The Sean McDowell Show - Detransition: The Latest Research (and Inconvenient Truth)

Episode Date: April 16, 2024

What does the current research show about transition, transition regret, and detransition? Dr. Paul Rhodes Eddy discusses his in-depth study of the latest scientific findings, and also shares his insights for how to love people who are transgender. READ: Re-Thinking Transition (Paul Rhodes Eddy): https://shorturl.at/JQ347 WATCH: A Transgender Man's Journey with Scripture (Response): https://www.youtube.com/watch?v=asN7s5-f50Y *Get a MASTERS IN APOLOGETICS or SCIENCE AND RELIGION at BIOLA (https://bit.ly/3LdNqKf) *USE Discount Code [SMDCERTDISC] for $100 off the BIOLA APOLOGETICS CERTIFICATE program (https://bit.ly/3AzfPFM) *See our fully online UNDERGRAD DEGREE in Bible, Theology, and Apologetics: (https://bit.ly/448STKK) FOLLOW ME ON SOCIAL MEDIA: Twitter: https://twitter.com/Sean_McDowell TikTok: @sean_mcdowell Instagram: https://www.instagram.com/seanmcdowell/ Website: https://seanmcdowell.org

What does the research show about detransition? How many people genuinely regret gender transition? What are the strengths and weaknesses of current research? Our guest today, Professor Paul Rhodes-Eddy, is the author of a new study. It's available online. It's called Rethinking Transition. On a separate note, he's a co-author of a book called The Jesus Legend, one of my all-time favorite books on the historical Jesus. Paul, we'll come back to that study in due time, but this is a study you did with the Center for Faith, Sexuality, and Gender.

And although you and I both have philosophical and political and biblical ideas about this question, here you're really just looking at what does the academic research show? So I appreciate that professorial approach that you take. So really appreciate you coming on. We're going to dive right in. Let me just ask you a question. Before we look at the data, what is detransition? What do we even mean by it? Yeah, which is not an easy question all the time. And by the way, it's great to be with you, Sean. I think in order to answer the question, what is detransition, we have to take one step back and answer the question, what is transition? Because whatever transition is, detransition is in some

sense undoing that. So I'd say real broadly, transition simply means in some way, shape, or form, transitioning from one sex slash gender, and I often use that language in writing, to another one, which means that therefore detransition by definition is either halting or in some sense reversing a prior decision to transition. And so I guess that's the broadest category, I think, in which I think of it. That's really helpful. Now, in a moment, I want you to kind of flesh out some of the different kinds of detransitions that people experience. But tell me your own, your motivation, the reason you've studied this.

You have another book that you kind of compiled on this. What's your personal motivation and training that you kind of bring to this larger question of gender and sexuality? Right. Honestly, this started—I was a historical Jesus researcher, as you know. But then in 2008, the church where I serve as a teaching pastor asked me to rewrite our sexuality statement. And I realized within about 10 minutes I didn't know enough to do that. And so this has been really a journey for me of just learning about what I think the church is calling is to lean into a fresh examination of everything from biblical and theological implications

around sexuality all the way up to how we engage our culture in a Jesus-like fashion around these questions. How do we talk about these things? Well, the church hasn't done that in a great, doesn't have a great history on that. So it really comes out of almost a missiological hope that the church can do better at this time and place than maybe it has done for a lot of its history on this topic. I love that approach, and it's very similar to my interest in this topic. I had other topics I was covering but felt like the church is not doing this well. It's an issue in our day, and I don't know what I think about it. I've got to start researching it with a missiological focus.

So I suspected that was your reason for getting into it, but let's shift back to this report. I had no idea. The idea of detransition had so many levels. There's medical detransition. There's physical detransition. There's social detransition. You don't have to walk through all of them, but give us a sense of kind of just the plethora of different ways that people detransition, so to speak.

Right. And again, the multiple ways of detransitioning are all going to hinge to particular ways of transitioning in the first place. Got it. And so I think real simply, and you started to name some of these, I see the three basic categories of transition as social, medical, and legal. And so here we're talking about in terms of social, anything that would be an adjustment of one's public presentation of gender shifting to a different one than their prior one. And let me just say to Sean that language is very, very difficult on anything regarding sexuality, certainly on gender. And what I try to do is I try to find the context I'm talking in

and then try to use language that's germane to that context. That's tough when we're shifting between medical categories and sort of cultural, social categories. So I'll often use language of natal or birth sex, but also assigned sex, just depending on which context I'm in. But let's say we're talking about social transition. That might be a young natal or assigned male child who starts to suggest they don't feel as if they are a male and a parent might therefore start changing names, pronouns, hairstyle that's social transition okay um medical is the next stage that's where we're actually talking about hormone therapy uh surgical

procedures these sorts of things and finally legal would be taking the step of actual official documentation in some national context or state context to align one's presentation of gender with the actual official documentation. So in a sense, somebody could do one, they could just do social transition, but not medical or legal. They could do two or they could do all three, right? Exactly. Exactly. Okay. Now you start off in your book and you in, in this report and you give kind of a background on medical transition and how far back it goes. I had not really thought about that. So you don't have to give us the entire history. People can get the report and read it, but just give us some of the facts of when this started, how it shifted over time that might help us kind of place this

cultural moment that we're in. right yeah i mean honestly if we were to do a thorough history would have to talk about some ancient history because we know that there were some gender transition rituals in the ancient near east and we know that the third century the third century emperor actually had his physicians try to medically detransition him so this stuff goes way back in history in In terms of the contemporary context, though, several things had to happen before what we'd call modern medical transition was possible. Things like plastic surgery, things like hormone therapy. And so really this is a 20th century and on phenomenon.

I think we can say the very earliest gender medical transitions were happening. Probably we could say I put the year 20 or 1912 in Germany with Magnus Hirschfeld. This was a early sexologist who had an institute in Berlin and did some partial medical transitions. He wasn't able to reconstruct anything, but he was able to do removal of certain things. And within, well, actually, within 20 years, his institute was doing full-on reconstructive things. So 1931 is a big year. Three major surgical procedures for different people happened there, including the first uterine transplant surgery, 1931. Wow. That quite a ways. Jump ahead to the 1950s. I think it was December 1953, the New York Daily News announced that a

USGI from World War I had just become, in their words, a blonde bombshell. This was surgery over Europe. Europe was really the center for quite some time. 1965, the first United States gender clinic opens at Johns Hopkins University. That's where it starts in the U.S. And it's just increased really on up to today. That is so interesting. I was reading my wife last night. I'm like, look at this in the ancient Near East. This was happening in the early 1900s. It's obviously precipitated in our cultural moment for a range of different reasons. But to hear how long this has been going on is instructive and it's interesting. Now, this is kind of a side point in your study, but it caught my attention just because I've written on intelligent design. I study the history of ideas, but there's this little section in there in which you talk about how Darwinism sets the stage for the idea that a man can become a woman. Connect those dots

for us. Sure. There's a great book on this topic by Lawrence Birkin. But what he basically suggests is that Darwinian evolutionary theory and the components of it really set us up for this idea that human sexual, biological sex, let's use that category for a moment, isn't binary. That what it really is, is along a continuum. And this would be everything from Darwin's observation that early life forms don't reproduce by sexuality at all, they're asexual. Then all of a sudden there's the development of sexuality. There's comparative embryology where, you know, and this, we know this is true that, that our very early embryonic structures, both male and female were similar. It's, it's androgens, it's testosterone that starts making the differentials. And so those sorts of things as evolutionary development idea really sets the stage that fundamentally, uh, male and female aren't, aren't like opposites. They're just two ends of the spectrum that's so interesting

now this is a story carl truman tells in his story the rise and triumph of the modern self in his book and he walks through and he says there's this technological piece like you said the ability to do surgery the pill there's these cultural factors like entertainment and media but there's these history of ideas he really goes back to the 16 1700s that really come to climax so that's a different story people want to read that they can go to carl truman's work but i found it fascinating you incorporated that because you're right on darwinism there's not these fixed essences that we have it's something we refer to as essentialism today, which has become kind of a bad guy, so to speak, if you adopt a certain paradigm about sexuality. All right,

let's get back to your report. So you talk about how there's the first attempt at surgery and change, maybe in the ancient Near East east in the early 1900s but it seems that there's been a significant growth since the 90s how has this kind of hockey stick increased since the 90s and what do we see in that increase with children oh yeah yeah 90s was it was a crucial decade for for the transgender movement. It just was. I mentioned earlier that 1965 was the, actually 66, I think, was the first U.S. gender clinic

performing medical transitions. Through the 60s and 70s, those proliferated. I think there was over 20 U.S. gender clinics in university-based context by the end of the 1970s. For some reason, we could get into this, but a number of cultural reasons, the 1980s led to the end of many of those university-based gender cliques. It was just a more conservative decade than in the past. The 1990s, and I think things here are important, like the rise of the

internet, for sure, the rise of transgender studies as its own discipline in the academy. These things really allowed the transgender movement to kind of get a new ground for influence in our culture, for creating communities in online context as well as in person. And it was out of that, therefore, that a new awareness of gender dysphoria and transgender experience and identities just really began to grow. And so that began to really trend now towards, not surprisingly, more both people identifying as transgender and therefore more medical and social transitioning. In terms of young people, I know one research team that's argued that between 2004 and 2007, like these few years here, something very significant happened in the Western culture. So this is transnational. Think North Atlantic, at least.

There just became a significant spike in the number of children and adolescents reporting gender dysphoria. And so that phenomenon has only continued to increase since the first decade of the 21st century. I'll just give you an example. A recent, so it's about a 2016 study published in 2017, so 2016 data from the Minnesota Department of Education, surveyed over 80,000 ninth and 11th grade students in Minnesota and found that 2.7% of them reported some sort of transgender or gender diverse identity, 2.7. Just a stunning increase from past decades. More recently, 2021, so two years ago, I think it was Philadelphia, maybe it was Pittsburgh. I know it was in Pennsylvania. Again, school district study, 9.2% of the students on this study reported gender diverse identities. So just something as unprecedented is going on. The language that

researchers use are words like substantial, staggering, unprecedented. I mean, these are quotes right out of the literature. I would want to note that another interesting phenomenon is happening here. While children and adolescent numbers are increasing something else has happened and that is a sex ratio flip up until um 15 20 years ago the predominant number of children and adolescents reporting gender dysphoria were uh natal or assigned males today it's clearly dominantly natal or assigned females that's another interesting change that's transpired. And there's also a high percentage, at least when it comes to rapid onset gender dysphoria, of people with autism, isn't there? Autism connections to gender dysphoria are definitely

repeatedly shown in the literature. Absolutely. Why do you think more people are seeking gender transition today? And again, for those, if they just tuned in, we're not talking necessarily legal or medically. It could just be a social transition because one side of the narrative says, well, now that we talk about this more, there's just more permission for people who've always wrestled with this to finally express who they are. I think that's a piece of it, but I'm not convinced that's the whole reason why so many people are transitioning. I think what it means to be human, I think social media, I think there's all these other factors that are contributing to this, not just people getting permission to share who they always are. Do you have thoughts on some of the reasons why so many people are seeking transitions

today? Yeah, definitely. And I think you're right, Sean, you're pointing towards a multifactorial approach to this question. And I think we have to do that. In our politically polarized culture, there's this tendency to want to narrow the reasons down for this sort of thing. And not surprisingly, those reasons tend to align with people's political persuasions or worldview persuasions. And one of the, you mentioned this earlier, one of the real goals of my study was to try to push beyond the polarization and the culture war context this conversation so often takes place in, and to try to just put out the data of what I'm seeing as fairly and accurately as I can.

I'm sure I have my biases, but that was my goal. And so I was always looking for multifactorial answers to questions. Here's some of the answers I think that I would propose. Certainly the rising rates. No one can ask why the rates rising. I, you know, increasingly a phrase is being used in the literature around study on these topics, and it's biopsychosocial, a biopsychosocial model of how to approach these things. I love that. Because it's saying there's probably some biological stuff going on. There's probably some psychological stuff going on.

There's probably some sociological stuff going on. As a Christian, I don't want to add actually a fourth category. I don't want to add pneuma, psycho, social, bio. In other words, there's also some spiritual stuff going on as well. I think it's a holistic question. So I wouldn't be surprised, for example, if some of the things around both intersex statistics and gender identity statistics might have to do with biological dimensions, including some science argues chemicals in our world that are increasingly acting is kind of hormone mimickers now that might come out more

clearly at intersex conditions but others have argued that so for some people transgender identity isn't what one scientist puts it an intersex condition of the brain a lot of debater on that one today i'm not even sure why i stand on that but it's something that's in the literature we need to consider um i think you've mentioned uh some sociological stuff uh there is a in our culture today the predominant model uh to approach these things is the gender affirmative model. And with that comes a sort of default setting for assuming that this is sort of a baseline reality for people without a lot of social implications or social influences. You also mentioned rapid onset gender dysphoria. Other scholars have

argued, wait, we got to look at the possibility that social features like social media and other things, particularly for young people, could be an influential dimension to this. I don't know how we would avoid considering that thing. Here's some other things. Increase in insurance companies willing to financially underwrite these things. Financial problems or financial under-resourcing was a major reason people in the past 60s, 70s, 90s, 90s weren't able to access these things. So insurance is a big issue. Yeah, I mean, just there's so many different angles on this question when you start looking at it that arise arise i think arts and entertainment just the social norm normie of this uh is certainly becoming uh you know the 1940 2014 and 2015 were key years with um bruce uh caitlyn jenner phenomenon um and with laverne cox uh starring

in a major television show so these yeah just yeah, just a multidimensional answer to this question. I think that's really fair and helpful. And by the way, your study is very fair. You come across and you are an academic who's just looking at where the data leads. So when I read it, I start, I'm like, okay, I have my biases. I have my views and my beliefs and my narrative that I think is right, but I've got to bracket that and see where does the academic research actually lead. And we're going to get into that in a minute. One of the things he talked about is how far the technology is advancing in what's called a uterine transplantation so that a biologically or natally born male could potentially deliver a child.

Now, a couple of things surprised me. Number one, that I think you mentioned, I can't remember, the 30s or the 60s, people were doing this a long time ago or trying to do so. But even the idea that this would ever be possible is just alarming and surprising to me. As far as you know, where is that technology at? Yeah. So you're right. Again, it was 1931. Lily Albee, a Danish woman, underwent, a trans woman underwent the first uterine transplant that I'm aware of.

That was her final surgery and four surgeries. but she died of that surgery due to infection. And so there was never any chance to see what would happen. I think the first, as far as I'm aware, the first successful uterine transplant into a natal woman, and eventually a successful birth was 2015, so just eight years ago. By 2018, a number of gender researchers were saying this is now the pioneering frontier for transgender medical transition. I read one person who studies this area who surveyed a number of transgender, trans women asking the question, if you could have this surgery and give birth, would you be interested? And this person reported that around 50% of the people said yes. Wow.

So there's certainly a significant demand for pioneering research to be done in this area from the trans community. That's really interesting. I remember going to a... It was about 10 years ago, an event at Biola. The title was like, 10 Biotech Revolutions That'll Rock Your World. It was the idea of a completely artificial womb from the beginning, which would push viability back to conception, interestingly enough, but that's a separate issue. And the more I've studied it, it's still decades, decades off,

as far as I understand. Does it feel like people are talking about this, wanting this, there might be some demand for it, but the technology is still ways down the road. We're not going to hear something in six months of somebody who can take a biologically born male, have a uterine put inside and then deliver a child. No, I think you're right. The current people working on this are very clear that there are some anatomical challenges that have to be overcome before this is possible. And I haven't heard anyone say that they figure those out yet. So I overcome before this is possible. And I haven't

heard anyone say that they've figured those out yet. So I think that this is still a ways off. Okay. Very fair. Now we're about to get into some of the data, but tell me, so you're a pastor, you obviously come at this as a Christian with certain conservative theological ideas about sex and marriage, et cetera. What are your concerns about how this conversation is even taking place? We'll come back to academia, whether you trust a lot of this data or not. That's a separate one. But just culturally speaking, inside the church or outside, what's the concern about that? And how do you wish this conversation were taking place? Yeah, great question. Yeah, you've named the two areas of my concern. One is the wider cultural context, and then the second one

is how that context is impacting and impinging upon the church's conversation around these things. And the wider cultural context, and honestly because um at least in the us uh the church and culture have been so interwoven for so long it's hard to sometimes tease those two categories out um though as we enter an increasingly post-christendom world i think we'll have to do is the church make a distinction between culture and what we as god's ambassador people are called to be doing within our cultural context. At least that's my hope. My concern in the wider culture is this culture war context in which these conversations have begun to get wrapped up,

literally in particular political parties on one hand and the platforms but also on wider world view issues um you know issues are for so many sexuality is now the first thing you think of when you think of say human rights issues let's say and so now we're talking about world big worldview contracts like individualism uh and what what role and I want to distinguish the individual and the dignity of individuals, but individualism, when we isomize something, ideology emerges, right? And my concern that the individual is now sort of deified. I align myself with a gentleman named Schwetter and others who argue that there's three basic ethical pillars to human life in any culture you go to the divine the social collective and the individual

and personal okay in our culture i think that the divine and the social are largely being have been demoted to almost nothing in the dignifying and now deifying of the individual at the expense of the social and the divine. And I just, as a Christian, see that as seriously problematic. I want to hold on to the values of individualism because really good things have happened

with dignifying individuals, but we don't have to, I think, negate the social importance of community and certainly the fact that we are divined by a personal triune God who has purposes for things like our sex and our gender. creeping into the church is setting the table for conversation, even linguistically, linguistic vocabulary to limit things in ways that I don't think are healthy and certainly not serving a Christian perspective on this thing. That's really fair because this issue covers linguistic issues, and we're not going to debate this here, but do we use preferred pronouns or not? That's where language comes in.

My first concern is for the church. Second, for the wider culture. I don't always know how to navigate this. I really want to love my neighbor, care for people, meet them where they're at, but I have real issues in terms of certain gender ideology that's being promoted in culture that we also need a prophetic voice to resist as well.

And balancing that is easier said than done. Maybe we'll do a whole show on that at some point. How would you assess the detransition movement? So you've looked at this historically. Is it gaining steam? Is it growing? Are more detransitioners sharing their story? If so, why? How is that movement taking place? Because I think you see this from a different angle that I do, but it feels like we're hearing more stories. More people are speaking up. There are certain lawsuits now pushing back.

It seems like it's really growing from where I sit. Do you agree, disagree? What's your sense of the detransition movement? Yeah, I think you're right. I think it is growing. And my hazarding guess, I think it will only continue to grow in the years to come. So in this study, I looked at studies from 1960s up to today. 2022 was my last year.

And just per decade, looking at a range of representative studies in terms of things like transition regret, as well as what we now today call detransition. And just to summarize, although every decade and its major studies have suggested that most people who do transition do report some positive response to that, it is also the case that from the very beginning, early studies, like going right back to 1960s and the earliest studies that we have that are tracking folks who even in earlier decades, 1950s, were transitioning. How did things go? From the beginning, we've seen that for a segment of people, there is either regret and or transition, detransition for some reason. I think we are going, are seeing and are going to probably see increasing numbers because of some of the factors we've talked about. it just on a real base level the statistical level the more people that experience gender dysphoria transgender identity and medically transition just gives us a larger data pool from which a segment

are going to detransition so just numbers tells you that but i think also factors like this um we are now for the first time in a social context where young children are being socially transitioned. That was not a phenomenon widespread at all in the earlier decades. And studies have shown that when a child social transitions, it is statistically more likely that child will eventually medically transition. And so just the childhood dynamic, the childhood and adolescent dynamic, I think is going to lead to an increasing number of transitions and therefore detransitions. Add to that the fact that the detransition community is now finally being recognized now what i found in my research is that's been a hard-fought battle and it still is there's a significant sensibility among gender

affirming people that to highlight or acknowledge in a significant way the detransition community is going to be a negative boomerang effect on the transgender community um and that that's just the the conviction of a lot of people it's why frankly a lot of research is not being done on detransition today um but the research that is being done a little bit of it i've been able to find and i think it will increase by the way uh and certainly the detransition community itself suggests that there is a voice that is now being less muted uh youtube has been a real avenue for this um but finally researchers are starting to open pandora's box here and say we have to acknowledge this phenomena we actually have to study it. And I think as that research continues, we will see that in fact, this is not the very minor movement that has often been portrayed. I think the other piece of this, culturally speaking, is when you have voices like J.K. Rowling, you know, the writer of Harry Potter, who's not really talking about detransition,

but pushing back on certain gender ideology. And she's not a Christian, as far as I know, she's not conservative to the right, has power that gives permission for other people to just share their stories. And there seems to be a little bit of a snowball effect that's kind of growing and more people speaking out because of this that's maybe trickling into the academic community you know this is a separate conversation but it's interesting in one sense somebody who detransitions is a heretic of the larger lgbtq movement but we also have this phenomena of deconversion of Christians leaving their faith a lot of people have talked about. And comparing and contrasting how the church deals with this and how the LGBTQ community deals with this would be very, very interesting to compare and contrast.

If somebody's listening, do a doctoral dissertation. Tell us what you find. Now, let's jump back to your study uh tell us you hinted at this difference between transition regret and detransition where is the state of academic research on one or both of those what's the study starting to reveal now that more people are paying attention to this and studies have been coming out? Yeah. So in terms of detransition or transition regret, here we're talking about everything from someone who transitions and would say, generally say they're very thankful, but let's say they experienced medical complications or post-operative pain of some sorts.

In fact, the main causes of regret over the decades have basically been three things. Some medical complication, a less than satisfactory functional outcome of their particular surgical process, and a less than satisfactory aesthetic or appearance outcome. So those have been the three areas that seem in most studies to have precipitated people expressing some level of regret or wishing things had gone better. Sometimes regret leads to then someone saying, I regret this enough that I want to detransition back to the prior prior sex and so in terms of statistics on numbers you'll hear often in this area would be 1% to 1.5% maybe one study had a 2.2% regret rate.

Detransition rates in a lot of studies have often come in around 0.5 to 1%. Again, kind of depending what we mean by detransition. Are we talking complete physical? So there's so many subcategories. The statistics get very, very dicey on these. That's why I'm very leery of statistics until I see all of what goes into that particular statistic. That's fair. So let me flip this around. I think this might surprise some folks. You're saying if somewhere one to two and a half percent have regret that means 98 to 97 to 98 percent who transition in some

fashion don't at least express regret so that means the vast that number is thrown around a lot okay it comes from a particular the one the one to 1.5 comes from a particular study, I believe it was 1993. And I suggested that in my study that that was a pretty decent study at the time. But let's remember, if you're studying something in 1993, or if it's published in 1993, your data is certainly coming from earlier. And it was, that was a longitudinal study that was reaching way back, I think, to people transitioning in the 1960s. So it's like probably three decades of data. But here's the thing. Back in the 1960s and 70s and 80s, in order to transition, some things had to happen. You had to have a significantly clear medical diagnosis in order to have that happen. You had to go through

several psychiatric evaluations to make sure that your medical providers thought you could, you know, were up for this. You usually had to live, socially transition for a year in order to make sure. So there's a lot of sort of safeguards, you could say. The more we are moving in our culture, and this is another reason I think there will be an increasing number of e-transitions, is we are moving away from that sort of medical model of approaching things to what's called an informed consent model. Part of this is coming from a movement among trans activists to depathologize transgender identity. The argument is, if this is just who someone is, they shouldn't have to jump through medical hoops in order to be able to access medical transition. Just let them know the data and they make an informed consent-based decision.

Well, not surprisingly, when you lighten up on requirements, that quite likely will lead to an increasing number of people who end up changing minds later on. And I think the data does show that this trajectory is, in fact, the likely trajectory for the future. That's a really helpful distinction. If we're using a study in the 90s, and people, like you said, for a year socially lived this way, there were safety nets, there was counseling, it's almost like they're trying to try everything else first,

and then at the end we will transition if nothing else works. Now, Christians, we could have this debate for a different time, whether or not even in that circumstance, it's okay to transition. That's a separate conversation. But in the medical field, now those barriers are being removed, probably for ideological reasons you could correct me if i'm wrong but we want to push back on the idea that your biology is determinative of who you are there's a new sense of where i dent our identity is rooted and if i feel like a woman then i am a woman and to say otherwise is to not treat trans women as real women. The ideology has shifted since then. I was just listening to a G Transitioner this week describe how she went in and within 30 minutes as a teenager was being prescribed certain kind of medication, puberty suppressant blockers at that point within 30 minutes. And she said, as I start to share my story, I've been demonized and told that people don't believe me and this

doesn't happen and all these safeguards are there and she's sitting there going, there's not, I'm a testimony to this. So let's, if the 90s, the vast majority of people with all those safeguards in place, it seems safe to say, even if we said, all right, it's 75%, a significant majority with those safeguards in place will not have regret. That seems safe to say the data points to. Would you at least agree with that? I think so. Okay. Fair enough.

I appreciate the academic qualification. I think so. Good job because we. I appreciate the academic qualification. I think so. Good job, because we're looking at where the data goes. So now the reason we might have more and more regret and more and more detransition is not only are the safeguards removed, but people are encouraged to transition as quickly as they can. And still, I guess you would say in the 90s, as I think about it, there was still a social stigma from doing this. Now you are celebrated to do it. So there's positive encouragement

and everybody has to rally around you and say how wonderful this is and you found yourself. So it's like almost every conceivable safeguard medically and ideologically and socially is removed fast forward 5 10 20 years we might see a very very different picture is that what you would project that's my sense uh and looking at the data of the um the few studies on transition uh detransition that have been done and actually listening to the detransitioners voices, which is a big emphasis in my study,

that often in this conversation, the detransitioners themselves have not been listened to. And when we do, when we actually see what are their reported reasons for detransitioning and what was their experience like, and many of them, their experience, Sean, reflects something like the experience you shared with the detransitioner you mentioned a minute ago, is that they did not feel in hindsight

that as a young person under the age of adulthood, they do not feel that they were given the care and the caution in moving forward on this decision. A lot of them talk about, you know, rapidly moving through the system and these sorts of things. And these are their experiences. That's their, you know, in hindsight, reflections on what they went through. And that makes sense in a cultural context that's largely adopted in affirmative stance. But the question becomes now, do we allow these increasing voices of detransitioners to impact the conversation, both at the research level and at the cultural level and within the church? That's a great question.

What's so interesting about this is in so many other areas, we want to hear the voices of people who are marginalized. We want to give a voice to people who don't have a voice. We want to give a voice to people who feel like they're the victims. But in this case, we don't as a whole, as a culture, because it challenges certain narratives that have been pushed as well. So it will be interesting to see. I think if I was a detransitioner, I would really play that card up for people to consider and hear their voice just kind of because of the cultural moment that we're in today. I think the reason this has become so politically charged, I could be wrong about this, but even probably most Christians would have theological views about what the Bible says about gender and marriage, but realize we're in a pluralistic society, and if somebody wants to

transition, that adult can transition transition but now when we're talking about kids and these ideas are being promoted in disney and in laws in california where i live there's a certain ideology that's behind it with children who should be protected that's where this it's almost impossible for it not to become a political issue. Because one side clearly thinks, I'm helping this child liberated from certain cultural expectations and gender expectations to be who they are, and you're evil if you don't adopt this transition.

The other side is saying, no, you're rushing into this. These kids, your body is a part of who you are. So it almost feels like there's no common ground, especially because kids are involved. Do you agree with that's the heart of why this has become such a political cultural bomb, Chell? Absolutely. As one journalist put it, the gender dysphoric or transgender child question is the front line of the transgender battlefield today. And that is where all the attention is being placed. Like you say, once you're an adult, in a democratic, pluralistic context, people are generally allowed to make their own decisions. But this is also important, Sean, because the age at which younger children are being identified as gender dysphoric and or given a transgender identity is becoming younger and younger.

There's a major study being done now that's a prospective study. So it's going to be done over a longitudinal period of time with a number of test points, data points, is on a cohort of children that when they started the study were between the ages of three and five. And then we're socially transitioned between the ages of three and five. And they're now documenting what happens to those children over the years to come. And so the fact that transgender identity is being associated with children as young as two or three sometimes suggest that this really is a kind of a new moment compared to anything in the late 20th century that we were having to wrestle with in terms of what does gender dysphoria mean when it's indexed with the question of of childhood and adolescence I'm curious what some of your methodological concerns are with post-transition research, because I've read some of the literature and was really suspicious about small sample size, biased questions, biased community of who was selected to answer questions.

And it really felt like a built-in bias that shaped the academic research pretty powerfully. And there were entrenched reasons for people to accept certain views about same-sex marriage. And some people arguably punished and criticized for not towing the line. So we see this politics weaving into academic research. As much as we'd like to think it doesn't, it happens in other areas as well. Issues like evolution, intelligence, and a range of issues. So when you look at detransition, are you confident that the researchers as a whole are going to follow the data where it points? Or are you looking at this going, man, alive, I just don't think the studies

are trustworthy. There's entrenched, whether it's tied with somebody's reputation, their job, their funding, like what's your sense of confidence on the academic research tied to detransition? Yeah, this is, this became a really important question for me with this study. One, I didn't think I would spend much time with, and yet it became a pretty significant section. Um, I want to be careful here, Sean, because,, because I don't want to be perceived as like some anti-science guy. I'm not. I love science. I think it's done some wonderful things for us. But I see the question you've posed,

kind of what's my sense of the reliability of transition regret and detransition studies, this transition outcome study, I see that as a subsector of a larger concern that a lot of psychological science is facing today. It's what's called the replication crisis. And this is an ongoing conversation across the many disciplines of psychological science has really become something that's on the radar i would say in the last last decade probably certainly started before that but the last decade has really become a a significant concern among psychological researchers. And that is that often what we depend upon for a basis of psychological research and the data for that, a study or set of studies is sort of put forward as a conclusion on an area,

but those studies are not replicated in their findings by later studies. And that sort of is often left unresolved. You either end up with just different sort of infighting schools that don't much talk to each other depending on their persuasion, or sometimes a study gets such a high profile, it just overshadows all future studies, even when future studies undercut that study. So there's just a problem with replication in psychological science. That's the background to me for my concerns around particularly outcome studies on gender transition. And let me clarify, my study in this area is primarily medical transition, because that's where most of this data comes from. That's fair.

Here's my, the areas of concern that I noted were things like this. There's a real lack of standardization of language and standardization of measuring tools in this field. Particularly when you're realizing we're going back to, you know, again, 1950s and 60s and drawing still some of that data is turning up in studies today, all the way up to today, just a lot of differences in how we measure things or talk about things. There's a predominance of retrospective studies, which means asking people to reflect on what they remember thinking, how do they remember thinking how they felt about things X number of months, weeks, or years ago, right? Well, now you're depending on fallible memory, as opposed to prospective studies, which take a number of data points along a longitudinal framework. Most of the studies are retrospective today. You mentioned small

sample sizes in the work you were doing. This continues to be a problem in this area. I would say this is getting better. I noticed this. Over the decades, larger sample sizes are happening. However, a couple of areas that continue to concern me are things like the wide variation in time spans of follow-up. So how longitudinal is the longitudinal study? How long was that study? This is really significant because two fairly recent studies have shown, at least in their data, that somewhere between the year 8 and 11, I think, was the range. That it was after, in one study, year 8, and in another study, year 11, is when regret and detransition decisions started to be made. I cannot tell you how many studies are being proposed today to offer data on this that are far, far short of eight or 11 years.

There's studies that are giving us data on six months out from surgery and making conclusions. So this is a huge problem is longitudinal length of study. Another huge one, huge one is a loss to follow-up rate or attrition rate of studies. Why this is so significant, let me just give you a concrete example. Often the way studies assess regret and detransition is by going to medical providers and asking people, how many people that you served in medical transition have come back to you and expressed regret or detransition. Seems like a sensible way to do things. And when you do that, you get a fairly low rate. Problem is, we now know from listening to detransitioners that the majority of detransitioners never return to or have communication with their pride provider. They don't see that as a safe person to detransition

with. They go to someone else. So we have a completely large loss to follow up group of folks that are being left out of the data. And that becomes a huge problem. That's really interesting. When I looked at the study that you put in here, the percentage of people that are actually returning was so incredibly low. If I had to guess who's more likely to return somebody who's upset with the surgery or pleased with it, I guess you could make a case that somebody would return because they need more help.

But I would argue they likely wouldn't return if this person was encouraging and help to the transition and would go elsewhere for hope help you're going to return back if you're generally pleased so the fact that there's such a high fallout just minimally makes me really really suspicious now in publishing this i only saw because i got an email from uh our our buddy preston sprinkle at the center for sexuality faith in general was like wait a minute what is a study pulled it up was like holy cow this is from our buddy Preston Sprinkle at the Center for Sexuality, Faith, and General. He was like, wait a minute, what is this study? Pulled it up.

I was like, holy cow, this is really thoughtful research. Must have taken you months and beyond. But are you like a John the Baptist crying out in the wilderness? Are there other people drawing this together, trying to speak in the way that you are? Because I haven't heard this uh talked about enough um yeah quite honestly uh sean to to do anything like my study as a sexual studies researcher today i think would instantly put you in a category of suspicion. Now, there are some scholars who have sort of been more the mavericks in this field for some time anyway. And I don't

think they would have a problem doing this. But in terms of reputation, in terms of, I don't know, having your articles published and leading, there's just there's social pressure like there's in any field. I'm not saying this is some show, some demonization thing. This is the way all of academia works. It just it just is a certain predominant views in a field. And to go across, you know, cut across those just leaves you you as a maverick or a minority position. I think, however, that where a lot of science, you have those things in all science, but once, because this issue has become a culturally and politically polarized issue,

it's only intensified and accentuated that. You know, there was just in a recent issue, I think, two months ago, or three months ago, maybe, of the journal Archives for Sexual Behavior, which I consider probably the leading journal in the field, in the world today, an issue devoted to several articles talking about what they call cancel culture in sexuality studies today when they found themselves coming up against what were considered the disciplinarily appropriate perspectives to take on things so i think this is another dimension we have to consider that's interesting that such a reputable journal that's academic would cry out against cancel culture.

Maybe that's a good sign that people are waking up to this. Everything takes... Go ahead. The editor of that journal, Kenneth Zucker, has been one of the people who've been canceled. The editor of the largest, you know, and so he, thankfully he's willing to acknowledge what he went through and it was on transgender issues with children. He had a far, for years, he ran the, one of the major gender clinics in North America, up in Toronto.

And eventually the clinic was closed down by pressure from trans activists. Um, and so he, uh, he, he's felt this thing personally and his journal is willing to talk about this. That's really, really interesting. Uh, I'm going to put a link to the study below. Folks can get it, but it's, it's academic. You're not writing to pastors. You're not, you're just trying to say as fairly as you can, and I think you do so. Where does the data point? Now, let me have you take your academic hat off for a second as we kind of wrap this up. You're a pastor, and are you a dad too as well, Paul? I am. I am. How should some of the studies in this affect some of the findings, affect the way we approach the church and even parents?

And this is a whole nother hour plus conversation, but maybe just one or two things that jump out to you. You'd love, say, the church to do in light of what the data shows. Let's start there. Yeah. Great question. That's where the rubber meets the road right um i'm working with a number of families uh who's uh families and and folks who are experiencing gender dysphoria as christians and um i'm seeing really different things amongst just the families I'm working with. I'm seeing everything from younger children struggling with this.

And honestly, I still think the jury's out on whether there will someday be definitive evidence, say, for some biological predisposition towards these things I the data is just very very diverse on that question right now so I'm kind of holding with withholding judgment on that working with the number a couple of other situations families where the dysphoria has come out kind of laid up we call late onset so in adolescence and honestly I am concerned about some of the social influence dynamic here I I'll say this that my first advice to parents who are struggling with this is one, to do, find some good resources that do take a non-polarized position, a gentle and humble posture with regard to these things. Honestly, I think Preston's work is an example of this in

his book Embody. He's, I think Holy Ones were an historic Christian view, but doing it in a modeling of beautiful and humble posture. So good resources. But the next thing is going to be the question of, if your child's really struggling with this, who do I take them to see? And the whole field now of therapy around this area is just as polarized as anything. There's a new model that I've identified as what I call an exploratory model. And it's an alternative to simply the gender affirmation model on one hand, or just saying, oh, this is is nothing don't worry about it which is not any model at all but I've seen a lot of conservative Christian parents just refuse to actually engage their child on this issue if they're having this and

and we've seen that here's clear documentation for children who are dealing with gender dysphoria the single most significant factor for their mental health is the love and support of their parents and so we've got to find a way to thread this needle uh some way and there's a new model emerging that as i call and others are called the gender exploratory model and it's willing to step back from just gender affirmation and look at a range of possibilities. And I think that is not a bad place for a therapist to start. That's a whole nother conversation you have intrigued me here. And of course, where it gets hard is on all sides, people say we got to love our kids.

But what does that look like? What does that mean? That's where one narrative is. If you don't affirm 100%, you're not loving. And of course, you and I both agree that's not necessarily, not at all a biblical response, but ultimately showing real love and care and relationship and leaning in for the long haul is the right posture. So maybe we'll follow up and have that study, that conversation about that. In the meantime, I've got the link below. I want to encourage folks.

It's just called Rethinking Transition. They can find a link, read it. It's free. You put a ton of work into this. Really thoughtful, really helpful. I will be reading what you put out on this topic because it's just nuanced and researched and really well done.

So Dr. Paul Rhodes, Eddie, thanks for joining us today. Thank you, Sean. It's been a great enjoyment. Before the rest of you click away, make sure you hit subscribe. This is a topic we will come back to, biblical sexuality, other cultural topics. So please make sure you hit subscribe. If you thought about studying apologetics, would love to have you study with me in a distance program. I'm actually doing a full class this fall on biblical sexuality in our master's program. You can come on campus for a weekend, hang out with me, or you could even watch it kind of distance by Zoom. But we're going to walk through a lot of these issues that we discussed today. Looking forward to it. So information is below. Would love to have you in

the program. Again, Paul, thanks for coming on, my friend. Thanks, John.