Episode 68

68 - Pioneers Series: Cultural Misunderstandings with Paul L. Vasey

Published on: 25th March, 2022

This is the last episode in our pioneers series and the second interview with Dr. Paul Vasey. If you haven’t heard our conversation with Paul in episode 57, I recommend you go back and listen to that one first, as we build upon many of the ideas we introduced there. Today we continue reflecting on the way Western activism interacts with research and the interpretation of the fa’afafine, the muxe, and other third-gender individuals from different countries. We talk about the implications of the fact that the fa’afafine, for example, don’t try to identify as women and whether there are conflicting rights issues in Samoa. Paul also explains how Western funding organizations can end up imposing foreign concepts onto other cultures. We even touch on the implications for things like puberty blockers and early medical intervention.


It was a real pleasure to wrap up our series with Paul and we hope you’ll enjoy this interview and stick around next week for the post-series analysis with me and Stella.



“What can the Samoan ‘Fa’afafine’ teach us about the Western concept of gender identity disorder in childhood?” by Paul Vasey and Nancy Bartlett (2007).Pubmed.ncbi.nlm.nih.gov/17951883/


Extended Notes

  • Stella and Sasha reflect on the last episode they had with Paul, having now the time to digest what they’ve learned so far in this series.
  • What is the implication of the fa’afafine to have their own gender category?
  • Fa’afafines having their own gender role consequently makes gender dysphoria uncommon in these cultural settings.
  • Paul talks about sports teams and how the fa’afafine participate in them as an example.
  • What is the Samoan’s opinion about today’s phenomenon of trans women competing in international sports?
  • Paul shares the impact the western culture has with the fa’afafine and the common questions he gets from them.
  • What is the most important thing we can learn from the Samoan culture?
  • Paul is skeptical about the imposition of ideas from other cultures to work when they don’t develop organically.
  • Gender-diverse individuals in non-Western cultures are commonly depicted in idealized terms but there is no such thing as a gender utopia. Paul talks about how he thinks that’s not the reality of their everyday lives.
  • What are the points of difference between fa’afafine and muxe? Paul shares what they are.
  • The similarities between fa’afafine and muxe mean there is a biological structure to same-sex attraction that can be culturally universal.
  • Sasha asks Paul how he addresses cultural relativism between different cultures.
  • Paul does not suggest that either conceptual framework for understanding male femininity and same-sex attraction is better or worse than the other. Each has its own benefits and costs.
  • In Samoa, male same-sex attraction doesn’t really mean anything. Paul explains this further.
  • Paul also talks about the statistics between Western gay people vs fa’afafine vs. muxe and their implications.
  • How do cultural influences contribute to ROGD? Paul shares his insights.
  • Talking about cross-cultural context, Paul highlights the importance of historical change through time in terms of what boyhood femininity means.
  • Paul uses the term female gynephilia as exclusive and explains why.
  • Paul mentions Paul Bailey and what he said about having less flexibility in men and what that implicates.
  • It’s natural for cultures to interact with each other and it’s natural to exchange ideas and concepts in order to evolve. But what happens when one culture imposes on another?
  • Paul often finds a lot of people who are outsiders of a certain culture self-identify themselves as experts which in turn misrepresent these people.
  • If it’s an actual person born from that culture who then moved away, that person can better represent as a spokesperson of a particular ideological perspective.
  • A majority of these local communities would not pay attention to these topics because it’s not a relevant conversation for them.
  • How does funding of research studies influence these communities?
  • Paul shares that the LGBTQ+ community does not make sense to most non-Western cultures.
  • People can assemble and form groups in any way they desire but it’s valuable to be sensitive to cross-cultural perspectives so the Western way of thinking is not imposed.
  • There are downstream consequences to tinkering with these cultural systems because they might not be as optimal as the ones currently in place.
  • If tolerance and acceptance are just social constructs, then they can crumble and disintegrate very quickly and we can’t take that for granted.


This podcast is sponsored by ReIME and Genspect. Visit Rethinkime.org and Genspect.org to learn more.


For more about our show: Linktr.ee/WiderLensPod

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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.