Maintenance Phase Podcast Summary
Episode: BONUS: Breaking Down The Latest Anti-Trans Victory Lap
Release Date: July 1, 2024

Hosts: Aubrey Gordon & Michael Hobbes
Description: Debunking the junk science behind health fads, wellness scams, and nonsensical nutrition advice.

Introduction

In this bonus episode of Maintenance Phase, hosts Aubrey Gordon and Michael Hobbes delve deep into the controversial CAST (Cass) Report, an anti-trans document that has stirred significant debate in both the UK and US. Released amidst mounting transphobic sentiments, the report purports to investigate the rise in transgender identifications among youth, positioning itself as a comprehensive analysis. However, Gordon and Hobbes argue that the CAST Report is fundamentally flawed, biased, and serves more as a tool for moral panic rather than an objective scientific inquiry.

Background of the CAST Report

[00:40] Aubrey: "We sort of shortchanged the CAST report in our rapid onset gender dysphoria episode because we wanted to focus on how this specific narrative has taken over institutions in the US and the UK."

The CAST Report was commissioned by the NHS in 2020 amidst growing media reports suggesting a surge in referrals to gender clinics. The hosts highlight that the report's Terms of Reference were inherently biased, aiming to investigate why more individuals are identifying as trans rather than assessing the legitimacy or efficacy of transgender care itself.

[05:54] Michael: "This is gonna be like the Boulevard of Broken Dreams episode."

Methodological Critique

Gordon and Hobbes criticize the CAST Report's methodology, pointing out several red flags:

1. Leadership Bias:
   [07:35] Aubrey: "Dr. Hilary Cass has not, like, she's not a trans physician. This is seen as an asset."
   The report is chaired by Dr. Hilary Cass, who lacks a background in transgender healthcare, raising concerns about impartiality.

2. Lack of Transparency:
   [09:37] Aubrey: "It's not clear how much Cass engaged with the actual clinicians at the clinic under investigation."
   The process lacked transparency, particularly regarding engagement with trans healthcare providers and affected individuals.

3. Questionable Exclusions:
   [11:29] Michael: "There were inconsistencies regarding suicidality and/or self-harm."
   The report dismisses numerous studies as low quality without adequate justification, often excluding comprehensive and relevant research.

Social Transition as a Medical Intervention

The CAST Report controversially labels social transition—such as changing pronouns or names—as a medical intervention. Gordon and Hobbes refute this characterization, emphasizing that social transition is reversible and lacks the permanence of medical treatments.

[38:53] Michael:
"Social transition may not be thought of as an intervention or treatment because it is not something that happens within health services. However, it is important to view it as an active intervention because it may have significant effects on the child or young person in terms of their psychological function."

The hosts argue that this misclassification serves to medicalize fundamentally social and personal identity changes, positioning social transition within a flawed medical framework.

Puberty Blockers and Hormone Treatments

Puberty Blockers:
The CAST Report reviews studies on puberty blockers, finding inconsistent results regarding their impact on mental health. Gordon and Hobbes counter that the available evidence generally shows either neutral or positive outcomes, questioning the report's dismissive stance.

Hormone Treatments:
When discussing hormone therapy, the CAST Report again labels the evidence as insufficient. [47:31] Michael:
"There were inconsistencies regarding suicidality and/or self-harm, with three of four studies reporting an improvement and one no change."

Gordon highlights that the majority of studies indicate beneficial effects, contradicting the report's claims of weak evidence.

Critique of Psychological Interventions

The CAST Report critiques traditional psychological therapies for trans youth, suggesting they may not be effective and even potentially harmful. However, Gordon and Hobbes argue that this ignores the high demand for effective, compassionate care and the desire within the trans community for evidence-based treatments.

[56:30] Michael:
"One of the main red flags is the kind of terms of reference, but then there's all kinds of other red flags in the process of creating the CAST report."

Conclusion and Final Thoughts

Gordon and Hobbes conclude that the CAST Report is a product of moral panic rather than a genuine scientific endeavor. They advocate for closing the debate based on biased and flawed evidence, emphasizing the need for continued support and research into transgender healthcare.

[62:32] Aubrey:
"I have some bad news, Aubrey. I will no longer be replaced by AI."

The hosts reaffirm their commitment to debunking flawed narratives and supporting evidence-based transgender care, urging listeners to critically assess reports like CAST and recognize the underlying biases that drive such agendas.

Notable Quotes

• Aubrey Gordon ([02:24]):
  "I feel like this is like a moral panic document that is produced by a government that is in the throes of a moral panic."

• Michael Hobbes ([18:42]):
  "They're trying to throw out any evidence that shows that this care helps children, and they're trying to validate these other approaches that are just not related to the issue at hand."

• Aubrey Gordon ([33:38]):
  "This is just evolving a body of medicine. Right. There’s nothing inherently, like, suspicious about this."

• Michael Hobbes ([42:08]):
  "There are only 11 studies of social transition of trans kids. So very small number of studies, they throw out nine of the studies and they're only left with two."

• Aubrey Gordon ([44:00]):
  "They are trying to cast an easily reversible step as irreversible."

Key Takeaways

• CAST Report's Bias: The CAST Report is heavily criticized for its biased approach and flawed methodology, lacking proper engagement with trans healthcare professionals and affected individuals.

• Misclassification of Social Transition: Labeling social transitions as medical interventions undermines the nature of personal identity changes and medical practices.

• Insufficient Evidence on Treatments: While the CAST Report claims weak evidence for puberty blockers and hormone treatments, existing studies generally indicate positive or neutral outcomes.

• Need for Continued Research: The episode underscores the necessity for ongoing, unbiased research into transgender healthcare to ensure effective and compassionate treatments.

• Closing the Debate: Gordon and Hobbes advocate for ending the misguided debate fueled by flawed reports, emphasizing support based on robust scientific evidence.

For more insightful discussions debunking health myths and exposing wellness scams, subscribe to Maintenance Phase on your preferred podcast platform.