Episode 114

114 — The Dutch Protocol: A Deprivation of Sexual Development with Julia Mason and Stephen Levine

Published on: 19th May, 2023

In the wake of such comprehensive exploration and analysis around the foundational medical research cited time and time again regarding child and adolescent gender transition, the Dutch Protocol, we extended an invitation to Dr. Stephen Levine and Dr. Julia Mason to join us in a discussion about their most recent paper, co-authored together with Zhenya Abbruzzese in a thorough critique of the Dutch Protocol.

Dr. Stephen B. Levine is Clinical Professor of Psychiatry at Case Western Reserve University School of Medicine. He is the solo author of five books, all of which are concerned with love and sexuality. He has been teaching, providing clinical care, and writing since 1973 and has generated over 180 publications, 35 of which have been related to gender dysphoria. He and two colleagues received a lifetime achievement Masters and Johnson’s Award from the Society for Sex Therapy and Research in March 2005. His recent publications on gender dysphoria have been read by thousands of people.

Dr. Julia Mason is a pediatrician who started medical school in the Medical Scientist Training Program but emerged with a Master's degree in Nutritional Science rather than the planned PhD. This extended her medical education and kept her grounded in the scientific basis of medical care, which may have made her more likely to be skeptical of pediatric “affirmative gender care” when she saw it taking root in her hometown of Portland, Oregon. Julia is a founder and board member of SEGM, the Society for Evidence-based Gender Medicine. She is a full-time practicing pediatrician in Gresham Oregon, her gender work is extracurricular and entirely voluntary.

Our conversation with Drs. Levine and Mason evolved into a pretty intense exploration of sexuality and the consequences that blocking an adolescent’s puberty has on their developing sexuality. We explore why so many adolescents are consciously or subconsciously seeking to block their sexuality and seek, sometimes desperately, to avoid opportunities for experiencing natural sexual development. And what about the impact and consequences of easy access to extreme varieties of pornography? But most importantly, why are we robbing young people of the opportunity to develop their sexuality? This is the key question. The discovery and exploration of sexual desire are critically important for the adolescent experience. Puberty blockers and cross-sex hormones not only disrupt but eradicate the normative and positive experience of coming to grips with one’s desires and sexual self.

Please note that this conversation includes many topics explicit in nature, listener discretion is advised.


Co-Authored article with E. Abbruzzese

The Myth of "Reliable Research" in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies-and research that has followed


Stephen Levin, MD’s most recent published article with E. Abbruzzese:

Current Concerns about Gender-Affirming Therapy in Adolescents https://link.springer.com/article/10.1007/s11930-023-00358-x

Selections of Julia Mason, MD’s Published Work

Op-Eds co-authored by Julia Mason, MD

Stephen Levin, MD’s books:

He was also the Senior Editor of the first (2003), second (2010), and third (2016) editions of the Handbook of Clinical Sexuality for Mental Health Professionals https://www.amazon.com/Handbook-Clinical-Sexuality-Mental-Professionals/dp/0415800765.

Society for Evidence-Based Gender Medicine (SEGM) Spotlight Page: https://segm.org/news

KevinMD: https://www.kevinmd.com/

If you liked this episode, more episodes you might find interesting:

  • “The Dutch Studies” | GWL Episode Playlist


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For more information about Sasha’s & Stella’s private membership groups:

Sasha Ayad: https://inspiredteentherapy.com/parent-coaching

Stella O’Malley: http://www.stellaomalley.com/parent-coaching

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Extended Notes:

  • Julia says every patient she sent to the gender clinic received the same treatment. Everybody was affirmed.
  • Julie was involved in the creation of SEGM, The Society for Evidence-Based Gender Medicine.
  • There are almost 300 diseases classified in the DSM-5.
  • Self-proclaimed experts are often not experts.
  • Stephen remarks that a common characteristic of adolescents is that they are arrogantly certain.
  • The group questions what makes an expert in the field of gender identity.
  • Julia explains Innovative Practice research.
  • Stephen questions a teenager’s ability to make decisions about their sexuality before they’ve had a sexual experience and a surgeon’s decision to remove sexual organs before a patient has had a sexual experience.
  • Stephen and Julia dissect the Dutch research to convey its flawed data.
  • Will children who are prescribed puberty blockers ever experience a natural sexual awakening?
  • Stella points out society’s misgivings about speaking to children about their sexuality.
  • Julia shares her thoughts on the influence and exposure of porn on children.


“The thing about this topic [gender-affirming care] is the more you read into it the more confusing it gets.” — Julia Mason [9:04]

“In dermatology, there are 274 known diseases and that’s about as many diseases that we have classified in the DSM-5. Almost 300 different entities, if you look at sub-types. None of us can understand the basis for the therapeutic recommendations for over 200 diseases. It’s just impossible. And so, what happens is somebody at a high level does research and creates a policy based upon that research or on a set of beliefs in the case of transgender medicine.” — Stephen Levine [10:38]

“I don't know when it first came in. ... It was kind of the elevation of the lived experience to being equal to the expert and that has created a very muddy scenario of what is an expert. If I’ve been alcoholic for 20 years does that make me an expert in alcoholism? That has really been driven in with gender I think in particular.” — Stella [19:52]

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About the Podcast

Gender: A Wider Lens Podcast
Two therapists explore the expanding concept of "gender" from a psychological depth perspective.
Gender dysphoria has become a minefield for public discussion, with many afraid to express their views or question the narrative. Our mission is to examine this important and complex topic from a range of perspectives, but always through a psychological lens. By openly considering and examining gender identity, transition, and the transgender umbrella, we hope to give all interested parties permission to engage these fascinating topics with less fear and more honesty. Interviews and discussions will involve clinicians, medical professionals, academics, transgender people, parents, detransitioners and other interesting individuals whose lives have been touched by the concept of gender.

Conversations between two practicing therapists give listeners an opportunity to contemplate gender from a depth perspective not currently taken up in most of today’s accessible debates. As a result of their work with gender dysphoric therapy clients as well as their personal divergent experiences with gender, Stella and Sasha hold a refreshing and informed perspective.

Is gender identity a facilitation of development and expression of creativity, or can it be a defense against painful existential realities of living in a human body? What can we discover about masculinity, femininity, identity, gender performance, and sexuality when we peer beneath the surface and dive into a deeper psychological exploration? What is the relationship between body, mind, identity, culture, and psyche?

This podcast engages listeners in an intimate and fascinating behind-the-scenes inquiry about a topic as taboo as it is salient today.

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Genspect - an international organization which offers an alternative to WPATH. Providing a range of education, resources and supports to anyone impacted by gender distress, Genspect unites many different organizations globally, and gives voice to 1,000s of previously untold stories. For more info, visit genspect.org.

GETA - an association of therapists who believe that individuals experiencing gender related concerns ought to be treated using a whole person approach. GETA connects like minded clinicians, provides educational resources and trainings, and helps people with gender dysphoria find support. For more info, visit genderexploratory.com.
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About your hosts

Stella O'Malley

Profile picture for Stella O'Malley
Stella O’Malley is a psychotherapist and author who works in private practice in Ireland. Her work focuses on parenting, family dynamics and working with teenagers.

Much of Stella’s counselling and writing focuses on mental health and the importance of well-being and she is a regular contributor to the media. She is also the resident psychotherapist for the current TV series, Raised by the Village, a family programme that helps troubled teenagers reconnect with themselves and their families.

Stella's first book, Cotton Wool Kids, was released in 2015 while Bully-Proof Kids: Practical tools to help kids grow up confident, resilient and strong was released in 2017. Stella’s latest book Fragile, was released in 2019 and focuses on overcoming anxiety and stress.

Stella was the presenter of the documentary Trans - Kids: It’s Time To Talk broadcast on Channel 4 in November 2018 and she contributed a chapter to the 2019 book, Inventing Transgender Children and Young People.

The Jungian analyst, Lisa Marchiano, and Stella launched Secrets of the Motherworld in September 2019, offering thoughtful exploration of the most intimate aspects of motherhood in a bid to help mothers feel less alone.

Stella is a Clinical Advisor for the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners. She is also the lead facilitator for the Gender Dysphoria Support Network.

Stella holds a B.A. in Counselling and Psychotherapy and a M.A. in Cognitive Behavioural Therapy.

Sasha Ayad

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Sasha Ayad is a Licensed Professional Counselor who works in private practice, and has treated adolescents for over 10 years. Her work focuses on teens and young adults struggling with issues of gender dysphoria and gender identity.

She became interested in the sharp rise in teenagers who declare a trans identity for the first time during adolescence. She discovered, through working with hundreds of families, that many teens were developing gender dysphoria only after adopting a transgender identity. She questions the practice of medical transition for children and teenagers, and her clinical work focuses on developmentally appropriate, least-invasive-first talk therapy.

Sasha is also a founding member and Clinical Advisor in the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners.

Sasha’s previous work experience includes:
- School counselor for middle and high school students at a charter school for underserved communities

- Behavioral therapy with children on the autism spectrum

- Individual and group counseling for women and children impacted by domestic abuse and sexual violence

- Developed and ran the first counseling program at a large state supported living facility for adults with intellectual disability

Sasha holds a B.S. in Psychology and an M.Ed. in Counseling Psychology.