Episode 5

full
Published on:

8th Jan 2021

5 - Hormonal Interventions — from Fringe to Mainstream: A conversation with Dr. Will Malone

Quick Notes

Endocrinologist Will Malone joins Sasha and Stella to discuss the pivotal position that endocrinologists have in the new practice of childhood transition. In this conversation, Will describes attending a conference in 2017 run by the Endocrine Society where suddenly everything related to trans healthcare appeared to shift, without any discussion or analysis.

Extended Notes

●    A quick introduction about Dr. Will Malone.

●    How did Dr. Will get involved in this field?

●    Dr. Will was seeing small clusters of females declaring they were trans. What was going on?

●    Primary doctors were calling Dr. Will for help. They had never seen anything like this before.

●    Dr. Will explains what he’s been seeing in his practice when it comes to teens experiencing gender dysphoria.

●    Stella notes that the three main professionals needed are surgeons, endocrinologists, and psychologists to help teens through this journey.

●    What is the role of an endocrinologist and what kind of guidelines should they be following when helping at teen transition?

●    Dr. Will doesn’t agree with the treatment protocol for hormone blockers in teens.

●    Dr. Will was surprised by the study they based this new treatment protocol off of. It referenced only one study and the quality of evidence, he believes, is questionable.

●    Endocrinologists prescribing puberty blockers or sex hormones to teens outside of clinical trials — they are engaged in experimental medicine.

●    “Let’s see what we can do.” Is not an approach any medical professional should take. People will be harmed by this.

●    Sasha recaps how medical professionals were treating gender dysphoria prior to 2010 vs. how they’re treating it now. It’s alarming.

●    Where’s the data?

●    What are Dr. Will’s peers and colleagues saying about the Endocrine Society’s stance on this?

●    The harms can be significant. We’re talking about infertility, increase in heart disease, and irreversible effects in children.

●    Dr. Will has attended conferences where counterpoints are presented when it comes to prescribing new medicine, but he did not see this occur when it came to gender dysphoria. It was difficult even to submit questions.

●    What type of person/endocrinologist pursues this field of work (sex hormone blockers)?

●    How did SEGM get started?

●    The UK recently had a ruling about puberty blockers. Dr. Wil shares more details.

●    On a chemical and medical level, what happens when you stop puberty?

●    Can a simulated puberty be the same as biological puberty?

●    Why halt puberty with a mental intervention? Why aren’t we getting more psychologists on board during this process to help distressed teens navigate their new bodies?

●    The medical field is more than happy to provide solutions to client demand, even if it is to the detriment of the client.

●    Sasha is seeing something very shocking happening with parents and their gender dysphoric children right now.

●    Parents are being ignored. It seems to be culturally acceptable by medical professions to skip the due diligence and go straight to hormone blockers. Any questions parents bring up — they are deemed bigotted.

●    UK medical professionals think the guidelines are rubbish and are not biting. U.S. medical professionals see it differently: These are the guidelines, therefore it must be okay!

●    It’s a difficult position for Dr. Will to be in. He’s going against the herd and he’s receiving peer pressure from it.

●    Dr. Will says it again: If you intervene when there’s no evidence, there is likely to be harm.

●    Stella shares what’s happening in Ireland right now when it comes to puberty blockers.

Links:

Will Malone twitter: Twitter.com/will_malone

SEGM: Segm.org

SEGM Tweets: Twitter.com/SEGMtweets

Michael Biggs

Video: Youtube.com/watch?v=9VHlkE40cFk&t=971s

Academic Paper:

Link.springer.com/article/10.1007/s10508-020-01743-6

Endocrine Society's Guidance on Gender Dysphoria:

Endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence


UK Ruling in Kiera Bell Case:

Bbbc.com/news/uk-england-cambridgeshire-55144148


Pressure to Medically Intervene:

Theguardian.com/society/2015/sep/12/transgender-children-have-to-respect-who-he-is

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This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Rethinkime.org


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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.

* We are partially sponsored by ReIME, Rethink Identity Medicine Ethics. ReIME is a non-profit organization dedicated to improving long term care for gender variant individuals. To learn more, visit https://rethinkime.org/
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About your hosts

Stella O'Malley

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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.