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Megyn Kelly hosts a discussion on transitioning and de-transitioning, featuring Walt Heyer and Grace Ladinsky-Smith, both of whom regret their transitions. Walt transitioned to Laura Jensen in his forties but de-transitioned after realizing he needed therapy for childhood trauma rather than surgery. He recounts how adverse childhood experiences, including emotional and sexual abuse, influenced his decision to transition. He emphasizes that many individuals who transition may be dealing with unresolved trauma rather than genuine gender dysphoria. Grace, who began questioning her gender in her twenties, underwent a double mastectomy and hormone therapy but later recognized her mistake. She describes her experience as being influenced by social media and a mental health crisis, leading her to believe that transitioning would resolve her issues. Both Walt and Grace face backlash from trans activists for sharing their stories, highlighting the societal pressure to affirm transitions without exploring underlying psychological issues. The conversation shifts to the medical perspective, with Dr. Julia Mason and Dr. Erica Anderson discussing the implications of puberty blockers and cross-sex hormones. They outline significant risks associated with these treatments, including bone density issues, cognitive effects, and irreversible changes to sexual function. They express concern over the lack of thorough evaluations before medical interventions are prescribed, noting that many young people may be seeking transition as a solution to broader psychological problems. The discussion also touches on the increasing number of young girls identifying as trans and the potential societal factors influencing this trend. Both doctors advocate for a more cautious approach, emphasizing the need for individualized assessments and addressing underlying mental health issues rather than rushing into medical treatments. They call for a systematic review of the scientific evidence surrounding these practices, similar to actions taken in countries like Sweden and Finland, which have begun to reassess their approaches to gender-affirming care for minors.

Chris Moritz discusses the financial aspects of what he terms "Transgender Inc.," highlighting the $7.5 billion market for sex reassignment surgeries and hormone therapies. He notes the absence of long-term studies on the efficacy of these treatments, particularly for minors, and emphasizes the invasive nature of procedures like vaginoplasty, which can lead to irreversible loss of sexual function. The number of transgender youth has doubled in five years, raising concerns about the medical community's approach, which often relies on guidelines from the World Professional Association for Transgender Health (WPATH). Moritz argues that the shift in defining gender dysphoria from a mental illness to a condition requiring medical intervention has facilitated this trend. He points out the financial incentives for healthcare systems and pharmaceutical companies, with significant revenue generated from surgeries. Moritz warns of the potential long-term health consequences of hormone treatments and the societal implications of these medical practices.

Dr. James Cantor discusses paraphilia, defining it as innate sexual interest patterns that can be profound and immutable, such as exhibitionism and pedophilia. He emphasizes that these interests are distinct from typical sexual orientations and often debated in terms of their classification. Asexuality is explored as a complex label that can signify low sex drive or serve social functions, but it can also be adopted by individuals avoiding insecurities. Cantor highlights the "older brother effect," where the likelihood of male homosexuality increases with the number of older brothers, suggesting a maternal immune response to male fetuses. He notes that while male homosexuality has biological underpinnings, female sexuality is more context-dependent and influenced by relational factors. The conversation shifts to the stigma surrounding pedophilia, differentiating between the sexual attraction pattern and criminal behavior. Cantor argues that many who identify as pedophiles do not act on their attractions and often struggle with societal condemnation, which drives them underground instead of seeking help. He discusses the complexities of transgender identities, noting that while gender identity is not located in the brain, there are neurological patterns associated with sexual orientation and atypical sexualities. Cantor expresses concern over the rapid acceptance of transitioning in children without sufficient evidence of long-term outcomes, advocating for more robust research and therapy. The dialogue touches on the intersection of mental health and suicidality among transgender youth, emphasizing that the high rates of suicidal ideation do not necessarily correlate with the need for medical interventions. Cantor calls for a reevaluation of the medical establishment's approach to transitioning, advocating for evidence-based practices and caution against hasty decisions that could have lasting consequences.

On Origins Podcast, Lauren Schwarz and Arthur Rousseau discuss their chapter in The War on Science, focusing on gender-affirming care (GAC) and medical standards. They argue that the World Professional Association for Transgender Health (WPATH) wields influence, with U.S. medical bodies deferring to it, while the UK’s Cass report and countries have begun to curtail such care. They describe WPATH’s standards of care (SOC 8) as presenting itself as evidence-based, lifesaving care, yet note published reviews finding the strength of the evidence often low or indirect, and that guidelines are not always consistent with the underlying literature. They recount that Johns Hopkins underwent political pressure to withdraw systematic reviews and that WPATH later imposed an approval mechanism over future publications. The speakers condemn the reliance on “lived experience” over rigorous evidence, and highlight concerns about age restrictions being removed and consent for minors to hormonal or surgical interventions. They cite a lack of long-term outcome data, no conclusive evidence that gender-affirming care reduces suicide, and cases illustrating the risks of messaging to afraid families. They call for better education, transparency, and a return to science-based medicine, while referencing the Tennessee minors’ care case and urging global alignment.

J. Michael Bailey discusses the retraction of his article on Rapid Onset Gender Dysphoria (ROGD) from the *Archives of Sexual Behavior*, attributing it to pressure from transgender activists rather than academic misconduct. He claims the retraction has increased the article's visibility, with nearly 100,000 downloads. The article, co-authored with Susanna Diaz, explores a surge in gender dysphoria cases, particularly among adolescent girls with pre-existing mental health issues, who suddenly identify as transgender. Bailey argues that many of these girls demand serious medical treatments, often leading to worsened mental health after social transition. He contrasts two theories explaining the rise in transgender identification: increased societal acceptance and social contagion, particularly among females. Bailey emphasizes the need for further research on ROGD and plans a new study with Lisa Littman and Ken Zucker to gather extensive data on gender dysphoric adolescents. He also touches on the complexities of sexual orientation, paraphilias, and societal influences on gender identity, advocating for open discussion and research in these areas.