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

[@widerlenspod]

If you enjoyed this episode please remember to like and subscribe! Also visit our Substack here www.widerlenspod.com/ and sign up for a Paid Subscription for Bonus Content with Zhenya Abbruzzese and other guests. It is the best way to support this show. Thank you so much!

[@sueinraleigh3091]

Zheyna just filled in so many gaps for me. This is one of the most important programs you’ve produced.

[@sueinraleigh3091]

It would be great if you could have a call in show or have a show where you answer emails to follow up on this. I have many new questions. Damn these greedy clinicians and societies.

[@lucydayLucida]

Yes, it is one of the best. Such a valuable source of information on this subject.

[@Gingerblaze]

40:36 the children born in the late 90s early 2000s were the first to grow up spending a great deal more time than ever before, interracting with other people thru the internet than they did face to face with people in real life. There are multiple reasons why this has had a societal impact on their concepts of sex and gender that have not effected children in geographical areas with demographics whose children are still primarily socializing in real life much more than online. One of those reasons is how, when on line, one can exsist without declaring what sex they are or be assumed to be or present oneself as the opposite sex to what one is in person. Another is the vast influence of adults portraying themselves as children in gaming spaces and the promulgation of sexual and pornographic imagery and conversations which happened and continues to happen in these spaces that parents were and are largely unaware of.

[@The-Finisher]

Dead on.

[@877swissmiss]

That porn stuff is really a huge bad influence. I had a bf in early 2000‘s who thought he knew a lot about sexuality and women. Turned out he gained „his knowledge“ from porns only. I had to teach him a lot and he almost couldn‘t believe how wrong, how absurdly women are portrayed in porn movies. If he was an early example of the development of kids into adults I‘m not surprised at all of today‘s problems teens &young adults have who rarely interact w ppl face to face& live in the virtual world mainly.😢

[@pjglory3348]

There is another facet to this medical explosion which is the changes to the DSM to allow a diagnosis of gender dysphoria in adolescents. Once there is a diagnosis, then there can be an insurance claim.

[@Gingerblaze]

Especially concerning since "gender dysphoria" is very common during puberty for nearly everyone.

[@nonpareilstoryteller5920]

And if this were reverted, it would quite possibly collapse the demand that rarely existed prior to that alteration, certainly the contagion that we now see. One has to ask, seeing logically the demand that was created, why is it not being corrected and who benefited from the changes that were involved in writing this specific change to the DSM? Who were the lobbyists?

[@LR2894h]

Wow, the story about her son in the ER is very illuminating.

[@lucydayLucida]

Absolutely this. Since when has a mental illness required a surgical intervention? Since last century when lobotomy was used as a treatment. And that was just one of the many heinous institutionalised 'treatments' of mental illness. Things haven't changed as much as we'd like to believe.

[@AndyJarman]

And the SoC 8 of WPATH.

[@AndyJarman]

I'm from the UK, I'll never forget a friend stubbed his toe when in San Francisco and ended up with a full hip to toe leg plaster - he had travel insurance. This meant he qualified for business class on his flight home and two seeks paid leave. We cut the leg plaster off after he got home.

[@balalaika852]

I stubbed my toe and was just curious if it was broken or not, got a scan at A&E (in the UK) and the nurse tapped one toe to the other with a plaster with dinosaurs on it. There's literally no reason to do anything else. US is a ridiculous place.

[@ravencole8727]

This is by far the clearest, most informative analysis I've seen on this topic. I hope you clip the heck out of it!

[@janebennetto5655]

As a UK retired paediatric gastroenterology nurse- I have always worked within a team that was research-based. Also if there were any medication that was to be used ‘off-licence’ - there was a huge process within our hospital Trust - to eventually allow (or not) the drug to be used. I have been appalled how the ‘gender affirming’ care has been allowed to continue here- especially after listening to this programme. We need to be alert to the most recent UK recommendations to allow puberty-blockers only within a research process OR in exceptional circumstances - I know certain medics will say everyone is ‘exceptional’ to get the drugs prescribed. This is in light of reviewed research that suggests harms are in excess of benefits. Let’s keep the children safe. X🇬🇧

[@wendypratt6837]

What an incredibly well spoken lady who has brought so much clarity to this topic! I am actually listening for the second time so I can make notes of some of these excellent points! Thank you Sasha and Stella for your tireless work!

[@hnybee113]

Zheyna is my new hero!! I seriously need to attend her languaging of her stance and truth about Trans everything. As a progressive in America who works in Behavioral Science primarily within the autistic community. I need knowledge and words to get ready for the wave of regret I feel will be overcoming our young adults in years ahead.

[@widerlenspod]

She is fantastic, isn't she? Thanks for your comment

[@susantempleton5882]

One of your best and most important discussions yet. I'd not heard it stated so clearly before that transition doesn't work.

[@megankwisdom]

Wow, I don't even know what to say because that interview was so informative and so thought provoking. I'm just like trying to wrap my head around it all. I will definitely be thinking about this issue in a new way after this. Thank you

[@shelbyschnoor9369]

Honestly it blows my mind that this is happening to children. It makes me very sick about our culture, medical system, government.. I wish people would just wake up and call for all of this nonsense to stop.

[@trollsearching8968]

The average person has not sat in the board meeting and leadership financial meetings where the organization states it's goals for Money and how to get into and focus on "Markets" to achieve this. I have been there. While the average individual health care provider is hoping to really do good, they even are unaware of what the organization is doing and how it sets these crazy goals in the name of Money.

[@ArtU4All]

Tremendous guest. Crossed the T’s. Highlighted the obscure. Warned of the underwater rocks.

[@widerlenspod]

Indeed! Thanks for watching

[@polinas.4249]

Sasha, Stella, an amazing and very important episode, thank you! But you ended up not talking about Canada after all! Please, please, please, can you have a Canadian landscape episode? Perhaps interview one of the more careful practitioners, like Dr. Joey Bonifacio who wrote a while ago in the National Post (I think), warning against uncritical affirmation?

[@scorpina69]

More eye and mind opening wisdom and exposure. More food for thought! These interviews are so important.

[@beemacs7282]

Excellent piece. Well worth remembering the fact that a single study does not indicate success - the fact that no systematic review of the evidence exists. Policy and law should never be generated on such lack of evidence. I love the logical analytical way Zheyna explores this and her take on the dutch experiment confirms completelybwhat we sort of knew.👏👏👏

[@ljhay1789]

Very well done. Thank you for this episode. This segment caught my attention “I think parents are listening to detransitioners. And this is giving them credible evidence that the doctors might have been wrong. Right. I think the laws that are happening in America, some of them are quite draconian, others are more reasonable. But these laws are being passed as a result, in my opinion, as a result of medical societies refusing to engage. And so when insurance companies can't pump the brakes, and medical societies are refusing to pump the brakes, then elected representatives begin to slam the brakes.”

[@amylombardi7378]

Excellent episode. I very much appreciate the description of systematic review. Bottom line, the US medical system is not steered by evidence-based medicine.

[@debbielondon1809]

It's beginning to irritate me that American broadcasters seem to think the UK has been super sensible! The UK did not review the situation because it is more cautious, but because some very brave people at the Tavistock Clinic rang the alarm bells etc. And we are not out of the wars yet. The new rules are that minors can access "gender affirming care" only if it is part of a trial....this means that kids can still access these invasive treatments but have a different set of hoops to go through.

[@transitionsnc]

This is a phenomenal interview. Thank you!

[@grothd09]

The whole subjective thing is so absurd! If a person has elected to have their healthy body parts removed and/or harmed & take medications that aren’t for a physical diagnosis and then say they feel much better even though evidence indicates they are doing worse…then that is a CLEAR sign that person has significant psychological dysfunction!

[@davidleemorgan]

This was the most useful, illuminating discussion of the medical abuses in 'transgender medicine'. Especially useful was the wildfire analogy, looking at the tremendous positive that is coming out of this: the much more widespread acceptance of gender nonconformity in children. But we are also starting to see a big negative pushing in the opposite direction: the parental rebellion that Zhenya hopes will be a corrective to the abuses in the US is being channeled into a rightwing fundamentalist rejection of not only the medicalisation of gender nonconformity but of gender nonconformity itself. That's why it is so important for organisations like Genspect and SEGM to take on both enemies: the gender fundamentalists of both the Right and the pseudo-Left, who both in their different ways, are upholding sexist gender stereotypes.

[@rachginsberg]

Very informative conversation.

[@madincraft4418]

That answered so many questions

[@bogdiworksV2]

Definitely not boring! I could've listened even further about how insurance works and how it influences the provision of care. Excellent interview and great comparison between the US and Europe.

[@careyparis5460]

Wow. Fascinating! Thanks so much for this!

[@cestmoi4532]

Another excellent, informative, and nuanced conversation.❤

[@dimad645]

This podcast is one of your best. You should have Zhenya again. I follow KZbin channel of Dr Suneel Dhand who is British but now lives in the US, and he has a similar analysis of American healthcare.

[@smooth_pursuit]

Dr Dhand tells it like it is 👊

[@ArtU4All]

Suneel is great!!! There is nothing like a fresh-experienced look at the US by the American Doctor from a different country 🙏🌱🌳

[@petiadavis5122]

Dr Suneel is a true hero for exposing how rotten the American health system is

[@bridgetteparker7719]

I'm no expert, but it seems to me that part of the push towards medicalization is the sociatal tendency to dismiss the psychological field. In other words catering to the physical proof crowd. "Your depression isn't real unless you have a diagnosed chemical imbalance that needs medication. Your PTSD isn't real unless you can point to a cinimatic quality traumatic event and I see a movie script panic attack. Your gender noncomformity isn't real unless you go through with a medical transition." The finger of blame could be partially pointed at the insurance-based structure of US medical industry where key word diagnosis leads to coverage. But I think a lot of it is also based in the concept that mental health is only validated if there is a concrete cause and highly problematic effect (such as brain wiring doesn't match gonads and end result will be suicide) and anything less than that is just a personal moral failing.

[@susantempleton5882]

Interesting points. We are in a cultural moment when we seem to be attributing every psychological issue to the body. Popular solutions change the body as well. So, take a pill. So, use exogenous hormones. So, get surgery. There’s even a movement to find that trauma symptoms are genetic and not related to past events.

[@bridgetteparker7719]

@@susantempleton5882 Yes, and I say this as someone who totally attributes my pych problems to genetics (mostly) and takes meds, but I also put value in therapy etc.

[@baconsarny-geddon8298]

26:00 the problem with relying on the subjective self-reporting of those who:ve been thru "transition", is the distortion of "sunk cost" logic. Anyone who's been thru significant chemical OR surgical "transition" (ESPECIALLY if they've had ,"""bottom surgery""") is beyond the point of no return; REGARDLESS of how negatively or positively the procedure may have impacted them (in fact, ESPECIALLY if it's had severely negatively impact), their own internal mental health relies on the fact that they HAVE TO tell themself "I DEFINITELY did the totally right thing!!" Because, let's assume "transition" DID have very impact- Say they've lost capacity to orgasm, they're not happy with how the surgery turned out for whatever reason; Whatever the specifics of a "worst-case scenario" is; So what ELSE is a person in this situation going to tell themselves, EXCEPT "Sure, there are SOME downsides... But overall, I am SOOOO glad I get to live as my TRUE self?!?" They CAN'T go back, and get UN-surgery, or UN-hormones; That toothpaste is NOT going back into the tube... So they are STUCK with the outcome they have, however bad that outcome may be.. So unless they want to spend the rest of their life wallowing in pointless, un-actionable regret, all they CAN do, is convince THEMSELF of the most positive spin they can put on things. I,ve heard detransitioners, esp those who went thru "bottom surgery", affirm this, saying "NEVER trust a trans person, talking up how AMAZING their post-bottom surgery orgasms are..." Because the 'sunk cost' they've invested means they CAN'T admit regret, to themselves, LET ALONE to others

[@freddieoblivion6122]

Great talk... Could there be a confusion (possibly deliberate) of the terms 'dysmorphia' and 'dysphoria' by the medical community? It seems as though there are many young people who simply don't like the body they were born in - not because they think they're the opposite sex, but simply because they aren't as attractive as the instagram models we're finding all throughout social media - some of whom are only pretty with the help of beauty filters, creating the perfect inadequacy trap for any average human being. They may see transition as a possible path out of (for lack of a better word) ugliness. I know the feeling of wanting to escape my current physical form, being born and growing up overweight and unattractive, though I didn't grow up in the age of the iphone, thank goodness. I fortunately was told that we have to do the best we can with the cards God dealt us - this was the message in all the TV shows we watched in the 80s and 90s. Add a profit motive, and we have the current mess we're in.

[@joane24]

I think it's not just not looking as pretty as an influencer (which of course is part of it, and was so for a long time, before if was eating disorders etc.) but also that today the influencers, other media representations of women are so sexualized, it's only natural for girls/women to want to escape it.

[@DorianPaige00]

Jordan Peterson intentionally conflates body dysmorphia with gender dysphoria because it has more destructive and he knows better. Intervention here is used to conflate with interference as it sounds intrusive unlike the word treatment.

[@user-rq4rt3ti8l]

So thoughtful. Loved the takeaway at the end that people are more accepting now, and that we can let gender non-conforming children be and now they can thrive. Love it.

[@ebert8756]

Its sunk cost fallacy. You cant be not glad you did it when its so irreversible

[@robertmarshall2502]

I've always thought this. If someone were do these surgeries to a random person against their will to the point where there is no way back then the choice to "detransition" or try to live as this new gender would be very very hard. You can't get anything back in any real sense (function, sensation normal sex) so why put yourself through life threatening surgery (not lifesaving) to gain the appearance of your old body but actually nothing like it? I think you're more likely to just avoid all intimate contact and try to get by as best you can.

[@annebroome1758]

Am so grateful for this excellent information. Congratulations to you brave, good women. And congratulations and many thanks to Zhenya for her measured delivery on what is clearly an horrific tragedy for many children and families.

[@danak2230]

This episode answered so many questions I didn't know I had about how the gender ideology became so ubiquitous. Zhenya is a gem!

[@mwellh113]

High loss to sample follow-up is one of the most common flaws throughout the pro-affirmation research.

[@astrid5522]

So enlightening, thanks very much for posting

[@shannonsayshi]

I absolutely agree about the good that can come out of the wildfire - a generation of kids who are comfortable w even extreme gender stereotype non-conformity in themselves and their peers... and the benefit to all of them i.e less bullying and misery all around. KEY is avoiding the irreversible harms of medicalizing. Being "trans" - whatever that means to the individual - is increasingly not equated w surgical & hormonal transition from what I've seen - in younger groups. While I tend to think GI is all external appearance based froo froo... removing the medical harm makes it also IMO a healthy way for young ppl to explore and express their individual development too. If I was trans... I would be very interested in the fact that biases abound in all the studies being pushed on me... specifically to promote hormones and surgery without credible evidence of benefit... and known risks etc. And the suppression of the truth about detransitioners too.

[@Kelsea-im8ob]

At the risk of being a downer, I think GI has become a neo-religious belief, and the bullying will just move to those who don't believe. It's nice to think gender nonconforming people will no longer be a target either, but the young people seem to just be conforming to new gender standards, that are just as policed as the old ones. You brought up something interesting, though, and that is that there's a greater variety of expression that's permitted.

[@vthompson947]

Certainly at my kids school it's the gnc kids that are the bullies. Even staff are afraid of one girl.

[@ingairen21]

Yes, now it’s cool to bully vanilla normies. The bullying sadly does not disappear it just moves target.

[@shannonsayshi]

@@vthompson947true.. in every cult there are opportunistic narcissists.

[@darkydoom]

I don't know how deep the progress goes in Australia, but when we started seeing gender specialists, immediately they said no to hormone blockers because my child already started puberty, so they wouldn't have access to anything until they were over 16yo. I just wish it was easier to get mental health care services here. Things are an absolute mess. We, as parents, had to ban school psyches from speaking to the kids because they were causing more damage and chaos than actually helping. Waitlists are 18 months at the moment, and most places have books closed, and if you're between 14-17 years old, you're too old for paediatrics and too young for adult psychiatrists, so there's just a freaking blackhole for adolescent mental health care. It's really scary at the moment.

[@Clem62]

I listened to a doctor radio station from America yesterday and the subject was LGBTQ dermatology. It was nonsense from the beginning. As if there us something different with my gay skin. A transman has bad acne from testosterone but so what.

[@miroirs-jumeaux]

« Ask your doctor today about managing your gay psoriasis better with rainboxedrine! Do not use if you are allergic to rainboxedrine or any of its ingredients… »

[@InterstellarDreams]

@@miroirs-jumeaux Uh-oh.. I think I may just have developed an allergy over the last few years, that finally went into just FULL-blown systemic dystopian shock mode, this here Pride month! Wearing a suffragette lanyard on the sly, that sort of works as an antihistamine, when exposed to more than 10 rainbow / "progress" flags in 60 seconds. But.. hoping it won't set off some poor TRA's allergies, and land them in systemic "TRIGGERED!!! / How dare you have filthy opinions that disagree with mine" shock!! Ah, this brave new world... 😵‍💫

[@barbarabrooks4747]

An unfavorable change in appearance can be devastating for emotionally fragile teens and young adults. The unnatural levels of testosterone will definitely make acne worse than in most young people.

[@khalid7377]

I've been meaning to watch this episode since it came out but only just got around to it. This is one of the best videos you've ever made, Zhenya was an amazing guest to have on. Thanks Stella, Sasha and Zhenya!

[@juvenalsdad4175]

Excellent discussion. I always learn more here than from the culture war trenches of either side.

[@widerlenspod]

That's the greatest compliment, thank you! We really strive to go much deeper than trite talking points and warring factions

[@wenkeadam362]

Thank you for sharing this excellent conversation. I have been reading and binge watching about this strange phenomenon I call "Rapid onset trans Ideology" for the last two years trying to make sense of it. A month ago I concluded that it had to be a case of Perfect Storm. I am happy that you think similarly.

[@sharee3135]

Great interview. Thanks 🎉

[@maanvis81]

Thx for doing this interview, it fills in so many gaps, and also explains why the USA is different from Europe in their healthcare systems. Totally appreciated!

[@barbarabrooks4747]

I'm really surprised that insurance companies do not require extensive therapy and psychosocial evaluations prior to approving hormones and/or surgery. Any major elective surgical change in appearance is stressful and puts strain on caregivers. Minors seeking gender transition typically have multiple co-morbidities and/or troubled parents. Autistic girls may get bullied and have other children tell them they are trans or lesbians. Perhaps neurofeedback could improve their neural connections and result in better social and self understanding. Sometimes changing school or homeschooling can help. We need a charity to help parents move or change to private school if their child has rapid onset gender dysphoria. My guess is that if the underlying co-morbidities, peer and teacher pressure and family issues are dealt with by competent therapists, including hypnotherapists when indicated, the majority of young people would decide against medical transitioning. However, early intervention is the key. A toxic peer environment, a disturbed parent or abuse by a family member must be addressed as soon as parents or the school is aware. Sometimes moving in with another relative or friend of the family may be required to stabilize the young person. Avoiding medical transitioning or postponing it until the young person has had several years to work through their problems should be the goal. Young people should get to meet detransitioners in person and ask them questions to help them make informed decisions and realize that transitioning will not solve all their problems.

[@ludaw2975]

yes, why, in the first place, we don't teach kids that it's ok to have a female body but feel like a man and vs! instead we make them physically distort their bodies to conform to a stereotypical image of a man or woman, and by doing so commit them to lifelong medical treatment and numerous side effects

[@carolynbrightfield8911]

In the 1970s, as a feminist I was one of those "dress how you like". My sons wore (on their request) 9:53 pink sometimes, painted their nails as an experiment and cried tears like real humans. That's how they were raised. And now we're back to this.

[@Phoenix-lc7jv]

23:50 wow, what an eye opener.

[@877swissmiss]

I think what could lead to the subjective perception of feeling better after starting transition: They get some kind of care, where they don‘t have to bring much own effort to get better. In a psychotherapy we need to contribute with own effort and reflection. In the „affirning care model“ doctors affirm suffering and there‘s kind of a promise like „you‘ll be better when your body finally matches your identity“. It‘s like a promise of the healing phase that had started w hormones and surgery and whatever problem a transitioner has during that phase, they can always relate it to the not yet finished transition, to society that is discriminating etc. They feel cared for by docs and are waiting to get better, not working internally to get better. I simplified it but I think this could play a role. Obviously many „transpeople“ suffer from comorbidities and it sure doesn‘t help to reduce any illness to being just part of g dysphoria and the consequences of it for daily life.

[@robertmarshall2502]

17:51 bombshell for me The basis for the adolescent transition being that the Dutch didn't think adult transition was very successful. Complete opposite to other claims by trans activists. 52:44 Great catch Stella!

[@joane24]

You can't eat or drink before surgery 🤦‍♀️. If you do, they'll gonna discharge you and cancel your termin. How is that not a common knowledge, that she was surprised about that? That's also one reason emergency surgeries might be more dangerous, because of no fasting before.

[@robertmarshall2502]

They didn't know a surgery was going to happen. And in fact one wasn't necessary. When they were checked in maybe a nurse could say maybe don't eat anything in case they need to do surgery. But even then until you're checked who knows. I have been told before I couldn't possibly have broken bones and then when they did the check they offered me a wheelchair. Rightly or wrongly we trust medical professionals to give us the right guidance. Also in some countries you wouldn't just be discharged, they'd keep you over night and do the surgery after enough time had passed or allow you to go home with strict instructions to return at a booked appointment. Not just abandon you like they didn't give a flying fuck what happened next TO A 4-YR-OLD.

[@ayacahtli4]

It's a horrible rationale. I don't like anything that is coming put of the gender affirming medicine. Thank you for having guest to discuss this important topic

[@hannahd1726]

Years ago I was writing a masters thesis in labour economics looking at employee incentive systems. And there was a paper on how performance metrics applied to doctors at some US hospitals were based on the newborn baby's heartbeat (as a measure of how stressfil the birth had been for the baby) which led to a strong preference among physicians for c-sections because these resulted in predictably lower heartbeats in newborns and better performance ratings for doctors. The paper cited this as a classic example of an employee incentive scheme producing less optimal outcomes because it chose a narrow and unrepresentative measure of outcome.

[@widerlenspod]

wow! That's fascinating

[@prof.jezebel]

The negative objective outcomes for Dutch adult transitions show that even as we may challenge the new ideology and medicalization of kids, we need to keep actively supporting trans people, promoting social acceptance and their rights to be free of discrimination in housing, employment, etc.

[@widerlenspod]

We couldn't agree more, thank you Jennifer

[@AndyJarman]

Contemplating the idea treatment to reinstate genitalia and breasts is possible is almost as horrific as contemplating the idea cosmetic surgery is actually "changing" the person's sex.

[@Spacy-Paws]

Another great discussion, but sadly I don't agree with Zhenya's positive take away about a more accepting society; I grew up in the 70s and 80s and there were groups who were very accepting of gender non-conformity and those who weren't. Things really seem to have got worse since then with more polarisation in gender norms, so much so that non-conforming children are opting out of their sexed class by declaring themselves non-binary. I don't see this denial of sex as the way to a future utopia the way they do.

[@imawordgirl]

In reference to that first study you discussed, the affirming crowd would likely say that many of these transitioned individuals likely couldn't find jobs due to discrimination. FWIW.

[@widerlenspod]

Indeed. Sasha brings this up in the episode.

[@AndyJarman]

The reporting of Covid infections by hospitals in the US was similarly warped by the American healthcare system. Hospitals were rewarded monetarily for reporting infections.

[@alisonmcculloch5693]

This was very interesting, though I'm skeptical of Zenya's argument that we now have a generation that's so much more accepting of gender non-conformity. I don't see how this can be the case when so much of the basis for transitioning kids appears to be gender stereotypes, i.e. if you're a boy who likes dresses and dolls, you must be a girl. How does one reconcile being liberated from gender conformity by an ideology that is based on sex-role stereotypes around masculinity and femininity?

[@carolynbrightfield8911]

C section is a major operation, takes weeks, if not months to recover. Natural childbirth (no stitches etc) recovery - well, you're body is feeling okay in a week ime. Six weeks used to be the last gynaecological check. My sister was preggers at age of baby 15 months. So, she was healthy by 6 months. My daughter in law (c section) told not to get preggers before baby 2 y.o. minimum.

[@myfriendisaac]

38:52 That part 🌈🤷🏾‍♂️💯

[@John-tr5hn]

Two other issues that lead to more C-sections in the US: Fear of being sued, and the advanced age of first-time mothers. They're sort of related. Doctors would rather not be sued for bad outcomes, and C-sections tend to lead to fewer baby deaths, even if they're unnecessary and even if they lead to worse outcomes for the mother. Many of these worse outcomes aren't anywhere near as bad as a single dead child, so many OBs would rather err on the side of expensive, unnecessary surgeries than actually look at individual cases. Also, mothers in the US are generally much older than in many parts of the world, so it makes sense that older mothers are more likely to have complications. But most (all?) US OBs won't allow a mother who has had one C-section to delivery naturally thereafter, so if your first child was delivered via C-section, the rest will be too.

[@littleboots9800]

It is no longer normal practice to insist on subsequent births being C sections after a first. There is no reason a healthy mother with a healthy baby shouldn't have a natural birth after a c section as long as it isn't a pregnancy rapidly following the c-section. Not in the UK and Europe. I know women who have had natural births after a couple of c sections and one who had a natural birth after 3. Most women can go for a natural birth after up to 4 c sections now the guidelines state.

[@shelbyschnoor9369]

The first thing I thought when I realized how awful the process of medical transition is that there has to be a profit motive in the American healthcare system, otherwise this would not be done… it’s clearly medically unsound so there has to be a money reason. Cuz you know the American healthcare system is barbaric

[@joannemoissiades5321]

Don't worry about trends phobia worry about the lawsuits that will be world wide

[@singingway]

On the "healthcare marketplace" the government pays part of the premium. So we are all paying for it.

[@rebeccawhitney235]

Life Saving ❤

[@Joy2Life333]

What is the NIH study mentioned at about 1 hour 13 minutes? Where can I find it?

[@iamanomas]

Canadian here - really hoping this doesn’t hit Canada the way it has hit the US.

[@widerlenspod]

Unfortunately this is already a big challenge in Canada

[@karatyson8234]

The American Academy of Pediatrics skipped off the deep end over 10 years ago when it proposed that pediatricians offer to "nick" the genitalia of young girls whose families came from countries that have FGM.

[@AndyJarman]

If you hold your finger on the letter n it is possible to select intonations to indicate a more precise pronounciation, like ñ.

[@robingow7276]

You lost me at Canada. Clearly there is a little bias towards socialized medicine. Canada is way more taken by gender ideology than the Us. It is against the law to miss gender someone. The US is huge, population wise, compared to individual European countries. Could it be that they can pivot much faster the the US.

[@kay1312]

Google Nathan Pinkoski, "What Led to Canada's Crisis." It's not about gender but he does describe what he calls Canada's ideologically supercharged managerial class, which models itself on the US elite.

[@miroirs-jumeaux]

8:52 😮

[@joannemoissiades5321]

What do you mean why wait to trans because the longing you wait the better? The structure of the original biological body will develop.

[@shahar7349]

1:03:40 Exactly, the adults in charge are not doing their job, so it falls on the political field.

[@iamanomas]

I always say when it comes to US healthcare, just follow the money.

[@bee-eu6cg]

Money..... 🎉🎉🎉🎉

[@karentracey9948]

Indoctrination by teachers has a lot to answer for,this never was a concept with my generation or my daughters,they are 36 and 31 but i fear for my grandkids,theres a whole generation now that are brainwashed,they are angry and violent and erasing women. 😢

[@AndyJarman]

Listen to the expression being used all the time by this guest "gender transition and "gender journey"". Surely that is very "transphobic?" It's an example of how people are lulled into accepting nonsensical ideas like the notorious "sub prime mortgages" of 2009.

[@joannemoissiades5321]

😂