0:01

This. Episode is brought to you by

0:03

shopify. Whether you're selling a little are

0:05

a lot. Shopify. Shopify.

0:08

Helps you do your thing however you

0:10

teaching from the launch your online shop

0:12

stage all the way to their we

0:14

just hit a million orders States no

0:16

matter what state you're in, Shopify is

0:19

there to help you grow. Sign up

0:21

for a one dollar per month trial

0:23

period at shopify.com/special offer all lower case.

0:26

That's. shopify.com/

0:28

Special offer. Bruce

0:30

Gog is a lawmaker in

0:32

Idaho. On: I'm

0:34

an ankle injury literally. Talk about

0:37

charges. But you are a group

0:39

of go on phone calls that

0:41

are. Now this is him.

0:43

About a year ago talking to a

0:45

group called the Idaho Freedom Foundation about

0:47

a law he cosponsored. That. Would

0:49

punish doctors with up to a

0:52

decade in prison for providing gender

0:54

affirming. Care. To young people. That

0:56

these are doctors. Who would be

0:58

following standard set by the

1:01

American Academy of Pediatrics work

1:03

that is widely accepted in

1:05

the medical field. Still, the

1:08

new Idaho law bans puberty

1:10

blocking drugs, hormone injections, any

1:12

surgical changes that my quote

1:15

induce transients or permanent infertility.

1:18

So. That means doctors can't offer this care.

1:20

Even with the consent of parents. Who

1:22

are indoors approved for. For. Procreation

1:24

to have children. We.

1:27

Ended a fundamental right that is the

1:29

highest in. Okay, that

1:31

bit about procreation. this

1:33

is important. To his argument for

1:35

the bill apparent can't give up their

1:37

own child not consented other should not

1:39

be allowed to do with those in

1:41

for their children. Because. Augur. Well

1:43

it's up to the burbs the to

1:46

decide know you can't take away your

1:48

child road to prove he can on

1:50

not as barbarism worked in his book.

1:53

Also this we representative Skog an Idaho.

1:55

Lawmakers notched a minor when

1:57

with the Us. Supreme Court.

2:00

The justices plucked this case from

2:02

the emergency doc at. An issue

2:04

to ruling that says that a

2:07

said despite ongoing. Legal challenge from

2:09

some families of trans kids. The.

2:11

State is allowed to temporarily.

2:14

Enforce this law against

2:16

doctors. So. To them

2:18

and share with you a conversation I had back and

2:20

twenty. Twenty Two was in the first weeks

2:22

of this podcast, but it's gonna give

2:24

you a peek at what it looks

2:26

like to be doing this work in

2:28

the current legal environment across the country.

2:31

Not. Just in places where like

2:33

Idaho, it's fast being criminalized. You're

2:35

gonna hear from some pediatricians who

2:37

work with transgender youth who the

2:40

com targets for people who believe

2:42

that that work is morally wrong.

2:45

And are willing to do almost anything

2:47

to make that point. A

2:49

happy I as arrested a woman for

2:51

making a bomb threats that Boston Children's.

2:53

Hospital the hospital says is being

2:56

inundated with threats because of what

2:58

they call misinformation about their treatment

3:00

of transgender patients. Were growing number

3:03

of doctors say they are under

3:05

threat from far right activists because

3:07

they care for transgender patients. What

3:10

these doctors describe is a constant

3:12

stream of online threats and menacing

3:14

letters and phone calls and street

3:17

protests. And it wouldn't be the

3:19

first time that Us doctors face

3:21

personal threats for providing certain. Kinds

3:23

of medical care. Like. Say

3:26

abortions. Women picketed since

3:28

Nineteen Seventy Five. My

3:31

office and I'm blown up. We're

3:33

her know. four thousand people. Arrested

3:36

outside my office and Nineteen Ninety

3:38

One Ninety Ninety Three Years arrived

3:41

in says nursing home. Now.

3:43

I don't know about you, but for

3:46

me, there's a bit of Deja Vu

3:48

here. It is today. We'll take for

3:50

granted that abortion clinics are built like

3:52

fortresses with protesters behind barricades and chaperones

3:54

for the patience to the front door.

3:57

but that's because between the seventies and

4:00

eight there were more than a hundred

4:02

cases of arson and bombings against abortion

4:04

clinics across 28 states. There

4:07

were murders and attempted murders of

4:10

doctors and medical staff. That's

4:12

not the future that gender-affirming care

4:15

doctors want for their field. What

4:18

we need are more people doing this work

4:20

and brighter people doing this work. And

4:23

I'm concerned that, like, if

4:25

you're a medical student or, you

4:27

know, a young pediatrician, who

4:29

would choose to go into a

4:32

field when this is what they

4:34

may face? I'm

4:36

Adi Cornish, and this is

4:38

The Assignment. Okay,

4:45

first, what actually happens in the

4:48

offices and clinics that are drawing

4:50

so much attention? I mean, there's

4:52

no shortage of misconceptions surrounding the field.

4:54

Oh, there are so many. Here's

4:57

your hand sanitizer. Here's your puberty blockers on your

4:59

way in. Yes, that's not how we operate. That's

5:03

pediatrician Dr. Angela Gepford, who

5:05

identifies as queer and non-binary.

5:09

In 2019, they founded the Gender

5:11

Health Program at Children's Minnesota. They're

5:14

the medical director of that program. And

5:16

since its opening, Gepford estimates that

5:19

the program has served nearly 600 trans

5:22

youth in the region. And it's got

5:24

a year-long waiting list, probably

5:26

because it's the only program of its

5:28

kind in the state. Parents and patients find

5:30

it a lot of ways. Recommendations

5:32

from pediatricians, from family

5:35

therapists, just searching around

5:37

online. So

5:42

a parent comes in, maybe their child is 10

5:44

or 11, and they're hearing

5:46

all kinds of aspects of

5:48

gender-affirming care, probably

5:50

through the media. What

5:53

are the first conversations like? Well,

5:57

at our program, and I can't speak for all programs,

5:59

but at our program, integrated model so

6:01

they're going to have an intake with a

6:03

mental health clinician first. So the whole family

6:05

sits down in a room with a person

6:07

who starts asking what kinds of questions? Asking

6:10

about the family, the family system, the child's

6:12

health history, their mental

6:15

health history, what's happening at school, and

6:17

then getting into you know why are you here today?

6:19

What do you want to talk about about gender identity?

6:22

Tell us what the journey's been so far and what

6:25

questions you have and what struggles you're having. What

6:27

kind of answers do you get? Really

6:30

varies you know sometimes families have

6:32

been supporting their transgender child from

6:34

the time they were very young,

6:36

three, four, or five years old.

6:38

They've socially transitioned meaning they're now

6:40

wearing clothes and outwardly expressing through

6:43

name pronouns and other things the

6:45

gender expression that's aligned with their

6:47

identity. Sometimes that's been happening

6:49

from a young age they're now coming in because their

6:51

child is starting puberty and they're wanting to ask more

6:53

questions about that. Sometimes their child

6:55

has just started asking questions about their gender

6:58

identity for the first time and parents aren't

7:00

sure what to do. Sometimes

7:02

they've just been in the emergency room because

7:04

of a first suicide attempt for a

7:06

patient and they're scared and

7:08

they're hearing about their child's gender identity they worry

7:11

this might be the stress related

7:13

to that and they want to get

7:15

help. The

7:17

care part includes a range of

7:19

things therapy support groups, referrals to

7:22

vocal coaches or hair removal. It

7:24

could even include letters for legal

7:26

name and gender marker changes and

7:29

if warranted hormones. And

7:31

this is what the major medical associations the

7:34

American Psychiatric Association the American

7:36

Academy of Pediatrics this is what

7:38

they have agreed on when it

7:41

comes to what's clinically appropriate for

7:43

adults and children. There's

7:45

a big misinformation

7:48

campaign to position

7:50

gender affirming care as surgeries

7:52

on kids bodies and

7:55

that's just not the case. Surgeries

7:57

on any transgender person who's under the age

7:59

of 18 are pretty rare and

8:02

certainly nothing that would ever happen for

8:04

a child. And

8:06

for many kids it's no medications at all.

8:08

That's the other misperception. A

8:10

lot of what we're doing is

8:12

talking to families, answering questions, helping

8:14

them navigate school and grandparents and

8:17

clothing. Not all

8:19

kids are going to be receiving medications for

8:21

their care. There's no

8:24

kind of factory cookie cutter approach to this

8:26

care. We're working with

8:28

each kid, each adolescent, each family

8:30

on an individual basis and

8:33

tailoring their care to what works for them. But

8:38

Gepford says these days parents are

8:41

likely to wade through a lot

8:43

of anti-trans material. Articles

8:45

questioning this work, questioning the science.

8:50

I would actually say most parents come in hesitant.

8:53

And I don't know that that's because of the

8:55

recent negative attention or just because

8:57

it's a big deal. Yeah, that's why it's big. Right?

9:00

It's your kid. It's your kid. And in some cases you

9:02

as a parent are being asked to help

9:05

participate in decisions with them and with a healthcare

9:07

team that may have long-term implications for

9:09

their future. And it's hard. So

9:13

I would say most parents come in

9:15

a little weary. I mean, grateful for

9:17

the information, grateful for the help. They're

9:21

not sure when they come in what comes next

9:23

or where this is going to go. What

9:26

is something you want people to understand about what it's

9:28

like to be doing this work right now? I

9:35

think what I want people to know is that it

9:39

shouldn't be this hard. At

9:42

times what it feels like is wanting

9:45

to say, hold on. Hold

9:47

on a second. You need

9:49

more accurate information. You

9:51

need to understand more about these kids and

9:53

teenagers that we're providing care for. You

9:56

need to listen to their stories. You need to know

9:58

what their lives are like because... you're

10:01

making a big mistake. So

10:07

the program launches in 2019. Is

10:10

it controversial out the gate or like

10:13

what's the vibe? Unexpectedly

10:16

no, actually. We launched

10:18

pretty publicly. We were on the front page of

10:20

the local newspaper here, the Star Tribune, and

10:23

really didn't hear much.

10:26

But a few years later, the messages

10:28

started. Dr. Gepford says they

10:30

more or less sound the same. Still,

10:33

I asked them to read one. Do

10:35

you want me to read it verbatim? Yeah. It

10:38

has foul language in it. That's okay. It

10:41

says, you need to have your license stripped.

10:45

F***ing rumor. Children are not

10:47

trans. They think they are because people like

10:49

you tell them they are. When I

10:51

was a child, I liked to wear my mom's heels and

10:53

dresses. You would have told me I

10:55

should have been a woman and I would have

10:57

grown to kill myself like most trans. You think

10:59

you're doing the right thing, but you are a

11:01

borderline pedophile. F*** you. I'm

11:09

sorry to make you relive that. Yeah,

11:15

I mean, it's

11:18

not, certainly

11:20

not pleasant. This

11:24

is the kind of message they have to

11:26

turn over to the hospital security team. How

11:31

should I say this? It

11:34

feels like we've seen this movie before, so to

11:36

speak, when it comes to abortion clinics. It

11:41

does feel familiar. I mean, this is the

11:44

way I have felt over the last

11:46

year, specifically kind of the last

11:48

six to nine months, is how

11:51

my colleagues who've been women's

11:54

health providers or abortion health providers have

11:56

felt For years. And

12:00

it is when it comes to

12:03

attacking reproductive rights And that's. Attack

12:05

the providers and attack the patience

12:07

and some. People do more one than

12:09

the other night and I think that

12:11

that's exactly what's happening for us, both

12:13

attacking the providers and attacking the kids.

12:18

And when we dug into the news

12:21

archives about this for violence after the

12:23

Nineteen Seventy. Three supreme court decision

12:25

on Roby weighed. It's

12:27

a lot. In September this real

12:29

abortion clinics shut down after someone

12:32

dumped the nauseating chemical inside blockades

12:34

of clinics that perform abortions. Acid

12:36

attacks and others are dollars of

12:39

the Redding, California Feminists Women's Health

12:41

Center was firebombed three times people

12:44

were shot or those patients and

12:46

doctors late term abortion doctor George

12:48

Tiller has been done. Down during

12:51

services that asserts in Wichita, Kansas.

12:53

And then there were and continue.

12:55

To be reports of the

12:58

protests, lawsuits, and state legislation

13:00

to ban procedures. So even

13:03

though at that time abortion

13:05

rights were constitutionally protected, access

13:07

became a huge issue because

13:10

clinic shut down. Given

13:13

the history. It's not a stretch to

13:15

say that we could witness the same thing

13:17

play out when it comes to care for

13:19

transgender kids. Coming

13:22

up, a doctor who is been at

13:24

the center of these attacks speaks out.

13:27

Someone. Somewhere is going to get hurt

13:29

and is like is that when it's gonna

13:31

end you know, right? there is no room

13:33

in this discussion for this kind of heat.

13:38

More. In a minute. We.

13:58

JD Power ranks Sleep Number number one

14:00

in customer satisfaction with mattresses purchased in-store.

14:02

And now, the Queen Sleep Number C4

14:04

Smart Bed is only $1,599. Save

14:08

$300 for a limited time. Only at

14:10

Sleep Number stores or sleepnumber.com.

14:16

Apollo, the the god has music,

14:18

was also the god of medicine

14:20

and so there. There's been a

14:22

long time link between music. And

14:24

sound and Health that is my favorite. Fact

14:26

of the month the says it's so that's.

14:28

Apolo, the god of music, was

14:30

also the.of medicine I may get.

14:32

Everybody. Let's explore the world

14:35

we're living in every weekday with

14:37

on points from Wb you are

14:39

Boston's Npr find and follow on

14:41

point wherever you get your podcasts.

14:49

You. Know Doctor Garofalo. I in as start

14:51

just by saying that. This.

14:54

Is the kind. Of interview that it's

14:57

nerve wracking. As a

14:59

journalist to ask people to do

15:01

you can imagine spied. Are

15:04

you scared to be doing an interview? Actually,

15:07

I'm this is the first time

15:09

that I've ever sort of been

15:11

nervous. Rob.

15:14

Garofalo is in Chicago, which is where

15:17

he code reds the gender and sex

15:19

development. Program at Lurie Children's

15:21

Hospital. And he's also in

15:23

charge of the Division of Adolescents

15:25

and Young Adult Medicine on more

15:27

very important credential. To mention here,

15:29

he's also among a handful

15:32

of researchers behind what might

15:34

be the only National Institutes.

15:36

Of Health funded study looking

15:38

at the outcomes of medical

15:40

interventions for gender affirming carrying

15:42

youth. So. He's got a

15:44

long history in this work. And. He feels

15:46

like. He's watched this slow

15:48

rise and what he calls misinformation

15:51

about gender affirming care. if

15:53

you would have told me five years ago that this

15:55

is where we would be in there are a discussion

15:57

around center for me care i'm i might never have

16:00

believed you. You know, I

16:02

think it was like during the Obama

16:04

administration, the Attorney General said that transgender

16:06

kids and adolescents were seen. And that

16:08

was for me like a seminal moment.

16:12

And for many reasons, I think that

16:14

optimism has just slowly eroded over the

16:16

past, you know, three or four years.

16:19

First, I think sort of insidiously

16:22

and sort of slowly. And then

16:24

I think over the past year,

16:26

it's become much more organized and

16:28

directive and structured

16:31

and pervasive. When

16:34

it was insidious, what did it look and feel

16:36

like? Can you give an example? I

16:40

mean, I think there were always parts

16:44

of society or

16:46

segments of our culture that

16:48

question some of the work that

16:51

we do, right? I mean, there are... I

16:53

want to be careful how I say this, so let me think about this. Wait,

16:55

let me think. Can

16:58

we give this some thought for a second? Sorry. No.

17:02

And I want you to take your time because one of the things that I've noticed

17:04

about the reporting on this, people can

17:06

be taking it out of context pretty quickly. Yeah.

17:09

Yeah. So I'm being... And

17:11

I've never... I give a lot of interviews

17:13

over the years and the

17:15

level of anxiety and just

17:18

concern I have about saying

17:20

something that might be incorrect

17:23

or easily mischaracterized or

17:25

reframed is super

17:27

high even as we're having this conversation.

17:31

And that's just so crazy

17:34

to me on some level, but

17:36

that's the world that we live in. And

17:38

so I say insidious because there's always

17:41

been sort of an undercurrent of a

17:44

segment of our population that have

17:47

been concerned about the work that we

17:49

do that's either wedded usually in cultural

17:52

or social or even religious mores.

17:55

What I would say has changed recently

17:58

is just... the

18:03

tone and the

18:05

pervasiveness of the rhetoric,

18:07

which has gotten increasingly

18:09

hostile and wedded

18:11

in, I think, intentional

18:13

attempts to misrepresent the work that

18:16

we do, intentional attempts

18:18

to mischaracterize the work that we do.

18:20

And in some ways, I think really has nothing to do

18:23

with health or healthcare. Yeah, because

18:25

now you're in an area of what

18:27

we would call politically sensitive medical

18:29

care. Yeah, I mean... Abortion

18:31

would be under that, I think.

18:33

Correct. That label in that category

18:36

as well. Do you remember a

18:38

specific moment,

18:40

event where, you

18:42

know, you felt like something

18:44

isn't right? Well, yeah, I mean,

18:46

a couple. I mean, one, I think when

18:49

the legislative ban started to happen really over

18:51

the course of the last year, I think

18:53

many of us were put on alert that,

18:56

you know, shit was about to get real, part of my

18:58

language. So that was over the past

19:00

year. But then a few

19:02

months ago, you know, I

19:04

had an incident. I was actually in Nigeria

19:06

where I'm doing work for Global Health. So

19:08

you were a world away from Chicago. Correct.

19:11

I was in Lagos, Nigeria,

19:14

really like unaware in

19:16

some ways of what had happened on

19:19

sort of the local news. And I

19:22

listened to the voicemail and suddenly there was a

19:24

man who said that I was a piece of

19:26

shit and was

19:29

going to rot in hell and that he hoped that

19:31

someone would run me down with a truck and kill

19:33

me. And for me,

19:35

that was a moment where I was just like,

19:39

what is going on in

19:41

the world? Yeah, what is this? Why is

19:43

this happening? Exactly. And then I

19:45

was, I turned on the news quite literally, you know, and I

19:48

happened to be CNN because that's what we watch. Then

19:50

there was a story about the bomb

19:53

threat at Boston Children's Hospital. And

19:56

so I logged onto my Twitter account,

19:58

which I don't often use. There

20:00

were just hundreds upon hundreds of

20:03

sort of messages related to

20:06

a erroneous video that was a

20:09

spliced job of interviews I

20:11

had given, which had completely

20:13

mischaracterized what I do, who

20:16

I am, how I feel with

20:18

regards to the care that we provide to these

20:20

kids. And so it was in that moment, thousands

20:22

of miles away from

20:25

Chicago or the United States, that I

20:27

knew that this was going to get

20:30

bad. You

20:35

know, people using your own

20:37

words against you, right? Like taking interviews

20:39

you've done, manipulating them, cutting them in

20:41

a way that, as you said,

20:43

is like mischaracterizing your work. Did

20:46

that feel scary,

20:49

personal? Like what did you

20:51

think of like the kind of impact of that?

20:53

Yeah, first it felt just violating, right?

20:55

You know, and in some ways very

20:59

personal on any

21:01

one of a number of levels. And

21:03

it just made me both

21:05

sad and really enraged. I mean, I was

21:07

really mad that like this

21:10

was actually happening. What

21:12

does it look like? What does it feel like to be the

21:15

focus of a kind of, just to

21:17

start, social media onslaught? I

21:19

mean, honestly, none of us who are pediatricians sort

21:22

of went into this work to be prepared for

21:24

this. It just

21:26

felt really overwhelming. It's almost

21:28

like a wave crashing on you in

21:30

some ways because you're just ill-equipped,

21:34

I think, to manage just

21:37

the sheer volume of messages. You

21:40

know, I mean, all of a sudden something that I

21:42

had posted had 500,000 viewers and comments.

21:48

And so it was sort of being without

21:51

your consent thrust into this

21:53

world that was

21:55

filled with vitriol and hate in a way

21:57

that just was.

22:00

was deeply upsetting and really hard to

22:02

manage. I mean, I would just describe

22:04

it as just draining. I mean, I

22:06

had a woman in my building, you

22:09

know, who watched one of the

22:11

videos on Twitter, like harass me

22:13

in the lobby, calling me a

22:15

groomer and saying that I'm,

22:17

I'm not even to say what she said, because I

22:19

don't want to give those words airtime, but saying

22:22

that I did things to children

22:24

that is just repugnant and crazy,

22:28

honestly. So Dr.

22:30

Garifalo says this leaves him and others

22:32

in a kind of catch-22. Speak out,

22:35

see your words twisted against you,

22:38

say nothing, and let the misinformation

22:40

take over any meaningful debate. So

22:43

it's no wonder he and his colleagues are nervous

22:45

to speak out. Right? Because

22:47

the hatred now is so targeted

22:51

towards harming people

22:53

and violence that it makes it

22:55

difficult to know exactly what the

22:58

best strategy is to respond, you

23:01

know, for fear that any sort of

23:03

response, either on social media or

23:05

in real life, will sort of foment

23:07

even more vitriol and anger and hate.

23:10

And so that's, I think, a really

23:12

unique aspect of this and

23:14

has caught many of us and even

23:16

pediatric institutions a bit off guard

23:18

as to how to best respond. What

23:22

we are hearing about is that some

23:24

clinics are, for instance, taking down the

23:26

images of the medical

23:29

care providers, right? Like taking down

23:31

phone numbers off the websites, basically

23:34

becoming less visible. Oh, for sure.

23:36

It seems kind of like the opposite

23:38

of the mission in a way. Completely.

23:40

And that is exactly what's happening. So

23:42

people are scrubbing their presence

23:44

to the outside world, either their

23:46

social media presence, their websites, scrutinizing

23:49

material that's being distributed to patients

23:51

and families. And that's,

23:54

I think, carefully designed to limit

23:56

access, right? I mean, you know,

23:58

so by doing that the very people

24:00

that we need to reach are suddenly

24:03

now not being reached. It

24:06

seems like the effect of this is

24:10

naming and shaming of doctors. Have

24:14

we seen this before? Oh, I

24:16

mean, for sure. I mean, you mentioned

24:18

it earlier, the reproductive justice field around

24:20

abortion is, I think, a really good

24:23

example of where we have

24:25

seen this before. Has that

24:27

come up in an area of conversation in any way?

24:29

I mean, I don't want to force the analogy on

24:31

you. No, no, you're not.

24:33

I mean, it's a real analogy. And I think

24:37

many of us have asked and

24:39

reached out to abortion-providing

24:42

organizations around communication strategies or

24:44

safety for ourselves or for

24:47

our patients. So we are

24:49

trying to quickly learn from

24:51

one another and not

24:54

reinvent the wheel because this – I

24:57

think what is new, I think, is this

25:00

is targeting pediatricians as a field. The

25:05

stereotype of the pediatrician is like a

25:07

very kind person, like hugging a teddy

25:09

bear, right? Yeah, with

25:11

lollipops in their coat jacket. Correct. I

25:14

mean, I'm not – we're very kind

25:16

and loving. And

25:18

so the stereotype is

25:21

in complete opposition to what

25:23

the current rhetoric is saying. And I'm

25:25

being really careful not to repeat the

25:27

words that are being used

25:29

in part because I've been

25:32

told now as some of the

25:34

new communication trainings that we've received

25:36

to be very careful not to

25:38

repeat those words for,

25:40

again, fear that they're going to

25:43

be misquoted, misrepresented. And so –

25:46

but yeah, to your earlier question, this

25:48

is not new. It's

25:50

just in some ways new targeting this

25:53

particular population and these

25:55

particular providers. When

25:58

I think back to the 90s, though, I think – You

26:00

know that that ended in some murders of

26:02

doctors Well,

26:04

you know I Get

26:07

like emotional even just thinking about it in

26:09

some ways because one of my thoughts When

26:12

I answered that phone call in Nigeria,

26:14

honestly, like my first thought was Someone

26:17

somewhere is gonna get hurt and

26:20

it's like that when it's gonna end, you know, like

26:22

is it gonna take? someone

26:25

getting hurt to Wake

26:27

up people to the reality

26:29

that there's no room in this discussion

26:31

for this kind of hate I mean

26:34

there were very real Debates

26:36

that maybe need to be had but they

26:38

can't be had in an environment

26:40

where Violence

26:43

and death threats

26:45

are are ruining the day It

26:49

honestly has kept me up at night sometimes

26:52

just fearing that like

26:54

one day Like

26:57

a colleague of mine or someone that I

26:59

care about and know and and love you

27:03

know may get hurt and whether that's

27:05

a Doctor

27:08

or a staff person

27:10

or even worse like

27:12

a parent or patient. I mean

27:18

That's just really hard to

27:20

sort of navigate when you're

27:22

When you're training is really

27:26

just designed to like care

27:29

for people and Make

27:33

them better, you know and provide

27:35

them an environment that supports and affirms them Have

27:44

you wanted to stop doing the work and I don't mean never You're

27:46

saying that but you are on the edge here like you're

27:49

saying that You're on the

27:51

edge here like your your emotions are

27:53

right here. Yeah Yeah,

27:56

they are but I've never once even

27:59

considered not

28:01

continuing to do this work. In fact,

28:04

even with my emotions which can run high

28:06

and hot, I

28:08

am more committed than ever to

28:11

making sure that these

28:13

young people and their families have

28:16

the access they need to what

28:18

I am convinced is life-saving

28:20

care. What about

28:23

the next generation of care providers?

28:25

So what happened with abortion, right,

28:27

is like there was a stigma

28:29

and fewer people went in

28:31

to learning about those services.

28:34

I think that's something that I

28:36

am really personally concerned about.

28:38

I mean I've been doing this work

28:40

for a really long time and I

28:43

very much worry that what we need

28:45

are more people doing this work and

28:47

brighter people doing this work. And I'm

28:50

concerned that like if you're

28:52

a medical student or a you

28:54

know a young pediatrician who

28:56

would choose to go into a

28:59

field when this is what they may

29:01

face. Are you also getting

29:03

more attention because there are more people seeking

29:05

the care? Oh. And that

29:07

has raised questions for a certain segment

29:10

of the population. Yes. So I think,

29:12

let me think

29:14

about this for a second because this

29:16

is where I don't want to be

29:18

mischaracterized. I

29:21

definitely think that that part

29:23

of the concern has been the rapid rise

29:25

of the sheer number of clinics that are

29:27

doing this work. And

29:29

I think there are legitimate questions that

29:32

the field needs to ask itself about

29:34

how we train providers and how we

29:36

ensure that the models of care that

29:39

we have are as focused on quality

29:41

outcomes as they are on just access.

29:44

Right. I think for too long and in

29:46

many ways the trans community has accepted

29:50

models of care that the outcome

29:52

is strictly about access. And what

29:54

I hope for for my

29:56

patients are making sure that the

29:58

models we care are focused on

30:01

healthcare quality as they are

30:03

just on access. What's

30:05

happening to that discussion under

30:08

the scrutiny? Well, that's exactly right. You can't

30:10

have those kind of discussions under this kind

30:12

of scrutiny because people are

30:14

afraid to have, I think, very

30:17

real conversations around some

30:19

of the unanswered questions, around

30:21

models of care and ethics.

30:26

But you can't have serious scientific

30:28

debate in a context where

30:30

people are fearing for their lives. I

30:33

have to ask because, you know, as

30:36

we just saw with reproductive rights and

30:39

the end of Roe v. Wade, it

30:42

is effective, this kind

30:44

of sustained naming, shaming,

30:47

politicizing of

30:50

medical care. There is now a kind

30:52

of effective playbook for that. And

30:56

there are a great number of states where

30:58

it was down to one clinic or

31:00

no clinic. Is that where this

31:02

is headed? I mean, it's not where

31:04

it's headed. It's where we're at in some of

31:06

these states. I mean, I think there are some

31:08

states where now there are virtually no

31:11

clinics where to get this care. And

31:14

thousands of children and their families now

31:16

have to really scramble to think about

31:18

where they can get healthcare. On

31:21

this show, we like to talk to people who we say

31:23

are kind of living in the headlines. But

31:26

your story is not over, right?

31:28

Like it feels like this is

31:30

in the middle of

31:32

something. What have you learned so

31:34

far? I mean, one, I've

31:37

learned to just have

31:39

a bit of a thicker skin, you know, like,

31:41

I mean, every morning I wake up and

31:44

I recognize that I needed

31:46

to do this work And

31:49

that I've got to show up and

31:51

that I can't afford to be tired

31:54

or fatigued or cranky or upset because

31:56

then the people that want to shut

31:58

down this work win. That's a

32:00

completely unacceptable option for me. Doctor

32:07

Ross care follow I'm Laurie

32:09

Children's Hospital in Chicago. The

32:15

sign in. This

32:19

episode was edited by Rena

32:21

Falter and produce bias Okay

32:24

Samuels. Jennifer Lie and Alison

32:26

Park or. Senior producer is Matt

32:28

Martinez. Mixing and sound design by

32:30

David Showman and then to Sula

32:33

is our technical. Director Steve

32:35

Lickteig is the executive

32:37

producer of Cnn. Audio

32:39

and that team includes Haley,

32:42

Thomas, Alex Monastery. Robert Mathers,

32:44

John De and Aura Lenny Steinhardt

32:46

game as Andrus the Cole has

32:48

the roof and Lisa now morale.

32:51

Special thanks as always to Katie Him

32:54

and I'm Audie Cornish And thank you

32:56

for listening.