Theology in the Raw - What Do We Actually Know about Transition Regret and Detransitioning? Dr. Paul Eddy

Episode Date: July 18, 2024

Dr. Paul Eddy is professor of biblical and theological studies at Bethel University and is on the pastoral executive team at Woodland Hills Church (Minneapolis). Paul is the author/editor of several books and articles, including Understanding Transgender Identities: Four Views. Paul also serverd as a research assistant at The Center for Faith, Sexuality & Gender, where he produced the largest summary of research on transitioning, detransitioning, and transition regret, which is avaialble for free HERE. This paper is the background of our discussion.  Learn more about your ad choices. Visit megaphone.fm/adchoices

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My guest today is my very good friend, Dr. Paul Eddy, who is a professor of biblical theological studies at Bethel University. He's also part of the executive team at Woodland Hills Church, alongside his good friend, Greg Boyd. Paul is, as I'll say in this podcast, I mean, he is one of, if not the best researcher I've ever met. This guy, absolutely his, his candy is sitting behind a desk with a stack of books and scholarly articles and just spending all day researching. And he's so, so fair and thorough with his, in his research, whatever, whatever he wants, whatever he researches, he's just, uh, he, he's incredibly exhaustive. So, um, several years ago, we at the center for, uh, faith, sexuality and gender, we commissioned Paul to be kind of a, a part-time research

associate and we gave him a couple of projects to research. And, uh, the one that we're going to talk about in this podcast is a research project that he published titled rethinking transition on the history experience and current research regarding gender transition, transition regret, and D transition. It's a very long subtitle. This is a 250 page research paper with over a thousand footnotes, typical Paul Eddie on a very controversial topic, the phenomenon of transition regret. And that's what we talk about in this podcast. We, we basically go through what he found in this massive study. And yeah, just to give you a warning upfront, this, you know, everything in this massive study. And yeah, just to give you a warning upfront,

everything in this topic is very controversial. We understand that. We try to be thorough and fair and gracious with how we're even talking about something that's very, very personal and very significant and very debated. So we also, just to give you a heads up too, this whole conversation was not discussing significant, very debated. So we also, just to give you a heads up too, we are not, this whole conversation was not discussing, discussing the ethics of transitioning. We don't raise

that question. We've talked about this elsewhere. I've written on it in my book embodied. For this episode, all we are focusing on is what do the studies show? There's been several studies done on the percentage of transition regret that exists among people who identify or identified as trans at one point. So that's our focus is just looking at the studies. Is it very minimal? Are we looking at 1% of people who might regret transitioning or is it much higher

than that? And as you'll hear in this conversation, it's, it's actually pretty complicated. So without further ado, please welcome to the show. First time, the one and only Dr. Paul. Hey Paul, welcome to theology and are off for the first time. I embarrassed to say that this is your first time on theology and raw, but I'm, I'm glad we're finally making it happen. Hey, I've waited a long time, man. So you did this research project on transitioning and D transitioning. I think it is the most thorough study I've, I've ever come across. Have you come across anything that's as thorough as this study that you

produced? I have not, I have not. So just, I mean, it's over 250 pages over. I ask you how many footnotes were in it and you didn't know. And I went to the last footnote and there's 1000. What was it? Over a thousand footnotes, 1026, I think 1026 footnotes. And you've, I don't even know. You don't have a footnotes on bibliography. How many studies you interacted with? I mean, it's gotta be in the hundreds at least. Yeah. Yeah. Yeah. Don't know. but it's all your fault, man. You asked me to do this. I did. So there you go. Well, I, you know, part of the motivation was anecdotally, if you, if, if you go online, you go to YouTube, you go to Reddit, you talk to people, talk

to other people, friends, friends of friends, you know, it seems like there is a decent percentage of people that have or are D transitioning, meaning they, on some level transitioned, you know, from male to female or female to male could be social, could be hormonal, could be both, could be surgical. There's different stages of transitioning, but they ended up D transitioning for, for whatever reason. And it seemed like this is a decent percentage. I mean, maybe just even anecdotally, you know, 20, 30, 40, 50% it seems like, but then you look at the percentages that are often thrown around and you often hear one to 2%. There's one to 2% transition, transition regret. So

that, you know, transitioning is basically except for a tiny percentage of people is, is gonna, you know, people are very satisfied that they transition. So that was part of it. I was like, man, what, well, what studies are there on this? And then you look around and there's hardly anything out there. So that's, that was, that was the motivation when I said, all right, Paul, you're the, you're the most thorough researcher I've ever met in my entire life. And that comes to me, I love the research, but you are on a different planet. So I know you're not going to leave any stone unturned. And given the fact that you have over 1050 foot notes, you did not leave any stone unturned. So anyway, that's the backdrop to why we commissioned you to do this study. Tell us, why don't we

start here? What, when did you first become interested in the broader trans conversation and what was maybe your motivation for that? Yeah. You know, I don't think I ever told you this, but you played a role in it and before I knew you, right? So, I was a historical Jesus scholar minding my own business in the ancient world, right? And then I'm also a pastor at a church here in the Twin Cities. And some questions on the pastoral side of my life began to be raised.

This was 2008, nine, 10, just about the stuff that's going on in the church in terms of sexuality and how do we respond. And one of my colleagues and good friends at Bethel, Jim Bilby and I have been doing a series of books by that point on multi-views, right? Like take a controversial issue, get some people together who disagree,

demand lovingly that they have a loving conversation so we can show that the church can handle disagreements in a Jesus-like way. And we had done a bunch of theological topics, atonement, foreign knowledge, all that stuff. But we were deciding, what should we do with the next book? And I'd been having these sexuality issues come up at our church, and I remember that you had pretty recently edited the two views on homosexuality. And Jim and I were talking about that and saying, gosh, what else could there, what recently edited the two views on homosexuality.

Jim and I were talking about that and saying, gosh, what else would be helpful to talk about in terms of debate around sexuality stuff in the Thursday? It was the same year as 2015 we were having this conversation when Caitlyn Jenner's famous interview with Barbara Walters. It was like, wow, this trans thing might heat up and it did. And so we decided to do a book, four of you is on Understanding Transgender Identity that came out in 2019. Actually that book is how we connected. Yeah, it's right. He's writing an email about it and yeah, and our friendship came out of that. So that's where I started was just a topic,

another topic to help Christians learn to disagree well together. I had no idea it would become my dominant area of writing and research for the next number of years. It really has. I mean, since that book, a good chunk of your research time has been devoted to this topic, right? Oh, absolutely. I mean, really, again, that was you when you graciously invited me to come on as a research associate at the center. And to work on this issue, that became for, well, from 2018 to 2022 when I finished this study.

Four straight years, that's all I did. We did the desistance study before that, which is posted on your site. So yeah, it really became, uh, all of my spare time. And since I have no hobbies, this is, uh, this is what I do. And you, you are, what's the most, so you're the most thorough researcher I've ever met. Like you will look at all sides and you're so incredibly fair. Like of anybody who doesn't, we all have biases. We all have stuff that

we want the evidence to say this, you know, like that's always underneath our skin, but you seem to be almost immune to that. Like you are so driven by which is what does the data say, regardless of whether I agree with that. Was that, I mean, what did that, what does that come from? I mean, one, I appreciate you saying that. Cause I really do have a burden to try and do that. And I think the reason is, you know, a lot of my academic work with these multi-view books, and then Greg Boyd and I did a book across the spectrum,

which takes 17 debates in evangelical theology. And we write it each view from a first person perspective, trying to look back and I think, I think God has called me through my academic career to help the evangelical church wrestle with deeply controversial, personal worldview issues in a way that acknowledges that while I might be very persuasive of you, there are sisters and brothers that love Jesus, that believe in the Bible, and that just disagree with me. And if we don't find a way to de-escalate the rhetoric and listen and learn together, then the church will never be able to be the beacon

of hope for agape love, for humility, for a different way of being people that I think is the whole point of the church. So it's really a missional ecclesiological anchor for me that this is what we're supposed to be doing. And boy, if I don't do it in my research, then I instantly I mean, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm not, I'm, I was, yeah, it was an M just so impressed with, with how you tackled it. Let's jump in. I let's just maybe start 30,000 foot. Like how many studies are there

on D transitioning? Like it's not a lot, right? And like, yeah, w w just tell us about the data that's out there before we kind of jump in and kind of examine what the data tells us. Like what, what, you know, what has been done on, you know, D D transitioning. Yeah. Well, so you're, you're, you've already noted that there isn't a lot done, right? Which raises the question, why not? And so from 30,000 feet, let me throw a few ideas out of the conclusions I've come to on why not and sort of the field today in this whole area. I think so you've mentioned what we're talking about when we talk about detransition. And so it really broadly, just to reiterate your point,

it really means any way, shape, or form of stopping or reversing a gender transition that has happened. And when you think about that really broad definition, and you think more than like three seconds about the kind of things we're talking about. You realize that instantly you push like a tab and a whole menu of like subcategories and options start floating.

Social transition, right? Don't touch your body, but you do things like, you know, change clothing, hairstyle, names, pronouns, that's just socially transitioning. Then there's medical transition. You already mentioned hormone therapy, various surgeries. There's legal transition, right? Legally applying for name change or sex status. And so all these ways of transitioning can also become different ways of detransitioning,

and they do not all come together as a package, as one might expect. And so it starts to tell us why the field and understanding the studies is really pretty difficult. Add to it now the political dimension. And this became a pretty significant part of my study, is naming the politics that's behind this whole thing, doing my best to have a little shot in the arm for the church of saying, hey, let's try to depoliticize this conversation

so we actually can talk about what's happening on the ground. You know, John Sokoluk, who's one of my great hopes for the future of sexual science, because the dude is like super concerned about the evidence base in sexual science today. He's gone on record as saying that sexual science is probably the most politicized area of scientific research on the planet. Oh, wow. Once you realize that, then for any area dealing with transition and detransition, you've got to suspect that there's some serious political influence on what's

happening in the field. Even though scientists are supposed to be the sector of our society, they're the objective people. Disinterested objectivity. It's like, no, we're human beings. And let's just name the politics here. When you talk about gender transition and gender detransition, instantly the politics emerges for this reason.

Conservative political forces naturally want to highlight high detransition rates because that does serve the political purpose of making people nervous that we've gone too far with this gender affirmative model. We are transitioning people that will eventually regret it and cannot really undo their medical bodily changes. And so we need to put brakes on this thing, even put some laws in place. And on the other side, the affirmative folks know that that's precisely what a conservative perspective will do.

And so they run the other side of this and say, we've got to emphasize as much as possible low D transition rates so that we don't have a rollback on the medical possibilities for people who are identifying as transgender. And so it's a pretty obvious problem. You can see why the politics are there. I, in the study, discussed three really kind of seismic moments of this.

James Caspian in 2017, just a master's student at a university in the UK, wanted to just do a study on detransition. And the board that verifies or imprimiters the dissertation said no, and one of their comments said, this is a politically incorrect topic. Yeah. And the list goes on. It's a tough deal. So ultimately, why so few studies?

Because it's unavoidably political, and very few researchers want to risk their careers and reputations and, to be honest, mortgage payments on doing something that's gonna look as if they were out to undermine, generally undermine affirmative advocates. And so there's what I would call, what the field calls research avoidance bias.

It's an actual term. And it means that a field of research is intentionally avoiding a particular issue. And it is an example of data suppression because it messes the field up in terms of actual data pool for any conclusions. But that is what's going on, I think. It's unavoidably true. And it's why we find so little on this topic.

Regarding the political, because I mean, it makes total sense that there is that people have viewpoint motivation. They have, you know, certain assumptions about this topic that they're very passionate about. And that that can get in a way well that that can influence how they read the data. Can you see that? Is that, is that subtle? Is it like hard to see that political bias or does it, does it, can you see it in the studies that you have read and, and, and, and maybe how, how, when you do see something, it seems like, man, this, this seems a little skewed in one direction. What is that? I don't identify that. So I think my answer to your question would be three basic ways in which I sense that going on.

One is when you get a kind of a tidal wave of studies that seem to be coming to the same conclusions. And let's just say it, that in the field of sexual science today, the dominant political influence is, of course, towards the gender affirmative paradigm. If you're going to go against that, and by going against that, I just mean publishing a study that just, let's say, happens to show a high rate of de-transition. Whether you like it or not, whether your colleagues like it or not,

it will be perceived as an attack on the gender affirmative paradigm. There's no way around that. And on trans people, like you would be- And trans people by direct correlation, absolutely. And so all of a sudden, your resource statistic becomes an act of vengeance on the trans community. That's how this gets played out.

And so you start to wonder, at least I did, when I start to see study after study after study that shows really, really low rates of de-transitioning,, okay, add to other things, just then you look at the section in any normal journal article study that probably is the least read section of any study, but is the most important section. It's called the limitations section. It comes to the end of a study and that's where the researchers are supposed to let you know, oh, by the way, here's the limitations to our study and why you shouldn't generalize this to all.

And I started reading those, and you start realizing, oh my goodness, there are a lot of the same limitations going on across the field. For example, often very small sample sizes, often convenience sample sizes, meaning not a population-based sample, but let's say samples taken from gender-affirmative Reddit groups, something like that, where there's going to be an obvious political bias to that particular sample. What would it be like? I mean, it'd be like standing outside of a mall and surveying whether

people like to shop. Exactly. 98% of people love to shop. Yes. Yes. And see, we never... That what's tough. Because you know, what happens to these studies is their statistics get picked up by mass media and end up as headlines. Right. And those headlines. Now we're one major step removed from anyone going, well, wait a minute. What was the samples of people who say this? It's just people surveyed say, and yeah. So you can see why things get really, really messy

very quickly. And finally, my final answer to your question is, I fear that we will never see most, the effects of most of the bias for, and it's the final issue I deal with in the study, it's called publication bias. And what it proposes is that, and we know this from wide fields of research, not just transgender studies,

that when there's a particular political default setting in a field of study, it becomes increasingly rare for people who do a study and find statistics that go against that default setting to ever publish their studies. They just never publish them. It's called the file drawer effect. And it was coined by a guy who says, what happens when researchers realize if they publish something, their reputations will be tarnished in the field, is they take that study, it might have worked for two years on it, but they put it in their file drawer, the four-door file in their office, they locked the drawer and no one ever hears about it.

And one of the main researchers of this problem, he theorized his guess is that for every published study in any field, 19 studies are never published of the results did not go the direction that the author hoped they would. I mean, this is a little, I mean, so when you read a headline and it says in it has to do with sexuality, gender, and it say study studies show, or a recent study says, or this study concludes like anything that references a study in this general area of sexuality and gender, do you just kind of chuckle? I mean, how do you do? I mean, should we just basically say, I mean, unless I'm going to do a really thorough examination of this study and 10 other studies, I just, I can't, I kind

of take it with a grain of salt. Is that Speaker 3 So Preston, I hate to have to to say this but of all the things I learned in this two-year project the thing that I'm that most impacted me I think is How profoundly my confidence in science? Took a nosedive And I realized that you know the area I'm in is as John Succo like says, the most politicized area. So I don't want to extrapolate this to all science.

But boy, I could not believe the ways in which really smart people and well intended people are making claims that when you look at the methodological flaws and limitations, we should all be saying, I think, we don't know. Open people's file drawers and maybe we'll find out someday. But yeah, yeah, it was really, really disheartening. It is tough these days to stay healthy. And as I get older, I noticed that when I'm not eating healthy, I get lethargic, my brain slows down, I start promoting heresy, you know how it is.

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supply of vitamin D3K2 and five free AG1 travel packs with your first purchase at drinkag1.com forward slash TITR. That's drinkag1.com forward slash TITR. Check it out. So give us a bird's eye view of what, what are some of the major studies that have been done and maybe talk us through what did they conclude? And then the methodology of those studies. So a big section of my paper looked at studies from 1960 to 1922. That was my window. So six plus decades. 2022.

2022. Yeah. And interestingly, it's important to know that I think I think we tend to think that, you know, gender transition is a pretty new thing. But in fact, it's not that new. In fact, I was surprised to find an ancient Assyriologist did an essay a few years ago showing that back in like the ancient Near East, there's at least four different gender rituals that Assyrians were using to

transition genders. So, I mean, this idea goes way, way back. We know there's a third century, one of the third century Roman emperors who tried to transition to a female and had his his physician surgically create a vagina for it. So I mean, this has been a human thing, right? Is that elegant? Yes, exactly. Exactly. He used to, he used to hang out at brothels and have sex with men or he would, he would like learn how to have sex as a woman with other men. He would watch other women. I don't quote me on this. It's something like that where he, he wanted to learn how to have sex with a man as a woman. And he would go to brothels or, and learn something like that.

Just a study of Roman emperors is a logical minefield. Isn't it? It is. It's a Tony is this to, oh my gosh. It's, it's, I mean, Nero had his anyway. Yeah. That's another podcast. Okay. So you, so yeah, go ahead. Well, just to, yeah. So the studies from sis, yeah, I'm looking at your table of content. So you spend about 50 pages surveying all these key studies all the way up to present. I would imagine the more present day ones are the most more significant ones, right? Oh, absolutely. But so important to know that the first surgical gender transitions are already happening in 1931. All right. That was kind of a major year.

And by the 50s, we're talking now not much in the US. In fact, US is not till the 60s. But in Europe, in Mexico, interestingly, in Casablanca, Morocco, there are a good number of these things happening in the 1950s, which means in the 1950s, people performing transitions began to have some of their clients come back to them and say, this did not go well. In fact, I'm regretting this.

So detransition reports start happening by the 19, late 50s at least. By the 1960s, we do, it's becoming enough of an issue that researchers who are trying to do longitudinal analysis of, so how does this go for people once they do, are starting to record? Well, for some people, it doesn't go so well. In fact, some want to reverse this already in the 1960s. So it's surprising to me how little research is being done when this is a phenomena we've known about and have record of for over six decades, right? That's the thing, something we need to account for. Jump ahead and decade after decade, 60s, 70s, 80s, 90s, you continue to have in transition outcome reports, I would say a significant, not the majority. The majority of people in

almost every study I've ever seen have said they were glad they did transition. But a significant, a statistically significant number of people also report things like this. I had real difficulties. Not saying how I regret it, but I have real difficulties. Or I regret it. Or not only do I regret it, but I regret it enough that I want you to do everything you can to surgically reverse this for me. Those tend to be the three domains of what I do call in the paper negative transition experiences. And because researchers don't usually tease those three out, they get glommed together

and it doesn't go well for assessing things. So what I did when I went through the studies, I had those categories in mind, which actually were proposed just in 2020 by a researcher. We got to separate these things. And I tried to do an analysis of those three different types of negative experiences. What you have today when most people talk about regret and detransition is you hear these same statistics over and over. You hear, well, it's 1% to 2%.

Yeah, I hear that a lot. That's just the common thing. Why do they say that? Here's why. Because in 1992 and 1993, a researcher named Pafflin, in one article alone and another with a colleague in 92 and 93, did a very, very good study of a number of decades of reports on people who had transitioned.

And they in this 1992 study said they found that between 1 to 1.5% of people expressed regret. Okay. That's where we get that statistic. It's a nineteen ninety-two stat. Now, I think there's real problems with the fact that you're continuing to hear that stat thirty years later. Here's just one reason. Back in those days, the only people who were able to transition were people who'd

gone through serious psychological examinations, um at least six to a year month social transition first. This was not an informed consent based thing like's happening today. This was you had to pass a battery of things before anyone would ever consider operating on you. That's no longer the case today.

We're increasingly moving to more lax standards and informed consent model. We're comparing apples and oranges. I had the study pulled up here. So this is Friedman, I can't pronounce that last name. Friedman-Pathlin. Pathlin, gosh, there's a lot of consonants in that. You made it sound good.

Astrid-Yung? Y it sound good. Astrid, you do. Okay. Astrid. That's a makes you think of an office episode. You know what? I don't want to the things that comes up in other studies methodologically is they don't say they survey a hundred people like pre-trans like pre-transition hundred people. And then they might serve then, then they kind of follow up. But a lot of times there's a lot of people lost in the follow-up. So they might only have 52 that they follow up with and 50 are happy to regret. But it's like, well, what about the other 48 that we don't even know where they are? Like, right. Is that, this is a huge problem and it's only come to light. I would say in the last, probably seven years. Um,

and where it started to come to light was not researchers, but it was people within the de transition community in online social media blogs saying, wait a minute, all the, me, talking first person, you know, as a detransitioner, and all the detransition people I know, we never go back to our original medical professional. They have no idea that we'd be transitioned. We're not showing up in the studies.

That was starting to be said out loud in 2015, 16, 17. And it wasn't until 2020, 2021 when about six, finally, six pretty good studies from researchers on detransition who did not show the kind of bias that I've seen in the past said, we are probably meant this is the statistic I'm seeing today. Probably 75% of D-transitioners never report to anybody that they D-transition.

Now this study in 1992, did you have that issue as well? Or, cause you said this was a really thorough study. Well, thorough in the sense of longitudinal. Okay. But not thorough because they didn't know about this problem. Oh, so they might have all, this is the one, the one to 1. Okay. But not thorough because they didn't know about this problem. Oh, so they might have all this is the one the one to 1.5. I think for sure that study does not. Well, okay, first off, there were just fewer people who had gone through transition at all back then. So when they're

publishing in 92, they're probably working off data from the 60s, 70s, and 80s, which was a much smaller number of people that had ever transitioned, like total. But I still suspect that there were some people they did lose. But in increasing, you see, the more people that transition, and certainly now the more the de-transition is a known category with a community behind it that refuses to go back. And like, this is a snowball effect on how significant this problem is as we go forward. So I suspect it affected those. But today, if this is not being accounted for, we are just wildly out of line with, with what's happening on the ground today.

Wow. Okay. So, so that one to 2% 2%, are there other studies that came out after 1993? Yeah. I would say the three big studies on the affirmative. So folks who are affirmative will quote one to 2% pretty frequently. What do they get the 2%? In 2014, Desgny et al., there was a group of people in Europe, a team in Europe, found a 2.2% regret. Right now what's interesting is they defined regret as applying for legal detransition. So it wasn't just a regret stat, that was a detransition stat. Those two often get confused. And then now the statistic you're

going to see increasingly among affirmative folks today is actually dropping 0.3 to 0.6. You're going to start seeing that more and more. And here's the reason why. A 2018 study by Weepjuz et al., it's another European group, found this stat that female to male, regret rate 0.3, male to female 0.6, so below 1%. And I'm starting to see that study statistics being replicated now. Why? Well, they did find that and it's a pretty longitudinal study. However, they note in this study, and this is another important limitation factor we've got to take into account with any study, they note that the

average time span between transition and detransition, the average was 10.8 years. Oh, wow. Now, that means if you have studies that are assessing people short of 10 years, you're having a deflated rate of detransition because most people don't even get to it to that point. And boy, when you start looking at and tracking longitudinal time spans, most of them run between six months since transition, like six months, up to five years. That's the bulk of them. 10 years, according to this team,

that's when the average person actually realizes. So we are not only having a loss to follow-up problem, we are having a missing the longitudinal length necessary to catch when most people eventually de-transition. Do we have any studies that are longitudinal past 10 years like that? Yes, we do. And what do they show? But it's very few. And the weak just one was a longer study. But see, now why did they get such low rates on that? Because they were starting with the 1960s data, 60s, 70s, 80s.

Remember again, in those early years, because of the rigorous processes, it was fewer and fewer people who transitioned at all and fewer and fewer people who detransitioned because of the rigorous assessments they had to go through to be able to do that. And so all of that data got brought into the WIPCHA's analysis. And I think we have to remember that that shift is, is something that we're, we can't apply 60, seventies, eighties data to the context today. And yet it is done in longitudinal studies that go back that far. So if there was thorough analysis, you know, people have gone through counseling, psychotherapy, like they've exhausted all other ways to maybe

reduce, manage, mitigate gender dysphoria. Nothing's really working and transitioning is kind of a last, you know, last ditch effort to, to, to relieve someone's dysphoria. If all that is, do the studies show that if that those steps are taken, that there is a very, very high satisfaction rate. Would you say the studies at least bear that out? Yeah. That's where I think you get the statistic that I suspect is, is accurate. Even though we have all these other problems, methodology, I suspect that if you do all that, you're probably in the ballpark of, you know, 90% satisfaction rate. If those protocols are followed. Even the studies that show higher detransition rates,

they're all like 7.9 in one, eight in another. I think the highest regret detransition rate that I've ever seen came out of a study by Green and Fossum, I think it was. It was a 1990 study, and they found that for female to male, in their study, the detransition or regret rate was 3%, but the male to female was 13.1%. That's the highest that I've ever seen. Now, again, that's 1990. So they're working off 60s, 70s, 80s, really strict protocol data. I think we got to realize that Roberts et al, this is a group that just published a study two years ago, 2022. Now what they were studying is not surgical transition, but hormonal transition.

And they found that 30% of people who transitioned hormonally began cross-sex hormone had stopped doing that within four years. 30%. So, once you start saying it's not just surgery, it's also it also can be hormonal. Then we have a completely different ballgame and very few studies have ever tracked that. Roberts, I can't think of another one, honestly, and they found one third of the people desist or don't persist in their hormonal therapy after four years. So I think that with what's happened in terms of the explosion of gender dysphoria, the move to a strongly affirmative view,

we're in such new territory that the longitudinal studies we need to understand what we're doing now will not be able to happen until 10 years out from when, let's take the break point of 2015, Time magazine said that was the transgender tipping point here. That means only next year could we start to get 10 year data on people that transitioned in 2015 and then keep that going to know what's really going on in this kind of new world we're living in. data on people that transitioned in 2015 and then keep that going to know what's really going on in this kind of new world we're living in. Can you explain to us for those who don't know, which is probably most of us, the changes

in healthcare for trans identified people, like, cause you, you referenced like in the past, they go through thorough psychological evaluation and you're kind of hinting at that that's not the case anymore. Yeah. Can you maybe expand on that? When did that shift happen and why did it happen? Why is there no less if any psychological evaluation before people are suggested to transition?

Yep. Yep. And I don't't wanna suggest that there's like a night and day thing. This has been a slow evolution, but really what the impetus behind this shift is, is that the trans community has said that what's happened to them is that the medical establishment has basically pathologized

their condition. It's an illness, you know, it's a mental health issue, it's a diagnosable condition, and so they are gatekeepers, you know, the gatekeepers. The medical establishment gets to decide, you know, and the trans community has been pushing back on that saying, wait a minute, And the trans community has been pushing back on that saying, wait a minute, we're the ones who know. And I think what's really going on here is this is part of a larger cultural phenomena, Preston, that we're seeing personal identity as measured by people's subjective sense of self is becoming the fundamental authority in the Western world today. It's not just trans, it's everywhere. And so this is just part of that locomotive that's running with increasing speed

through Western culture. And once you grant that, that first-person experience authority is the fundamental authority in our lives for who we are, then it only makes sense that it's not some guy giving me an assessment, but my own sense of self that should be at the helm of the decisions I get to make for my body. And that's why there's an increasing pressure for pushing back on the medical establishment and saying, no, informed consent should be the rule. In other words, just like most medical procedures, you tell me my odds, you tell me the pros and cons,

and you let me decide. Now, the standards of care that are produced every so often, updated every few years by the WPATH, World Professional Association for Transgender Healthcare, has been one of the barometers for this. And up till recently, they suggested, it was always just suggestions, but it was suggested, that every person transitioning

have at least two recommendations from mental health experts. That's been being undercut increasingly. In fact, SOC 8 just came out recently. I forget if I know there's a lot of debate about what should happen. Do you remember whether that got dropped to I didn't follow that now. Yeah, I know there was pressure to maybe drop it to one or maybe pull the whole recommendation necessary step out at all. I forget what happened there just last year. But that pressure and even these

are suggestions, actual caregivers don't have to follow that. And I know, I've seen a number of studies where people are saying, we just feel as affirmative clinicians that our job is not to get in the way of people's sense of what they need, but to support their own sense of self. And so there's Joanna Kennedy down in San Francisco and in the main clinic saying that she supports double mastectomies for minor-aged young women

because of the informed consent principle. And I saw her in a discussion once where someone pushed back and said, what if my 15-year-old daughter plays the informed consent thing and wants a double mastectomy at 15. And what if she decides she was wrong at 22? And Kennedy said, well, we can handle that, that we have a reconstructive surgery now. She can go get, if she wants her breast back, she can go get them. I saw the video. It was, uh, she literally said they can go get them their breasts as if, as if a breast

is like an appendage or something, you know, like it's a human organ. It's not, you can't actually go get them, but yeah, that's wow. And I've seen the kid, I mean, this is a side, a tangent a bit, but I mean, you kind of brought it up. What is that? What is it? Is it each state has its own law on how old a person needs to be that does that where they don't need parental consent? And I heard, I heard, see if this is true, in Oregon, I think it's as young as like 15. As long as you're 15 years old, you

don't need any parental guidance to sign off on a medical procedure. Or is that vary state this? And please, if people are listening and you're interested in that, go fact check me. I could be off on that. I remember reading that somewhere a couple of years ago. Is that something each state decides that? Is that as young as like 15, 16, 17? Or do you already know? Yeah. That is a great question. And honestly, Preston, I think now that you raised

that question, I realized so much, the bulk of my research really focused on the scientific side of things. I never got into a lot of the legislative side of this. So I don't know the answer to that question, but it's a very important question. And obviously in the last couple of years, a much debated question in many state legislatures around transgender care for children and adolescents. So major issue.

Who is the major world renowned psychologist who specializes in gender dysphoria who got fired from his Toronto clinic because he was advocating for a year of psychoanalysis before people transition. Who was his name? Yeah, it was Kenneth Zucker. Zucker, yeah. And Zucker, ironically, is the editor, has been for a couple of decades, I think, of the archive journal called the Archives of Sexual behavior, which arguably is the leading journal in sexual

science in the world. And yet got fired from his position at Toronto when he was there for decades, uh, because of this very, very issue. This is how, how political it's, it's really become. And, but not, he didn't, he wasn't opposed. I mean, he just said we should, people should go through a rigorous cycle analysis analysis before. Right. And then they accused him of advocating for like, uh, reparative therapy or something. Well, here's the thing. Zucker and his team at Toronto for many years through the eighties, nineties into the two thousands, um, they were one of the leading clinics, certainly

one of the North American clinics for childhood gender dysphoria. And their approach really was, let's see if we can do psychological interventions that lead to desistance of gender dysphoria. And so they weren't taking, they certainly weren't affirmative. They weren't even taking what kind of the third major model, the watch and see model, watch and wait. They were actively attempting to do psychological interventions.

And that got tagged then by affirmative folks as conversion therapy. And that's why he got blackballed by that whole side. Has there been some reevaluation now? So there's been a very gender affirmative only standard of care in the United States and I believe Canada, right? Where kind of what you said earlier, like as long as the person's in, you know, has informed consent, then they're the ones who can decide whether they want this, you know, hormones or surgery or not. Do you, have you been following this stuff like in the Scandinavian countries and UK

and even where there's been some kind of like pulling back on that saying, maybe we do need to go back to emphasizing more psychotherapy before we have, you know, advise, you know, invasive surgeries and so on. Is that Speaker 3rd-5 Yes. Yes. And you're absolutely right. I mean what's interesting here is Europe really was the initial kind of location for embracing a more affirmative position, right? I mean believe it or not 1931

Switzerland Made it legal. I think of Switzerland So the Switzerland of Sweden made it legal to change your sex 1931 so this and I think that was Switzerland and then Sweden Made it legal in 1972 So a lot of this kind of Europe Europe led the way on this US was sort of slow on the uptake on this now Particularly over the last, I'd say, four years, and I think a lot of

this goes back to a particular lawsuit that got filed in the UK known as the Belle V. Tavistock suit. It was a young woman, Ciara Belle, who had undergone transition surgery, hormonal and mastectomy at the UK's major gender center, the tax called the Tavistock. Think at age 17 and by age early 20s, she had de-transitioned and brought a suit against them. A lot of the European nations, and we're talking here, Sweden, Finland, I think Norway, and now the UK itself, have all pulled back when they've seen a rising number of younger detransitioning, particularly natal females who transitioned to male, rethinking that within a few years. Most the D transitions happening not surprising because so many are now

Female to male transitionings that that numbers just exploded a lot of the D transitioners are people who began a transition Towards male and are wanting to go back to female and often it happens in adolescent years transitioning and by mid to late 20s, detransitioning. And that I think has really caught the attention of a lot of the lot of governmental agencies in Europe. For some reason, it seems that the North America is kind of doubling down on the affirmative path in face of this. So it's not slowly following behind, like following the lead of these European countries? I know, not amongst what I would consider to be the really influential researchers in our country.

I think again, part of this is it's got caught up into the politics of it all, that conservative lawmakers in certain states are pushing against it. And so we don't want to be them. And it's a real mess. Talk to us about, you kind of mentioned a few times, just the really skyrocketing rates of teens, especially females now experiencing gender dysphoria and or identifying as trans. And how does that factor into the question, like these studies in a sense? I mean, you kind of touched on it,

longitudinal, we don't know. Well, maybe let's start. What is unique about this younger population and the trans conversation and how does that contribute to how we should think about the transition regret rates? Yeah. Well, from very early on, and we can go back to the 1930s. When you looked at the people who were requesting transition, it was for decades, dominantly natal males requesting to transition to female. And that was the case right up until I would say, from what I can remember, I would say the key years would

be 2005 to 2007. In fact, I think it was Ken Zucker himself in an article that said something happened in the midst of that first decade of the new millennium where we started to notice that the number of females, natal females requesting transition were rising. They actually met the number of females, natal females requesting transition were rising. They actually met the number of males and then within a few years exceeded. And to this day, it is now dominantly young females who are requesting, who are expressing gender dysphoria,

requesting ultimately medical procedures for transition. And that is, I mean, the numbers are pretty stunning. ultimately medical procedures for transition. And that is, I mean, the numbers are pretty stunning. When you realize that from the 30s to the 2000s, it was a dominantly male phenomenon. So now we're wandering into, you know, just to kind of name it, this is a very controversial area. Some people refer to it as rapid onset

gender dysphoria. The question of how much is one's social environment, both social media and school environments and friendship groups, peer influence, how much of the social environment is influence, is contributing to a natal females, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, it's a, that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point.

And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point.

And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point.

And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that's a really good point. And I think that really closely when it first really started to be talked about 2018 through maybe 22. I haven't followed as much in the last couple of years. Are people still saying that there is no social influence? Is that, is it still like politically like debated or politically incorrect to say, Hey, maybe there's some social influence going on here. Or is that, or most people kind of saying like, yeah, I think there's, it's kind of like Biden's dementia. Like now we all know, but I mean, you know, like back in 2020 is like, no, he's totally fine. No, that's all, you know, I don't, what are you talking about? No, he's totally, you know, like as if dementia happens overnight, you know, is it like, where

are we at with the, again, the quote unquote, rapid onset conversation within, within the broader discussion. Yeah. I think to understand the answer to that question, we have to remember that by raising this question, how much of gender dysphoria with any person or cultural context is biologically influenced and how much is socially influenced. We're wading into what I have come to see as one of the most contested issues within the scientific community itself with regard to sexuality. It's remarkable how divided sexual scientists are on the biological side versus the social influence side of things. So that you've got, you know, biologists and evolutionary

psychologists all kind of working out of a Darwinian paradigm, really emphasizing biological stuff. And then you've got most of the social scientists, psychologists, anthropologists, sociologists, going, wait a minute, you forgot about cultural influence stuff. Now, this is the backdrop, right? And people, almost everybody says, if you ask them, where do you stand on this? They'll go, well, I hold to a biopsychosocial model.

Yeah, yeah. It's everything. It's very complex. And if I could count the number of times I've seen someone say biopsychosocial, it's very, you know, and yet who don't follow that out in their methodology. In fact, in other words, everyone appeals to,

well, it's probably some of each, but so many people when it comes down to their conclusions on their issue, line up either strongly biological or strongly social. It's just ironic. Anyway, here's another irony. The social science people, this includes psychologists, which are a big part of the sexual science field, they're the ones who have always pushed social construction, social influence, right? So you'd think that when it comes to trans identity, they would say, well, there's an important social, but no. Because once you say social, that can undercut the trans community's claim that this is a

fundamental part of my identity, not something that was externally imposed on me. So the irony is that a lot of people whose field should predispose them to say social influence are saying, Oh no, this is biological. And they're pulling from the biological side. It's just, it's really, yeah, it's pretty interesting. I know we're getting a little bit off, but this actually is such an important piece of the main thing we're talking about. What do the studies in your opinion, what do the studies show on social influence? Cause cause that's going to end up playing some role in people making irreversible decisions

that end up regretting later. Like in the, in the special Alaska, like, you know, in the last couple of years, except like in the first, you know, 2018, 2020, like any study that did say, Hey, there's social influence here. They were really hammered. All right. I mean, they were shut down pretty hard, but then I keep seeing kind of more and more studies from different people, not just Lisa Littman and you know, her friends, but like other people kind of looking at things. And so yeah, is it, what do the more recent studies show with regard to social? Yeah, no. I mean, what you said is exactly right. Ever since Littman published, or was

it 2018 published her, her rapid onset gender dysphoria article that instantly became now part of the turf battle, right? And anyone who even talked about it was had, was just ostracized by most sexual researchers. I think where things have shifted in the last few years is as soon as researchers, particularly in 2021, this is the year with some, like three or four really good studies, turned to the detransition community with some good surveys. And it was reported by them, the detransitioners themselves, when asked, why did you originally transition, that a number of factors were socially influential factors. And once you hear it, not from some researcher that you say has an agenda,

but from the community that's being studied, it's more difficult now to dismiss that without being seen as dismissing an entire minority community. And so that's why I think now with the voices of the detransitioners being finally heard in academically respectable journals, it's an issue we can no longer avoid. And they themselves report that that was their experience,

that peers who were talking about this or social media or being on YouTube. Now I think we ought to be careful because the impetus for I think a lot of Christians is to go, ah see, never was anything but external influence. You know, you and I have talked about this, Preston, particularly when you were doing your book on transgender experience, that there's a lot of complex data on sort of the etiology questions, like the origins questions.

Where does gender dysphoria come from? And I think there's still a lot that we will be learning about that in the years to come. But the fact that social influence has been cut out of the conversation by the dominant sector of sexual science for a number of years, I think that is another major limitation and weakness in most studies. And I hope the last few years we're beginning to see a turn to at least seriously consider that that we have not seen for the most part of, because I mean, it's not, if you, if you

add up all the pieces, like it would seem like serious. I want to say malpractice. Maybe that's too strong. Maybe not to, you know, say a 16 year old female is to say, you know, is seeking transition and they're being told, well, I mean, yeah, there's only, you know, one to 2% regret or there or there, there somebody is saying the chances of you regret it. It's are so minuscule. Yes. I would recommend this, but they're basing this on a, on a previous studies and a previous demographic that is very different than this younger generator. It's almost like it's, it's just a different category. Like you're saying we don't have data on the, on Jen, Jen Z's reg transition regret rate.

It's longitudinal because it just wouldn't have been around that long, you know, like, so we really don't know. Like we really don't know what kind of regret range were, were we can anticipate for, you know, 17, 18, 19 year old people seeking transition. Would that be again, just as a base on the data, I don't want to give you like, is my concern legit? I think so. The study I mentioned by Roberts and L and his colleagues in 2022, right? Two years ago, one of the first studies, more recent studies to track transitioning away from hormonal therapy. When you see a number like 30%, I mean, I was just stunned when I saw that. We've been talking about single digit de-transition rates since the 1960s, and all of a sudden

it jumps to one third of the sample. Again, that wasn't surgical. But see, that's always been the point is that there's pretty good evidence to this person that the more radical the level of invasiveness of the medical procedures, the lower the detrans rates. And there's probably a lot of, I just read an article in this not too long ago of a scholar pointing this out. So for example, social transition, which doesn't affect the body, there's probably a significant portion of people who stop socially transitioning, they go back. Less invasive medical transition, like hormonal therapy, well, in this study, 30 percent,

but once you start literally taking away body parts or adding whatever, that level of invasiveness, particularly when it gets to the genitals, it just is probably the case that people have thought longer and harder, have probably waited longer to think about this, have more medical professionals going, look, this isn't just hormones, this is your, you know, there's just, even in our sort of lax, increasingly lax culture, there's still more safeguards.

And so it weeds out more people who would have sort of flippantly done this kind of the area I'm most interested these days is we're finding that a lot of people who are transitioning today, particularly natal females do not go through with genital surgery. Most don't. Yes, good number, double mastectomy, but most of it is hormonal. Most of it is taking testosterone to masculinize. And so that study of Roberts, who showed what most people who are natal females,

and that's the explosion area, are doing today, that 30% of them within four years decided to reverse that. That's the kind of thing that we need to start tracking into the future. And you're right, we just don't have the data on that. Well, and even hormonal hormone therapy, that can have really drastic effects.

I mean, infertility after, you tell me, you're the expert, but like after two years of a natal female, two to three years, isn't that when we start seeing like, yeah, this person will probably never be able to have a child again? Dr. Mark McClellan Yep. I think infertility is like at the top of the list. And what's also interesting is I don't remember the statistics off the top of my head, but there's a number of studies now, fairly recently that have been done on people who've transitioned some time out, I don't know, five years maybe, asking them the question, do you wish

you could have children? Would you like to have children and do you wish you had done something that would have been at least fertility preservation options? And the statistics, I remember, were well over 50%. I read that study. Who said yes. I read it, yeah. Fertility.

But when you ask the question, how many adolescents are saying, yes, I wanna pursue fertility preservation before I, it's like single digits. Hardly any teenager wants to have kids. Exactly. Exactly.

It's another kind of another data point of our adolescents really in the position to decide that sort of thing for themselves without a good likelihood of regret in the future. Yeah. Yeah. And there's also, of course, you know, I mean, fertility is a big one, but voice transitions, you know, masculinizing your vocal cords that most likely will never go back after a certain point. So there are long-term consequences just to cross sex hormone.

Yeah. We're getting out of time here. And so that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, that's the, through, through this, you know, if they're, if they're either considering it or maybe passionately really wanting it, like how do you navigate that? What's interesting. Once word gets out that you do what I'm doing and what you're doing,

people start asking you for advice, right? So I've over the last few years worked with a number of families who just find me somehow and ask, you know, what should I right? So I've over the last few years worked with a number of families who just find me somehow and ask, you know, what should I do? And I'm certainly no therapist on this thing, but I share what I can of data, you know? And I just think of three situations of families that I've worked with that kind of represent to me some of the spectrum of views. One, very young child, six years old, who is insistent, increasingly insistent that they're a girl, not a boy. Another family, young teen, female,

who rather quickly went from quite a, just a feminine persona to requesting hormone therapy. And then a person who is in their 20s before even really acknowledging or sensing gender dysphoria and wondering as an adult what is. So there's a lot of the pastoral piece is always a challenge, but so important. And I guess where I've come out on this, Preston, is, you know, I go into these conversations and I let them know what the surrounding culture is, has done to this conversation that's going to make their decision making as a family very

complicated, namely the political polarization stuff. And I just lay out what I see happening politically and encourage them not to allow that to be the basis on which they decide, particularly if they're a parent, trying to help their child navigate this. And then to start just talking again, some of the data that I feel more confident in. It does seem, one issue we haven't really talked about and it comes into play here is,

what does the research show with regard to being the type of factors, pre-transition factors that if those are in place, lead to eventually people saying, yes, this was positive as opposed to I wanna de-transition. And one thing that's pretty clear is that early onset, meaning pre-puberty versus late onset is a significant factor. And so for example,

when I was working with couple families now of who of teens who's gender dysphoria just emerges during or after puberty. To me, that's, that's a category now that has a much greater chance of eventually regretting any significant bodily changes. And so I strongly have encouraged those parents to don't... this is my my parental heart would be do what you can to ensure that your child knows you are on their side. You do not want to set up an us versus them thing, no matter how strongly you feel about this. Your child needs your love and for you to walk with your child, not against them. However, that does not mean you cannot bring in love and in gentleness some very important

information to your child who might not be getting this, particularly if they are deeply immersed in certain social media platforms and peer group conversations. And I, at least in a couple of situations I've been involved with, I've seen where that loving parental support, but nonetheless, bringing some information that challenges

some of the kind of monotone channels they're getting in social media has slowed the child's process down, which I think is always a very good thing. It has. So that was my question, bringing information to your child. Does that ever do anything when they're... Yeah, I think it can.

Depends on the parental relationship you have with them. I think it does. It hangs a lot on keeping that parental, that the parent-child relationship in a context of trust. Doesn't mean you agree, but it means your child knows that their best interests are first and foremost for you and that what they think about their own best interests does matter to the conversation. It doesn't necessarily determine it, but it matters and that you hear them and that you

do your best to imaginatively step into their shoes and live life with them. And all of that just softens hearts, I think. It reduces family polarization. It builds bridges where the child then, the child senses, they're really trying to get me. Well, that, man, that just invites allowing the child to imagine them trying to get the parents and what they man, that just invites allowing the child to imagine them trying to get the parents and what they have read and what they're concerned about. And

now we're talking about dialogue as opposed to two monologues that are passing each other. Where do you see, I mean, if they're, do you, do you anticipate a growing number of transition regret as we're having a much higher percentage of trans people transitioning, you know, we're still waiting for years to pass to see how many people end up regretting, which again, maybe there's going to be a rise in that percentage of regret. Where's that going to lead us? I mean, is that, do you think that was going to, there's going to be kind of a, you know, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a, a,'s going to be a rise in that percentage of regret. Where's that going to lead us? I mean, does that, do you think that was going to, there's going to be kind of a,

a more public broadly public concern if all of a sudden we have 15, 20, 30, 40% of people regretting it and maybe some lawsuits and stuff that might come out. I think that's inevitable. I think you're absolutely right. When you have journals like the Journal of Homosexuality, very affirmative journal, and Archives for Sexual Behavior, now publishing articles that are sympathetic, not even neutral, but sympathetic to the detransition community. Ellie Vanderbush's article, 2021, in Journal of Homosexuality, things like that. There is a shift happening amongst researchers where I sense that they now realize

the voices of this community can no longer be ignored and this field stay reputable. And that means some of that sizable loss to follow-up groups, 75% perhaps, of people are going to be coming back into the data pool somehow. And that can't help but raise statistics on de-transition. It just, I don't see any way around it. It's going to you know, and Once that happens and look all it took was one major lawsuit in the UK, right? You know I know yeah Bell for everyone to go wait We would have can you imagine the lawsuits that if this starts happening? And I mean, let's face it money does a lot of the talking money in this culture I think money does a lot of the talking and I'm not like, I've done my best in this study,

not to get drug into the politics. But when it's the case that a particular field has for whatever reasons, generally cited with one political position, I think we've got to name that. Because that does influence the science. And I'm concerned that not just the political sphere, but the literal consumer market,

the dollars being spent on this industry, pharmaceutical and surgical, is no small matter. I think the number I saw, there was a 2020 study maybe, projecting out to 2027, the market share of transition surgery medical costs. And the industry was like, was it $1.5 billion industry projections? I mean, it's remarkable. So we're not just having political issues for feeling this. We are having financial

investments that are fueling this. And that's a lot of social influence that we've got to account for. I just want to, I just cut a couple of clarifying points that, you know, at the end, I, maybe I said this in the intro, I haven't recorded it yet, but first, first of all, the purpose of this episode was not to evaluate the ethics or morality of, of transition. We said we're, we're just looking at mostly almost all secular studies done on whether or not people regret their, their transition. And also, even if we could, could, it could sound, I hope it doesn't sound like this,

but kind of, we just said the beginning, like we're not wanting the percentage to be higher. We're not needing the percent. In fact, it could be, it could be 1%. And that doesn't say anything about the Christian ethics of it. So there's no, I don't, I don't neither you or, and I need a percentage given kind of how we view the ethics of the whole thing. And even if it is even a 30%, it's still less than 50. So the majority now again, if we're going on longitudinal studies, there's a lot of unknowns here, but there's people that don't regret it at all. They're super happy with their transition. I've got at least two friends that have transitioned and it's been a long time in years, you know, a couple of decades almost. And for one, and

you know, they're super happy that they transitioned to have no regrets. So, and I think sometimes they, they, when they hear talks like this, they, they, they feel like their voice isn't heard. So yeah, I, man, Paul, you're the sheer level of research you put into this. I would invite if anybody's really curious to go read the study, I mean, it's free online. I'll put a link in the show notes. It'll take a while. I mean, you're, you're remarkably clear in your writing, given how dense the research and topic is. So it's not, it's not, it's not, it's not a, it's not a bedtime read, but it's, it's, it's not, it's not an impossible read. So yeah, I would invite people to go check. I did try to keep the language accessible to a wide audience. And there are some, some kind of summary and

conclusion sections where you can get the gist without reading most of it. So that was so helpful. That was so yeah, if you could almost go and skip through, read the summary and catch something that you want to go deeper on and, you know, spot read those sections. But Paul, thanks so much, man, for your hard work here. And thanks for being a guest with the algebra. Oh, presence and honor being part of your center, being able to do work with you and yeah, really fun being on a podcast with you. This show is part of the Converge Podcast Network.