Episode 32: Dr. Lachman Testifies

“The defense calls Dr. Sophia Lachman,” Senator Travis summoned his witness from the audience.

Judge Connor swore her in.

“What kind of doctor are you?” Senator Travis began. “Are you one of those people who get called a doctor because they got a Ph.D. in Women’s Studies?”

“Objection!” Senator Castillo popped to her feet. “Argumentative!”

“Sustained!” the judge ruled.

Senator Travis turned back to his witness. “Tell us about your background.”

Dr. Lachman smiled. “I am a medical doctor, board certified in child, adolescent, and adult psychiatry. I’ve seen and treated hundreds of patients in my career.”

“Let me ask you your professional advice, Doctor,” Senator Travis continued. “When our children express a preference of some kind, should we as good parents, as parents who love them and care about the welfare of our children, should we always affirm them?”

“Of course not,” Dr. Lachman replied. “If your child wants to put on a cape and jump off the top of the house, or play with matches unsupervised, or try to learn how to juggle knives, a responsible parent tells them ‘no.’ If a child says he wants to be a pirate, we don’t gouge out his eye, fit him with an eye patch and schedule him for peg leg and hook surgery. Children sometimes have difficulty distinguishing between fantasy and reality. They’re often not mature enough to assess risks and dangers and consequences. That’s their parents’ job.”

“Well, what about teachers?” Senator Travis followed up. “Should a teacher always affirm a student?”

“Affirming children in all their whims and wishes and desires is a recipe for disaster,” Dr. Lachman noted. “We expect teachers, and other responsible adults in our children’s lives to act on children’s behalf, looking out for them as if they were standing in for the children’s parents. There’s a legal term for it, too; I don’t recall.”

“In loco parentis,” Senator Travis nodded. “Yes. Well, why then are we told by… certain advocates that children know best when it comes to their gender identity?” he asked. “That we always have to respect their decision to change their name or their pronouns or dress differently, or even receive hormone treatments or surgeries?”

“The affirmation model is the prevailing narrative in education and mental health today,” Dr. Lachman confirmed. “Supposed experts tell parents to let their child run the show with respect to gender identity. Parents are supposed to step back and respect the child’s decision. Adults who can’t so much as define the terms ‘man’ and ‘woman’ tell us children know better than anyone else who they are and how they should identify. They claim children should be allowed to make the decisions about using a new name, opposite sex pronouns, how they’re going to dress, how they’re going to get their hair cut, what’s called ‘social transition.’ As they get older, children are allowed to undergo ‘medical transition,’ to select various medical interventions including hormones and surgeries.”

Senator Travis shook his head in disbelief. “Why do parents step aside and allow these so-called experts to guide their children in such important decisions?”

“It’s a psychological manipulation and a power grab of the worst kind,” Dr. Lachman opined. “Experts – teachers, doctors, activists, and counselors – tell parents to defer to their children. They say these are important interventions needed to avoid mental harm or suicidal ideation. They ask ‘would you rather have a dead daughter or a living son?’”

“Are these children at risk for suicide?” Senator Travis asked.

“It’s true that gender-confused people are at a high risk of suicide,” Dr. Lachman agreed, “but that’s true whether or not they are ‘affirmed’ or undergo medical interventions. Michael Biggs reviewed data from the world’s largest clinic for transgender youth and found their suicide rate was 5.5 times higher than average. But there didn’t appear to be a difference between the suicide rate for those receiving medical treatment versus those on the waiting list for treatment. That’s why it’s terrible emotional blackmail to tell parents the only solution is medical intervention. It’s critically important for parents to educate themselves and seek out sources of information beyond the mainstream.”

“What is gender dysphoria?” Senator Travis inquired.

“Gender dysphoria,” Dr. Lachman looked up, thinking through her answer, “is unhappiness or discomfort with your biological sex and with your body, and wanting to be the other sex.”

“How common is gender dysphoria?” Senator Travis asked.

“Until recently, gender dysphoria occurred very rarely. Maybe one in many tens of thousands of individuals or even less common. You’d read about it in the textbooks, but you could go an entire career without running into a person with gender dysphoria living as someone of the opposite sex. Now, it’s a huge portion of my practice. It’s exploded. In the past decade or so, the incidence of gender dysphoria has skyrocketed. There are school classes in which 25% of children identify as the opposite sex.”

“That’s a huge fraction,” Senator Travis reinforced his witness’s testimony. “Is it… contagious?”

“There IS a social contagion aspect to it,” Dr. Lachman confirmed. “Many teenagers never had any indications of gender dysphoria, but then their friends start going through it, and they decide to join in. Eating disorders like anorexia and bulimia have exhibited similar behaviors. Dr. Lisa Littman showed that when teens undergo ‘rapid-onset gender dysphoria,’ where they suddenly present as transgender, a majority of them have friends going through the same process. No one is immune to this happening, and parents should be prepared for it.”

“So, does this just happen?” Senator Travis settled in, sitting on the corner of the defense table. “What causes gender dysphoria?”

“Adolescent-onset gender dysphoria is more complicated than the management of early-onset gender dysphoria,” Dr. Lachman answered, “in that individuals with adolescent-onset are more likely to have significant psychopathology. The presentation of gender dysphoria can occur in the context of severe psychiatric disorders, developmental difficulties, or as part of large-scale identity issues.”

“Severe psychiatric disorders, developmental difficulties, or as part of large-scale identity issues,” Senator Travis echoed his witness and shook his head. “So, is it a good idea to just blindly reinforce or affirm children who suddenly present with gender dysphoria? To go ahead and help them with social and medical transitioning?”

“Absolutely not,” Dr. Lachman declared. “Certainly not without looking into the underlying causes first. The APA Task Force noted in 2012 that…”

“APA?”

“American Psychological Association,” Dr. Lachman explained. “The APA Task Force on the Treatment of Gender Identity Disorder,” she continued, “notes that adolescents with gender dysphoria ‘should be screened carefully to detect the emergence of the desire for sex reassignment in the context of trauma as well as for any disorders such as schizophrenia, mania, or psychotic depression that may produce gender confusion. When present, such psychopathology must be addressed and taken into account prior to assisting the adolescent’s decision as to whether or not to pursue sex reassignment or actually assisting the adolescent with the gender transition.’”

“That certainly makes sense,” Senator Travis nodded, reinforcing his witness’s testimony. “Can you tell us where all these ideas about transgenderism came from in the first place?”

“A German physician, Magnus Hirschfeld, was a pioneer in studying and advocating for homosexuality in Weimar Germany,” Dr. Lachman explained. “He coined the term, ‘transvestite,’ and grouped together those who did not identify as male or female into what he called a ‘third sex.’ His research and pioneering sex-change medical experiments ended when the Nazis destroyed his institute and burned his work. He died in exile in France in 1935.”

“So, that was the origin of this notion that gender was an arbitrary personal decision that should always be affirmed?” Senator Travis asked.

“In Hirschfeld’s day, the concept of gender hadn’t been invented yet,” Dr. Lachman pondered where to begin. “If you’re looking for an origin, I suppose you could point to the 1960s when behaviorism ran rampant through psychology. They thought that everyone was born tabula rasa, or as a blank slate. They believed that nurture trumped nature, and that environment determined life outcomes. It was thought boys became boys, and girls became girls, because their parents gave them trucks and dolls, respectively, to play with. Children in intellectually-enriched environments, with lots of books and good teachers would become smart, those without such benefits would languish in ignorance and stupidity.

“For instance, in one classic and controversial experiment, a clinical psychiatrist, Peter Neubauer, teamed up with a New York adoption agency to place a number of identical twins in different households with different families who had different socioeconomic backgrounds. Contrary to the researchers’ expectations, the twins showed remarkable similarities in development and even interests despite their very different upbringings. The researchers abandoned the experiment without ever telling the children and their families. Some children involved only found out about it at random as adults when they happened to encounter their identical twin and put the pieces together.”

“So, we learned from that study that our biological nature does indeed trump nurture?” Senator Travis summarized.

“That particular study was never published,” Dr. Lachman pointed out, “so it’s tough to draw firm conclusions from it. The data and results are kept under lock and key at Yale University, and they are not available for scrutiny. A host of other research, however, demonstrates that ‘nature’ plays a key role, with some influence from ‘nurture.’”

“Well then, how did modern theories of ‘affirmation’ arise from that erroneous notion that nurture always trumps nature?” Senator Travis asked.

“The pioneer on gender identity was a psychologist named John Money – the first researcher to identify ‘gender’ as distinct from sex,” Dr. Lachman explained. “He suffered from gender dysphoria himself. ‘I suffered the guilt of being male,’ he once said. ‘I wore the mark of a man’s vile sexuality.’ His doctoral research was on ‘hermaphroditism,’ or as now we call it ‘intersex.’ That’s where someone is born with both male and female sex organs – a rare condition that occurs in about one in ten thousand births. Money proposed without evidence that everyone is born a psychological hermaphrodite – that nature is irrelevant and nurture influences where on a continuous spectrum between male and female we happen to exist. He argued that gender was a social construct. He was interested solely in behavior, so he distinguished ‘gender’ as something distinct from ‘sex.’”

“In his theory,” Senator Travis inquired, “how do we define sex?”

“Money identified six different factors by which to define sex: assigned sex, external genitalia, internal reproductive structure, hormonal and secondary sex characteristics, gonadal sex, and chromosomal sex. The basic idea…”

“Ah yes,” Senator Travis interrupted, looking at President Buchmann sitting behind the prosecution table. “We’ve heard that before. Please continue, Dr. Lachman.”

“The basic idea,” she summarized, “is that sex is biology and gender is… well, everything else, and in Money’s view, the two don’t have to match. He argued that babies are born gender neutral and adopt an identity as either male or female under the influence of their parents, their schools, and their society. Purely nurture, he argued, not nature. Gender, he thought, is largely a social construct.”

“Was this just idle ivory-tower philosophizing,” Senator Travis inquired, “or did Money put his ideas into practice?”

“Objection, your honor,” Senator Castillo rose to her feet. “Relevance?”

“Your honor,” Senator Travis countered, “Dr. Andrews has been indicted under a statute which prohibits the teaching of the biological theory of sex, and instead mandates some vague and nebulous kind of gender affirmation. The prosecution must prove, as part of its case, what that biological theory is, and how it is in conflict with their concept of what gender is, and how affirmation works. The prosecution had their opportunity to lay before the jury their view of gender affirmation. Now, if it please the court, the defense wishes to lay before the court, and ultimately before the jury, the ACTUAL history of gender affirmation theory, what it is, and how it works in practice.

“We will demonstrate that the concept of a personally-chosen gender identity is a potentially arbitrary personal choice that by its nature cannot possibly contradict the truths of biological science. We will demonstrate the harms inherent in blindly affirming arbitrary claims of gender identity – harms that fully justify Dr. Andrews ignoring the GAIA Act.

“We respectfully request you allow the defense to get this entire testimony on the record, so that it may be available upon an appeal.”

The judge looked thoughtful. “Very well,” he declared at last. “Overruled. But keep it relevant.”

“Thank you, your honor,” Senator Travis acknowledged the ruling. Then, turning to Dr. Lachman, he continued his questioning. “Did Money put his ‘gender as a social construct’ theories into practice?”

“He did indeed,” Dr. Lachman confirmed. “He was a pioneer in sex-change surgery. In 1965…”

“Wait a moment,” Senator Travis interrupted her. “I thought you said he was a psychologist, not a doctor.”

“That’s correct,” Dr. Lachman confirmed. “He was a psychologist, but he teamed with the doctors and surgeons at Johns Hopkins University who performed the first sex change surgery in 1965 and who founded the Johns Hopkins Gender Identity Clinic in 1966. The clinic closed thirteen years later after their own study failed to prove that sex-change operations benefit transsexual people. Nevertheless, Money was a Professor Emeritus of Medical Psychology and a Professor Emeritus of Pediatrics at Johns Hopkins for over half a century until his death in 2006.

“The famous case that made his reputation – for better or worse – was the case of the Reimer twins,” Dr. Lachman continued. “The Reimers had twin boys. When they were eight months old, the Reimers took them to be circumcised. There was an accident. The doctor burned off Bruce Reimer’s penis.”

“Ouch,” Senator Travis cringed. “What happened next?”

“A few months later, the Reimers heard about Money. Money was telling the world that children were blank slates, and that a boy could be raised as a girl or vice versa, with no harm done. The Reimers thought their problem was solved.

“They allowed Money’s team to castrate their son, and remove his testicles when he was seventeen months old. The surgeons formed an approximation of a vagina for him. The Reimers called their son, ‘Brenda,’ clothed him in pink dresses, raised him as a girl, and were instructed to never ever tell him he was born a boy. Money told them it was ‘the most humane’ course of action.”

Dr. Lachman took a deep breath. “He thought it was the perfect experiment. Identical twins. Same nature. Same nurture – same environment and upbringing. Except one twin would be raised as a boy, and the other as a girl. They went back to Money for annual monitoring until the age of nine and sporadically thereafter until 1978 when ‘Brenda’ fled in panic during his session.

“Money reported the results in the psychological journals claiming complete success,” Dr. Lachman shook her head. “Money never did acknowledge that his experiment fell apart. ‘Brenda’ wasn’t happy as a girl. He wanted to be a mechanic. He never felt like he was a girl. He would even pee standing up.”

A murmur of chuckles rolled across the courtroom.

“When his parents finally told him the truth,” Dr. 1 ignored the interruption, “‘Brenda’ switched back to identifying as a male. He took testosterone to counteract the damage from the estrogen he’d been forced to take while growing up. He had the artificial breasts imposed on him removed, and he underwent reconstructive surgery to try to create a penis. He changed his name, not back to Bruce, but instead, he chose to be called David. He married and adopted his wife’s children.”

“At least there was a happy ending to his ordeal,” Senator Travis said.

“No.” Dr. Lachman shook her head. “Back when the young twin boys visited Money for medical appointments, Money directed them to take off their clothes, to inspect each other’s genitals under his supervision, and to explore their sexuality while he observed them engaging in simulated sexual acts including…”

“Objection!” Senator Castillo popped to her feet again. “Prejudicial!”

“The jury isn’t present,” Senator Travis preempted Judge Connor, “and the facts of how gender affirmation works in practice need to be in the record to support our defense.”

“I’m going to sustain the objection,” Judge Connor decided. “This is both prejudicial and of questionable relevance, and it is clearly hearsay.”

“Your honor,” Senator Travis countered, “evidence from a deceased witness is an exception to the hearsay rule. As Dr. Lachman can testify, David Reimer ultimately died by suicide; his brother died of an overdose of anti-depressants.”

“I’m still not going to allow this evidence, Professor,” Judge Connor insisted. “It’s prejudicial, inflammatory, and of questionable relevance.”

“The defense takes exception to your ruling, your honor,” Senator Travis declared.

“Noted,” Judge Connor replied. “Take your line of questioning somewhere else.”

Senator Travis eyed the judge a moment before acquiescing in his ruling. “Very well.” He turned to face Dr. Lachman. “What is the scientific basis used to justify affirmation, including the social and medical transitions the prosecution advocates?”

“It’s called the Dutch Protocol,” Dr. Lachman answered.

“Ah, yes,” Senator Travis replied, looking at President Buchmann. “I believe we heard something about that also from the prosecution’s witness. Could you explain that study and what it shows?”

“Certainly,” Dr. Lachman continued. “One of the critical problems in treating gender dysphoria is that it’s impossible to know which children will ‘persist,’ or continue in their dysphoria, and which children will ‘desist,’ or stop having discomfort with their body, and reach an acceptance of their bodies, and be fine with it. Many studies show that the majority of children will desist and reach comfort and peace with their biology. A lot of those children will be gay or lesbian, but they will be fine with their bodies as they are. Between 60-90% of children will desist without any intervention or medical treatment. In fact, The American College of Pediatricians reports that 80% to 95% of pre-pubertal children with gender dysphoria will experience resolution by late adolescence if not exposed to medical intervention and social affirmation.

“The Dutch researchers wanted to see if it would be helpful to intervene early with the children they thought most likely to persist in their dysphoria. They selected 55 children who met strict criteria. They had to have exhibited gender dysphoria since early childhood. They could not have significant mental health issues – no anxiety or depression or autism, for instance. They were given puberty blockers to prevent puberty at age 12, cross-sex hormones at age 16, and then allowed to have surgical interventions at age 18. After a year and a half, the researchers reported they were doing well, and their dysphoria had decreased.

“So, what’s wrong with making that study the basis for how we affirm children with gender dysphoria?” Senator Travis asked.

“First off,” Dr. Lachman shook her head dismissively, “we’d like to have a control group for comparison. Did the treatment make the children better? Or would they have gotten better anyway without the treatment? We can’t tell from this study. Second, a year and a half isn’t a very long time to assess the long-term consequences. Finally, all the participants in the Dutch study had expressed gender dysphorias from a young age, and had no other mental health issues. Proponents are using this study to justify intervening with children who exhibit rapid-onset gender dysphoria and with children who sometimes have other serious mental health issues. Those are two criteria that would have excluded them from the Dutch study.

“Doesn’t it make sense to at least start with these interventions?” Senator Travis asked. “To ‘hit the pause button on puberty’ as President Buchmann testified, and give children a chance to sort things out for themselves?”

“Absolutely not,” Dr. Lachman declared. “They’re saying puberty blockers are reversible based on studies of children with what’s called ‘precocious puberty,’ children at age six or seven or eight whose hormones are out of balance. It’s not healthy for a six-year-old girl to develop breasts or a six-year-old boy to start growing a beard. Puberty blockers prevent precocious puberty. Stop the blockers at age eleven or twelve, and those children do fine.

“There isn’t a single country in the world where puberty blockers are approved for the purpose of pausing puberty in adolescents who should be undergoing puberty for healthy development of their bodies. These children have no detectable medical problems. Their hormones are fine.”

“Do these puberty blockers help young people with gender dysphoria?” Senator Travis inquired.

“It doesn’t appear so,” Dr. Lachman explained. “Oxford Professor Michael Biggs provided a comprehensive review of the experimentation with puberty blockers performed at the Tavistock Institute in the UK. He found no improvement in psychological functioning from administering puberty blockers.”

“Do puberty blockers have side effects?” Senator Travis asked.

“Absolutely,” Dr. Lachman affirmed. “There are very serious side effects. A healthy adolescence is essential for good bone density. Biggs found that puberty blockers interfere with that. The brain undergoes significant changes and growth in adolescence. We have no idea if we prevent the body from going through puberty, what effect it will have on brain development. They’re administering these hormones to adolescents in a very dangerous experiment – an experiment that can cause life-long irreversible body changes: sterility, cardiovascular issues, strokes, osteoporosis, and other debilitating issues.

“That’s very troubling, Dr. Lachman,” Senator Travis reinforced his witness’ testimony, shaking his head in a calculated gesture of disbelief.

“Is there ANY connection between the science of biology or your specialty, the science of medicine,” Senator Travis continued at last, “and the claims of these gender-affirmation ideologues?”

Dr. Lachman thought about her answer a moment before continuing. “This ideology claims that the concepts of male and female are disconnected from biology, and biological thinking must be brought into alignment with a persons’ inner feeling of being male or female. In my view, that attitude is utterly destructive of biology, of medicine, and of science, in general.”

“Does the concept of gender identity have ANY basis in biological science or medicine?” Senator Travis asked.

“No,” Dr. Lachman confirmed. “It is an arbitrary concept, disconnected from any scientific basis.”

“Where DOES the idea of ‘gender identity’ come from?”

“It all goes back to John Money,” Dr. Lachman explained. “Prior to John Money in the 1950s, the term ‘gender’ was purely grammatical: the assignment of nouns to categories like ‘male,’ ‘female,’ or ‘neuter.’ An English speaker trying to learn Spanish quickly discovers he has to pay attention to noun gender. It’s ‘el libro,’ the book, masculine. But it’s ‘la biblioteca,’ the library, feminine. It oftentimes doesn’t make much sense. Like ‘la barba,’ the beard, feminine.

“John Money took the word, ‘gender,’ from linguistics. He used it to describe a person’s… ‘inner experience’ of being male or female. That usage got popularized in feminist literature and scholarship. The concept of ‘gender identity’ is arbitrary and disconnected from any scientific basis. It’s a potentially subjective personal preference. Attempts to recast biological sex as a social construct, which then becomes a matter of chosen individual identity, are wholly ideological, scientifically inaccurate, and socially irresponsible.”

“So, Dr. Lachman,” Senator Travis concluded his questioning, “If the notion of a so-called ‘gender identity’ is an arbitrary concept, disconnected from any scientific basis, well then, is it possible for any scientific biological teaching to conflict with it?”

“No,” she answered. “I don’t see how.”

“Your witness,” Senator Travis resumed his seat.