In this eye-opening discussion, Malcolm Collins and Simone Collins dive deep into three major events that have shaken the foundations of trans activism: the Cass Report, a longitudinal study on gender non-contentedness, and a leak from the World Professional Association for Transgender Health (WPATH). They explore the implications of these studies, which suggest that the majority of gender non-conforming youth will eventually desist in their gender non-contentedness, and that many in the trans community are aware that children cannot fully comprehend the long-term consequences of transitioning. The hosts also discuss the importance of waiting until adulthood to make irreversible decisions, the potential risks associated with hormone therapy, and the need for a more nuanced approach to gender-affirming care.
Malcolm Collins: [00:00:00] Hello, Simone. It is exciting to be here with you today. You and I have done a number of episodes around trans issues before and trying to get to, what is most likely the truth about this stuff because it is so politically charged.
It is very hard to get accurate readings of what's going on one way or the other if you're the type of person who's really into sexuality research, which we are, we've written a book on the subject.
While I consider those. Episodes pretty comprehensive in terms of our views of the issue.
There have been 3 really big events that have happened since the recording of those episodes. And each of which are really worth diving into and we'll use that episode to do this. The 3 events that I am speaking, of course, are about the cast. Report huge for people who don't know what this is.
This is a report that did a review and it's like now the gold standard that the UK is using to determine how they relate to trans [00:01:00] treatment, particularly in individuals under the age of 18.
And it came out pretty critical of a lot of the stuff going out on the field right now. Another was a big study.
On longitudinally on trans individuals and the trans community was pretty unhappy with the findings that it had with the biggest, from my perspective, being that of gender conforming youth, over 90 percent end up being totally okay with their gender when they're adults. This is obviously a very important thing to know when you're looking at things like affirming gender care.
And then the final 1 was a leak of 1 of the major trans organizations that sets a lot of the policy positions for Canada and the United States and the leak. A lot of people who are really anti trans, or I'd say overly trans skeptical, have taken this leak to be uniquely damning. And I think that there's actually a more nuanced perspective on some of these emails and what's going on with this.[00:02:00]
So I want to go over every one of these in turn with you. And with our audience to try to find out what's really going on here.
Would you like to know more?
Malcolm Collins: So the 1st thing I wanted to do was to go into the study because to me, this is most interesting. The cast report is more just like a political thing that's happening.
It's not really new information. This study is new information and it's really interesting information. And it's called. Development of gender non contentedness during adolescence and early adulthood, and it came out in February, 2024,
So this is what the study says. We found that gender non contentedness, is most common around the age of 11, and that the prevalence decreases with age. Moreover, we identified three different developmental trajectory types of gender non contentedness throughout adolescent and early adulthood.
One, the majority, 78 percent of the sample, consistently indicated to never experience any gender non contentedness. So [00:03:00] 78 percent of people at around the age of 11 just are totally okay with their gender. All right, to a group reporting gender non contentedness in early adolescence, but not any longer in adulthood.
19 percent of the sample. So this is a population that starts feeling very non contented with their gender and then gets over it as they get older or no longer has these feelings. These are transient feelings to them. And we'll go into this group in a bit more detail in a 2nd, 3, a small group. 2 percent of the sample showing the opposite pattern of increasingly reporting gendered non contentedness with age. We found that female sex and participating in the clinical rather than the population cohort was associated with increasing gendered non contentedness. So this is actually really important what they said there being in the clinical, not the population cohort. So what that means is when this study was conducted, A portion of the [00:04:00] participants that they were using were from the general population.
A portion of the population they were using was from a, clinical transitioning groups. Okay.
All right. So what they're saying here is that this percentage, so if you're taking like a random shotgunning and just in case you haven't done the numbers in your head, this means that of the people who at the age of 11 feel gender non contentedness Over 90 percent this feeling persists in them.
They do not feel this in adults. It's actually mentioned in the studies that of this percent of the cohort, not a single one of them felt gender non content in this by the time they hit their twenties.
Simone Collins: And this harkens back to the research that you had done when writing the pregnancy guide to sexuality, that sort of showed that a lot of people.
Either weren't super married to their birth sex or otherwise, just not like we're okay with playing around
Malcolm Collins: with different printers. Yeah. Now, what gets really interesting here is because this comes from the clinical cohort. It means that actually, in the gender, the general population, more broadly, [00:05:00] these numbers are probably even lower of this group where this feeling increases over time, which means that it's probably lower.
Low like the number of people who have gender non contentedness when they're around 11 that end up not having it when they're adults. This part of the cohort is likely much, much larger than 90%. I might go as far as to say 98 percent given what the data is showing here, which. Is obviously a really devastating point for trans individuals.
So a lot of them have been attacking this study pretty vociferously, but I think that this shows a, but there's also individuals in the trans community who see the study and are quite excited about it because they're like it does show that you have this 2 percent when the problem gets bigger over time.
And this is really interesting, so I'm gonna keep reading some more, because the key question then for the trans community is how do you distinguish between these two groups?
Simone Collins: Yeah. How do you tell when it's like real [00:06:00] trans versus, transient trans?
Malcolm Collins: Yeah. Transient gender non contentedness that has to do with puberty, which I've said in previous videos, is a common part of childhood is being non content with your gender.
Or the changes that are happening with your body over puberty. That's normal. And so what this study now does is it changes the entire playing field of transness because we're also going to go over it in the context of previous studies because it really is the best of the long term studies in this space.
And it shows very exactly that if a Young adolescent comes to you and says they do not feel content with their gender. Odds are hugely on the side that they're not going to feel like this as they get older, and therefore affirming these feelings is a bad idea.
Simone Collins: Yeah. Yeah. Especially affirming them in any way that is, Biologically irreversible.
If for example, they decide that their pronouns are going to be whatever then.
Malcolm Collins: But what it means is that right now the standard of care, trans affirming care [00:07:00] takes it as a medical, like
Simone Collins: a medical prognosis or not prognosis, a medical mandate.
Malcolm Collins: Yes. If a child comes to you saying this, you have a mandate to affirm them.
And now we are seeing that. Is probably not the best course of action, which changes what would be the recommended standard of care in use who are gender nonconforming
Simone Collins: highlight. 1 of the things that makes this really meaningful is that before this came out. Because the research is so bad, and one of the big themes of the CAS report is the research is just so bad.
It's not like there's a ton of information showing it's damaging, but there's also not any information that says it's really useful.
Malcolm Collins: Hold on. We'll get to the CAS report when we get to the CAS report, because if somebody who has only heard the trans side of the CAS report argument, they will hear, oh they threw out X kind of research, which actually isn't bad.
Okay. And there's a lot of misinformation going on around the cast report, so we need to wait till we get to that. We're going to focus on this study. [00:08:00] Okay. Because I do want to go down a big rabbit hole on good versus bad studies and what studies have actually been done and haven't been done.
But that's more related to the cast report than this. Okay.
Simone Collins: Okay.
Malcolm Collins: So to keep going, in addition, individuals was increasing or decreasing gender non contentedness trajectories had lower global self, worse, more behavioral and emotional problems. and more often had homosexual or bisexual orientation compared to individuals without gender non
No one: contentedness.
Malcolm Collins: And so right here, I'm talking about the cohort that ended up getting more of these feelings over time.
No one: An
Malcolm Collins: increasing gender non contentedness trajectory was significantly associated with a clinical cohort, a homosexual or bisexual orientation,
No one: the
Malcolm Collins: self concept subscale global self worth, and female sex.
But not the self concept subscale physical appearance. No, this is just I don't know what that means. So fascinating, I'm gonna unpack what this means. Please do. We're seeing a few things here, right? One is [00:09:00] that if you are a male assigned at birth and you feel non content with your gender in your youth,
No one: You are
Malcolm Collins: actually very unlikely to be in this cohort where those feelings get worse over time.
If you do nothing, if you do not engage with the communities that are extra affirming of this, it desysts. So that's one thing that this is saying, which goes against what a lot of people would intuit. Two, and this is what I think, why is it that the people with the gay and bisexual orientations are more likely to have this increase over time?
They are more likely to be in communities that affirm these feelings than individuals without this. And so the feelings get are more likely to get snowballed or sound echoed. I, like when you put a microphone too close to the speakers and then you end up getting that screeching sound, you can get that within these communities.
These constant. And the fact that
Simone Collins: you can gain status in those communities by showing how extreme you are and a more extreme form of being in those communities is often turning trans.
Malcolm Collins: So that's why I think, and then especially if you have low global self [00:10:00] worth, you are more likely to. Oh, because
Simone Collins: You feel like you need to appreciate your value in those communities. Yeah.
Malcolm Collins: And the self affirmment that those communities are giving you for leaning into this, the sort of love bombing behavior you have. Oh yeah. So yeah,
Simone Collins: The affirmation you get if you do lean into being trans, if you're feeling really insecure, that's going to feel all the much better.
Malcolm Collins: Yeah, now let's argue this from the other perspective, this is me arguing from a more critical perspective, what an individual could say is that if an individual is in these communities that are more accepting of trans identities, i. e. they're gay and bisexual anyway, they are more likely to transition, and it's less of a jump because they're already presenting a non normal sexuality, So why not, also go in this additional direction as well with the global self worth, they'd say, if you live in a transphobic society, wouldn't you have lower global self worth if you fell into one of these groups?
But here is why I do not think that's a strong argument, the global self worth argument, because individuals who felt equal [00:11:00] amounts of gender discontentedness, but had higher global self worth, as a youth, so clearly they were okay with showing that they felt this, ended up desisting in those feelings over time.
So that doesn't explain to me like the lower global self worth is clearly not a result or downstream of these feelings. It is what guides how these feelings, whether these feelings end up persisting or not persisting in the individual, which is really interesting. Now, one of the most interesting things is the final thing where you're like, I don't know what that means, the physical appearance scale.
So what this is showing is contrary to what a lot of people think, how attractive you are. And how comfortable you are with how you look has no correlation with whether you're in this true trans group, the group that, where the gender discontingentness gets worse.
Simone Collins: Golly, wait, so the researchers are like grading
Malcolm Collins: the,
Simone Collins: he's a seven.
He's a four.
Malcolm Collins: Yeah and self conceptual [00:12:00] subscales. So it's how they judge their own attractiveness. But this is important, right? Because we've had we've talked a lot with groups like the
Simone Collins: Trans Maxxers.
Malcolm Collins: Trans maxers, which is a group of like incel males who are transitioning.
And you can be a
Simone Collins: three as a male and like a seven as a female, depending on the way that you may be unattractive as a male. If you look too effeminate or skinny or whatever, like suddenly you're a gorgeous woman.
Malcolm Collins: Yeah. And there's this stereotype of becoming trans is failing at your own gender.
And so you go with the other one. That's just not true in the data right now, what we're seeing that, that does not appear to be correlated with this group. So that's really important. No. One thing I wanted to know, because I had mentioned this, but I want to read the quote from the study here. The second largest group that was identified, 19%, had a decreasing trajectory of gender non contentedness.
At the sixth assessment wave, around the age of 25, none of these individuals reported experiencing gender non contentedness anymore.
Simone Collins: Wow. None. All right. So it's [00:13:00]
Malcolm Collins: not like a iffy thing, it just goes away. Interesting. Now, here I'm going to read a chunk, because this goes into the lack, because I think people are generally pretty surprised by the lack of longitudinal studies done in this space.
And this is something we could go way deeper on with another episode, potentially. But people may be like, wait, why haven't a lot of good long term studies been done of trans individuals? And the core answer is because the data banks for in the social communities for trans individuals really push against them participating in studies.
And the, and they push against releasing data. Now, if you want to take it from a kind perspective, you could say they're afraid of
Simone Collins: scrutiny or
Malcolm Collins: scrutiny I guess the data being used, what data will say, and they're afraid of the studies being run
Simone Collins: which is damning which
Malcolm Collins: is really damning.
But I will go over what studies had been run in the past from the abstract of this, no, this, sorry, not from the abstract, from the intro to the paper. [00:14:00] Furthermore, The few longitudinal studies that have been conducted in a clinical setting found low persistent rates of early childhood gender dysphoric feelings into adolescence and adulthood.
And then it lists a few studies here. It was found that children who socially transitioned in early childhood were more likely to have persisting feelings of dysphoria, non clinical sample of 317 children. mean the age of eight years, who identified as transgender, but who were not assessed according to the DSM 5 criteria for dysphoria, 94 percent still had binary transgender identity and 4 percent had non binary identity at a five year follow up assessment at 13 years of age.
In this sample, it was also suggested that gender transition before puberty is associated with continuing transgender identity. However, with only one follow up assessment until the age of 13, the further gender identity development into mid and late adolescence remains unknown. So what they're doing here is like the big studies in this space that have been done recently, either [00:15:00] showed that most of these feelings desisted or stopped at a very young age, at the age of 13, which this study may have shown a large level that you would still have these feelings.
So it aligns with what this study found. Um, And from another study here, they're saying, or only contained one follow up in the Taiwanese sample. 87 percent never reported any dissatisfaction. 8 percent reported dissatisfaction at the age of 13, but not at the age of 21, 5 percent at 22 and not at 13 and 1 percent reported persistent dissatisfaction.
So this is a different sample. This is pottery tall 2021 and this was in the Taiwanese data set. And what this study showed again, Is it feelings of gender dissatisfaction are actually very transient between the ages of 13 and 22,
Simone Collins: which really matches with our general thesis around adolescence being a period of body dysmorphia in general, which makes sense because your hormones are going out of control and your body's changing a lot and it's [00:16:00] super gross.
Malcolm Collins: Yeah. Yeah no, it does make perfect sense. And it's just worth noting that this is being repeatedly found across studies.
Simone Collins: Yeah. When people bother to do longitudinal research,
Malcolm Collins: yeah that's not just and I wouldn't know if you heard from the earlier study. Actually, I'm not going to go over that.
I'll just do that. Okay. So to go further in clinical samples, it was found that gender dysphoria is associated with homosexual orientation also. And this is from a different study, not theirs. So this is again, showing that if you hang out in gay population clusters, you are more likely to experience gender dysphoria.
Okay. Also in population based samples, associations between gender typical behavior in children and sexual orientation are found. For example, in one population based study, children with gender non conformity regarding play behavior at ages 3 to 5 were more likely to report a bisexual or gay orientation later in life.
That's from what
Simone Collins: we've been told. Oh, this sort of ties into what we always talk about with the TIDE studies, right?
Malcolm Collins: Yes, this indicates that this could be downstream of okay, I just need to, [00:17:00] Simone is referring to studies that look at endocrine disruptors that are present in utero when male fetuses are developing, it's been shown that it is correlated with more female like than male like play behavior at a seven year follow up study and so this would correlate to then say if you're looking at this Play behavior is a correlatory thing here.
And then you look at another study that looked at like basically three to five year olds to then see if they became gay growing up. It suggests that even at a biological level, we should see far more gay individuals in the general population than used to exist before these endocrine disruptors became
Simone Collins: pervasive.
Yeah.
Malcolm Collins: So very interesting to me. I find this study to be, it's absolutely game changing for me because yeah. Before all I had to go on was my assumptions around this, right? Like your
Simone Collins: intuitions. And also we'll say related research that we've seen such as the tide studies, such as people's.
responses to surveys about arousal pathways and [00:18:00] sexuality, et cetera.
Malcolm Collins: And unfortunately what this stuff indicates to me is that just this first study in isolation, right? Is that you pretty much are better off always delaying gender affirming care until after the age of 18. Actually preferably from the age of 22 or 25.
Yeah. Yeah. And an individual can say, But then it's harder for an individual to really fully transition, right? Yeah. But then I would say, yeah, except it's easier for women to really fully transition to men. That's more a problem with male to female transition, which it turns out is a category where the desire to transition desists if it is not affirmed.
Yeah, it's the population that would have the most inclination to do this is a population that should most be dissuaded from doing it.
No one: Yeah. Yeah. In
Malcolm Collins: addition to that you've got the problem of what is the thing that really distinguishes these 2 populations? It is an. increased desire over time [00:19:00] in a desire to transition between the age of the 13 to 25.
And I think that is perfectly reasonable. Basically, it says that for the individuals who actually are trans, they do end up figuring this out eventually. And that seems to be the safest way to sort them within the population.
Simone Collins: Yeah.
And I think what we tell our kids too, is And what I really expect to have happen is that treatment for transitioning is going to improve over time.
This is all pretty new stuff. And I think a lot of what's going on, for example the dysphoria continues or could possibly worsen when people actually do go on treatment. I think a lot of that comes down to the fact that honing in on the right levels of hormones and everything, getting everything right.
Is really difficult. So
Malcolm Collins: we're on the edge of having like plasmid gene therapy, for example, exactly. Yeah.
Simone Collins: So like in the future, it might not even matter if you're trying to transition after age 25 because through the help of AI [00:20:00] and many other medical advancements. You'll be able to handle it really well.
It might actually be better to delay.
Malcolm Collins: And I think that will be one of the core areas of complaint that many of these individuals are going to have is there will be like the first generation of people who get cybernetic implants, and then, a few years later, the implants are dramatically better.
And the first generation of like, why did I get stuck with gen one tech? Yeah. So that's, I think another really important thing. It's a really important thing that you're pointing out there, but let's go to the CAS report really quickly. So I'm going to read some notes on this because it is absolutely critical.
This report, while it is not really new information, it's almost a meta study of what's been going on, is critical because it is completely changing the general narrative around the way governments deal with trans individuals. I would say doctors,
Simone Collins: like general practitioners, like just doctors and therapists in general.
Malcolm Collins: Yeah, this study has been accepted among a lot of people in the mainstream left, not among the extreme cultists, but in the mainstream left, this is seen as the voice of the [00:21:00] authority. And so we're going to go over both the study and the complaints about the study and the counters to those complaints.
Simone Collins: Goodie.
Malcolm Collins: Okay. So Dr. Hillary Cass, the pediatrician commissioned to conduct a review by the NHS. Two children and young people questioning their gender identity said that while doctors tended to be cautious in implementing new findings in emerging areas of medicine, quote, quite the reverse happened in the field of gender care for children, end quote.
They studied a total of 23 guidelines published by different countries between 1998 and 2022. All but two were published after 2010. Quote, health care services and professionals should take into account the poor quality and interrelated nature of the published guidance to support the management of children and adolescents experiencing gender dysphoria and incongruence.
In one study, she said a single Dutch medical study, quote, suggested puberty blockers may improve psychological well being for a narrowly defined group of children with gender incongruence, end quote, , Has formed the basis for their use [00:22:00] to quote spread at pace to other countries in quote.
Subsequently, there was a quote greater readiness to start masculinizing slash feminizing hormones in mid teens in quote, she added, quote, some practitioners abandoned normal clinical approaches, holistic assessment, Which has meant that this group of young people have been
 Extra petitionalized compared to other young people with similar complex presentations. They deserve much better, end quote. So here, what I want to pull out is a few things that she said here, which are really important. One is that she's noting that most of the government guidelines that they're using for transition and gender nonconformity.
In. Minors are really just based on other government reports on the same thing. It's a bunch of studies pointing at each other without a lot of primary evidence, and we're going to get to this claim because this is the thing that a lot of, trans activists will have a complaint about is the not a lot of primary evidence.
So just to keep going here. [00:23:00] Most of them lacked, quote, an independent and evidence based approach and information about how recommendations were developed, end quote, the researcher said. Few guidelines were informed by a systemic review of empirical evidence, and they lacked transparency about how their recommendations were developed.
Only two reported consulting directly with children and young people during their development, the York Academics found. Data from the gender clinics reported in the CAS review showed that the vast majority of people who started puberty Suppression went on to have masculinizing or feminizing hormones, suggesting that puberty blockers did not buy people time to think.
Now, this is actually really important because this is seen in a lot of data. The moment you start puberty blockers or really any form of gender affirming care, you're basically in the pipeline and almost nobody leaves the pipeline, which is why this other study is really important because it's looking at people who don't fall into the pipeline.
And a lot of the studies that were done on quote unquote trans individuals in the clinical population only looked at people who had pre [00:24:00] gone into the pipeline. And that's why it was so important for her to find control groups in blind studies, which was her core complaint of a lot of these studies.
And we know from other studies, once you're in the pipeline, you're in the pipeline, there's really no getting out of it.
No one: Which
Malcolm Collins: makes sense if your entire social community at that point affirms this decision. And if you detransition, and we're going to see this in the leaked emails, you get completely ostracized from your entire community.
It's likable. Converting out of being a Jehovah's Witness or an Amish or something like that it is incredibly difficult to do and it is incredibly difficult to stop from a social perspective. If you're in these systems and for the individuals who are like can't you understand that they feel threatened by the narrative around detransition?
And it's you're the very people who criticize people like Jehovah's Witnesses for the way they ostracize people who form new beliefs and systems. Like, how can you not see how hurtful what you're doing is and why it makes people afraid to leave the pipeline and why it [00:25:00] creates These psychological cycles where it becomes very difficult to leave the pipeline.
Okay, but now let's keep going. I want to then talk about debunking the CAS report, right? Because I went through a lot of people who were talking about debunking this, and it is very interesting and worth digging into.
Simone Collins: Yeah, okay.
Malcolm Collins: Here's from a Reddit post. Now here are the four points that they had found for debunking, if they're just arguing against it.
Okay. The report engaged with anti trans hate groups and was written by someone affiliated with them. Does anyone have a source for this? Question mark. Um, basically the sources for this are here, I'll give it to you. Cass follows the LGB alliance and transgender trend, both recognized as anti trans groups.
She doesn't follow any pro trans groups. That is the full extent of that. So
Simone Collins: yeah, basically hate group is anyone who's Oh, let's be careful about this.
Malcolm Collins: Yeah. Yeah. And that's because, as in the same way that like, if you're in Scientology, anyone who even questioned Scientology, what are they [00:26:00] called again?
What's the word for them?
Subversive persons is the term.
Malcolm Collins: It's something that
Simone Collins: sounds surprisingly corporate. Yeah.
Malcolm Collins: Yeah. You're not allowed problematic individuals. Hold on. You're not allowed to in any way.
And this makes sense if this is more like a religion than like an actual. And it is that as we've argued in our episode has a cult evolved under the trans movement? And I think that one kind of has so the second one here is puberty blockers are seen as perfectly safe for CIS children who have precocious puberty.
, so they shouldn't be any different for trans children. This is just comical CIS children who are using them to delay precocious puberty are undergoing purity at a time when they shouldn't be undergoing purity. Trans children are. undergoing puberty when they shouldn't be undergoing puberty.
Basically, cis children are using this so that their puberty happens as it normally happens. Trans individuals are using this to attempt to turn off puberty and then attempt to restart it later, which we know just doesn't work. You do not get your full puberty if you would try to start it later. That's what a lot of, when I like go over the data, that's what it [00:27:00] seems to indicate.
So this is a really bad point. Which I think is great that we're seeing how bad the points against this are, because to me, when I want to know should I take something seriously, I should look at the people who are arguing against it and see how strong their arguments are. The third one is, if any antidepressant was successful at improving mental health slash suicidality as blockers slash HTR are for trans people, it would be considered a miracle drug.
Again, does anyone have any numbers to back this up? What? Numbers don't back this up.
No one: Wow. There's positions they
Malcolm Collins: want to be true and then they look for numbers, right? The final point is wait times for accessing this health care are so high that there have been several people dying of suicide before they reach the end of the waiting list.
And there is currently NHS care for trans people who need to access it. This is just one of those things where we already know that the suicidality within this group is really high regardless, even after they get gender affirming care. I'm not gonna, I think it's really twisted to consider everyone in [00:28:00] this pipeline who ends up committing suicide as killed by the treatment.
I would say that if we're going to do that, then we should count as everyone who has transitioned and then commit suicide as being killed by transition. It's not going to look good for the trans community. No one
Simone Collins: mentions that. No.
Malcolm Collins: And here is the key argument that you see used against it.
This report, and I'm going to quote here, some have focused on the report's omission of evidence, including studies around purity blockers that have not used control groups. People have argued that control groups in these studies would be impossible because people would know if they'd been assigned a placebo or not a placebo.
Yeah. And here you see a lot of people complaining just over and over again. Complaining about you cannot block all the studies that didn't use blind control groups because you can't really use blind control groups here. Now I am going to post on the page, over the screen here so people can see, highlighted in the report why [00:29:00] she threw out these studies.
No one: Because what
Malcolm Collins: would you be lied to if you believe they were thrown out? because they didn't have a blind control group. The specific line that was used over and over again was lack of blinding And no control group. This
is critical. These are two different things. They both did not have blinding and did not have a control group. Now I want to be clear because a lot of people, my backgrounds in medical research, a lot of people here might not understand how Freaking horrific it is if you had no control group. Okay. You don't need to like assign people placebo meds or something like that and blind them to put them in a control group.
What you need to do for example, if I'm looking at rates of suicidality, what I would do [00:30:00] is I would contrast people who did like just totally normal members of the population was individuals who are undergoing this kind of trans care, right? people
Simone Collins: undergoing this treatment. And to the earlier point, those who are stuck on the wait list.
Malcolm Collins: Yeah. And I can get to the wait list. Perfect control group. Perfect control group stuck on the wait list. Very easy to do. They're not using this, right? So the goal is to get the control group as close to the population that you're doing as possible, but they don't have to be exactly like the population.
They can be quite different to have a no control group at all. You're basically not even trying for real data at that point. You were just trying to affirm a position. And this is what really gets me is this lie that she. Was discarding studies because they didn't have a blind control group. She was discarding studies because they didn't have any control group at all, which is a basic thing in most medical research Okay.
And this is, and people were like with some cancer patients, you wouldn't have a control group was like chemo or [00:31:00] something like that. And it's yeah, but this isn't like that. There are comparable groups that you, yeah,
Simone Collins: there are lotteries that are wait lists. There are, yeah it's there are those who can financially afford it.
And those who can't all sorts of things.
Malcolm Collins: What this says to me like my big takeaway from this is because the criticisms of the cast report were so weak, she engaged with naughty people. So we cannot like think about her as human anymore. And that is what cults do. If you talk to people who are critical of the cult, they will say, we just can't trust anything you're saying anymore.
That is a just complete nonsense. This complaining about her throwing out studies that were poorly conducted, Again, just complete nonsense.
And they'll be like she included studies that didn't use blind controls and it's no. They still had controls. That was what the big mistake was.
You're including this blind word, which wasn't the critical word. So now we're going to go to one final thing that you haven't really looked into yet. Actually, do you have any further things you wanted to say from like you went over the block and reported on this and [00:32:00] everything?
Simone Collins: I think the important thing is pointing out that this isn't because she's found any particular outcome.
It's a lot of it's just the research is so bad while there isn't a lot of information about it being very, Oh, definitely you're going to die if you go through this, but also definitely going through this isn't going to help you. I think the important thing is in the past and what may be changing now and what gives me a lot of hope is if you are a therapist or you are a doctor and someone sends you their child and their child appears to have some form of gender dysphoria, the responsible thing for you to do and what you would do to avoid any like form of liability is to just send them to a gender transition or, a gender treatment clinic.
Just refer them to that. This is, off by plate. There's no, I don't know what to do. The only evidence out there that's being shouted from the hilltops is cherry picked studies saying your child is going to die if you don't do this. So people from a sort of media [00:33:00] standpoint and from a public discourse standpoint, doctors and clinicians and therapists were forced to throw people into this pipeline, which as you point out, then is a very slippery slope.
You can't get out of it, a Chinese finger trap so now with the cost report, what makes me so hopeful is. Doctors, therapists, et cetera, have something else to point to, to say, no, this is not necessarily the best pathway. I'm not being necessarily responsible by telling you to sit this out, find some other interventions, work on self confidence, et cetera, which is really encouraging.
Yeah.
Malcolm Collins: And now we're gonna get to the last study here, which I find really interesting and I don't think that you had heard about this. It's not a study, it's a major event. So there was a leak of files from an organization called the World's Professional Association for Transgender Health W-P-A-A-A-T-H, or wpath, I guess is how I read it.
Yeah. wpath.
Simone Collins: Yeah. That's how they go wpath.
Malcolm Collins: And you heard about this?
Simone Collins: Yeah. In [00:34:00] blockchain reported, cause I love them. They talk about the WPath files a lot. Yeah.
Malcolm Collins: Oh, they do. Okay. This was really interesting. So this organization has, you know how I mentioned that there was like an echo chamber that a lot of countries were using for their use, gender affirming care.
Yeah. That people just
Simone Collins: kept referring to the same. Like other studies and no one actually, when making claims about this is the best way to go. Everyone agrees that this is true was actually referring to real, profoundly robust research.
Malcolm Collins: Yeah, it was coming from this organization and we began to, through these leaks, get an understanding of how individuals within this organization really saw what they were doing.
And the biggest sort of thing that came out of the WPAS files was really Two things, and we'll get into some specific quotes around this, but the first being, being that they understood that many of the kids could not make an informed consent to what they were doing.
Simone Collins: What, wow what [00:35:00] indicates that?
That's pretty damning.
Malcolm Collins: Oh here I'll give you some quotes then.
Simone Collins: Yeah.
Malcolm Collins: I think the thing you have to remember about kids is we're often explaining these sorts of things to people who haven't had biology in high school yet. He says discussing the potential of loss of fertility and options to preserve fertility with a 14 year old is, quote, always good in theory, end quote.
He said in the video. Because many will go on to cross sex hormones that will leave them sterile. But, quote, I know I'm talking to a blank wall, end quote, he says. And, quote, and the same would happen for a cisgender kid, right? They'd be like, ew, kids, babies, gross, end quote. Quote, We try to talk about it, but most of these kids are nowhere in any kind of a brain space really, to talk about it in a serious way, end quote.
And he adds, quote, I, that's always bothered me, but, we still want the kids to be happy, happier in the moment.
Simone Collins: Happier in the moment. Happier for now. Damned in the future. Why for
Malcolm Collins: a doctor? This is like the Hays [00:36:00] movement where it's like it makes them happier in the moment to tell them that overeating isn't going to make them unhappy in the long term or cause long term negative bodily repercussions in the long term or be unhealthy, so you just don't tell them that.
That's why it's evil to tell people that. Taking in far more calories than you burn is unhealthy for you because it makes them happier in the moment to not tell them that. And this is what we talk about when we talk about this virus or this form of engaging with this. No, you're a doctor.
And you are saying right now, I understand that children cannot make an informed decision. Consent to the surgeries that we are allowing them to consent to the treatments that we are allowing them to consent to, and they will have a major repercussions later in their life, specifically sterility and never being able to orgasm again, or never being able to experience an orgasm at all.
They don't know what these things are. They can't understand these things. And as we talk about was in prenatalism, many people develop their identities when they're young. So they don't [00:37:00] understand that if they found kids gross when they were a teenager, that doesn't mean they're going to find them gross as an adult.
And it is natural for young teens around this age for biological reasons to have an instinct like gross young kids. I don't want to be around that.
Simone Collins: Yeah. On that too. I think even if like even if a young teen can comprehend that as an adult, they're going to want something different. There is a rebellious streak in many.
And I felt this myself as a teen that would take away. The ability of that person in the future to have that choice I hate the idea so much now that I'm going to make sure that my future self doesn't have the ability to do it when they try to like someone who's trying to, get rid of eating sweets, decides that they're going to make sure they never have sweets in their house in the future.
So their future self that wants sweets can't even get them. Yeah. So I think even when they can comprehend, even when they know the biological consequences, they, in their current state of mind may still choose intentionally to override the wishes of their future [00:38:00] self.
Malcolm Collins: Yeah. And we know that kids have, poor self control.
This is why we don't generally allow kids to sign lifelong contracts and stuff like this. Yeah. They can't join the
Simone Collins: military. You can't sell organs. You can't.
Malcolm Collins: Wild. Yeah. It is wild, but it gets worse than that. They are showing how little the kids understand from some of these quotes that you have here, right?
I guess what's
Simone Collins: wild to me is that they acknowledge that these things are damaging.
Malcolm Collins: And this is where I'd say that I think the far like the far anti trans movement goes a little far with this stuff and maybe reading a little too much into it, but I'm going to read another quote here.
Simone Collins: All right.
Malcolm Collins: The one, one clinician had written about a number of her patients, quote, they seem to feel that they should be allowed to switch back and forth merely at their request. I'm not comfortable with this at this point, we need to be better at understanding how to handle this type of situation in quote. Now that an individual, they had started transitioning thought that this was something that you could just switch whenever you wanted to really easily.
What that [00:39:00] shows to me is that this individual didn't understand what they were committing to, or how permanent it was, at all. And this again shows why people don't think that young people should be allowed to consent
Simone Collins: to this. This is, again, another reason why This is so important to put off as long as possible because in the future I have plenty of confidence that people will be able to seamlessly switch whenever they want to Maybe not in our lifetime, but it'll happen But not now
Malcolm Collins: and they show some really concerns about this.
One clinician wrote quote kids can't fully understand what they're agreeing to in quote Kids can't understand what they're agreeing to We can never do this, and it's abuse to do it, even when a parent or doctor are on board that it is the right thing for the child. Who is this? Anyway, I'll look at this later.
So here I want to note something right here that is really interesting. But Bowers has also said that acknowledging detransition exists, quote, [00:40:00] even to a minor extent is considered off limits for many in our community.
No one: I
Malcolm Collins: do see talk of the phenomenon as distracting from the major challenges we face, end quote.
There is a mission within the transitioning community and within the medical community around this to just pretend that de transitioners don't
No one: exist. And this is
Malcolm Collins: another big problem, right? Because this is a very big and growing movement that it seems like if somebody was forming informed consent, and they had been given both sides, they would know this.
And this is a big problem because when I look at transforms and their Transitioners, they're like, look, didn't you read the back of the like pill bottle? Didn't weren't you told about everything that could go wrong? Like, why are you out there complaining now and complaining about our community now?
And the answer is because they were transitioned at 11 and they obviously didn't understand. Yeah. Doctors giving them the transition knew that they didn't understand. And it was well known among the people who are writing the national guidelines. Like in countries like Canada, that the people who are [00:41:00] transitioning didn't understand.
So you don't get to come out here. You cannot both be pro the transitioning of children and say that they shouldn't have the right to say, I didn't fully understand this. Now, one of the particularly damaging things that came out was this was many cases of people who ended up getting cancer because of
Simone Collins: this.
Whoa whoa. Why didn't. Wait, what correlates with cancer? Is it the estrogen justice or what?
Malcolm Collins: Yes. If male to female correlates with cancer, which is actually really interesting because there was one study done recently that shows to female to male might actually lower rates of cancer in individuals because you don't have the mammary tissue
Simone Collins: anymore.
Malcolm Collins: Or the uterus sometimes. Which are two of the more common locations that females get cancer. Yeah. But I'm going to quote here. In one, a doctor writes about a 16 year old patient who developed two benign liver tumors after several years of taking birth control and one year of gender reforming testosterone.
In another, a different doctor recalled a colleague who died of liver cancer after nearly a decade of taking testosterone. That doctor wrote that, quote, to the best of my [00:42:00] knowledge, the cancer was linked to the hormone treatment. The doctor was noted that they didn't have any other details because the patient had died.
Simone Collins: That's so interesting that, yeah, this isn't discussed. Whereas people going through IVF or people concerned about IVF often bring up concerns about cancer. Cause they're like, Oh gosh if I take even for a freaking month. extra estrogen, I'm going to get more cancer. And yet that like that. So I also, I don't think it's poorly known that this is a risk because if people are concerned about one month
Malcolm Collins: fringe risk, and it is not a complete fringe risk.
It's a known side effect of these drugs. Taken over short periods of time and that's the thing that you're pointing out here, which is really important to note. Is it individuals? No they're like, oh, but this has been used in other treatments for a long time. Yeah, but
Simone Collins: people worry about those other treatments.
Malcolm Collins: They worry about it in the other treatments and the use of it is extremely limited in terms of time windows. And they're like, oh, but like [00:43:00] hormonal therapy has been used in birth control for a long time. And it's those are different hormones at different levels. And then the ones that are causing cancer in these individuals.
Yeah. So this doesn't matter. But I will also say that to an extent, these leaks have been blown out of proportion. Really as bad as the leaks could have been, this is pretty minor to me. It was in how extreme some of these communities get. And it does show that the doctors. Do you actually have some level of self reflection and concern about what's happening and knowledge that kids can't really consent?
They just have fears around acknowledging that was in their community, which I think is something that like anyone who is looking at this situation with any level of sanity already knew was a phenomenon.
Simone Collins: Yeah.
Malcolm Collins: So between these three things, my question is now, what has this changed for you in terms of your perspective of what's going on?
And do you think that the battle is genuinely tipping against the transitioning children activists? [00:44:00]
Simone Collins: I think it, yeah already things, programs for youth gender transition were being defunded, criticized, shut down. I think youth gender clinics are, Going to be a thing of the past very soon.
And my hope is that this means that transitioning like those who are trans activists and who do to your earlier point, really care about that 2 percent that really does have persistent gender dysphoria and that really does need and want to transition that it gets them to focus on instead identifying those people.
Validating their concerns and preparing that, like giving them something to do in the interim while they wait until they are old enough to make that transition safely, we'll say after age 25. I think that would be such an amazing.
Malcolm Collins: Oh, yeah, it would be great. If you could get better studies on that would be fantastic.
And I think that's the direction that the trans community and trans activists should [00:45:00] go from this. For me, the major thing that's shifted about this is one, it's a shift in the public narrative. It is now in, JK Rowling with all her stuff, she recently like absolutely went after someone.
They're like, now that it's okay to say the things that I risked my career saying for a long time that many individuals lost their career for saying, you now are jumping on the bandwagon with this when you didn't stand up for this, when you could actually really suffer for this. And the other big thing was in trans news that's happened is this law in Scotland, right?
This hate crime law and JK Rowling standing up against it and precedent in a way that
Simone Collins: nullified it. Yeah.
Malcolm Collins: Yeah and I think that she's right. We have to remember the things that we're saying now that are actually like, not that spicy anymore that, transitioning kids is probably not a good idea are things that individuals, even trans individuals have lost their careers for saying like Buck Angel, The original trans activist who really brought the community into the mainstream and then was completely isolated from the community from saying that kids shouldn't be allowed to [00:46:00] transition.
That was or that we should have some skepticism around this. That was to me, really heartbreaking to see how many people in the left, even when they change their mainstream position on this, when they're like, oh, we were wrong about that whole transitioning kids thing. They will never rehabilitate the people that they have.
Excommunicated or that they have labeled as
No one: heretics.
Malcolm Collins: They will never really put up the law of the wall of people. We attacked for things we now accept as common knowledge.
Simone Collins: No, I think it goes both ways. I don't think Buck Angel is gonna, embrace them after everything that they've done.
So
Malcolm Collins: he's like a very understanding person. So I think of it, this is, It's tragic that has happened, but the other thing, the big thing for me that changes is I now believe that the evidence states, and I think that if I was a trans activist and I was trying to help the trans community, I think the core thing that needs to change now is the understanding that most teens and preteens who are not comfortable with their gender, Are not trans.
No one: They're
Malcolm Collins: just going to grow out of this. [00:47:00]
No one: The
Malcolm Collins: vast majority of preteens who are not comfortable with their gender are not trans. And so now the question is how do you sort out of the people who aren't comfortable with their gender, which should. Undergo further treatment, and which shouldn't, where the previous go to thing within the trans community is if you are not comfortable with your gender, you are trans and you should be treated as trans and you should immediately put on a gender affirming pipeline.
You should immediately be put on puberty blockers to give you more time to think. And what this research shows is they don't give you more time to think. You're basically locking in a decision. The moment. You go into gender affirming care, you go to a psychologist that is gender affirming, or you undergo a puberty blockers.
And what I would take in a
Simone Collins: hot second is if there was just, if we nuked youth medicalization if it was, all right, we're going to change your pronouns. And now you're going to dress differently and you're going to have this different, fine. Because at least that enables people to maintain optionality until they're fully myelinated until [00:48:00] they're, In their twenties and they can decide, if it's just if it becomes the equivalent of going goth for a few years, and being different, I'm super happy with that.
The most, even when I was a kid,
Malcolm Collins: I wore like a girl pants and stuff like that in like the golf days where you get these super tight, like hot topic pants and stuff. And
that was like, It was the style at the time for young men
 So I tied an onion to my belt, which was the style at the time.
Malcolm Collins: You were like an extra rebellious, young guy or whatever.
And it's one of those things where it's totally cool. If my kids were like, okay, I'm going to do dresses now or something like that. And that was like the rebellious style at the time. I think we need to Differentiate developing your identity in contrast to mainstream social mores and medicalization, and these two things have unfortunately been conflated due to the trans movement, not allowing you to say, hey, that teenager.
Who is doing this rebellious thing in terms of their identity. That's probably not a medical issue. That's probably just [00:49:00] being a teenager and we need to respect them while also telling them, tattoos are bad. They're permanent. You probably shouldn't be going out and doing that.
Simone Collins: Even if it is a medical issue, I think the important thing that we've realized now is that it's a medical issue. That will pass for the majority of people. And that really does, really ought to be addressed for a very small minority of people. And we cannot make a medical decision until someone's in their mid twenties.
That's an important thing too. So that's so comforting. This is just a great news. It's wonderful. It's fantastic.
Malcolm Collins: It, you don't know how far the pendulum is going to swing in the other direction yet. It's been swinging and it could swing far. What do
Simone Collins: you expect to happen?
Malcolm Collins: We could see a general pushback on transness in general, in a Oh, like even
Simone Collins: trans identities?
Malcolm Collins: Yeah, I can see, for example if we're talking about an extremely hard pushback, and I can see this being very realistic laws being pushed in conservative states that disallow trans people from teaching kids.
Simone Collins: Because they just basically found that if you don't lean into [00:50:00] it at all, it typically passes, especially for men.
Malcolm Collins: Yeah. And keep in mind, the other thing that I noted here is engagement with the LGBTQ community
Simone Collins: correlated
Malcolm Collins: with this persisting of your gender dissatisfaction. So disallowing a young person who seems at risk of this from engaging with other LGBT individuals Appears to be one of the best ways to prevent them from falling into this group, which can lead to a lot of negative action, even among well meaning parents.
Simone Collins: Yeah. Or even among like perfectly normal, non extreme, non brainwashy people who just happen to be gay,
Malcolm Collins: I even think about this was my kids, right? Is it just dangerous, even if they are same sex attracted to allow them to engage with that community. So long as that community. Is overly friendly with the trans community I don't know I think
Simone Collins: every community has to be approached differently.
On a case by case basis. And if you see that you, I think the key, and then this goes back to what you always talk about [00:51:00] with dominance hierarchies within a community, you have to look at what the virtue spiral of that community is going to turn into. Every community that's tightly knit is going to have a virtue spiral.
You have to figure out what that virtue spiral is going to be. Like, I guess in the prenatalist community, a virtue of spiral is probably someone going. Crazy hard in on kids and, telling everyone they should have kids and being really annoying and obnoxious about it or whatever it might be.
But you have to be, you have to know what that is. So
Malcolm Collins: hold on, there's two, most communities are actually not that at risk of virtue spiraling.
Simone Collins: Really? What makes you say that?
Malcolm Collins: virtue spiraling in a community is isolation. There aren't protected As soon as you have a protected class, some thing that you can attempt to maximize that you cannot be attacked for attempting to maximize.
So for example, within conservative circles, this might be like dedication to Trump, right? Was in certain Trumpist circles, you can not be criticized for being overly anti immigration or overly anti Trump or [00:52:00] overly. And because of that, you get these virtues files,
Where individuals will be like, you guys aren't conservative at all in your beliefs that I'm like, I think you might just be in a community that's like virtue spiraling because actually, we very much are for our generation.
You look at any mainstream statistics about population belief systems and stuff like that. You have just surrounded yourself with a virtue spiral until you don't know that. So you do get this in the right, but. The, and within the left, if you can't attack trans community, if you can't attack people who see psychologists, these are seen as protected classes.
You're going to get virtue spirals there of dedication of intense. As soon as you remove the protected class concept, you remove the risk of virtue spirals within the prenatalist community. We haven't really seen any virtue spirals because there is no protected class individuals who have a lot of kids.
We are still very critical of like their child rearing practices, stuff like that. And that across. Unity. There is not like when
Simone Collins: extremes can be criticized within a community, that community is safe from virtue cycles or sorry, sorry, virtue spirals. And then when extremes [00:53:00] are not ever criticized within a community, that is when it goes crazy.
That's when you have Salem, which trials that's when you have gods doing insane things to their bodies. That's when all this happens. Exactly. Okay. Then that's what we do with our kids. If we, cause again as we've discovered with so many LGBTQIA or poly or rationalist or whatever communities out there, any niche community of the same, like general name.
There are some which are super cool and there are some which are super toxic. So all we have to do is determine whether or not they criticize extremism. And if they do, it's fine. If our kids hang out with them, like this
Malcolm Collins: is such an important concept. It might even be worth building a holiday around it.
Don't engage with communities that have protected classes, whether those communities are on the right or the left or anything else, recognize the danger of this concept of a protected class and stay away from it. Or communities that
Simone Collins: don't criticize extremism.
Malcolm Collins: Yeah. How we can build that into a holiday.
I don't know yet, but I'll [00:54:00] think about it.
Simone Collins: Fun. Yeah. People can weigh in the comments too. How can this be turned into something cute? Photographable?
Malcolm Collins: I think the extremism is different from the protected class concept, and I would really focus on the protected class concept because I think it's much more defensive than the extreme of the concept.
Which is to say you can be extreme in beliefs, but there are certain beliefs where you're like, you just cannot criticize this group. Whenever you get that.
Simone Collins: That's when you're more defensive. I see. I see like in, in still in many conservative circles. And this is something that we're seeing dividing the Republican party and causing a lot of problems.
There is no level of extremism regarding restricting abortion access that people get criticized for. I actually had this guy call me out of the blue call me as a candidate out of the blue. And just start yelling at me like a madman about abortion. So I think that like really showed me, Matt, you, or
Malcolm Collins: was he, did he just want you to know?
Simone Collins: He was like I just wanna [00:55:00] know your position's on this. I'm like, okay, fine. Ask away. I'll tell you my position's on whatever you want now. I'll be perfectly honest. And he asked what's your position on abortion? And I said like obviously America pretty much agrees on. This moderate approach to abortion, before this period, more freedom than
Malcolm Collins: the current stuff at our state.
And I said
Simone Collins: that, yes, but he's no, it's life begins at conception and blah, blah, blah. And I'm like, yeah, let, that is your belief system. You are Catholic. I understand that. That's totally acceptable. Although the Catholics didn't always view it that way. So let's be honest here. But you have no more right to impose that.
on other people outside the Catholic culture, then other cultures have the right to impose transition, like youth, gender transition on your children. And he's no, God said this and therefore I'm telling you to do that. And I hung up on him cause he wouldn't stop talking. But that's one of those things where he's never.
been criticized for that view. Cause I also told him, I'm like, you can have that view. And that's, that is 100 percent [00:56:00] legitimate. I too am not really comfortable with abortion. But. You will not see your party get elected if you maintain a hardline stance like that, because you are not in the majority.
You will not
Malcolm Collins: have further restrictions on abortion that are realistic to impose.
Simone Collins: Exactly. And he, and that's what I said too. I'm like, there's no way that you're going to get anywhere close to where you want to be with that current stance. And it's he was incapable of seeing that. And so that, that is a really good example of a protected status, right?
He would never be questioned. For that by most people. And also he has this attitude of, if you do question me, I'm going to immediately shut you down. So I guess that's what we're talking about when it comes to protected status, right? Oh, I'm so mad at him. ,
Malcolm Collins: I love you, Simone. You are the best. And I appreciate your anger as a citizen of this country.
This is
Simone Collins: what I get for answering unknown calls. I should be answering potential cons, constituent calls. But when you're an idiot like that,
Malcolm Collins: I love you. Pick up that you're like, fuck off. We need to get a call. We need to get [00:57:00] that needs to go viral. It's like you telling some constituents.
Yeah, just people get
Simone Collins: to call into me as a political candidate. And I'm like, fuck you. I love you. I love
you.
2024: Trans Pendulum in Retrograde (The Study, The Leaks, & The Cass Report)