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A UTI becomes a prostate test for someone who never had one. A hospital wristband prints the wrong gender, and every interaction tilts from care to harm. With Kai Schweizer—researcher, educator, and trans advocate—we pull back the curtain on how systems ignore lived reality, why that costs lives, and what actually works when you put dignity first.
We move from personal stories to hard science. Kai explains how neuroimaging captures dysphoria in the brain, and why that matters when clinicians confuse it with body dysmorphia. We break down eating disorder treatments that help cis patients but retraumatise trans ones, and we talk frankly about why some teens starve to halt puberty when blockers are banned. This isn’t a culture war rant; it’s a clear-eyed look at outcomes, costs, and the biology of minority stress. Along the way, we explore co‑designed research, data literacy, and the nuance missing from public debates about prevalence and youth identity.
There’s hope here too. A receptionist who updates pronouns without fuss. A nurse who chooses the blue‑packaged pad. A clinician who asks, “What language do you want for your body?” Small choices stack into safety, especially while we push for policy reform, training that goes beyond tokenism, and healthcare that distinguishes dysphoria from dysmorphia. If you care about sex education, gender‑affirming care, neurodiversity, or just better medicine, this conversation gives you language, evidence, and practical steps.
Listen, share with someone who needs the science behind the headlines, and tell us the one change you want to see in healthcare. If the show moved you, subscribe, leave a review, and pass it on—your support keeps these vital conversations alive.
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Welcome back to Super Sex, the show where we talk about all the things your high school sex ed teacher definitely did not cover.
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I'm your host, Jordan, and today we're diving into one of the most fascinating and important conversations that we've ever had.
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This one is with Kai Schweitzer, a brilliant researcher and PhD candidate exploring the intersections of gender, neurodiversity, and sexuality.
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In this first of two episodes, we talk all things trans experience, from navigating identity and community to the weird, wonderful, and sometimes infuriating realities of living authentically in a world that loves a good binary.
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Kai brings humor, honesty, and some absolutely beautiful insights.
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And honestly, I laughed, I learned, and I felt all the feels in this one.
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So buckle up, grab a cup of something nice, and let's get into part one of this incredible chat with Kai Schweitzer.
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Welcome to Super Text, the Pokemon that dives into sex, relationships, and absolutely everything in between.
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We're stripping away shame, turning up the truth, and keeping it smart, playful, unapologetically real.
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So fuck a lot.
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Because the problem is the tape, the topics are juicy, and the safe work is always more.
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Let's get into it.
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Hi guys, we are back for another Super Snapchat episode.
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But today we've got a special guest, Kai Swater.
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Kai, you have just given us your elevator pitch off there.
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We were all in awe, just like, oh, that's a lot.
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And then you said something about spare time.
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Yeah, exactly.
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I was like, yeah, we we sort of gotta get this episode rolling because uh that is seriously impressive.
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But give us a lowdown.
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What is it that qualifies you to sit be sitting here in a super chair, super sex chair today?
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Gee, uh, I feel underqualified to sit in the chair, but um I think you're the most qualified person here.
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Yeah, I'm actually envious of your qualifications right now.
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Yeah.
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Um well my master's degree was in sexology, uh, so I know Kate studying together.
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Um and my my master's dissertation was in uh the treatments experiences of trans people with eating disorders, which has led me to do my PhD.
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Um so I'm currently in the second year of my PhD uh with UWA and the Kids Research Institute Australia.
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Um and yeah, I've kind of been doing research as my main thing for a while.
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Um most of my research focuses around gender diversity, uh, neurodivergence and eating disorders and the intersection of those things.
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Um, but sometimes also is getting to diverge back towards sort of sexual health and sexology more and more.
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So we did a little bit of work a while back looking at the prediction of people within the LGBTIQA plus community whether they would develop uh eating disorders or not based on how satisfied they were with their relationships, which was a lot of fun.
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Um and yeah, uh got to go to the World Sexual Health Congress uh, I think earlier this year, um, and present on uh sex therapy um in the context of like addressing body image concerns and disordered eating in sex therapy, which is a really common uh presentation.
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Yeah.
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So you're a researcher and an educator and a PhD candidate and a greyhound lover.
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Yes.
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Um I'm down with all of these things.
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I just want a signature now before like you get out there.
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Yeah, get in early, right?
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Yeah, yeah.
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So yeah.
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I'm I met Kai because we did our Masters of Sexology together, and I just found him so I don't know, like just a really important voice in this space.
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And when I heard like, well, we've been in touch a little while um since we finished study, like I've caught up with you a couple of times.
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I just thought, no, this is a very interesting human with some very cool perspectives.
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Yeah, let's chat.
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The thing I love about you know having you on as well is that, and Kate and I were talking a little bit about this before, is that generally speaking, within the sexology, there's quite a large representation of females, there's quite a large representation of queer people, and there's a quite a large representation of trans advocates, but there's not a whole heap of trans people who are actually having their own voice heard within that sort of real professional sort of space.
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There's heaps of people out there who are like really talking about this online, but you know, who have the qualifications and the actual brain gray matter to back it up.
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There is not that many people.
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So there's not enough, that's for sure.
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No, definitely not.
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So I love that you're on.
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Thanks for being here.
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This is great.
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So you're gonna join us for two episodes.
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We're gonna talk all about trans issues in the first episode, and then we're gonna start getting into neurodivergence, which I'm excited for.
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Yeah, um like as a person who works with neurodivergent kids, um I'm really looking forward to that one.
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But I wrote a paper last or first semester of this year around trans medical issues, and I think that sort of just fascinated.
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We had the similar pro um assignment, but mine more went towards um trans men working and I work in a women's hospital, so that was my one because I pitched it from a different side to you, though.
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Yeah, yeah.
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But it's fascinating, so I'm super psyched to get into this.
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Yeah, because you have a story and you have like stuff that you just want to tell us.
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I'm so excited for these episodes.
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I've been uh I started my medical transition over 10 years ago now.
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So I've had plenty of medical experiences in that time frame, um, which are often, you know, not ideal ones.
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I was gonna say that's where I'm like, I want to know.
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Yeah, like over over the 10-year period, would you like what percentage would you say were positive affirming experiences?
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Uh I had one GP who was really fantastic, uh, who I saw for a couple of years almost exclusively, but was hard to get in with, so I often had to kind of go to someone else in that time frame.
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Um, but I was pretty devastated when she retired because I was like, who am I gonna go to now that actually has the skill set to provide me with good medical care?
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Yeah.
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And the answer is I haven't found someone since.
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Like I've been seeing someone uh who is not terrible, but like basically the best that we can hope for is like not seeing someone who won't see you at all.
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Uh like we have an in-community list of the medical professionals that are considered sufficient, basically, with varying degrees of good.
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Um, but I kind of can't fathom anymore the idea of just being able to go to any random doctor and know that I'll get good care.
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That's just like not a reality for people like me.
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Um, and when you're in it, you kind of forget that other people can do that.
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Um, but like if I go to a random doctor for tonsillitis, I might come out with like not actually treatment for tonsillitis, but instead a bunch of forms to go get hormone tests that I don't need, um, or like a completely inaccurate diagnosis of something I don't have.
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Uh like I got a urinary tract infection and I saw a random GP and I came out with a form to go and get a test for a prostate infection.
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I don't have a prostate and I never have.
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I explained this to him and he was like, No, I'm very confident that you it's probably prostatitis.
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And I was like, Did you listen to anything I said about like my medical history or anything on the paperwork that you have access to?
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Clearly not.
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So you got a test for a body part that you don't actually own.
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Correct.
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Sweet.
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Yeah, but not the treatment for the thing I actually had.
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And the problem with that is that like I saw a GP, they didn't help.
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I saw this GP who gave me a diagnosis that was incorrect.
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And by the time I got to the GP, who was the really good one, who I'd been kind of waiting for an appointment with, the UTI had progressed to being very close to a kidney infection.
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So it was severe enough to then go, you need to go to the emergency department now because like this needs urgent treatment.
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If I'd just been able to get treated at the start when it was still mild.
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Instead of your invisible prostate.
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Then it wouldn't have progressed to like urinating blood and being in severe pain.
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But like the delay and the misunderstanding made it, you know, much worse.
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And then when you went to the ER for this, like, how was that?
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Oh, it was miserable.
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Okay.
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Going to the hospital is always miserable.
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Um, like there's not understanding of who you are at all.
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Like my legal gender in the state of Western Australia still says female.
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Uh, and like that means that when my medical wristband comes to me, it has F on it.
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And that means that everyone who interacts with me presumes I'm gonna be a woman.
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And so, like, they're writing notes that all say she on them, which is more obviously wrong when they actually meet me.
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But like, people in the background, you can hear them talking about you with the wrong pronouns and stuff.
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You just see I'm like fuming right now.
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Like, uh so um I've I spoke to Jordan about this working in a women's hospital, but there's limitation for everyone, even like you know, queers.
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Um, and um but my main role is when I see someone, then I'm like, okay, they identify as a he.
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I go up to them and I march them to the front reception and I make the clerks change it to like he, him, and change the name to the preferred name, and then like in brackets have the like their birth name.
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And the amount of people that go, Oh, this is no one's ever asked if I want to change it on the system before makes me so angry.
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So fucked up.
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Yeah.
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I've been thinking a lot about like the the bigger, broader system issues.
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Um, I'm currently almost done writing my first PhD study, which is like a systematic review of treatment outcomes of eating disorder treatment for trans people.
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And as is kind of the nature of research, most of the prior research is in hospital settings.
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Um and like the the thing for me that was important was that we changed the the focus to be treatment outcomes and also treatment experiences, because what the outcomes say where people, you know, did they gain weight or not?
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That's not the only thing that matters.
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Uh so we had a lot a lot of qualitative studies of trans people describing what treatment was like for them.
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And it was horrible, horrible.
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Yeah.
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Um, but like not just horrible at the, you know, didn't you get better or not level?
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Uh what's made it so such a long process to write is like kind of trying to articulate the broader system level problems.
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Like when you go to a hospital, the hospital system was not built with the idea in mind that trans people exist.
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And so not a single component of the system is built in a way that can accommodate that.
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So, you know, if your name's not legally changed, the wristband on your wrist is going to have the wrong name on it, and everyone's gonna call you the wrong name every second that you're there.
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Um, and like in my in my dissertation study, I interviewed someone who hadn't been an inpatient in Western Australia for an eating disorder and described like being on bed rest, which is common, where you're not allowed to get up because your heart's quite fragile when you're very malnourished, and being unable to get up with a wristband on that said the wrong name on it and the wrong gender, and having a nurse that's watching them at all times to make sure they don't get up, who's telling them that trans people aren't real.
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And you're in a situation where you literally cannot escape and you are very unwell, often because of the fact, like most of the time with with trans folks with eating disorders, it's very much related to trying to address the dysphoria in the way that you can.
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So, you know, if you uh like when people are very underweight, they often are more likely to be perceived as a man.
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Um, like the way that our body fat sits on our bodies is kind of perceived in a gendered manner.
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Um, and so like the distress is about gender, and then you go to get treatment, and people treat you in a way that causes more distress about the gender.
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Um, that's just not great.
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And then hospitals are also just fluorescently lit and loud and not great if you're an autistic person like me.
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Just not great in any way, really.
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So I wouldn't I had such a horrible experience in the hospital last year uh that I was like, I hope I never ever have to go to a hospital again.
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Was that when you went in for the urinary tract infection, or was that something different?
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Well, something different.
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Oh, yeah.
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We still don't know what caused it, but I got um I got colitis.
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So I thought my appendix had burst because that's what the symptoms matched.
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Um, and I went in and they thought I might need to have my appendix moved, removed, um, and then I had to have a bunch of scans done, and I ended up spending like almost a week in the hospital, and it was just like the most traumatic experience ever.
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Uh, and I got lucky that I was in a private hospital and I had private health insurance and I had family members who were there to kind of keep advocating for me.
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But like I suspect if they hadn't been there and I hadn't gotten really lucky with like the circumstances that I was in, that I like could have died from the maltreatment.
00:14:06.159 --> 00:14:12.879
Like um while I was waiting to find out if I needed to have surgery, I had to have I need to needed to be fasting.
00:14:13.039 --> 00:14:16.799
So I was fasting for four days while I waited to find out if I needed surgery or not.
00:14:17.039 --> 00:14:19.279
And that's a very long time to go without food.
00:14:19.360 --> 00:14:25.679
Um went into ketosis, which is like your body starts eating itself.
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Um, my mother's a type one diabetic, so she was like, You're behaving really odd, like you are not making sense when you speak anymore.
00:14:35.200 --> 00:14:41.759
It's very similar to like when I have a really low blood sugar, but the nurses refused to test my blood sugar.
00:14:42.159 --> 00:14:48.240
So my mother got out her little device and did it herself and went, look at this, fix this, please.
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And they freaked out, and finally, like they put me on a glucose strip immediately, and it was classed as like a medical emergency.
00:14:54.559 --> 00:15:00.080
But they wouldn't do what they needed to do to even find out that information.
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That is appalling.
00:15:03.679 --> 00:15:06.159
I would say, yeah, like majorly fucked up.
00:15:06.480 --> 00:15:10.879
Because that would never happen to anyone who is cisgender.
00:15:11.360 --> 00:15:15.519
No, like if that happened, that that wouldn't happen to me.
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If I went in and said, I've got an issue, I need it sorted out.
00:15:19.360 --> 00:15:22.399
Yes, sir, right away, sir, but let's get that sorted out.
00:15:24.240 --> 00:15:30.320
To hear that that is still happening in a private medical hospital in Perth.
00:15:30.799 --> 00:15:36.799
Perth, Western Australia, which is really quite left-leaning as well, you know.
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Like we seemingly seem very open to a lot of different people, no matter their their background or adversity.
00:15:47.440 --> 00:15:54.879
But yet to see how that actually gets applied and how it impacts the people who are there is absolutely horrific.
00:15:56.240 --> 00:16:00.240
It's also legally allowed to discriminate in some ways in medical settings still.
00:16:00.399 --> 00:16:09.200
So, like uh a friend of mine um was planning on having a gender-affirming surgery, and it's a surgery that they also do for cis women.
00:16:09.360 --> 00:16:09.519
Yeah.
00:16:09.679 --> 00:16:16.720
So the hospital was a Catholic hospital, which is where the that particular surgeon operates out of, because we have quite a lot of private hospitals here.
00:16:16.879 --> 00:16:24.080
Um, and the day before the surgery it was cancelled, and they cited their religious faith and religious objection to doing the surgery.
00:16:24.240 --> 00:16:26.879
They do that surgery on cisgender women all the time.
00:16:27.039 --> 00:16:27.279
Yeah.
00:16:27.519 --> 00:16:34.240
It was specifically and explicitly stated in the paperwork this is not being done because we oppose doing it on a trans person.
00:16:34.879 --> 00:16:36.159
And that's legally fine.
00:16:36.240 --> 00:16:37.039
They're allowed to do that.
00:16:37.120 --> 00:16:41.919
They have this exemption that says if it's not life-threatening surgery, they don't have to do it.
00:16:42.080 --> 00:16:46.639
They don't have to provide treatment to someone if it goes against their religious beliefs.
00:16:46.879 --> 00:16:56.960
And so this person spent years building up all this money for surgery, they paid the surgeon already for it in advance, like you're supposed to, and then it was cancelled on them.
00:16:57.120 --> 00:17:05.279
And they were like, if I was not trans, I would have been able to have this surgery, and it feels pretty shitty to not be able to because of that.
00:17:05.839 --> 00:17:19.839
It's so exclusionary because like I think people think gender-affirming care or gender-affirming surgery equals like changing your body to be something else, but it's actually like we all do it.
00:17:20.319 --> 00:17:34.480
Like, you know, we have breast augmentations, we have labioplasty, perfectly healthy, cisgendered people who change their body to feel more feminine or masculine all the time, and it's just ridiculous.
00:17:34.720 --> 00:17:35.599
It's bullshit, isn't it?
00:17:35.839 --> 00:17:37.279
It's the worst gatekeeping.
00:17:37.519 --> 00:17:49.519
And I've I think like I I think let's drag it right back because I think a lot of this is actually underpinned by just a general lack of understanding, right?
00:17:49.680 --> 00:18:00.720
When people hear transgender, like general community, when they hear transgender, they sit there and think, oh, you know, they're trying to do this and they're trying to do that and whatnot.
00:18:00.880 --> 00:18:06.720
They're not actually fully understanding that sex and gender are two completely different things, you know?
00:18:06.960 --> 00:18:12.400
And like that's where that whole debate over the Olympics and all that sort of stuff is starting to come up, you know.
00:18:12.640 --> 00:18:28.799
But there's this massive misunderstanding, and it seems the more informed that people get about transgender issues and transgender people is that the more accepting they are of it because they just, you know, they're just people just like us.
00:18:28.880 --> 00:18:29.119
Yeah.
00:18:29.359 --> 00:18:33.519
You know, there's this real sort of fear out of misunderstanding.
00:18:34.160 --> 00:18:41.839
Definitely is a fear thing, but like, does the research show anything around like what like what drives this misunderstanding?
00:18:42.000 --> 00:18:44.640
Is it that people just don't give a shit?
00:18:44.799 --> 00:18:47.279
Or like does education help?
00:18:47.680 --> 00:18:50.000
Like, what do you what's your take?
00:18:50.319 --> 00:19:01.519
In my assignment, it was a lot of um not edu the doctors weren't educated throughout university, and because it's an unknown area, they don't want to foresee any of that.
00:19:01.839 --> 00:19:02.480
Yeah, okay.
00:19:03.279 --> 00:19:08.240
So it is a big, big lack of education from that point of view.
00:19:08.720 --> 00:19:15.759
Like most people's information they've received about trans people has generally not come from trans people.
00:19:15.920 --> 00:19:25.519
Like we are a relatively small portion of the population, and because of the discrimination we face, we often tend to be quite insular and spend time with each other rather than with the broader world.
00:19:26.160 --> 00:19:27.599
Well, that's safer for you, right?
00:19:27.839 --> 00:19:28.240
Yeah.
00:19:28.400 --> 00:19:39.839
Um I think like I've spent a lot of years being like deep in my bubble of safety, and only in the last like two years since I met my current partner, kind of left the bubble.
00:19:40.000 --> 00:19:44.559
Like we often they call it tea for tea when you only date other trans people because it's just easier to do that.
00:19:44.640 --> 00:19:48.319
You don't have to explain everything and you don't have to kind of have all the tricky conversations.
00:19:48.400 --> 00:19:57.200
And there's something about being with someone who like understands this very unique experience of experiencing gender dysphoria that's like quite connecting.
00:19:57.519 --> 00:20:12.640
Um but like at the same time, if you're always inside your bubble uh and you're only like thinking of the world as unsafe all the time, I think that can actually like make it harder to engage in the broader world because you're always anticipating.
00:20:12.720 --> 00:20:21.759
We told we call it anticipated stigma that you anticipate the world's going to be hostile because of your previous experiences where it was hostile, but then you don't really get any new experiences that challenge that.
00:20:22.000 --> 00:20:28.160
And I've had a lot of experiences in the last few years of like pleasantly surprised at how good people can be.
00:20:28.559 --> 00:20:38.160
Um and at the same time, I think me doing that and getting to know other people means they now know a trans person and suddenly they have this emotional investment in the issue that they didn't before.
00:20:38.319 --> 00:20:38.640
Yeah.
00:20:38.880 --> 00:20:49.359
Like even my partner when we met was like very cool, very affirming, but also hadn't really thought about the existence of trans people very much because it wasn't part of his life.
00:20:49.519 --> 00:20:53.359
Um, and he had, you know, wasn't sure on certain issues within that.
00:20:53.519 --> 00:21:08.000
Uh and once you know someone and you care about someone who is trans, suddenly it's a lot harder to not notice when the news is talking about us or when there's like a controversy that affects us because you have that that emotional connection.
00:21:08.160 --> 00:21:14.480
I think like, yes, education can help and stats can help, but people also tend to switch off to that.
00:21:14.640 --> 00:21:20.559
Like we have this desire as humans to feel emotional connection to other people.
00:21:20.720 --> 00:21:28.160
And if we don't have that like actual empathy that comes from knowing someone, it's hard to like hard to care.
00:21:28.319 --> 00:21:36.720
You know, we we are faced with like so many different competing issues and things happening in the world at all times that we can't possibly focus on them all.
00:21:36.880 --> 00:21:40.480
Um, and so we tend to focus on the ones that matter to us personally.
00:21:41.039 --> 00:21:41.519
Yeah.
00:21:41.759 --> 00:21:48.319
That's also a huge um, like it's almost like this uh enormous burden to put on the community as well, right?
00:21:48.480 --> 00:21:52.000
Like it's like, well, you just have to get out there and make friends with everyone.
00:21:52.160 --> 00:22:09.759
So they, you know, like that's a that's a huge um ask if you are already like experiencing minority stress, if you already feel like the world is unsafe, knowing that the best way to to help your community and and raise the voice is to put yourself out there.
00:22:10.000 --> 00:22:11.440
It's it's a lot of effort.
00:22:11.759 --> 00:22:17.920
Yeah, it's not something people should have to do, and I don't think anyone uh should be expected to do.
00:22:18.000 --> 00:22:30.720
Like that's a huge amount of emotional labor, and it's also like the uh the anticipated stigma comes with like the physical anxiety of always being alert all the time to possible threats.
00:22:30.880 --> 00:22:48.000
Like they have recently discovered uh they did a study in the US of trans masculine people to measure for allostatic load, which is like the physical health implications of chronic minority stress or any kind of stress.
00:22:48.160 --> 00:23:02.319
Um and they were able to measure it against like how much discrimination that person faced was a very strong predictor of how high that allostatic load was in terms of you know their blood pressure, their heart rate, their um metabolism.
00:23:02.880 --> 00:23:14.799
And uh like I think some of the things I've been thinking about as a researcher is like people seem to really shut off to seeing statistics, or they kind of turn around and weaponize their statistics.
00:23:14.880 --> 00:23:20.400
So like we do stats to show that you know the suicide rate, uh the suicide attempt rate in trans people is much higher.
00:23:20.720 --> 00:23:26.559
Either people kind of just like don't compute that meaningfully, or they use that against us.
00:23:26.880 --> 00:23:38.000
Um so kind of thinking about how do we do research in a way that kind of is finding the same information, but in a way that actually like clicks for people and is translatable into the real world.
00:23:38.319 --> 00:23:42.319
So, you know, the physical health implications of that matter.
00:23:42.480 --> 00:23:45.680
Um for government, how much something's gonna cost matters.
00:23:45.839 --> 00:23:52.240
So for me, it's like the the Queensland government has banned puberty blocking medication for trans kids.
00:23:52.480 --> 00:23:55.759
That medication is eight hundred dollars a month.
00:23:56.640 --> 00:23:57.920
That's not cheap.
00:23:58.000 --> 00:24:10.000
Uh, and right now uh like fundraising is paying for those kids to still get that medication privately, but the cost of eating disorder treatment as an inpatient is much more than$800 a month.
00:24:10.240 --> 00:24:23.920
Yeah, and chronic health and mental health, and you know you add up the costs of that, uh it's not like good for the quote unquote taxpayer what decision they've made here.
00:24:24.240 --> 00:24:35.680
Um I also think like even though it's kind of a a risky area in some ways, that like brain scans and neuroimaging is something I'm very obsessed with, and I think has real impact.
00:24:35.839 --> 00:24:41.839
Like I instead of trying to explain what dysphoria is to people, now I just show them this image.
00:24:42.000 --> 00:24:48.799
And it's a comparative image of like a ciswoman and a trans man having their hand touched and their chest touched.
00:24:49.119 --> 00:24:51.599
And it's trans men who have not had chest surgery.
00:24:51.759 --> 00:24:52.000
Yeah.
00:24:52.160 --> 00:24:56.400
And you can clearly see that they have the same response in their brain to having their hand touched.
00:24:56.640 --> 00:25:04.799
Their somatosensory cortex that like recognizes touch uh lights up, and at the same speed, it looks the same.
00:25:05.039 --> 00:25:10.240
When they have their chest touched, a cis woman has the same response in their brain to their hand being touched.
00:25:10.960 --> 00:25:12.799
The trans man does not have that response.
00:25:12.960 --> 00:25:24.640
Their like somatosensory cortex that recognizes the touch and the body part like being there, it has this really weak and delayed response, like it doesn't recognize the body part as part of the body.
00:25:25.039 --> 00:25:33.599
And at the same time, uh there's a really rapid response in uh the the medial temporal lobe, I think.
00:25:34.319 --> 00:25:35.599
Don't call me on that one.
00:25:35.759 --> 00:25:45.359
Um, but the bit that experiences distress in the brain and like the trauma response bit lights up rapidly and intensely in a way that you can see we're not making it up.
00:25:45.599 --> 00:25:54.000
People fundamentally don't recognize these body parts as part of their body, and having them touched causes like a very severe risk distress response.
00:25:54.240 --> 00:26:04.319
And you can tell people that, but when you can show it to them in an image that's like this is an empirically done study of a scan of a brain, it just makes people understand it much better.
00:26:04.559 --> 00:26:04.799
Yeah.
00:26:05.119 --> 00:26:07.599
And we need more of that because they don't understand.
00:26:07.920 --> 00:26:08.799
No, they don't.
00:26:08.960 --> 00:26:16.319
And like I was saying, you know, they do try to weaponize facts and data and all that sort of stuff, you know.
00:26:16.400 --> 00:26:26.319
I mean, I've I've had conversations with people and they s even start going back to like the 1970s and saying, oh, you know, homosexual people are sick.
00:26:26.480 --> 00:26:30.640
It said so in a DSM way back in the day, so therefore it still must be true.
00:26:30.720 --> 00:26:38.000
And I'm just like, you fucking crazy ass man, like yeah, how the fuck can you be even saying that?
00:26:38.160 --> 00:26:45.519
Like, that's why medical science keeps evolving and we get rid of things and we add things in there because we're learning all the time.
00:26:45.680 --> 00:26:46.799
No, no, no, no, no.
00:26:47.039 --> 00:26:50.480
Homosexual people, trans people are sick because of that.
00:26:51.119 --> 00:27:01.680
And when you start reframing that as it's not sickness, it's difference to be celebrated, then that's when you can really start moving forward, right?
00:27:02.000 --> 00:27:16.240
But I mean, the whole thing with the dysphoria, that label, I mean, what we've just talked about there is it's it's a sort of medical difference that's actually happening.
00:27:16.559 --> 00:27:18.480
It's a physical response that's happening.
00:27:18.640 --> 00:27:20.319
So there is a difference there.
00:27:20.960 --> 00:27:27.519
But trans people need to keep that dysphoria label in order to be able to access health care.
00:27:28.000 --> 00:27:29.119
Is that correct?
00:27:29.279 --> 00:27:34.960
So they actually need to sit there and say, yes, there's something wrong with me in order for me to get that health care.
00:27:35.920 --> 00:27:37.440
Although it's not right.
00:27:37.680 --> 00:27:40.160
That's according to the research that I've done anyway.
00:27:40.480 --> 00:27:40.960
Yeah.
00:27:41.200 --> 00:27:54.000
Uh there's kind of like you need a diagnosis to access treatment, which is silly to me, because like when someone is pregnant, they don't need a diagnosis of pregnant.
00:27:54.160 --> 00:27:56.319
Like they are just they just are pregnant.
00:27:56.400 --> 00:27:59.759
Uh, and their care is not contingent on being diagnosed as such.
00:27:59.920 --> 00:28:05.279
You know, when you uh take a pregnancy test, it's a positive test, it's not like you know, you are ill.
00:28:05.759 --> 00:28:06.960
It's not a pathology.
00:28:07.359 --> 00:28:17.519
Um we have the the DSM5, which has the diagnosis that you need, is in the mental health section, which creates problems, yeah, and that's gender dysphoria.
00:28:17.759 --> 00:28:28.160
And then the ICD 11, which is the medical manual for broader than psychology and psychiatry, uh, the diagnosis is gender incongruence, which is in the sexual health section.
00:28:28.400 --> 00:28:42.000
And so uh generally having a gender incongruence diagnosis is preferable because it is not a mental health diagnosis, uh, and it has a kind of lowered threshold of distress.
00:28:42.160 --> 00:28:52.400
So, like, why do I need to be a certain level of distressed and prove how distressed I am to someone to get medical care?
00:28:52.880 --> 00:29:03.359
Like a gender incongruence is like an acknowledgement that the sex presumed at birth and the identity don't match, but you don't necessarily need to be distressed about that.
00:29:03.599 --> 00:29:09.359
Like I could be aware of an incongruence being there and want to change it, but I don't need to be distressed about that.
00:29:09.920 --> 00:29:18.559
And that's common, you know, like people can know that they want a certain kind of medical care and also not need to be in distress.
00:29:19.200 --> 00:29:30.079
Um, it would be nice if people didn't need to be in distress, but kind of the the way the system is set up is in a way where you kind of need to prove it, you know, prove you are sick enough, basically, to get the care you need.
00:29:30.240 --> 00:29:32.559
Um, and that just sets people up for distress.
00:29:33.839 --> 00:29:34.000
Yeah.
00:29:34.160 --> 00:29:34.400
Yeah.
00:29:34.559 --> 00:29:48.000
The body image experience of trans people is very different to cis people, and like we have often got the higher distress of gender dysphoria, but we also seem to be capable of a body image positive level that is beyond what cis people can experience.
00:29:48.160 --> 00:29:56.079
Like the experience of gender euphoria is a level up, essentially, from what is possible for most people.
00:29:57.039 --> 00:29:58.319
Can you speak a bit more about that?
00:29:58.559 --> 00:29:59.680
Gender euphoria.
00:30:00.160 --> 00:30:00.400
Yeah.
00:30:00.640 --> 00:30:08.079
Gender euphoria is like the positive good experience of when a person's gender is affirmed.
00:30:08.640 --> 00:30:12.079
So being called the right pronoun can bring euphoria.
00:30:12.319 --> 00:30:23.839
Uh some people would describe gender euphoria as like the absence of distress, which is a nice feeling, but for some people it's kind of like an even bigger good feeling, like euphoric.
00:30:24.319 --> 00:30:32.880
Um and for some people that's you know, I experienced it more earlier in my transition when things were just starting to be right.
00:30:33.440 --> 00:30:36.400
Um, but there are still times where it kind of pops up now.
00:30:36.880 --> 00:30:39.839
Um and so we're trying to understand that better too.
00:30:40.000 --> 00:30:48.480
That like it's possible for things to be good and be then better rather than being bad and trying to get to baseline.
00:30:48.720 --> 00:30:59.680
Um but like our system kind of presumes and needs us to be distressed, which I think sets people up for like feeling distressed.
00:30:59.759 --> 00:31:04.799
Like well, it sets people up for failure and it just makes it so much harder.
00:31:05.200 --> 00:31:05.519
Yeah.
00:31:05.759 --> 00:31:18.160
Like in a way, cis people would experience different levels of euphoria and distress over their body image, you know, like people want to change how they look, but the access to that does not require a mental health diagnosis.
00:31:18.400 --> 00:31:25.759
It requires I want my boots to be bigger, I need to lose some weight, or I want a butt implant, or I want a labioplasty, and you just go and get it.
00:31:26.000 --> 00:31:44.240
Yeah, I mean, I feel actually like this is one of the areas that I kind of have specialized a bit of time in in my research, is how important it is to differentiate between having body dysmorphia and having gender dysphoria, because those two things are very different, but when we conflate them, we create big problems.
00:31:44.400 --> 00:31:44.640
Yeah.
00:31:44.880 --> 00:31:48.640
So, you know, gender dysphoria is specifically about gender.
00:31:48.880 --> 00:31:54.319
Uh and it's usually when someone's sex presumed at birth for them and their identity don't match.
00:31:54.480 --> 00:32:00.640
So it's like my body does not align with the gendered ideas of what my body should be.
00:32:00.960 --> 00:32:04.480
Uh, and people don't perceive me correctly based on that.
00:32:04.720 --> 00:32:10.640
Whereas body dysmorphia is uh it's a distortion of body image.
00:32:10.799 --> 00:32:14.880
Someone's body and how they perceive it don't match.
00:32:15.200 --> 00:32:24.880
And that can sound to people like gender dysphoria, but body dysmorphia is very much about the external appearance, and it's usually a focus on one particular body part.
00:32:25.200 --> 00:32:31.119
So people think that their chest is not big enough, or they think that their nose is too big.
00:32:31.279 --> 00:32:37.440
And when we scan the brain of people who are experiencing that, it doesn't look the same as when we look at gender dysphoria at all.
00:32:37.599 --> 00:32:47.200
It's like it is not a distortion for a trans person to say, my body does not match what it should for my gender.
00:32:47.440 --> 00:32:53.759
It is a distortion for someone who has very large breasts to think their breasts still aren't big enough.
00:32:54.000 --> 00:32:58.720
And when we do the treatment for these two things, the treatments are very different.
00:32:58.880 --> 00:33:09.359
Like when people who have body dysmorphia and they say think their breasts aren't big enough and they go and get bigger breasts, it does not tend to actually alleviate their distress.
00:33:09.519 --> 00:33:09.680
Nope.
00:33:09.920 --> 00:33:17.759
They just want them bigger again and again and again because they're still not accurately perceiving their body, and changing it doesn't change their perception of it.
00:33:17.920 --> 00:33:18.240
Yeah.
00:33:18.559 --> 00:33:27.279
Whereas with gender dysphoria, most of the time when someone has access to gender-affirming medical care, their distress is alleviated by that care.
00:33:27.680 --> 00:33:30.240
It's very rare for that not to be the case.
00:33:39.200 --> 00:33:50.240
And I can back that up because my um assignment that we've submitted this semester when I did it on um the um female genital cosmetic surgery and how it should be FGM.
00:33:50.640 --> 00:33:55.440
Um but like you just said, they don't like after.
00:33:55.519 --> 00:34:01.039
So that about I think it was about 35% of women go back for more cosmetic surgery down there.
00:34:01.279 --> 00:34:01.599
Yeah.
00:34:02.000 --> 00:34:02.319
Yeah.
00:34:02.480 --> 00:34:20.480
And I think um like the the trouble that I find in my research right now is that like when someone has really severe body image concerns, whatever kind of body image concern that is, that is pretty commonly like leads to disordered eating or an eating disorder.
00:34:20.559 --> 00:34:26.480
But our eating disorder treatment is based on the assumption that that body image issue is body dysmorphia.
00:34:26.639 --> 00:34:32.639
And so the treatment is about helping you realize that what you see is a distortion.
00:34:32.960 --> 00:34:44.239
And so if you are then someone with gender dysphoria and it's not a distortion, you are being told over and over again in your treatment that you can't trust what you see and that your body image is distorted.
00:34:44.480 --> 00:34:49.360
And often that ends up being you're not really trans, it's just your eating disorder.
00:34:49.599 --> 00:34:49.920
Oh, great.
00:34:50.239 --> 00:34:54.559
And uh you need to just like work on that in treatment.
00:34:54.719 --> 00:35:02.960
And so, like a great example that they use a lot in cognitive behavior therapy for eating disorders is uh what they call mirror exposure.
00:35:03.039 --> 00:35:11.119
So you need to stand in front of a mirror and look at your body and scan it and sit with the distress of looking at it, and you keep doing that until the distress goes down.
00:35:11.360 --> 00:35:21.280
And that works really well for body dysmorphia because when you don't perceive your body accurately, spending a lot of time looking at it does help you to feel a more accurate perception of it.
00:35:21.519 --> 00:35:27.360
But if the problem you're experiencing is gender dysphoria, you're just distressed and it does not go down.
00:35:27.440 --> 00:35:27.599
Yeah.
00:35:27.840 --> 00:35:35.280
And you like you're just staring at dysphoric body parts for extended periods and getting distressed without the benefit of that.
00:35:35.519 --> 00:35:41.280
But the expectation, because the system is built for cis people, is that that will work for everybody.
00:35:41.840 --> 00:35:43.199
That is messed up.
00:35:44.079 --> 00:35:52.960
You know, that's pretty much the same as somebody standing me in front of the mirror and saying, You're an Englishman that lives in Australia, you will be an Australian.
00:35:53.199 --> 00:35:56.639
Keep looking at yourself long enough and you'll feel Australian.
00:35:57.039 --> 00:35:59.280
No, it doesn't fucking happen like that.
00:35:59.360 --> 00:36:01.440
You always feel what you are, right?
00:36:01.519 --> 00:36:02.800
And you know who you are.
00:36:03.039 --> 00:36:07.920
Yeah, what's getting reflected in the mirror is irrelevant to that internal state, feeling.
00:36:08.639 --> 00:36:27.280
Yeah, and um, I mean, I've thought on it a lot before kind of coming to the conclusion that I have, but like the d the definition of what people colloquially call conversion therapy, which we call conversion practices because it's not therapeutic, um, is amen.
00:36:27.920 --> 00:36:31.199
I feel like if I don't say conversion therapy, people don't know what I'm talking about.
00:36:31.280 --> 00:36:33.840
Yeah, then I have to be like, but we don't call it that.
00:36:34.079 --> 00:36:41.280
Um like it's any attempt to to suppress change or eliminate someone's sexual orientation or gender identity.
00:36:41.599 --> 00:36:52.639
When we sit a trans person in front of a mirror and say, you're not really trans, look at yourself long enough and you'll realize that that meets the definition of convergent practices.
00:36:53.119 --> 00:37:02.719
Like the kind of things we do to try and supposedly help trans people in a medical setting, sometimes are just like so irreparably harmful.
00:37:03.039 --> 00:37:04.639
What you mean they don't work?
00:37:07.199 --> 00:37:08.079
Oh god.
00:37:08.719 --> 00:37:26.320
I want to know, is there anybody like because it seems as though trans healthcare in the past, even all the way from like the early 19th century when who was it, Carl or Rich star started doing like the the work around trans healthcare?
00:37:26.639 --> 00:37:31.599
But that's always been led by cisgender white males.
00:37:32.239 --> 00:37:48.400
Are there people within the trans community now that are starting to come up to the fore and being starting to lead that sort of transformation of medical practice as, you know, this is the right way to do it for our people?
00:37:48.719 --> 00:37:57.280
It's you know, cis white guys, cis fat old white guys sitting in their lab coats shouldn't be telling us how to do this shit.
00:37:57.920 --> 00:38:05.920
Yeah, I think we've seen a shift in the last maybe like five years towards having a lot more involvement of trans people in trans health care.
00:38:06.559 --> 00:38:22.000
Like I've been to one Australian professional association for trans health conference, uh, and there was a lot of trans people there, but a lot of people there noted to me, like last time, two years ago, this was not how it was.
00:38:22.480 --> 00:38:24.880
Um, I'm going to the one in two weeks.
00:38:24.960 --> 00:38:26.639
It's in Tasmania of the same conference.
00:38:26.719 --> 00:38:28.400
So it'll be very interesting to see.
00:38:28.480 --> 00:38:59.119
Um, but I think, like, at least in terms of research, we have this very strong focus on co-design and having trans people involved in research from the very start in how we ask the questions, how we design the project, how we run the project, having advisory groups, having trans people on the research team as researchers and research assistants, and just like trying to make sure that everything involves us and kind of has a nothing about us without us perspective.
00:38:59.360 --> 00:39:03.360
Um, and I strove like feel quite strongly about that.
00:39:03.440 --> 00:39:09.519
Like a lot of my papers, if you look at the titles of them, they often have lived experience in the title each time.
00:39:10.079 --> 00:39:15.760
I recently published a paper where all three of us that wrote it are gender diverse people.
00:39:16.079 --> 00:39:26.000
Um, and uh the paper is called, I think like um disordered eating behaviors in autistic, trans and gender diverse people, a lived experience-led scoping review.
00:39:26.320 --> 00:39:33.920
Where we basically, like, even though it was the methodology does not need us to disclose that about ourselves, we decided to disclose it anyway.
00:39:34.000 --> 00:39:41.519
And we wrote a positionality statement, which I do in all my papers, even though positionality statements are typically for qualitative papers.
00:39:41.760 --> 00:39:43.599
My systematic review has one.
00:39:43.840 --> 00:39:54.079
Because uh, rather than kind of the old school way of writing a positionality statement where you're saying, like, let me disclose this about me so you know that I could be biased, essentially, is like what they get used for.
00:39:54.159 --> 00:39:57.199
It's like, this is my perspective, so read it with a grain of salt.
00:39:57.440 --> 00:40:06.320
Um, I often write in mind that you know, we designed the project based on our lived experience knowledge, and we think that led to more rich data.
00:40:06.639 --> 00:40:17.840
Like we asked different questions and we thought of different things to look at because we have that insight and that that's a good thing, that like should be an asset to the project.
00:40:18.079 --> 00:40:37.920
Uh, I think like the idea of like what counts as like knowledge that's worth knowing also is key is like we think of research that's peer-reviewed as like the highest quality, and then what clinical folks see as like the next one, and then the actual patients and people lived experience are kind of often the lower rung.
00:40:38.159 --> 00:40:45.920
But that knowledge to me is equally important because like you do a qualitative study, you're already asking those people anyway, you know.
00:40:46.079 --> 00:40:51.519
But like if someone says this happened to me and it was harmful, I feel that in itself is knowledge that holds weight.
00:40:51.920 --> 00:40:56.800
And uh yeah, it becomes an issue of kind of like testimonial justice, essentially.
00:40:56.880 --> 00:41:01.920
Like, who do we trust the experiences of to be valid knowledge?
00:41:02.079 --> 00:41:12.960
So if a if a trans person says I had this medical experience and it was awful, but then the doctor says, Well, that's not what happened, we're generally going to trust the doctor just out of like belief system.
00:41:13.440 --> 00:41:19.119
But like chronically not being believed in your experience is not great for us.
00:41:19.199 --> 00:41:24.800
And it's also just not good for the data and the way we end up doing practice as a result.
00:41:25.119 --> 00:41:25.519
Yeah.
00:41:25.760 --> 00:41:48.960
And it's I suppose it's like for for the assholes who want to frame it that way as well, they'll turn around and say something like, Oh, you know, you need to believe the doctor because the doctor's got five years worth of medical school and this many years of practice, and actually the trans person has got dysphoria, so they're therefore that means that they have a mental health issue, so they can't clearly advocate for themselves.
00:41:49.039 --> 00:41:52.639
And this is so it's like it makes no fucking sense.
00:41:53.519 --> 00:41:54.880
It's all like backwards, isn't it?
00:41:55.039 --> 00:41:56.480
Like you can't you can't win.
00:41:56.639 --> 00:41:58.000
No, no, you can't win.
00:41:58.239 --> 00:42:00.719
That's why I have to have the data to back it up, usually.
00:42:00.880 --> 00:42:07.119
Like often research is done in the the way of like, let's explore something based on what the previous data said.
00:42:07.199 --> 00:42:11.039
Whereas mine is often like, this is what I'm observing in the community.
00:42:11.199 --> 00:42:19.519
Let's see if we can kind of explore that in the data and see if that's like an anecdotal observation that doesn't hold up more broadly.
00:42:19.840 --> 00:42:22.800
Maybe it's just my little community, not the broader community.
00:42:23.039 --> 00:42:25.280
Um, but maybe it does.
00:42:25.360 --> 00:42:31.199
And like having that insight means we can then kind of show it in a way that is seen as trustworthy and valid.
00:42:31.280 --> 00:42:37.920
Like I've known for many years that like trans teens suppress their puberty by not eating enough.
00:42:38.159 --> 00:42:40.000
We were seeing this all the time.
00:42:40.239 --> 00:42:42.639
Now we have the data to say this is a thing.
00:42:42.800 --> 00:42:50.320
But like we knew that for years clinically in practice, and also just like listening to trans kids talk about themselves.
00:42:50.639 --> 00:42:55.360
But now we have that as you know something we can we can cite.
00:42:56.719 --> 00:42:59.840
It's messed up because if you don't eat enough, you don't get a period.
00:43:00.639 --> 00:43:04.079
I am deeply shocked by that.
00:43:04.320 --> 00:43:15.039
Like j just can you imagine the overwhelming emotion that you would have to be feeling to stop yourself from eating?
00:43:16.400 --> 00:43:20.960
And I I did a 24-hour fast last week.
00:43:21.119 --> 00:43:24.079
I got to 23 and a half hours and couldn't handle it anymore.
00:43:24.480 --> 00:43:29.440
Like, I don't know how you did four days, like I would have ripped somebody's head off.
00:43:29.679 --> 00:43:47.119
But my god, for somebody to have such strong, powerful feelings within themselves that they stop themselves from eating just to stop something within their body from happening that they feel as though shouldn't be there.
00:43:47.760 --> 00:43:49.760
But you know, then they've got to listen to that.
00:43:49.920 --> 00:43:55.119
But they've got but then they don't because they've got society saying, but you don't know who you are until you're like 18.
00:43:55.199 --> 00:43:58.400
Like these kids don't know who they are, they're too young to know.
00:43:58.559 --> 00:44:00.719
They're starving themselves, so they don't get a period.
00:44:00.880 --> 00:44:02.480
I think they've got a fair idea.
00:44:02.639 --> 00:44:05.519
Yeah, I think they're I think they've vegetated themselves enough.
00:44:05.840 --> 00:44:11.760
Well, if you think about it, right, like puberty causes irreversible changes to the body.
00:44:11.840 --> 00:44:16.159
And there are some changes that happen to the body that you cannot undo with medical transition.
00:44:16.400 --> 00:44:26.159
Like, that's why we think young people being on puberty blockers can be really beneficial because once your bone structure grows to full adult size, that's how tall you're gonna be.
00:44:26.239 --> 00:44:27.360
We can't make you shorter.
00:44:27.519 --> 00:44:33.119
Like, uh, once your hips are as wide as they're gonna be, there's no procedure that shrinks them down to a smaller size.
00:44:33.760 --> 00:44:39.519
Um, and there are lots of like trans kids who can't access puberty blockers.
00:44:39.679 --> 00:44:48.239
You need to live in a state where they're allowed, you need to have two parents who consent to that, you need to have enough money to go to the medical system for that.
00:44:48.480 --> 00:44:53.280
In the UK, it's banned across the entirety of the UK for trans kids to have them.
00:44:53.679 --> 00:45:04.880
So when you have no other option aside from go through puberty or like resort to personal extremes, uh a lot of young people resort to those extremes.
00:45:05.039 --> 00:45:25.920
Like, I think it's an area that kind of fits strangely across sexology and like research in other fields, is that in the case studies that have been published of this exact phenomenon, a surprising number of them cite the original place where the young person learned that they could suppress their puberty by not eating was in their sex ed class.
00:45:26.079 --> 00:45:33.360
Because like their sex ed and health class talked about the female athlete triad and about like looking after yourself and good nutrition.
00:45:33.519 --> 00:45:37.039
And most young people hear that and go, okay, cool, I'll follow that advice.
00:45:37.199 --> 00:45:43.519
But some gender-diverse young people hear, wait, you telling me there's a way I can opt out of this extreme distress I'm having?
00:45:43.760 --> 00:45:44.400
Fantastic.
00:45:44.480 --> 00:45:45.840
Thank you for telling me that.
00:45:46.000 --> 00:45:51.039
Uh, and it's not being met like in the the intended way that the message is being given.
00:45:51.119 --> 00:46:02.239
And so it's like how we sensitively share information about health and nutrition and well-being, we have to think about how people might perceive that who are not cis people.
00:46:02.639 --> 00:46:13.519
Um but like the the one study that was done of young people who had disordered eating already, they found that in 75% of those cases they were doing it to suppress their puberty.
00:46:15.920 --> 00:46:21.360
And in my study that we recently haven't finished yet, but we're about to publish, there's 95%.
00:46:22.480 --> 00:46:31.039
Like no one can see this on the pod, but the three of us are just shifting super uncomfortably in our seats because we're like, especially me from a medical background.
00:46:31.199 --> 00:46:33.519
I'm like, that is so fucked.
00:46:33.679 --> 00:46:33.920
Yeah.
00:46:34.000 --> 00:46:43.679
I mean, like, it's it's a funny, it's a like darkly funny thing that I observe with my partner who's like a cis man, is he'll tell me things when I ask him.
00:46:43.840 --> 00:46:48.639
Like, like uh he's met a bunch of my friends who are trans and gender diverse people.
00:46:48.800 --> 00:46:54.480
And sometimes he'll be like, not to be rude, but like, I had no idea this person was trans.
00:46:54.559 --> 00:46:56.000
And I'm like, yeah.
00:46:56.320 --> 00:47:02.239
Uh and he he'll note like five people and I'll go, those are the five who had anorexia as teens.
00:47:02.880 --> 00:47:08.159
Like the reason you can't tell, quote unquote, is because they had puberty suppression.
00:47:08.320 --> 00:47:10.880
They just didn't have medical puberty suppression.
00:47:10.960 --> 00:47:24.880
And because of that, you know, their bone structure is smaller, uh, their voices never dropped, their like appearance is different from the young people who or like the people around me who had to go through puberty one and then puberty two.
00:47:25.519 --> 00:47:30.480
Um it makes like a lifelong difference to how that person looks.
00:47:31.119 --> 00:47:32.639
And so like it's not a good thing.
00:47:32.719 --> 00:47:44.880
I like I the there's lifelong health consequences to having like severe malnourishment that are like sometimes irreversible things, but the which are gonna cost the taxpayer a fuckload of money.
00:47:45.039 --> 00:47:47.440
Yes, and patient treatment is real expensive.
00:47:47.840 --> 00:47:52.719
But like you said, like I my old neighbor when I first moved, I didn't know was a trans man.
00:47:52.800 --> 00:47:56.719
I was like, oh my god, like and I kept touching his beard, I was like, this is amazing.
00:47:59.199 --> 00:48:05.920
It was good, but even at work, like you'll get the patients in, and I'm just gonna come up with a random name Bob.
00:48:06.079 --> 00:48:09.039
I don't know, Bob the Builder was playing this morning, so it's in my head.
00:48:09.199 --> 00:48:18.960
Um Bob would come in and I'll call Bob to the room, and they'll get up for an examination because obviously I work in Ghani, and I'm like, this is amazing.
00:48:19.039 --> 00:48:21.679
Like you I would not tell in the public.
00:48:21.840 --> 00:48:22.079
Yeah.
00:48:22.719 --> 00:48:27.039
But do you get like a lot of trans trans men coming in for gynecological stuff?
00:48:27.440 --> 00:48:28.000
Yes.
00:48:28.159 --> 00:48:30.159
So um I do it.
00:48:30.239 --> 00:48:44.719
There's a really good gynecologist, so we make sure they're booked in um on her list and that I'm around because I know they're on testosterone, so they're gonna be dry, it's gonna be painful, um, it's not gonna be a pleasant experience.
00:48:44.880 --> 00:48:49.519
So, and we can't really say, hey, take some estrogen and progesterone before you come.
00:48:50.400 --> 00:48:51.840
So it's better down there.
00:48:52.000 --> 00:48:59.760
Um, so I get pain relief, your vomit bags, I get everything I can to make it the most comfortable experience possible.
00:49:00.000 --> 00:49:03.519
Crack open my ghani jokes, and there you go.
00:49:03.760 --> 00:49:07.599
But I've had the most positive feedback from a lot.
00:49:08.159 --> 00:49:10.320
Well, I'm sure you're gender affirming in that.
00:49:10.400 --> 00:49:10.559
Yeah.
00:49:14.559 --> 00:49:15.920
I always ask though, what do you want?
00:49:16.239 --> 00:49:17.760
I mean, maybe you are, but you're a funny ass.
00:49:19.920 --> 00:49:20.639
Is it time?
00:49:20.800 --> 00:49:20.960
Yeah.
00:49:21.199 --> 00:49:21.679
Yeah.
00:49:22.000 --> 00:49:25.280
Well, I'm just like I'm seeing me.
00:49:25.599 --> 00:49:26.239
I'm fun.
00:49:26.400 --> 00:49:29.840
Um, but I always ask, what do you want us to call the area?
00:49:30.000 --> 00:49:32.239
Because a lot of people don't want us to say cervix.
00:49:32.400 --> 00:49:32.639
Yeah.
00:49:32.800 --> 00:49:34.159
I like calling it the donut.
00:49:34.239 --> 00:49:35.679
We're calling it the donut.
00:49:36.159 --> 00:49:38.960
Like, but like I just asked, what do you want us to call it?
00:49:39.519 --> 00:49:42.000
And there's there's something so powerful in that, right?
00:49:42.239 --> 00:49:47.519
Like we we've got trans kids at some of the schools I'll I go into.
00:49:48.079 --> 00:49:50.880
And just the fact of, hey, how you doing?
00:49:51.840 --> 00:49:52.800
What's your pronouns?
00:49:52.880 --> 00:49:54.000
What would you like me to call you?
00:49:54.400 --> 00:49:57.039
And it for them, it's just like, oh, fuck.
00:49:57.280 --> 00:50:00.400
You were the last person in the world I would have expected to ask the question.
00:50:00.559 --> 00:50:04.719
But like from then on in, they stick to you like glue because they feel safe around you.
00:50:04.880 --> 00:50:07.920
Yeah, one guy has to come back every six months.
00:50:08.079 --> 00:50:10.960
And when I first asked him, what do you want us to call downstairs?
00:50:11.039 --> 00:50:13.119
He's like, No one's ever freaking asked me that question.
00:50:13.199 --> 00:50:14.320
I don't know what you want to call it.
00:50:14.480 --> 00:50:16.880
And I was like, Well, what do you want?
00:50:17.760 --> 00:50:20.000
But we came up with a name Stacy.
00:50:22.639 --> 00:50:23.039
Wow.
00:50:23.440 --> 00:50:23.679
Yeah.
00:50:24.239 --> 00:50:27.840
So now he comes on, comes in, lays on the bed and goes, You ready to look at Stacy?
00:50:28.000 --> 00:50:29.119
I'm like, I always am.
00:50:29.360 --> 00:50:35.679
But yeah, I love the naming convention of that.
00:50:35.760 --> 00:50:37.280
That's yeah, yeah.
00:50:37.440 --> 00:50:44.400
I think like um like having lower surgery is much more common amongst transfeminine people.
00:50:44.480 --> 00:50:48.079
Like the the technology is a lot better, uh, so that's more common.
00:50:48.159 --> 00:50:52.960
Whereas most trans masculine people don't have lower surgery statistically.
00:50:53.440 --> 00:51:00.400
Uh the results for people who do vary quite significantly from very good to very poor.
00:51:00.639 --> 00:51:05.519
Uh, but the cost of that surgery is about the same as buying a house.
00:51:05.920 --> 00:51:06.480
Wow.
00:51:06.719 --> 00:51:14.000
So the cheapest you'll get bottom surgery for a trans mask person for phalloplasty is about$200,000 out of pocket.
00:51:14.239 --> 00:51:20.079
So that's not feasible for most average people, especially a group of people who tend to be living in poverty.
00:51:20.320 --> 00:51:26.800
Um and so, like, you know, things like gynecological health issues become a key issue to talk about.
00:51:26.960 --> 00:51:36.960
But like, and a lot of trans mass people also just have no interest in having surgery because they either don't want it or just have accepted it's never going to be feasible cost-wise.
00:51:37.599 --> 00:51:41.519
Um not everyone has dysphoria about that area of their body.
00:51:41.679 --> 00:51:55.199
It's like people have different body goals in their head, but um yeah, I think it's an area that's like very uncomfortable for people to think about or talk about because like it's such an extremely gendered discussion.
00:51:55.679 --> 00:52:00.880
Like people, when they talk about the idea of pregnancy, they always say pregnant women.
00:52:01.119 --> 00:52:02.159
Yeah, like that's true.
00:52:02.400 --> 00:52:09.920
And if uh there's been times where the guidelines have been changed to say pregnant people, and there's been such backlash, they've changed the guidelines back.
00:52:10.639 --> 00:52:11.039
Yeah.
00:52:11.280 --> 00:52:26.480
Like it was a US election issue that someone said pregnant people, and it allegedly cost them the election, or was a component in that because people are so gendered in their way of talking about things to do with the body and pregnancy and gynecology.
00:52:26.639 --> 00:52:42.639
And so, like, to step into that environment when you're a dude or a masculine person or just not a woman is like uh so complicated because it's such a threat to the self when you're like being there implies you're a woman.
00:52:42.880 --> 00:52:43.039
Yeah.
00:52:43.360 --> 00:52:46.719
I have a personal question, which you don't have to answer if you don't want to.
00:52:46.880 --> 00:52:50.880
But like, do you have to get PAP tests and what is that like for you?
00:52:51.280 --> 00:52:52.800
I do have to get them.
00:52:52.960 --> 00:52:55.679
Um now you can come to me where you can have all the fun.
00:52:55.920 --> 00:52:57.519
You can name it Stacy.
00:52:57.920 --> 00:52:58.400
Yeah.
00:53:00.480 --> 00:53:04.400
Cervix is actually one of those words that I just like don't have a big problem with for myself.
00:53:04.639 --> 00:53:11.280
Because like I don't know, I feel people don't use it in the same degree of gendered manner that they do other body parts.
00:53:11.360 --> 00:53:14.559
It only really comes up in the context of screening or bashing.
00:53:14.880 --> 00:53:15.119
Yeah.
00:53:16.159 --> 00:53:20.719
Um but like I've uh I've had two screenings.
00:53:20.800 --> 00:53:25.760
The first one was while I was already getting an IUD put in, and the second one was under anesthesia when I was having surgery.
00:53:25.920 --> 00:53:31.920
But just I'm just gonna keep trying to line them up with when I don't have to be conscious or I'm already there for something else.
00:53:32.320 --> 00:53:36.400
For the trans community, um not a lot of people know you can actually do a self-collect.
00:53:36.960 --> 00:53:39.519
So um, yeah, for any of a self-collect.
00:53:39.760 --> 00:53:40.079
You can.
00:53:40.239 --> 00:53:44.880
Anyone can, as long as you haven't had like the last test was HPV positive.
00:53:45.039 --> 00:53:45.360
Okay.
00:53:45.519 --> 00:53:56.719
But if it's all been like no HPV at all, you can actually go and get a self-collect and you just cock a leg, chuck the little I've got a fake swab at home, not hasn't been used on anybody, except for Wanda.
00:53:57.199 --> 00:53:59.280
Um which is my Volva puppet.
00:53:59.599 --> 00:54:00.320
Just yeah.
00:54:00.559 --> 00:54:08.719
Um yeah, you just shove it up until you get a little bit of resistance, pull it back a little bit, and just swish it around for about 10, 20 seconds.
00:54:08.960 --> 00:54:10.239
Depends how fast you know.
00:54:10.480 --> 00:54:12.800
Then you just we are talking about a swab now, right?
00:54:12.960 --> 00:54:14.079
Yeah, okay, yeah, yep.
00:54:15.039 --> 00:54:27.440
I mean, I don't know which organization it was, but like my YouTube ads at one point gave me an ad for cervical screening that had trans people in it, and I literally cried because I was like, Yep.
00:54:27.760 --> 00:54:40.719
Oh, I have so used to not seeing me represented in this and having to translate things to make sense for me, that it just was very moving to just like have what feels kind of like basic.
00:54:41.039 --> 00:54:46.000
Yep, they've got the brochures and everything now that it is all like community acceptable.
00:54:46.880 --> 00:55:00.239
So I read an interesting stat the other day that adult adult trans people in Australia and the US sit between 0.8 and 0.9% of the population.
00:55:01.119 --> 00:55:10.480
Whereas trans youth in both countries sit somewhere between 2.5% of the population and 3.5% of the population.
00:55:10.960 --> 00:55:17.679
Now, you can argue that there's a whole heap of different reasons for that, you know, but is it social?
00:55:17.920 --> 00:55:19.760
Is it something that's happening with the food?
00:55:19.920 --> 00:55:22.559
Is it something that's just like a natural phenomenon?
00:55:22.719 --> 00:55:24.239
Who knows what's going on?
00:55:24.480 --> 00:55:34.400
But then I was sort of starting to think that here in WA, we have an Aboriginal population or indigenous population of between 2.7 and 3.1%.
00:55:36.079 --> 00:55:43.599
You have a look at all the advertisement and advocation for indigenous people around.
00:55:44.159 --> 00:55:48.159
And it it's almost smacking you in the face at every point.
00:55:49.119 --> 00:55:58.400
Yet arguably now, there is less indigenous people in the state of Western Australia than there are trans kids.
00:55:59.280 --> 00:56:03.760
Yet we're not hearing we're not seeing the advocacy there.
00:56:04.400 --> 00:56:06.800
And that was just like one of those comparative stats.
00:56:06.880 --> 00:56:14.480
I I sat there and thought about like how deeply fucked up are we as a society around that, you know.
00:56:14.719 --> 00:56:19.039
But and the thing is is that it's not it's not a phenomenon that's gonna go away.
00:56:19.199 --> 00:56:25.280
Like it's it's always been like tr being trans is not a new thing for human beings.
00:56:25.440 --> 00:56:26.079
We know that.
00:56:26.639 --> 00:56:35.920
But yeah, I just hope that in future well my hope is that we just stop being afraid and just create a world where people can just be their fucking selves.
00:56:36.159 --> 00:56:37.599
It doesn't affect anybody.
00:56:37.840 --> 00:56:39.199
No, yeah.
00:56:39.360 --> 00:56:56.800
I mean, uh I haven't seen that exact set of stats, but they published a like meta-analysis not too long ago of the prevalence of trans people, um, and they found it was about four or five four point five percent of adults and eight point four percent of children and adolescents.
00:56:57.039 --> 00:56:57.280
Wow.
00:56:57.440 --> 00:57:03.679
And I think often when people see that stat, they think, gee, why is the number of adolescents higher than adults?
00:57:03.920 --> 00:57:12.400
Uh and to me, it's just a case of well, there are more young people coming out younger who will eventually be the adults.
00:57:12.480 --> 00:57:15.360
So the adult stat next time they do it will probably be 8.4%.
00:57:16.320 --> 00:57:20.400
Um that's if they don't off themselves, yeah.
00:57:20.719 --> 00:57:22.719
That's if they survive to adulthood.
00:57:23.039 --> 00:57:29.599
But then there's gonna be a whole heap of dickheads out there who are sitting there thinking, well, that's why we can't give these kids puberty blockers.
00:57:29.840 --> 00:57:30.480
Because it's an epic.
00:57:30.800 --> 00:57:40.719
Because half of them, if it's well, eight eight point five percent to four point five, roughly half are gonna just go back to being their cisgender, heterosexuals.
00:57:41.199 --> 00:58:00.159
We have like a bit of a problem with like literacy around understanding data in like globally, because people make that inference of like the 8.4 will become 4.5, not understanding that we've taken a snapshot at this exact moment in time, and that's the current prevalence in adults and children, not that those children become the adults.
00:58:00.639 --> 00:58:06.079
Like those children will hopefully become adults, but that stat will need to be re-snapshotted as a moment in time.
00:58:06.239 --> 00:58:06.559
Yeah.
00:58:06.719 --> 00:58:15.519
Like uh as a researcher, I have to think a lot about like, can any single line in my paper be pulled out and weaponized?
00:58:15.679 --> 00:58:22.480
And I have to like go through it with a fine-tooth comb and make sure nothing can be decontextualized and used against us.
00:58:22.800 --> 00:58:27.920
So, like, I have stats in my work that I'm like, I'm not gonna publish that.
00:58:28.079 --> 00:58:35.280
It's not uh going to the direct research question, but also it feels too likely to be used in a harmful way.
00:58:35.760 --> 00:58:41.920
Um I think as well though, that like public health messaging is not a zero-sum game.
00:58:42.000 --> 00:58:46.559
So, like I would love there to be more health messaging directed at trans people.
00:58:47.119 --> 00:58:53.840
I also think like we probably still don't have enough health messaging aimed at Aboriginal and Terrestrial Islander people.
00:58:54.239 --> 00:59:00.639
And it's probably a case that like some of it just isn't tailored or isn't going to the right places.
00:59:00.800 --> 00:59:09.360
Like, if you're only I see a lot of that health messaging on like bus sports, but like not necessarily in the algorithms of the people who it's targeted at, you know.
00:59:09.840 --> 00:59:16.880
So sometimes I think there's a lot of it, but it's not going where it needs to go, or it's not written in a way that is targeted enough.
00:59:16.960 --> 00:59:21.679
Like different health public health messaging styles will work in different communities.
00:59:22.079 --> 00:59:26.639
Plus, like there's also Aboriginal and Tourist are people who are gender diverse.
00:59:26.800 --> 00:59:31.199
So, like, yeah, I don't think there's a lot of health messaging that targets their needs.
00:59:31.280 --> 00:59:44.239
Like, there's gonna be unique intersections and stressors that come from being part of two marginalized groups together, and like it's not like you, you know, kind of add them together and you get a new number.
00:59:44.400 --> 00:59:47.519
It's like there's unique experiences that come from the both.
00:59:48.400 --> 00:59:58.480
Um yeah, I've got some some friends who are brother boys and sister girls, and like uh that's Aboriginal and torso, like gender diverse terms.
00:59:58.800 --> 00:59:59.840
Um who
01:00:00.400 --> 01:00:40.639
you know there's just so much going on uh that they have to navigate on top of just being a person community yeah and that's that is like a heavy intersection of I've worked with some teens who are aboriginal who are trans who are neurodiverse and seeing and who also come from a background of poverty and trauma and whatnot and seeing the intersection of all those factors play out in this one child is so heavy but quite often all of that gets dismissed because they're trans.
01:00:41.199 --> 01:00:42.639
Being trans is the issue.
01:00:42.800 --> 01:00:46.800
Yeah it's not everything else and how they all intersect.
01:00:46.880 --> 01:00:51.760
It's that that kid's you know struggling because they're trans and that's that's the only problem.
01:00:52.159 --> 01:01:13.599
I think we're all like I think part of the problem globally is just like humans are too time for frankly that like when people are nurses or doctors and they have to see 6,000 patients and they get not enough time to actually meaningfully interact with each of them they don't have the time to actually ask the nuanced questions to understand that person's experience fully.
01:01:14.000 --> 01:01:22.400
And so they're kind of going off of shortcuts of patterns which is not ideal and it sucks for the patients and it also sucks for the doctor.
01:01:22.639 --> 01:01:33.599
Like I think it's not like one or the other um like the doctor's like a GP has like 15 minutes with you and that's if they aren't running late on their previous person.
01:01:33.840 --> 01:01:38.079
And so they can't really ask you everything they need to know to really understand your health in full.
01:01:38.800 --> 01:01:39.280
I agree with that.
01:01:39.599 --> 01:01:41.440
We need the system to be structured differently.
01:01:41.920 --> 01:01:45.519
Being a nurse I agree with that like we don't have a lot of time with patients.
01:01:45.840 --> 01:01:50.159
Appointments are 30 minutes what what are we going to get out of that meeting them for the first time?
01:01:50.559 --> 01:02:07.360
Yeah and medical knowledge is also growing research wise so rapidly that I saw a stat recently that for a doctor to keep up with their own specialty they would need to spend about nine hours a week reading papers just to keep up with that week's research on their specialty.
01:02:07.760 --> 01:02:35.360
And so it's impossible for that to be done really like I feel uh there's a lot of areas that I've spent time on and learned a lot about that mean that I'm accidentally diagnosing people all the time with things that they're GP probably should have too she's got a diagnosis of fucked up I do I do no but like in well we all went to the same uni when you had to watch the video at like your first what was that class semester one?
01:02:36.960 --> 01:03:11.280
Yeah and like I'm there looking at all the volvers I'm like oh I think they've got this oh I think they've got that like just diagnosing all of them when they're popping up yeah I mean I'm I've tried to be very careful to be like have you ever heard of X thing did you know these are the the you're like what you're describing sounds like it is consistent with that sometimes like there are specific measures you can do to actually determine that and if you go to the GP and you have to pay all that money I have the PDF of that same thing they're gonna make you do.
01:03:11.519 --> 01:03:18.079
So maybe we can cut the step out of having to navigate that by just like being able to do the measure first.
01:03:18.960 --> 01:03:22.000
And that's often like a neat thing to be able to do.
01:03:22.239 --> 01:03:34.239
Like I a lot of people I know have uh POTS posturalithic tachycardia syndrome which I also have yay found that out this year when my hormones got fucky um because it's very hormonally influenced.
01:03:35.039 --> 01:03:40.960
But like the test for it you can do in your house as long as you have like a watch that can do heart rate.
01:03:41.119 --> 01:03:44.000
And so if you go to the GP they'll do the same thing.
01:03:44.719 --> 01:03:51.199
Fibromyalgia is like a PDF where you take a bunch of boxes and then test the number you get at the end.
01:03:51.440 --> 01:04:13.760
So like if you can come in already with that that's nice to be able to to have I feel like um I have complicated feelings about the idea of diagnosis and that like diagnosis has to be a medical professional because like how does the doctor who meets me for 15 minutes know more than my entire 29 years of being alive with said condition.
01:04:13.920 --> 01:04:14.159
True.
01:04:14.320 --> 01:04:18.719
You know like who is the arbiter of truth on this?
01:04:19.360 --> 01:04:39.360
Obviously they have like specific medical knowledge that I don't have but at the same time like can we work together in a way that's like let me explain my 29 years of experience and then you can put that lens of your knowledge onto it and we can work together rather than it being like I am in power over you and I will tell you what is the what is true.
01:04:39.679 --> 01:04:40.159
Yeah.
01:04:40.400 --> 01:04:46.000
And let's be real most doctors will be replaced by chat GPT in about five years' time anyway.
01:04:46.079 --> 01:04:49.280
So I went to a doctor that Googled right in front of me my symptoms.
01:04:49.440 --> 01:05:05.840
Oh I had I went to a doctor that actually chat GPT my symptoms we could talk for for six million hours about AI I've um let's not I'm writing a paper on AI at the moment um in the context of neurodivergence so we could maybe return to that later we'll get you back.
01:05:06.079 --> 01:06:02.159
I like that yeah and on that note neurodivergence Kite this has been a fascinating conversation thanks so much I reckon we need to come back to this topic again later on because this is it was heavy though so like what what are your what is your hope for the future like what would you like people to to think about or know after they've listened to this because it is like it's hard to hear how difficult things are for people like what what is something that you would like people to I don't know to know or to to think about I think um we can never underestimate how much of a difference a single person can make like yes the systems and the structures are built in ways that are not right for us and at the same time like one person offering kindness within that structure makes a world of difference.
01:06:02.400 --> 01:06:07.360
Like I I had an IED put in a few years ago I got it taken out pretty fast.
01:06:07.440 --> 01:06:23.280
But the experience of getting it put in was painful and miserable and very gendered and awful but like uh one nurse was like I have to give you this because you might have some bleeding and handed me a pad and went I found the one that was in blue packaging for you.
01:06:23.679 --> 01:06:36.719
And like I'm getting such a little thing yeah but it just felt like in amongst all of this awfulness that the whole experience was it was like this tiny kindness that I still think about like over five years later, you know?
01:06:37.440 --> 01:06:44.320
So like uh those things doing them might not seem like a big deal but they often are very meaningful to us.
01:06:44.559 --> 01:06:47.599
So like don't underestimate what a little kindness can do.
01:06:48.079 --> 01:07:00.800
Yeah that was beautiful thank you in essence be a fucking human being yeah and meet other human beings meet other human beings no matter who they are what they look like where they come from yeah perfect place to end it.
01:07:01.039 --> 01:07:18.000
Kai thanks so much time so guys that was part one of our conversation with the incredible Kai Sweitzer and I think we can all agree it was one hell of a ride.
01:07:18.159 --> 01:07:26.079
We covered identity gender self-expression and what it actually feels like to live beyond the boxes that society loves to tick.
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Next week Kai's back for part two where we dive into neurodiversity sexuality and relationships and trust me it's just as funny thoughtful and mind expanding as this one.
01:07:38.559 --> 01:07:54.639
And hey if you love this chat as much as we did take 30 seconds to vote for Super Sex in the Adult Industry Choice Awards for of course the best podcast it helps keep these conversations going and honestly we'd love a shiny award to put in the studio.
01:07:54.800 --> 01:08:00.239
The link is in the show notes go give us a click and we'll see you next time on Super Sex