‘The Protocol’: The Story Behind Medical Care for Transgender Kids

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What is 'The Protocol' series about?

Michael Barbaro 0:03
From The New York Times, I'm Michael Barbaro. Today, the first episode of our new series, The Protocol.
Political Figure 0:18
With a stroke of my pen on day one, we're going to stop the transgender lunacy.
Anonymous Department of Interior Worker 0:26
I am so hated for just existing and being who I am.
Political Figure 0:32
It will henceforth be the official policy of the United States government that there are only two genders, male and female.

How do political decisions affect transgender youth care?

Anonymous Department of Interior Worker 0:42
How has this impacted us? Well, it was already not a safe place, but now we feel like asylum seekers in our own country.
Political Figure 0:51
And now I want Congress to pass a bill permanently banning and criminalizing sex changes on children and forever ending the lie that any child is trapped in the wrong body. This is a big lie.
Azeen Ghorayshi 1:08
Being able to transition absolutely saved my life.
Austin Mitchell 1:14
It's only been about two decades since trans and gender nonconforming kids in the U.S. have been able to get medical treatment to transition. Now, the federal government is looking to end it. And the Supreme Court is expected to rule on the issue in the coming weeks.
Expert Analyst 1:33
If the treatment's barred, some kids will suffer because they can't access the treatment. If the treatment is allowed, some kids will suffer who get the treatment and later wish they hadn't. And then the question becomes, how does the court choose which group?
Anonymous Department of Interior Worker 1:59
You do not have the right to abuse your kids. I'm scared for myself, for my own health care.
Advocate 2:08
There's not enough evidence to put our children out on a huge experiment. If they cannot get treatment, children will die. These treatments do much more harm than good. Trans kids are under attack. What do we do? We are not going to rest until every child is protected, until trans ideology is entirely erased from the earth. We are trans people. We are trans human. And we will never be eradicated.
Azeen Ghorayshi 2:44
So are you going to be able to bring that inside? No.
Austin Mitchell 2:47
I don't think so. No. I'm going to leave it out here. This is a story of how we got here.
Azeen Ghorayshi 2:51
That's why I wonder if they're going to even let our phones in.
Austin Mitchell 2:55
It's a story I've been reporting with my colleague Azeen Gureshi, a science and gender reporter, for nearly two years.
Okay.
Austin Mitchell 3:04
And it's a story she's been reporting for much longer. And from the beginning, she's been telling me this is not just a story about politics. It's a story about medicine. About a new kind of treatment for a small group of kids. How it came to be. Who it was meant to help. How that was codified into a protocol that spread around the world. and how, in the time since, the medicine and the politics have become impossibly entangled. From The New York Times, I'm Austin Mitchell. This is The Protocol with Azeen Qureshi. Part One. The Beginning. Okay, so where does this story start then in your mind?
Azeen Ghorayshi 4:10
Yeah, so there have always been a small number of young people who have felt this deep disconnect between their inner sense of themselves as boys or girls and their bodies, you know, how they're seen by society. But when it comes to the medical story and when these kids are actually beginning to interact with the medical community, there's actually a really clear beginning.

What led to the medical treatment of transgender youth?

Azeen Ghorayshi 4:36
And it's one that pretty much everyone in the field knows about and points to. And it starts in the Netherlands. The Netherlands is this small, very socially liberal country. And back in the 1950s, they were among the few countries in the world that were actually treating trans patients, so at this point, just adults, medically. Mm-hmm. So at the time, the mainstream medical establishment really viewed trans people with a lot of suspicion. So if a trans person came into a doctor's office saying that they felt like they were in the wrong body, often those doctors would assess those patients as being mentally disturbed or sexually deviant or even psychotic. And so if they got any health care at all, it would usually be from an analyst or a psychiatrist.
Austin Mitchell 5:31
And those professionals would be trying to kind of convince these people that they... Yeah, kind of talk them out of it.
Azeen Ghorayshi 5:39
I mean, it was sort of corrective, trying to convince them to let go of the idea that they could ever live as the opposite sex. But there were a small number of doctors around this time who felt like that approach was actually failing these patients, that it was completely ineffective in addressing the pain that they were feeling.

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