Ray Alex Williams is one of the more contraversial and fascinating characters in the online gender world. For 8 years, he lived as "Rachel", a radical progressive trans activist , going as far as writing a book about arguing for the legitimacy of trans-feminine identities as women. In 2023, he publicly announced his detransition and embrace of Christianity, quickly becoming a bête-noir to the trans activists he once identified with, which his regularly taking positions that sought to completely delegitimize the trans experience he had once embraced, while becoming a vocal proponent of autogynephilia being the primary driver of most male-to-female transitions Two weeks ago, Ray made a surprise announcement that he was no longer going to repress his desires, and posted a number of pictures of himself cross-dressed, stating he wished to re-embrace his desire for femininity while not re-transitioning and taking on a female identity. Along with this, he is promoting a more nuanced and balanced philosophy about trans identities and transition. Ray's circuitous life journey, his openness regarding gender expression, and his background in philosophy make for a very insightful and entertaining conversation. In this episode, Laura, Yvette, and I discuss autogynephilia and its role in motivating transitions versus autogynephilia being a consequence of innate feminine desire, the differences and commonalities between crossdressers and trans women, and his own continuing evolution of thought and his relationship to gender

Julie Rei Goldstein is a long-transitioned trans woman and voice actress who survived attempts at conversion therapy as an adolescent, which informs her advocacy to preserve access to gender affirming care for youth today. She is also notable for her detailed journaling of the numerous lawsuits filed by detransitioners against their care providers, and provides a trans positive perspective on the state of play of these cases On today's episode, we talk to Ms. Goldstein about her childhood and transition experience, focusing on why she believes there is no real difference between exploratory therapy and conversion practices, and on the limited evidence for their effectiveness. We also discuss our concerns about how the failure to make efforts to prevent young people whose interests are not best served through affirmation and medicalization may have created the conditions that led to an increase in regretful detransitioners We then discuss some of technicalities behind why many of these lawsuits are failing, and how the legal arena may not be the best avenue to seek remedies for perceived harms, and we offer suggestions for how the medical system and society can best meet the considerable needs of detransitioners and those who otherwise came to regret their transitions.

Karleen Gribble is an Australian breastfeeding and infant-feeding researcher whose work sits at the intersection of public health, emergency preparedness, maternal-infant care, and policy. She is affiliated with Western Sydney University, where her research profile lists work on breastfeeding, infant and young child feeding in emergencies, child protection, adoption, and sex and gender identity

She joins us on the podcast to discuss the increasing use of desexed language like "chestfeeding" and "people with cervixes" in health care settings, and why she believes that this is confusing and alienating to women, and may lead to meaningful harm, even while attempting to be inclusive

We also discuss the importance of accurate recording of birth sex in the medical records, and if there are ways to centre the importance of birth sex in health care decision making while respecting trans people's desire for privacy and dignity.

Dr. Quentin Van Meter is a pediatric endocrinologist who gained notoriety and national prominence as head of the American College of Pediatrics, a splinter group of pediatricians who split from the mainstream American Academy of Pediatrics originally over their endorsement of same-sex parents. During the 2010s, ACPeds, under Dr. Van Meter’s leadership, were one of the initial organizations to speak out in public and in the backrooms of government to make the case against pediatric medical transition from a clinical perspective, presaging the success of the current gender critical political movement.

In particular, Dr. Van Meter expressed concern about how pediatric medical transition interrupts the formative role that puberty plays not only in sexual and reproductive development, but how it is necessary for the health of nearly every organ system of the body.

On our show, Dr. Van Meter, Laura, and Yvette focus less on politics, and more on the medical side. We discuss his theories on puberty, whether it is important to go through a puberty that is in alignment with one’s sex (or will any puberty do), and on the stability (or lack thereof) of childhood and adolescent gender identity.

Jennifer Lahl is an experienced pediatric critical care nurse who is the founder of the The Center for Bioethics and Culture Network, which advocates for caution and expresses concerns surrounding the use of assisted reproductive technologies including in-vitro fertilization, artificial wombs and surrogacy. She is a recognized authority, having numerous national and international media appearances, and was invited to testify before the European Parliament and the United Nations to address issues of egg and womb trafficking, She has also expressed caution regarding the ethics and technical limitations of fertility preservation in young people who are undergoing medical and surgical interventions for gender dysphoria; interventions that are high likely to result in infertility or at the very least fertility challenges in young people who have a limited capacity to understand the implications of these interventions, and whose views on having biologically related children may change over time Jennifer joins Yvette and Laura for a spirited discussion on what makes children with dysphoria different that other young people (and their families) which seek these interventions.

Show Notes:

Here is the link to our paper on fertility preservation Resilience Health Network survey: https://resiliencehealth.network

Ms. Lahl's paper on fertility preservation: "Fertility preservation: is there a model for gender-dysphoric youth" https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1386716/full?utm_campaign=imp_mile_2024_fall_en_aut-ww

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In our 12th episode, Laura and Yvette bring on Dr. Melanie Crites Bachert (prounounced BUCK-ert), a pelvic reconstructive surgical specialist whose practice has been primarily centered on women's pelvic health, and on repairing congenital abnormalities of the kidneys and the bladder. However, in recent years, she has become more vocal about what she sees as the unacceptable high incidence of urinary and vaginal complications experienced by trans men (natal women) on testosterone, who find their way into her Oregon practice. She expressed concern about hormone prescribers not appropriately counselling their patients about the consequences of hormone therapy, and on what she believes is an abdication of responsibility in managing adverse effects associated with therapy Dr. Laura and Dr. Crites Bachert engage in some vigourous but respectful argument about the benefits of gender care, how we engage with medical uncertainty, and on the the amount of weight we put onto the pain and the consequences of living with dysphoria

In our 11th episode, Laura and Yvette are joined by pediatric bioethicist Dr. Ian Wolfe, of the University of Minnesota. Dr. Wolfe believes that young people with gender dysphoria should be able to access care to medically facilitate a gender transition, and that there is a well-established ethical framework to support it. Dr. Wolfe shares his rebuttal to common concerns raised by gender critical advocates, while also acknowledging some of the limitations and missteps in pediatric medical transition. Dr. Wolfe also discusses his critique of the HHS report and the restrictive legislation that has been justified by the conclusion of the report, and the challenges with learning clarifying information where even research into the subject is considered unethical

In our tenth episode, Yvette and Laura debate what responsibilities, and in what circumstances, a stealth or private trans person should be obliged to disclose their history of transition. We are joined by Dilan Esper (x.com/dilanesper), a Los Angeles based lawyer who is trans supportive, but who has challenged the trans community on its stridency in its advocacy We discuss this thorny debate in the context of San Jose State University former volleyball player Brooke Slusser, who described her experience with sharing an apartment with her teammate Blaire Fleming, who she did not realize at the time was trans. Later, co-host Laura muses on her obligations for disclosure as a physician who is often referred female patients who are looking for a woman physician