you know, changing their gender through surgery and what have you. There's quite a big increase. I know there is a big increase in women, at least if they don't go the whole way, but having their breasts removed. And there's quite a big increase between more so than women doing that than men, because it's so difficult to come from a position of male power, if you like, to, you know, transitioning to a woman. Because you may have the operation one, have you, but then your status, everything changes so much. So, you know, do you see this basically I'm asking just to finish up. Is this the way it's always going to be? Is this the beginning of a tide, or is it a trend? No, I think that's the way it's going to be. And I think this way is going to be for several reasons. One, women, men have, men have walked away. Men going their own way. Men have walked away. They refuse to accept responsibility, they refuse to commit, they refuse to invest. They refuse to form families. They refuse to engage in relationships and so on and so forth. In the absence of men, women have to be men. They have to fend off for themselves. They have to work hard. They have to make money. They have to attain financial independence. And they can't trust men to be there for them as they used to. This is point number one, point number two. Capitalism and the technologies, various technologies, encourage women and men to be atomized. They encourage them to be self-sufficient, to need no one and to interact with no one. Because there's a very simple trade-off. Any minute you give to your spouse, any minute you give to your boyfriend, any minute you give to your child is a minute taken away from Facebook and Twitter and Instagram. And so there is a built-in incentive for technologies and capitalism to destroy your intimacy and your human relationships because they take you away from them. Capitalism today is built on an unsustainable paradigm. It's built on the paradigm of eternal growth. And so for capitalistic societies to grow eternally, they need to generate consumption all the time. They need to interpolate you. They need to brainwash into consumption. Now, if you are a single and you work, then consumption becomes your religion and your anxiolytic, your anxiety-reducing activity. You consume in order to reduce or control anxiety. And this is precisely what capitalism wants, the current iteration of capitalism. So everyone is encouraged to live alone, to consume Netflix, to consume online, to not interact with other people because it takes away from profit. Everything is bottom-line oriented. And of course women play the game because it's the only game in town. And the irony is, this is a male game. It's not a female game. Third and fourth generation feminism sold out women to men because today women construct themselves to fit into a male world. They behave, they convert themselves into sexual objects for the male gaze and the male grasp and the male use. This is more of a male- There's a lot there, Sam. This is- I'm sorry, I'm just like, whoa, there's a lot, there's a lot there. And I'm sure, I mean, I'd love to discuss it even further. I know there's a lot there, a lot there. Sam, I hate to cut you short because it's very provocative what you're saying. And I'd love to go into it further. And indeed we must on another show, but unfortunately have run out of time. But wow, lots to think about. Sam, that's why I love talking with you because it makes smoke come out of people's ears and go away and consider things and at least think things through. So please, Sam, do come back and join us on a future show. Dr. Sam Vacnin, a professor of clinical psychology, and if that doesn't make you think, however you think about that, I'm sure you're all arguing about it somewhere in your household. And why have you, but at least we've made you think if that doesn't make you think nothing will. Dr. Sam Vacnin there on why he thinks that we've all come to one sex and it's not just about sex, it's about society, it's about consumerism and a whole lot of other things. Wow, lots to think about there. We're going to take a quick break and then we're going to come back to your phone calls and messages of which there have been lots back in a moment.