Episode 118

118 - Prioritizing Expensive & Invasive Interventions: American Healthcare w/ Zhenya Abbruzzese

Published on: 16th June, 2023

In this episode, Sasha and Stella sit down with Zhenya Abbruzzese, a healthcare researcher, analyst, and the author of several widely read peer-reviewed publications about pediatric gender medicine. Zhenya Abbruzzese papers include “The Myth of Reliable Research in Pediatric Gender Medicine,” “Reconsidering Informed Consent for Children, Adolescents, and Young Adults,” and most recently, “Current Concerns About Gender-Affirming Therapy in Adolescents.” She works with several healthcare organizations, including the Society for Evidence-Based Gender Medicine (SEGM), an international non-profit organization that aims to raise the bar of the quality of evidence in gender medicine, with a specific focus on children and young people. 


Previously, Zhenya led analytics efforts for a major insurer to identify low-value care and overuse of invasive and non-beneficial interventions. She also developed and led a venture-backed healthcare startup to help patients with medically-unexplained symptoms and health anxiety. 


A lifelong Democrat and supporter of progressive causes, Zhenya became alarmed when she saw the civil rights argument misused to justify the rapid proliferation and administration of highly invasive “gender-affirming” interventions to children and adolescents despite quality evidence supporting their use. 

During their conversation, Zhenya, Stella, and Sasha explore the origins of the Dutch Protocol and dive deep into Zhenya’s insights into pediatric gender medicine, as well as her experience working with insurance companies. Zhenya takes great care to point out that in addition to considering the cultural components impacting the current gender discourse, it’s necessary to explore the psychological piece as well. But in addition to that, the involvement of medical organizations like the APA and the American healthcare establishment as a whole all play key roles not only in what is happening in gender medicine but how it’s happening to such extremes.




Papers by Zhenya Abbruzzese

The Myth of Reliable Research in Pediatric Gender Medicine

Reconsidering Informed Consent for Children, Adolescents, and Young Adults

Current Concerns About Gender-Affirming Therapy in Adolescents

Methodological Bias (funny meme):


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

The Dutch Studies Playlist

We have done a number of episodes about the "Dutch Protocol" which precipitated the surge in youth gender transition. There are many things about the Dutch research that have been misinterpreted and misapplied in various medical settings. Here are all the episodes we've done so far where we dig deeper into the studies that started it all.


Conversations about Medical Interventions & Gender

In these episodes, we discuss the history, evidence base, modern debates and emerging investigations around medical interventions for trans-identified children and adults.


Episode 62 - Pioneers Series: Adolescent Identity with Riittakerttu Kaltiala


Episode 94 — WPATH’s Bizarre 8th Standards of Care


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


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

Sasha Ayad: https://inspiredteentherapy.com/parents-start-here 

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

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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.

Thank you to our sponsors:
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.