SIO314: Lisa Littman's Bogus Trans Studies, Part 1

Transcript

This transcript was generated automatically and may contain errors — the audio is the record.

0:00:11 Thomas: Hello and welcome to Serious Inquiries Only. I'm coming at you from Echo headquarters of my new house that's not set up yet. So it's bothering me and probably will bother exactly one other person out of all the listeners. How's it going, Lindsey?

0:00:26 Lindsey: I got a cold. I'm hoping that we can yell and break up some of the congestion here. I think that that'll help.

0:00:32 Thomas: I've never heard you yell, but maybe this will be the first time. One time I heard a slight, just like a slight irritation in your voice. And that

0:00:41 Lindsey: I think that was when we were covering the end of gender, and this is kind of a reprise on that. So yeah, all comes around.

0:00:45 Thomas: Oh. Joy, yeah, so Interesting. I, I had seen this, um, Litman study, a new study on trans people, and the usual bad sources that you see on Twitter, and that people were referencing. This is like, look, finally proof that, um, isn't actually good or something. I don't, I just, again, I've been moving, so I just saw like vague transphobia, new study, something, and I was like, and I held my hands out to Lindsey, and I was like, is this a thing to, for you to science us, uh, and sure enough, I think this is a thing for you to science us. Okay.

0:01:22 Lindsey: Yeah, I think this will be interesting. Yeah, we first encountered Lisa Littman when I read The End of Gender, and Deborah Soe cited her 2018 paper, which was on rapid onset gender dysphoria. And Deborah So claimed that this was an awesome study that showed evidence of a legitimately concerning trend in teen girls being peer pressured into identifying as trans. But, So said, that study was canceled by trans activists.

0:01:50 Thomas: No.

0:01:50 Lindsey: None of that is true. Yeah. And so we talked about that study in passing, but we didn't have time to get into to the details because there was just so much horrible shit in that book to get through. But we're going to talk about that 2018 study in addition to the one that you just referenced. So that one is hot off the presses, just came out this week, and it is on detransitioning.

0:01:51 Thomas: That's true? Wow. Yeah. Okay.

0:02:11 Thomas: Yeah, because I do remember definitely a few people were like, hey, I wish you had more, more time to go into that. I had never really heard about this new, again, it's another one of these like scare, scares, I guess, where it's like, oh, it's rapid onset, whatever. So I'm really curious to hear more about that. But I think, as usual, we should probably issue the normal notes that we're going to be talking about, probably some really transphobic stuff.

0:02:34 Lindsey: Absolutely.

0:02:34 Thomas: This is in the hopes of, you providing better information and showing why the studies that people are sharing around in the hopes of, in name of TERFdom, We're you going to hopefully show why those don't add up. But of course, to do so, I'm guessing we're going to have to discuss some gross opinions, some bad transphobia.

0:02:55 Lindsey: And not only that, but some of the things that she reports in her 2018 study are pretty hard to hear, especially if you've had experiences with, say, conflict with parents and and things like that. So I think, yeah, some content warnings up at the top are very appropriate here.

0:03:09 Thomas: Definitely. But with that said, I think we should get into it. So where are we going to begin with this, the story of this transphobe Lipman.

0:03:17 Lindsey: I do want to issue some things at the very top, right? So some folks go through a medical transition, right, or begin a medical transition. And then they pause or stop or decide to reverse that transition .And that's what is meant by detransition. That's the topic of the second article. And they make those decisions for a variety of reasons. And although it appears that that many folks, I would even venture to say probably most folks, have a good experience with transition. It does appear that sometimes people decide against transitioning part way through, or they have serious regrets about it. And again, those regrets can come from a variety of places.

0:03:52 Thomas: Sure.

0:03:53 Lindsey: So I do think it's important to learn about those experiences. And I obviously feel deeply for folks that have negative experiences with transition. And while Littman studies appear peer on their face to be coming from a place of similar concern, the implications that she draws make it very, very clear that she isn't advocating for better gender -affirming care. She's advocating against early transition and for more gatekeeping in access to medical transition. And she's advocating for alternative gender therapies, which have been denounced by the American Academy of Pediatrics and the American Psychological Association as unethical and harmful. And if folks are interested in knowing more about that, they can go back to our end of gender episodes.

0:04:14 Thomas: Right.

0:04:33 Thomas: Definitely. Go back and listen to those if you haven't. I strongly recommend them. Lindsay did such a great job. And I'm remembering now. Yeah, I remember this discussion a little bit. Strikes me as probably to be expected that out out of however many people are transitioning, because humans are complex and the medical system also is complex and not always great, that there'd be some amount of non-success stories, some, you know, some amount of people either change their mind. And also it occurs to me too, like with how complex gender is that, you know, maybe some people, if they have gender dysphoria and they, maybe they start to transition, maybe they realize, like, it's not so simple as binary.

Who knows, like maybe they realize they're non -binary or something and don't want to transit. This is just me speculating, but it occurs to me that there's plenty of reasons we might expect people to either stop a transition or detransition. And like you say, learning about that and understanding those cases, it seems pretty vital. But I think I remember when you talked about the sort of the percentages that the rate of detransition or that sort of not having a successful transition seemed relatively minor compared to any other like medical thingy. You know, I mean, there's plenty of medical procedures that don't go perfectly right. And we don't say like, "Oh, never mind. No more heart surgery." There's

0:05:04 Lindsey: Mm-hmm. Yeah. Yeah, yeah, yeah.

0:05:56 Thomas: One failure. Can't do it anymore.

0:05:58 Lindsey: Exactly right, and we're gonna, we're going to talk about that in a lot more detail, but yeah, absolutely. But I just, I wanted to get that out of the way before we talk about this stuff, because I don't want to at all dismiss the experiences, the folks that are featured in Littman's studies. I do want to do is criticize her conclusions and her policy recommendations, because they just don't follow. But I wanted to state at the outset that like the people that she is featuring in these studies, right, I absolutely care about their experiences.

0:06:12 Thomas: Hmm. Mm hmm.

0:06:25 Lindsey: So yeah, so we're going to talk about that new study. And I also want to talk about her 2018 study on rapid onset gender dysphoria, because both studies actually suffered from the same problems. So Littman uses sampling and recruitment methods for her participants in both studies that are likely to systematically include the people who will report the experiences consistent with her expectations and exclude the people who would contradict her expectations. And some folks are writing off this particular critique of her research as one that can be applied to any study that doesn't use random sampling.

0:06:56 Thomas: I was going to say that like I just saw the Jesse Singal or whatever his name is that I think Aaron Aaron is interviewed over on Embrace the Void. I don't know when that'll be out, but that's that's sure to be an interesting debate or whatever that is. But anyway, I saw him. He seems to be somebody with a following in the sort of anti-woke crowd. And he was saying that kind of thing. I So was gonna pose that question to you. Is it true that this is something that all basically every study, you know, has and it's only a big deal because the woke are trying to debunk this one study?

0:07:11 Lindsey: Yeah.

0:07:31 Lindsey: No, it's so, I mean, issues of generalizability, you to apply that critique to the vast majority of studies, but like the problems can vary in terms of their severity. And the problems in her study are so much deeper than you see in most studies. It's not just that it was a convenience sample, it's that she was almost handpicking the people she wanted to respond to it.

0:07:45 Thomas: Hmm. Right.

0:07:53 Lindsey: So it's a way bigger problem than just this being a convenience sample. And on top of that, right, she makes inappropriate generalizations from her data in order to recommend that it be even harder for transgender individuals to access appropriate care. Right. Those are my sort of broad critiques of both of the studies before we we get into it. Her 2018 study on rapid -onset gender dysphoria was originally published in PLOS One under the title Rapid -Onset Gender Dysphoria in Adolescents and Young Adults, a Study of Parental Reports. But following a post -publication review, Littman had to make several corrections to her paper, and the title was changed to Parental reports of adolescents and young adults perceived to show signs of rapid -onset gender dysphoria.

0:08:38 Thomas: Okay. A little softer language there.

0:08:40 Lindsey: Yes, and it centers where those reports were coming from. They were not direct reports from adolescents and Young Adults. They Were Parent Observations. And the title wasn't the only thing that she had to change. She had to changed the abstract, the introduction, the method, and the discussion sections. They all were subjected to substantial modifications. So let's talk about this paper. Littman says that she wants to investigate recent reports that parents had been posting about in social media forums. So these parents, she said, had been hosting about the quote, sudden onset of gender dysphoria in their adolescent and young adult children, and that parents were linking the sudden onset with either their children's friends being transgender or gender dysphoric, or with their child's social media and internet use or both. The implication being that these parents didn't think that their child really, you know, was gender non -conforming or had gender dysphoria, they were just sort of conforming to their friend group or believing things that they saw online.

0:09:36 Lindsey: So Littman specifically cites Fourth Wave Now and Transgender Trend as websites where parents were describing these observations. And just for some context, Fourth Wave Now's tagline is "a community of people who question the medicalization of gender atypical youth," and Transgender Trend's tagline is "no child is born in the wrong body." So both of these websites represent a sort of skeptical view of letting young people medically transition and of gender -affirming care more broadly, which they tend to represent as an approach to care that blindly embraces and maybe even pushes medical transition as the right option for every gender non -conforming person. As far as I have read, this is not an accurate representation of gender affirming care. So Littman says that the parent descriptions of gender dysphoria don't match those in the research literature and thus, quote, quote, "raise the question of whether social influences may be contributing to or even driving these occurrences of gender dysphoria," close quote.

0:10:34 Lindsey: So she's suggesting that parents are noticing a distinct type of gender dystphoria that has its root cause in social influences rather than in gender incongruity per se.

0:10:44 Thomas: How would you know that?

0:10:47 Lindsey: Yeah, how would you know that, right? And And

0:10:49 Thomas: Right. I mean, like, This strikes me as like the, you know, when people talk about, oh, everyone's getting diagnosed with autism lately. It must be a fake thing. And it's like, well, or maybe we didn't diagnose people before. And now And Now we're like actually Doing it, yeah. So how Would you, how would you possibly separate that? Okay.

0:11:02 Lindsey: Now we're detecting it. Well, I mean, there are probably ways to do that, but not the approach that she took. I can tell you that. But that's, you know, her hypothesis, I guess, as to what is explaining these parent reports, right? But, of course, there's a lot of other possibilities. Another possibility is that what seems sudden to the parents is not so sudden for the children, right.

0:11:27 Thomas: Can Ask how this is being lumped together, because I do, I have noticed among younger people, youths of today, that I think there is a trend toward rejecting, you know, gender binary pronouns and that kind of thing. And I, I don't know if that's always like any sort of gender dysphoria necessarily, could be, but it also could just be like, hey, down with with the gender binary, I want to just use they them pronouns or something like that. And is all, is all of that getting lumped in together, or is this this just talking about like kids who want to transition? Okay.

0:12:02 Lindsey: Mostly focusing, I believe, on parents of children who do express a desire to transition, or at least I think most of them do. So I'm not, yeah, I'm not sure how much that's all getting pushed together. Right. Yeah, I mean, there's multiple sort of explanations, I think, for these observations that they're raising. Right. But, you know, Littman only seems compelled by one explanation, which is that peer pressure and social media are confusing cisgender young people about their identities. So that's a good place to start. Is the last sentence of her introduction. Quote, the purpose of this research is, one, to describe an atypical presentation of gender dysphoria occurring with sudden and rapid onset in adolescents and young adults, and two, to generate hypotheses about the condition, including the role of social and peer contagion in its development. In the corrected version of the article that was released later, this sentence had several substantive changes applied to it. So in the correction, it reads, quote, the purpose of this descriptive exploratory research.

0:12:08 Thomas: Okay. Sorry.

0:13:00 Lindsey: Are new words that are important because so they, they, you the, the correction here that this study is in fact descriptive and exploratory. She's not coming to the table necessarily with a priori hypotheses. She's doing a descriptive sort of exploration of what's going on with these parent perceptions.

0:13:15 Thomas: Huh. Well, that's a weird correction. Does that, okay, as a science person, is That a correction? Because that sounds like, um, you tipped your hand in terms of what you're doing here. Can you, can you write that you're not seeking to just like put the cart before the horse and prove your own pet theory? Can you right that, like, you're just exploring this? Or is that a correction that's like your conclusions didn't support this, so I guess you need to write that? Is that because, because otherwise it seems like a PR correction to me.

0:13:18 Lindsey: So, I don't think that it is like the nature of the study that she did, like descriptive and exploratory are like terms that describe certain kinds of research studies. And that's what she did. And so they're saying you need to be more precise in describing what you're doing here.

0:13:58 Thomas: Okay. Okay, so it's like she categorized it incorrectly.

0:14:03 Lindsey: Yeah. Yeah, or she, I mean, there's a lot of details that she's just not very upfront about in her study. So yeah, I think that there are a lot of the corrections that they apply throughout the paper are just saying like you need to be more precise in your language here about how you're drawing, you know, you need not overstate your conclusions, you need be clear that this was descriptive and exploratory. Yeah, yeah. Of this descriptive exploratory research is to one, collect data about parent observations, experiences, and perspectives about their adolescent and young adult children showing signs of rapid onset gender dysphoria during or after puberty, right, again, the parent observation part was totally left out of her purpose statement in the original paper, and to develop hypotheses about factors that may contribute to the onset and or expression of gender dysphoria among this demographic group.

Compare that to the original, she originally said, to generate hypotheses about the condition, as though she already knows it exists, this is the first study on it, including the role of social and peer contagion in its development. How would she know that at the outset? She's, yes, she is implying in the original statement that she's already decided what she's going to find. And I think she has, right?

0:14:23 Thomas: Okay are

0:15:10 Lindsey: We'll see that as we go through the methodology. But yes, the correction is much more tempered and it uses much more appropriate language that's more appropriate to the actual methodology that she employed.

0:15:19 Thomas: I've seen some defenses of this. By the way, this is the 2018 study. It's also confusing because the quote unquote new study, didn't it take place in like 2016 or like the subjects, the data was from then

0:15:25 Lindsey: Yeah. I I think she might have been collecting data for these around the same time, um,

0:15:36 Thomas: Okay. Okay, so a little confusing, but anyway, in, in, people defending this latest study, uh, have pointed out that, oh, her 2018 study was massively substantially corrected, you know, and then I think the sort of the anti-woke crowd, or Team Turf, I guess we can call it now, uh, defense was like, well, no, these were minor corrections, none of the data or anything was corrected. I think that's like the kind of angle they're taking, like that there's, all it was minor stuff, cosmetic stuff, none of the data, uh, how does, how does that look, how does that seem to you, right?

0:16:10 Lindsey: But Yes, I mean, that, that is technically true, but that doesn't mean they were minor corrections. So Deborah, so actually defended her by saying that, but the problem, I mean, like the, the things that she's doing in her results are just reporting like percentages of things, that's all that she's doing. This is a very descriptive kind of paper, the, the big errors that she's making are in her inferences, and those were the things that were corrected in the paper.

0:16:27 Thomas: Yeah. Yeah. It strikes me as actually a pretty substantial correction, like I've got like data that, that shows a thing, and I make wild, wild inferences about it. And then I I have to temper those down to like, all right, I'm actually just looking at this and it's just a paper saying some things, but I didn't correct any of my data. That still seems like a substantial correction.

0:16:35 Lindsey: Yes. Mm- -hmm. Oh, It is, no, the, the corrections are extensive and very meaningful, these are not, these are cosmetic changes at all. Yeah. So yeah, let's, let's talk about what she did here. Sorry, she collected parent reports, this, this, the data that she, she's working with are exclusively parent reports. Her participants were 256 parents, 92% of whom were women, and most of them were between the ages of 45 and 60. Most parents, 83%, were reporting on a child who was assigned female at birth, and the child ages reported ranged between 11 and 27, with an average of 16 years old. Parents were recruited via links to the survey placed on three websites where, quote, parents and professionals had been observed to describe what seemed to be a sudden or rapid onset of gender dysphoria, close quote. And these websites were Fourth Wave Now, Transgender Trend, and Youth Transcritical Professionals. We talked about the first two sites already. Those are, you know, they're skeptical about gender affirmative care, particularly for young people.

The third appears to be A Private WordPress site now. I couldn't actually view it, but I assume that it was public at the time. But from what I read on Fourth Wave now, it was formed, quote, for for therapists, social workers, medical doctors, educators, and other professionals concerned about the rise in transgender diagnoses by children, adolescents, and young adults.

0:17:08 Thomas: Okay. Hmm.

0:18:19 Lindsey: Close quote. By the way, in the original paper, she does not describe what these websites are or their ideological perspective. In the correction, she had to add three paragraphs describing these sites.

0:18:27 Thomas: Really? That seems like a substantial correction to me.

0:18:32 Lindsey: It is, right? Yeah.

0:18:34 Thomas: Where would you go if you wanted to actually study something in a non-biased way, like, not here, right? Okay.

0:18:34 Lindsey: So, I mean, well, it's a tough question with things like this, right? Because it's a very specific population that you want, you know, parents of transgender youth, right. But if I was to do this, like one thing that you could do, I guess, is you could go to sites that are sort of like more pro gender affirmative care and recruit from those as well.

0:19:07 Lindsey: I don't know, if I were doing this, I would probably use a site like Prolific academic, which is a, it's like an online data recruitment site. And I would do like a screening study where I would ask people like just participants that use the site, like, do you have a child who, who identifies as transgender? And then the people who say yes, I would recruit for the full study. And then I wouldn't have to worry about the ideology of the site that I'm recruiting from or whatever. That, that would work, I think. Anyway, she doesn't do any of that. She just recruits parents that frequent these particular websites, right? A big deal here, I think.

0:19:44 Lindsey: So when we're thinking about, you know, to whom we can generalize these findings, it's the kind of, you now, people that are already very likely to be skeptical of gender affirmative care. Important question regarding her sampling is how the study was described to prospective participants. This is always a super important consideration when you're doing research because you need your participants to know what they have to do in your study. And so if it's a survey, they need to have an idea of the kinds of questions they're going to be answering because informed consent, right? But what you absolutely don't want them to know are your hypotheses.

0:19:30 Thomas: Yeah yeah right seems

0:20:15 Lindsey: If participants know what you expect or want to find prior to participation, this can likely influence two things, right. It can influence who decides to participate in your study and it can influence how they respond to your survey questions, right,

0:20:28 Thomas: Like the most basic kind of psychological principles that there could be do

0:20:32 Lindsey: -huh, yeah, Right, and so when I teach research methods courses and my students or putting together their consent documents or whatever, one thing that we spend a ton of time on is how to describe the study accurately without giving away their expectations. So with that in mind, here are some quotes from the study description that participants read before they decided to participate. Quote, "The purpose of this study is to gather information to describe an unusual presentation of gender dysphoria," right? This is already off the bat. This is already bad, but it gets a lot worse. Continuing, quote, "Online, more than 20 individual parent accounts have described seeing their child develop a rapid onset of gender dysphoria beginning in adolescence in the context of increased social media slash internet use and or being part of a peer group in which one or more multiple friends have developed gender dysphoria and come out as transgender during a similar time frame."

0:21:22 Lindsey: "This presentation is not consistent with what is known about gender dysPHOIA. You are being asked to take part in a research study if you have a child who, when they were between the ages of 10 and 21, developed a sudden or rapid onset of gender dysphoria. This may have occurred in the context of either increased social media slash internet use and or belonging to a friend group in which one or multiple friends have developed gender dysphoria and come out as transgender."

0:21:44 Thomas: You or anyone you know suffer from mesothelioma?

0:21:46 Lindsey: But Like she's telling, so, I mean, the main conclusions of her study were that she found evidence of this, this supposed new manifestation of gender dysfunction, and that it seemed to be associated with these variables, she put in her consent document that she's looking for people who have supposedly observed this, this relationship, yeah.

0:21:47 Thomas: Yeah, yeah.

0:22:08 Thomas: It Like the definition of cherry, cherry picking your, uh, your, your group. I also want to, a minor thing too, or maybe I don't know if it's minor or not. The idea of asking parents like, Hey, did your child rapidly develop, gender uh, dysphoria to me is a little bit off because it's like, maybe your child just finally told you one day or something, you know, like, yeah, when you're cherry picking, your own audience or whatever, your on study, subjects, the kinds of parents who would be like, yeah, like all of a sudden came out of nowhere are already going to be the kinds perhaps inattentive parents who, you know, had never noticed or hadn't been supporting their child through their dysphoria possibly or enough to like

0:22:11 Lindsey: Yeah oh I had the same thought, yeah.

0:22:49 Lindsey: No

0:22:49 Thomas: Know it was going on.

0:22:51 Lindsey: Exactly, yeah, it's, it's a great point, and one that we will definitely come back to, um, yeah. So, so if I were doing the study, I would have used more general language, I would have said that the purpose of the research is to gather information from parents who experience gender dysphoria between these particular ages, right? You qualify for the study if you have a child who experienced gender dysphoria, and then that would, would allow me to ask all the same questions in the study about rapid onset and social media and peer groups and all that stuff, but it wouldn't immediately guarantee that the vast majority of my participants say, "Yes, I noticed all the things that you want to say that are true about this," right?

0:23:26 Thomas: And again, without asking the child, I don't think you would have any way of knowing if it was a real quote unquote a rapid onset. Like that's just going to to be their opinion about it. It's just like your opinion, man.

0:23:34 Lindsey: Oh, absolutely. Absolutely. Yeah. That's absolutely true. So if I were to have done that study, I would have been very clear that no, the purpose of the study is that I'm really interested in knowing how parents experience this, I wouldn't say anything about, you know, what was actually going on. Because yes, you would need convergent reports from the children as well in order to make that case.

0:23:47 Thomas: Yeah. Far, not a good science thingy.

0:23:57 Lindsey: No, not a good science thingy. Yeah. And one other thing I considered about sampling, right? So let's say that, you knows, she's specifically interested in parents who have observed this rapid onset. She could still do that without including the language of may be linked with social media or peer groups, right? That would still allow her to get at these parents that, yes,

0:24:11 Thomas: Yeah, yeah. If anything, you need to do that, don't you? Because like, okay, let's say hypothetically, again, to entertain this notion in this episode, but like, let's say the rapid onset were some sort of phenomenon that you're either observing or trying to observe. Wouldn't you have to as a scientist wouldn't you have to like not include the part about like and there's... there's social media and there's whatever because you want it like you want to study like okay if this were a thing if this were actually happening I want to get information from the people responding to the survey and then from that information I could see oh there's a bunch of social media use and like oh there's a bunch of that and then go from that way to then draw your conclusion not start with your conclusion and try to recruit the people that fit that hypothesis yeah sorry

0:24:50 Lindsey: Couldn't say it better myself. That is absolutely what you would want to do. So like, basically, regardless of what these numbers end up showing, right, all we know is that among parents who think they have observed these things, these are some characteristics of their observations. That's all we know.

0:25:19 Thomas: Remind me what who is this person this is because it was always disturbing that Deborah so was actually somewhat qualified who is this Litman person and is she somewhat qualified as well okay

0:25:30 Lindsey: She is a medical doctor. She's a physician and she is an assistant professor at Brown University, or at least she was when Debra So was writing about her.

0:25:40 Thomas: So should know better probably or is or should not have like the research background maybe really

0:25:43 Lindsey: Well, you know, that's what I'm not clear on because a lot of the things that she's doing suggest that she doesn't have very good research training. Like, I don't get the sense that Lisa Lippman is is trying intentionally to be a bad actor here. I don't really get that vibe from her. It just seems like she, I, you know, I guess we don't know. Right. But I don't get the same vibes from her that I got from reading Deborah So's writing about this. She strikes me as a very misguided person who doesn't know how to do very good research.

0:26:02 Thomas: Okay

0:26:16 Lindsey: I, I you know I genuinely don't obviously but

0:26:15 Thomas: I guess Yes. Mean, given that she did one study, had to redact and revise a bunch of stuff and then did it again. I don't know. I feel like I feel Like she's got an axe to grind here.

0:26:23 Lindsey: Yeah, she does. I mean, she definitely she definitely knows what she thinks about this issue and is trying to to get evidence that supports it. And she's not doing it in a very good way. But I genuinely I don't I don'T know if she's trying to be like legitimate, like deliberately deceptive, I guess is what I'm saying. I don't know if shes a grifter.

0:26:46 Thomas: Oh, or if she's just incompetent. OK, so liar or incompetent is the debate you're having. Gotcha. OK. Yeah.

0:26:48 Lindsey: Yes. Yeah. Yes, that's right.

0:26:54 Thomas: And we're unclear. We'll look for more data on that, I guess. Yes.

0:26:57 Lindsey: Yeah I guess we will. Right. So normally at this point, I would tell you about her measures, but because this is a descriptive study and she's just going to go through all her questions and report percentages, I'll just give you, yeah, I will give you a sentence overview and then we will just get into the results. So Lippmann asked parents to report on their own demographics, like age, gender, and a couple of political views, which we will talk about, and then to report a variety of observations about their children. Right. So what did Lisa Lippman find? So Lippmann leads her results section with the fact that 86% of the parents in her study supported marriage equality and 88% believe that transgender individuals deserve the same rights and protections as anyone else, which I thought was an interesting thing to lead the results section with.

0:27:08 Thomas: Jeez, I could do that.

0:27:44 Thomas: Like trying to launder the thing a little bit, like trying to is this sort of like I don't have a racist bone in my body, but yeah. Well, because and it occurs to me that and this is the parents responses, right? Because it occurs to me, that it might be highly likely that these parents would be like, look, I'm all for trans rights. It's just my kid isn't trans, and I'm not listening to them when they tell me they're trans.

0:27:51 Lindsey: Mm-hmm. Yeah. Mm-hmm. Exactly. Exactly, yeah. But this fact has been used to sort of counter the objection that, you know, maybe these parents are just transphobic.

0:28:07 Thomas: Yeah, yeah, yeah. I would have voted for Obama a third time, basically.

0:28:18 Lindsey: Exactly! Yeah. So how can I be? How can I have problematic views about my child's gender? Yeah. Yeah, so she leads with that. Then she gets into some of the real things in the paper. So she says that that the majority of children, 87% total, either belonged to a group, to a friend group where one or multiple friends became gender dysphoric and came out as transgender during a similar time as the target child, that was 22%, or exhibited an increase in social media slash internet use, that was 20%, or both, 45%, right? So I would have rephrased that sentence, by the way, to say that the minority of parents reported that their children had these features in their friend group or, you know, increase social media internet usage. She just said that was true with the children, but whatever. She goes on to say that none of the children quote described in the study would have met the diagnostic criteria for gender dysphoria in childhood.

0:29:10 Lindsey: But again, she's asserting this based on parent reports. So she gave the parents the eight criteria for gender dysphoria from the DSM and just asked them to indicate which their children had exhibited prior to puberty. This is a diagnosis that would be made by a mental health professional, not by the children's parents, but she just asserts that none of the children would have met the diagnostic criteria for gender dysphoria in childhood. So then says that most parents, 81%, said that their child's announcement of being transgender came, quote, out of the blue without significant prior evidence of gender dysphoria. So this is her support for the existence of this rapid onset subtype of gender dystphoria, because the parents said it it came out of the blue.

Says that the majority of parents, 69%, believed that their child was, quote, using language that they found online when they came out. And then she spends some time talking about how when the child came out to their parents, the parents reported that their child's announcement seemed wooden or scripted, and that some parents were able to trace the source of their child'S comments to online sources. And I think that the point of of including this is that, you know, so obviously the internet is responsible for these kids, for quote-unquote turning these kids transgender, right? They're sort of mechanically repeating the things that they've heard, right. Any other explanations for why a child might consult an internet source to come out to their parents?

0:29:50 Thomas: Oh, my God. Uh -huh. Yeah, maybe a child Googled, how do I come out to my transphobic denial, in denial parents and then got some help and maybe they were really nervous and anxious about it and tried to like, you something or memorize something or use that as guidance. That seems pretty plausible to me.

0:30:35 Lindsey: Mm -hmm. Uh -huh. Mm -hm. Yeah. Yeah, coming out's pretty hard.

0:30:49 Thomas: Yeah, I bet.

0:30:50 Lindsey: I think that kids will look to sources about how to do that. So mm

0:30:53 Thomas: This whole thing, and we issued the warning. I'm glad you did. But this whole thing really breaks my heart. Like, I don't know. Again, I do not know who these parents are. I do know what is going on here. But everything about this cherry picking of this study is like, it just strikes, it just seems to me that it is attracting possibly like the worst parents. Like I can just imagine because, you know, I've heard stories. I've read my trans friends talking about, you know, their parents being in denial about it. Like the whole, oh, it came out of nowhere. They never, you know, displayed anything like that. And it just, all I hear is like, yeah, because you were in denial or you didn't want to see it or you were unattentive or, you know, like, oh it's just, it's heartbreaking.

0:30:59 Lindsey: -hmm mm -hm oh Oh, and that part gets worse. Yeah, there's some stuff that's even worse in that particular regard. Soldiering on, she says that 61% of parents reported that their children experienced increased popularity when they came out as trans, and 60% said that their child's friend group mocked people who were not transgender or LGBTIA. So I'll have to poll my colleagues who do developmental research, but if I wanted to get a reliable estimates of thing of things like popularity or the behavior of peer groups, parent reports is not what I would lean on most heavily

0:32:05 Thomas: That's got to be the worst. Yeah. If you ask my parents just anything, anything about anything about anything in my life at that time, any answer they would give would be wrong, it would be, I mean, that might just be me, but like, they would have no clue of any of that information, and my mom was a teacher at the high school I went to, by the way, she still wouldn't know.

0:32:06 Lindsey: Yeah. Yeah, yep. Mm. -hmm, yep, oh. Wow. Yeah. Right, because I mean, yeah, peer groups act differently around parents than they do yeah

0:32:30 Thomas: Yeah. And I think you know, I think parents might see what they want to see sometimes, like I can imagine as a parent that that'll be a barrier for me, like, I will want to see my kid as, as, popular, being in certain, like, I, it's just hard as a parent. I think you're not a very objective judge of these things.

0:32:35 Lindsey: Mm -hm yeah Yeah, and another thing about these, these questions, she doesn't make this clear, but the responses were prompted, like the survey included specific questions about whether the child's popularity increased, decreased, or stayed the same when they identified as transgender. And they also asked specifically whether friends in the child-friend group had ever mocked, teased, or made fun of people who were not trans or LGBTIA. Now, a little tricky on how to do this in a not-leading way, but I do think that those, those questions are a little bit leading. There's possibly a way you could ask this as like an open-ended response that maybe would be a little less leading.

0:33:22 Thomas: Yeah, like what changed after the transition or something?

0:33:25 Lindsey: Yeah. Yes. Right. I think that would be better. But like, starting them with this idea, right, I think is more likely to yield responses that are consistent with what you want to hear. Also reported reported on sources to which they attributed their child's rapid onset of gender dysphoria. So parents were able to check all that applied from this list of possible sources. The most commonly selected options were YouTube transition videos. So 64 % of parents said that it was YouTube transition videos that they attributed the child's gender dysphoria to. 62 % said Tumblr, 45 % said friend group, and 43 % said an online community or friend group. This is parents' reports of what they attributed their child's rapid onset gender dysphoria to. Next set of findings relate to parent -child conflict around gender identity.

0:34:14 Lindsey: And she put in here a lot of descriptions from open-ended responses from parents. I'm not going to dig too much into these because they're pretty heartbreaking and it was really hard to read. Um, it's really gut-wrenching stuff.

So 64% of parents reported being called transphobic or bigoted by their children for a variety of reasons, including disagreeing that the child is transgender, recommending that the child should take more time to figure out if the gender dysphoria would go away, expressing concerns regarding the use of hormones or surgery, and calling the child by their birth name.

And the the sort of narrative that's being, you know, woven around this is that, again, right, because the assumption is that this gender dysphoria is coming from online sources and friend groups and all that stuff, that that's also causing the children to lash out at their parents for just being reasonable parents. That seems to be the very clear implication of this narrative. Right, 36 percent of parents reported that their child had seen a gender therapist, gone to a gender clinic, or seen a physician for the purpose of beginning transitioning. And given how broad this, this question was, I find 36% to be surprisingly low. And, you know, you can interpret this in a variety of ways.

It's not clear whether the parents were denying the kids access to care, but that's certainly one way to read this. It's, yeah, it's not, it's not clear from the data reported. There are also, there are some heartbreaking passages here that excerpt open-ended responses from parents, and they range from descriptions of estrangement between the parents and their children to parents claiming that their children had completely rewritten their life history and their childhoods to fit their quote unquote narrative about being trans.

0:35:54 Lindsey: And obviously, again, there are multiple ways to interpret this info, but Lippmann uncritically assumes that the parents are correct in their perceptions. She says, quote, it is unclear whether this process, and by this process she means rewriting their childhoods, was deliberate or if the individuals were unaware of their actions. Be that the kids were actually providing information that the parents had missed or concealed?

0:36:02 Thomas: Yeah, yeah, yeah. I mean, even setting aside transition and gender gender dysphoria, all that, even just basic problems among children and parents, this pattern is absolutely, at the very least, if you're studying this, you better be aware that like, yeah, if I describe a problem in my childhood, there may be a good chance that my parents are like, what? I didn't even know about that.

0:36:28 Lindsey: Mm -hmm. Mm -huh.

0:36:41 Thomas: You know, like that's how human relationships work often, especially when you might have somebody who's like not a very good parent, like especially especially then, or, or maybe they were working 10 jobs and just couldn't take notice of these things. I don't want to judge every parent or anything like that, but like there going to be a significant, I think, proportion of any sort of conflicts like these or, or, know, traumas or just negative childhood experiences that parents will be oblivious to them.

0:36:41 Lindsey: Yeah. Yeah.

0:37:09 Lindsey: Yes. Yeah, exactly. But again, it's very clear how Lipman is interpreting that. Just, oh, okay, well, they're rewriting Their Childhoods? Well, that must be the case then. Last finding I want to highlight here was that she reports about the current gender identifications, as reported by the parents, as always, of the children, right? Right. So about 8 percent of parents reported that their child no longer identified as trans or, quote, seemed to be backing away from trans identification. Eighty three percent reported that Their child still identified as transgender. And the remaining 8 percent did not know how their child identified. Right. And it wasn't explained why they didn't know. But again, there were descriptions of estrangement. So, you so a few highlights from her discussion section. She concludes that she's found evidence for the existence of a new rapid onset type of gender dysphoria that is distinct from the one documented in past research, because these parent reports indicate that the onset was rapid and did not indicate that they had observed anything about their child previously that would have met the diagnostic criteria for gender dysphoria.

She also concludes that this type of gender dysphoria may be attributable to other mental health issues. We didn't get into those results, but like, they also reported on whether their children had had mental health diagnoses prior to the of gender dysthoria. She says that this type of gender dysphoria may be attributable to other mental health issues, may be temporary, and that this population, meaning the population of children,

0:37:14 Thomas: Yeah. Yeah,

0:38:32 Lindsey: With rapid onset gender dysphoria, is distinct from that described in previous research because the cases occur in, in quote, "cluster outbreaks in friendship groups," close quote, include mostly individuals assigned female at birth, and occurs suddenly during adolescence or young adulthood. Those are pretty strong conclusions based on what she's done in this study. Oh,

0:38:53 Thomas: Think this study would be so much less-grabbing, attention-grabbing if it was written as what it actually is, which is, hey, some parents experience their child's gender dysphoria as rapid onset.

0:39:10 Lindsey: As sudden.

0:39:10 Thomas: Yeah. Some parents Parents don't know their kid is, you know, like, how could you phrase that in what it actually is? Like some it's news to some parents that their children are having gender dysphoria. Like that's honestly, that's all this says, right? Great.

0:39:10 Lindsey: Yeah. Mm hmm. Yeah. And that and that this, this is occurring specifically in parents who seem to be very resistant to it.

0:39:33 Thomas: You would think otherwise, why are they on those websites? Boy. Not a great science thing.

0:39:36 Lindsey: Yeah. Mm-hmm? Yeah. So no, it's really not. Yeah." Just a little bit, a little bit more here to wrap up this study. She then describes two emerging hypotheses about the nature of rapid -onset gender dysphoria. The first one is, quote, social contagion is a key determinant of rapid onset gender dysphoria. And the second is, unquote, rapid -onset gender dysphoria is a maladaptive coping mechanism for adolescents and young adults.

0:40:05 Lindsey: And to help explain that One, she thinks that for some individuals who are unable to cope with stressors or traumas, might manifest gender dysphoria as a way of coping with that distress. Stress.

0:40:05 Thomas: Oh, for the love of God.

0:40:17 Thomas: Okay, I know we skip through the study pretty quickly. Were there questions on that, like what is, or is she just coming up with this out of nowhere, okay?

0:40:25 Lindsey: No, no, no. She did assess parent reports of whether their kids had any diagnoses prior to their expression of gender dysphoria. And she asked about whether the child had experienced any traumas, right? I just, I had to skip that for the sake of time. There was a lot of results.

0:40:30 Thomas: I Gotcha. Sure. Sure. Just wanted to clarify, so, but even, even still, she's skipping to like here's the possible explanation for the thing that I haven't even established, because this is a terrible study. Okay, so

0:40:48 Lindsey: Yeah, exactly. Yeah, and she, the way that she supports this, the second hypothesis in this section is the parent reports that their children had difficulty coping with negative emotions, institutions, um, that the children were predominantly assigned female at birth, right, which is not necessarily typical of, you, this previous population of that she's talking about I

0:41:06 Thomas: Interesting. Where is that coming from, do you think, because like it's one thing to cherry pick your study to be people who are mad, you know, mad at trans people or whatever, but like, why? I wonder why the sample would be disproportionately assigned female birth. Okay.

0:41:10 Lindsey: Mean I I really don't know, I mean, it's, it's a, it's very unique sample, I'm really not sure, like, what about this would have driven them to be mostly reporting on on children assigned, assigned female at birth, but

0:41:34 Thomas: I Who knows, I, I'm sure we need more information from that, but like, maybe there's some amount of, I guess, sexism and like belief, I could imagine that if a child is having issues, issues, perhaps gender expectations could color how seriously they're taken either way, you know what I mean, like I mean, we are don't we already know from other data that like women are not believed or listened to as much by doctors, right?

0:41:55 Lindsey: That's possible.

0:42:03 Thomas: Okay, so I don't know, this is pure speculation, but like, who knows if that plays a, a role in the sample of people who are like, nah, I'm not believing what, what you're saying.

0:42:02 Lindsey: That is true. Yeah, it is entirely possible. I really don't know what to make of that part of it. Yeah, so on the basis of this, on the base of this emerging hypothesis that this is really just a maladaptive coping mechanism, she thus suggests that medical transition is a harmful option for these individuals because it enables a maladapative coping strategy. And there it is, right? So she She concludes.

0:42:30 Thomas: She says that in this bullshit study.

0:42:32 Lindsey: Yeah, she does. She does. And she concludes the paper by cautioning clinicians against rushing into medical transitions with adolescents and young adults.

0:42:40 Thomas: Mean, that's just not good science at all. Like even I could tell you. I'm not even going to say demonstrated what data she has. She has data that some parents experience their child's gender dysphoria as sudden. And from that, and some other questions about, like, oh, were they going through a rough time? Oh, were they on social media? She's saying things like, don't transition. Like, what, come on, this is that is terrible that

0:42:43 Lindsey: No, no, it's not.

0:43:08 Lindsey: Yeah. Uh -huh. Yeah. But, you know, I think that we only feel this way because we're woke and we're sort of overstating the problems with our sampling for sure.

0:43:19 Thomas: Is just such, I, you know, I feel like I could have debunked this one, that's a that's saying something about how bad this science was

0:43:24 Lindsey: Yeah, you don't you don' don't need a science person for this yeah it's bad, yeah, um, So there was there was one other thing that I wanted to talk about here, so in terms of like, I was comparing, as I was reading the corrected version with the original article, to sort of look for differences. Um, one of the things that was included in the revised paper that wasn't in the original one was a third emerging hypothesis that apparently they asked her to add, which was that, quote, "parental conflict might provide alternative explanations for selected findings." So again, not in the original paper, incredibly important. And some of the things that she discussed in this new section were that, first, parents reported observed declines in the children's mental health and in their relationships with their children following the childrens' identification as transgender. The original paper leaned heavily into the conclusion that the identification, and, you know, the sources of it, right, from peers in the Internet, were causing the mental health declines and the conflict with parents.

0:43:29 Thomas: Wow.

0:44:23 Lindsey: But in this new section, Littman discusses the alternative possibility that the parents' reactions to their children's identification could have contributed to the mental help. The mental health declines into the conflict in the relationship, because, of course.

0:44:34 Thomas: Geez, I'm, I'm really surprised again, I, I, the same with Andrew when he talks about lawyers actually critiquing other lawyers, and science, apparently scientists might be the same way, like, like I'm surprised. They're not just like, hey, I got a revision for you, can you write here, okay, in this section, go fuck yourself, can you right that, and like, it's amazing how understated this, this is, like hey, let's do a light revision that totally goes against everything you're trying to say in your paper, but for some reason, just adding a sentence. At what point, and I don't know, like, what journal this is, what, who's doing these revisions or whatever, but at what point, as a scientist or a peer reviewer or whatever we're talking about, wouldn't you just be like, hey, don't publish, cancel this, cancel this article, this sucks, right?

0:44:55 Lindsey: Mm hmm. Mm hmm, well, no, I'm glad that you said that. And actually, you know, even in the corrected version, there were additional corrections that I would have requested if I was a reviewer. Like she's still there's still parts of it where I think that she's overstating certain things. So anyway, but the question of whether or not something should be published, right? There genuinely is interesting information here. It's just that she is interpreting it very, very poorly. So like reading that stuff about parental reactions to this, I actually found very interesting and valuable.

0:45:49 Lindsey: So I don't know that I don't want it to be published. I just really want her to be interpreting Mm

0:45:42 Thomas: Yeah. Sure, yeah, yeah, I Fair. Fair point. Like, I think, I, I, I think that's totally true, you're right, I think, but, like, I guess what I'm reacting to is, given how I just really sinister administer the original, it was as written, um, it's hard to cope with that as a person, you know, seeing what this, the destruction that this study is doing online.

0:45:55 Lindsey: Hmm. Yeah.

0:46:16 Thomas: And again, this is just the first study, we still have, we haven't gotten to this, the latest ruckus, but I guess, as a, as just a non-science person, it does suck that this is even at all published in that way, but I see what you're saying, it's, it's almost like the revisions need to be just a little bit stronger in my opinion.

0:46:36 Lindsey: Yes.

0:46:36 Thomas: Just like, hey, pure red marker everywhere, and just like, here's a collection of data from some likely transphobic parents, if you would like to know you information about how those interactions go down, which honestly might be useful information, yeah.

0:46:48 Lindsey: Yeah, yeah. To just to be a little bit the most charitable that I can possibly be about the parents in this study. It is clear from a lot of the descriptions that she was reading that they were incredibly distressed and incredibly confused. Right. And this

0:47:10 Thomas: Yeah, that's that's a good point, I, I, you know, I do want to, I do wants to echo that, I think, think you're totally right, as a parent, you, that your child, um, transitioning or expressing gender dysphoria, like, yeah, that's gonna be, uh, that's going to be a thing for you, as a, you know, especially given, I don't know who this selection is already, like, maybe it's a, it seems like it's going be a cherry pick selection of people who will not handle this well, based on the fact that they went straight to these, you know, they're on these transphobic websites and all that kind of thing. But I imagine that like set all this study aside and everything, like, yeah, that's going to be a thing to go through as a parent. And I've thought about this as a parent myself. Like if either of my kids went through this, like, don't, I think it's going be like a super simple thing for me to process or whatever.

0:47:11 Lindsey: Yes right yeah

0:48:00 Thomas: But like the key is challenges that I might have in trying to handle the situation well as a parent, you, something that I would need to keep, not keep to myself, keep to me and a therapist, and you know, maybe my co-parent or whatever, you know, like that's you got to realize that like your child is going through a thing, and a very serious thing, and they need help and support, and maybe you need help in support too, as a parents, there's nothing wrong with that, like you may need help and support to to process this, don't put that on your child as well when they're in the middle of what seems like possibly a crisis, so just wanted to say that, because I, and then I think you know, you were totally right to bring that up, like, I, I can, a lot of people in the world, there's, you know, there are a lot of people, especially parents, especially older generations, like I imagine are not going to be equipped very well to handle this problem.

And like, I want to say, like, if you don't handle this well, you're an evil person, but like, just note that you, that's, you listening or something, I think it's my opinion that that's something you really ought to try to manage without putting any of it on your child who is going through something more severe.

0:48:16 Lindsey: Yeah right yes yeah yeah Yep, I agree, um, one, one final thing on this study before we move on, I know that we were all happy to put Deborah So behind us after those first two episodes, but just as a reprise on how dishonestly her book was written, here are a few quotes from the end of gender, describing this study, now that we've gone through it thoroughly, and So's take on the reason that it was subjected to post-publication review and correction. Quote, "In August 2018, all hell broke loose when Lisa Littman, a physician and assistant professor at Brown University, published the first study on rapid-onset gender dysphoria, which consisted of 256 parents completing 90-question survey. Findings suggested that for some of these girls, being transgender is a form of social contagion. Due to activist pressure and public outrage, the study was quickly denounced as transphobic. Some left-leaning media publications called it junk science and anti-trans, and alleged that the parents who took part were recruited from right-wing hate groups."

0:49:14 Thomas: Sure. Yeah. Oh God.

0:50:10 Lindsey: What was most disturbing was that the opponents of Littman's study clearly had not even read it. Roughly 86% of the parents, who completed the survey, endorsed marriage equality, and 88% supported transgender rights. Lippmann described herself to me as a liberal Democrat.

0:50:16 Thomas: Oh really?

0:50:26 Thomas: Yeah, definitely. There's no, there's definitely no transphobia among liberal people, at all, yeah, again.

0:50:27 Lindsey: Yeah. No. Yeah, but yeah, checkmates, I guess, right?

0:50:34 Thomas: Checkmate.

0:50:34 Lindsey: There's, yeah.

0:50:35 Thomas: I would have voted for Obama third time, that's checkmate, it wins, it's come on.

0:50:38 Lindsey: So I guess there was nothing wrong with this study. We can let the audience describe, decide. One more quote. 2019, the journal in question, which was PLOS One, republished Lippman's study, noting a correction. The correction was flaunted by left -leaning media as a sign that justice had had been served. In actuality, the correction consisted of giving the study a new title and rewording its language in a few places. There was nothing wrong with its original analyses or findings. Now, either Deborah So just never paid attention in grad school, didn't read the article, or she knows that this is a bullshit thing to say. There are way more ways that a paper can be bullshit than just its analyses or findings. And also, rew wording its language into a few few places is a pretty kind way to say added critical information into her methods and corrected her totally inappropriate conclusions.

0:51:20 Thomas: Yeah. Well, Yeah, renaming the study seems pretty significant to me, like usually the name is going to be, here's the thing we found, and if you're having to change that, that, that already could be very significant and was in this case. Oh,

0:51:24 Lindsey: Yeah. Yes. Yeah. So I just, uh you know, I like to, I like to show my work when I criticize Deborah So, and I just felt like an opportunity I didn't want to pass up here. Yep.

0:51:47 Thomas: My God. You, here, I thought I was just going to be incredibly frustrated with Littman, but you've rekindled the burning flame in my heart of hatred for Debra So for that book. Oh my God.

0:51:58 Lindsey: You're welcome, yeah.

0:52:01 Thomas: It's so frustrating because she's either the worst liar or so oblivious as somebody who's qualified. Again, she should be qualified. She is qualified.

0:52:08 Lindsey: She does have a research

0:52:11 Thomas: Yeah, like she should know better.

0:52:11 Lindsey: Background, she Absolutely.

0:52:14 Thomas: So she's either horrible or just so bad at her job that she doesn't know better I mean, this is it's outrageous Well,

0:52:14 Lindsey: Absolutely should. Yep. I mean, that, that is the reason I was so mad reading her book. I was just the entire time I was like, I was just ricocheting between, is she lying or is she just completely incompetent? I really can't tell, but this seems, I just, yeah.

0:52:36 Thomas: Is that is that part one?

0:52:38 Lindsey: That is part one.

0:52:40 Thomas: That's only the study again, the older study that was changed, and we have not even gotten to the latest ruckus. So I think you're really going to have to tune in for part two. Uh, tell you what, how about I uh give part two early for patrons, um, because I, you know, we haven't been recording as much, so I feel like we got to give something to our patrons, uh, but look forward to part two, where we discuss the latest study. And I imagine it's going to be great science, you know, surely Lipman has learned her lesson, you get one mulligan in science, I think. You get one free do-over. Like, okay, here's a real study, thanks.

0:52:55 Lindsey: Ooh.

0:53:07 Lindsey: Yeah, I'm sure she has. Yeah I'm very optimistic about the quality of the second study for sure.

0:53:20 Thomas: So much for listening, everybody. Hey, thanks. Thanks to our patrons. Oh, if you've got questions on this, and if you want to hear part two a little early, go to patreon.com/seriouspod and make sure to check out the October spooktacular question thread. I hope we have a lot of spooktakular questions. I think we already do. Still time to get those in, because we record that Q &A at the end of every month. And I think it's just such a great way to give a place for people to ask questions as we go along. And then we can answer some cool questions about the month's worth of episodes, which in this month, because I was moving and it was really rough time, and it's still a rough time, there's not as many episodes, but you know what, it's okay, there's going to be good stuff there. Spooktacular questions um on awful transphobia, I'm sure. So thanks so much, check that out.

0:54:05 Thomas: Patreon.com/seriouspod. Thanks for listening, and again, thanks most of all to best science person in the biz, Dr. Lindsey Osterman, for breaking that down.

0:54:13 Lindsey: Thank you.

0:54:22 Clip: Thank you so much for listening to Serious Inquiries Only. If you like the show, the absolute best thing you can do is support us at patreon.com/seriouspod. The second best thing you can do, is please share it on social media or by word of mouth. Speaking of social media, follow me on Twitter at Serious Pod. If would like to be Facebook friends, send me a request at facebook.com Thomas podcast. If not up for that level of intimacy, that's fine. Maybe you want to join the discussion at facebook.com/groups/SIO members. Thank you again for listening. We'll see you next time.