[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.76,0:00:04.41,Default,,0000,0000,0000,,I want you all to think
Dialogue: 0,0:00:04.41,0:00:08.74,Default,,0000,0000,0000,,about the third word that was ever said
Dialogue: 0,0:00:08.74,0:00:11.58,Default,,0000,0000,0000,,about you,
Dialogue: 0,0:00:11.58,0:00:14.64,Default,,0000,0000,0000,,or if you were delivering,
Dialogue: 0,0:00:14.64,0:00:19.80,Default,,0000,0000,0000,,about the person you were delivering.
Dialogue: 0,0:00:19.80,0:00:22.08,Default,,0000,0000,0000,,And you can all mouth it if you want
Dialogue: 0,0:00:22.08,0:00:23.65,Default,,0000,0000,0000,,or say it out loud.
Dialogue: 0,0:00:23.65,0:00:29.60,Default,,0000,0000,0000,,It was, the first two were, "It's a..."
Dialogue: 0,0:00:32.27,0:00:34.00,Default,,0000,0000,0000,,Well, it shows you that
Dialogue: 0,0:00:34.00,0:00:35.94,Default,,0000,0000,0000,,I also deal with issues where there's
Dialogue: 0,0:00:35.94,0:00:38.71,Default,,0000,0000,0000,,not certainty of whether it's a girl or a boy,
Dialogue: 0,0:00:38.71,0:00:42.01,Default,,0000,0000,0000,,so the mixed answer was very appropriate.
Dialogue: 0,0:00:42.01,0:00:44.46,Default,,0000,0000,0000,,Of course, now the answer often comes
Dialogue: 0,0:00:44.46,0:00:46.86,Default,,0000,0000,0000,,not at birth but at the ultrasound,
Dialogue: 0,0:00:46.86,0:00:49.80,Default,,0000,0000,0000,,unless the prospective parents choose
Dialogue: 0,0:00:49.80,0:00:53.51,Default,,0000,0000,0000,,to be surprised like we all were.
Dialogue: 0,0:00:53.51,0:00:56.47,Default,,0000,0000,0000,,But I want you to think about what it is
Dialogue: 0,0:00:56.47,0:01:00.92,Default,,0000,0000,0000,,that leads to that statement
Dialogue: 0,0:01:00.92,0:01:02.60,Default,,0000,0000,0000,,on the third word,
Dialogue: 0,0:01:02.60,0:01:05.10,Default,,0000,0000,0000,,because the third word
Dialogue: 0,0:01:05.10,0:01:12.86,Default,,0000,0000,0000,,is a description of your sex,
Dialogue: 0,0:01:12.86,0:01:15.43,Default,,0000,0000,0000,,and by that I mean,
Dialogue: 0,0:01:15.43,0:01:20.34,Default,,0000,0000,0000,,made by a description of your genitals.
Dialogue: 0,0:01:20.34,0:01:23.20,Default,,0000,0000,0000,,Now as a pediatric endocrinologist,
Dialogue: 0,0:01:23.20,0:01:25.59,Default,,0000,0000,0000,,I used to be very, very involved,
Dialogue: 0,0:01:25.59,0:01:27.48,Default,,0000,0000,0000,,and still somewhat am,
Dialogue: 0,0:01:27.48,0:01:30.29,Default,,0000,0000,0000,,in cases in which
Dialogue: 0,0:01:30.29,0:01:32.88,Default,,0000,0000,0000,,there are mismatches
Dialogue: 0,0:01:32.88,0:01:35.32,Default,,0000,0000,0000,,in the externals
Dialogue: 0,0:01:35.32,0:01:39.31,Default,,0000,0000,0000,,or between the externals and the internals,
Dialogue: 0,0:01:39.31,0:01:44.11,Default,,0000,0000,0000,,and we literally have to figure out
Dialogue: 0,0:01:44.11,0:01:48.20,Default,,0000,0000,0000,,what is the description of your sex.
Dialogue: 0,0:01:48.20,0:01:50.68,Default,,0000,0000,0000,,But there is nothing that is definable
Dialogue: 0,0:01:50.68,0:01:53.92,Default,,0000,0000,0000,,at the time of birth
Dialogue: 0,0:01:53.92,0:01:57.92,Default,,0000,0000,0000,,that would define you,
Dialogue: 0,0:01:57.92,0:01:59.97,Default,,0000,0000,0000,,and when I talk about definition,
Dialogue: 0,0:01:59.97,0:02:06.27,Default,,0000,0000,0000,,I'm talking about your sexual orientation.
Dialogue: 0,0:02:06.27,0:02:11.72,Default,,0000,0000,0000,,We don't say, "It's a gay boy."
Dialogue: 0,0:02:11.72,0:02:14.37,Default,,0000,0000,0000,,"A lesbian girl."
Dialogue: 0,0:02:14.37,0:02:17.98,Default,,0000,0000,0000,,Those situations don't really define themselves
Dialogue: 0,0:02:17.98,0:02:21.67,Default,,0000,0000,0000,,more until the second decade of life.
Dialogue: 0,0:02:21.67,0:02:26.65,Default,,0000,0000,0000,,Nor do they define your gender,
Dialogue: 0,0:02:26.65,0:02:30.26,Default,,0000,0000,0000,,which as different from your anatomic sex
Dialogue: 0,0:02:30.26,0:02:33.64,Default,,0000,0000,0000,,describes your self-concept.
Dialogue: 0,0:02:33.64,0:02:35.58,Default,,0000,0000,0000,,Do you see yourself
Dialogue: 0,0:02:35.58,0:02:39.07,Default,,0000,0000,0000,,as a male or female
Dialogue: 0,0:02:39.07,0:02:44.69,Default,,0000,0000,0000,,or somewhere in the spectrum in between?
Dialogue: 0,0:02:44.69,0:02:49.67,Default,,0000,0000,0000,,That sometimes shows up
Dialogue: 0,0:02:49.67,0:02:52.75,Default,,0000,0000,0000,,in the first decade of life,
Dialogue: 0,0:02:52.75,0:02:56.30,Default,,0000,0000,0000,,but it can be very confusing for parents
Dialogue: 0,0:02:56.30,0:02:59.44,Default,,0000,0000,0000,,because it is quite normative
Dialogue: 0,0:02:59.44,0:03:05.51,Default,,0000,0000,0000,,for children to act in a cross-gender play and way,
Dialogue: 0,0:03:05.51,0:03:07.67,Default,,0000,0000,0000,,and that in fact there are studies that show
Dialogue: 0,0:03:07.67,0:03:10.72,Default,,0000,0000,0000,,that even 80 percent of children
Dialogue: 0,0:03:10.72,0:03:13.20,Default,,0000,0000,0000,,who act in that fashion
Dialogue: 0,0:03:13.20,0:03:18.23,Default,,0000,0000,0000,,will not persist in wanting to be
Dialogue: 0,0:03:18.23,0:03:20.46,Default,,0000,0000,0000,,the opposite gender
Dialogue: 0,0:03:20.46,0:03:24.39,Default,,0000,0000,0000,,at the time when puberty begins.
Dialogue: 0,0:03:24.39,0:03:30.11,Default,,0000,0000,0000,,But at the time that puberty begins,
Dialogue: 0,0:03:30.11,0:03:33.67,Default,,0000,0000,0000,,that means between about age 10 to 12 in girls,
Dialogue: 0,0:03:33.67,0:03:37.06,Default,,0000,0000,0000,,12 to 14 in boys,
Dialogue: 0,0:03:37.06,0:03:38.70,Default,,0000,0000,0000,,with breast-budding
Dialogue: 0,0:03:38.70,0:03:42.60,Default,,0000,0000,0000,,or two to three times increase in the gonads
Dialogue: 0,0:03:42.60,0:03:45.51,Default,,0000,0000,0000,,in the case of genetic males,
Dialogue: 0,0:03:45.51,0:03:48.89,Default,,0000,0000,0000,,by that particular point, the child who says
Dialogue: 0,0:03:48.89,0:03:53.30,Default,,0000,0000,0000,,they are in the absolute wrong body
Dialogue: 0,0:03:53.30,0:03:57.01,Default,,0000,0000,0000,,is almost certain to be transgender
Dialogue: 0,0:03:57.01,0:04:04.00,Default,,0000,0000,0000,,and is extremely unlikely to change those feelings,
Dialogue: 0,0:04:04.00,0:04:08.67,Default,,0000,0000,0000,,no matter how anybody tries reparative therapy
Dialogue: 0,0:04:08.67,0:04:12.66,Default,,0000,0000,0000,,or any other noxious things.
Dialogue: 0,0:04:12.66,0:04:15.10,Default,,0000,0000,0000,,Now this is relatively rare,
Dialogue: 0,0:04:15.10,0:04:18.63,Default,,0000,0000,0000,,so I have relatively little\Npersonal experience with this,
Dialogue: 0,0:04:18.63,0:04:21.20,Default,,0000,0000,0000,,and my experience was more typical
Dialogue: 0,0:04:21.20,0:04:23.61,Default,,0000,0000,0000,,only because I had an adolescent practice
Dialogue: 0,0:04:23.61,0:04:25.47,Default,,0000,0000,0000,,and I saw someone age 24,
Dialogue: 0,0:04:25.47,0:04:27.94,Default,,0000,0000,0000,,went through Harvard genetically female,
Dialogue: 0,0:04:27.94,0:04:29.65,Default,,0000,0000,0000,,went through Harvard with three male roommates
Dialogue: 0,0:04:29.65,0:04:31.19,Default,,0000,0000,0000,,who knew the whole story,
Dialogue: 0,0:04:31.19,0:04:34.88,Default,,0000,0000,0000,,a registrar who always listed his name
Dialogue: 0,0:04:34.88,0:04:36.99,Default,,0000,0000,0000,,on course lists as a male name,
Dialogue: 0,0:04:36.99,0:04:41.71,Default,,0000,0000,0000,,and came to me after graduating saying, "Help me.
Dialogue: 0,0:04:41.71,0:04:43.80,Default,,0000,0000,0000,,I know you know a lot of endocrinology,
Dialogue: 0,0:04:43.80,0:04:45.94,Default,,0000,0000,0000,,and indeed I've treated a lot of people
Dialogue: 0,0:04:45.94,0:04:47.34,Default,,0000,0000,0000,,who were born without gonads.
Dialogue: 0,0:04:47.34,0:04:49.05,Default,,0000,0000,0000,,This wasn't rocket science,
Dialogue: 0,0:04:49.05,0:04:50.79,Default,,0000,0000,0000,,but I made a deal with them:
Dialogue: 0,0:04:50.79,0:04:53.60,Default,,0000,0000,0000,,I'll treat you if you teach me.
Dialogue: 0,0:04:53.60,0:04:56.96,Default,,0000,0000,0000,,And so he did.
Dialogue: 0,0:04:56.96,0:04:58.77,Default,,0000,0000,0000,,And what an education I got
Dialogue: 0,0:04:58.77,0:05:00.45,Default,,0000,0000,0000,,from taking care of all the members
Dialogue: 0,0:05:00.45,0:05:03.26,Default,,0000,0000,0000,,of his support group.
Dialogue: 0,0:05:03.26,0:05:05.88,Default,,0000,0000,0000,,And then I got really confused,
Dialogue: 0,0:05:05.88,0:05:08.49,Default,,0000,0000,0000,,because I thought it was relatively easy at that age
Dialogue: 0,0:05:08.49,0:05:10.12,Default,,0000,0000,0000,,to just give people the hormones
Dialogue: 0,0:05:10.12,0:05:14.42,Default,,0000,0000,0000,,of the gender in which they were affirming,
Dialogue: 0,0:05:14.42,0:05:17.63,Default,,0000,0000,0000,,but then my patient married,
Dialogue: 0,0:05:17.63,0:05:20.40,Default,,0000,0000,0000,,and he married a woman
Dialogue: 0,0:05:20.40,0:05:22.10,Default,,0000,0000,0000,,who had been born as a male,
Dialogue: 0,0:05:22.10,0:05:25.79,Default,,0000,0000,0000,,had married as a male, had two children,
Dialogue: 0,0:05:25.79,0:05:31.18,Default,,0000,0000,0000,,then went through a transition into female,
Dialogue: 0,0:05:31.18,0:05:36.46,Default,,0000,0000,0000,,and now this delightful female
Dialogue: 0,0:05:36.46,0:05:40.25,Default,,0000,0000,0000,,was attached to my male patient,
Dialogue: 0,0:05:40.25,0:05:42.98,Default,,0000,0000,0000,,in fact got legally married because they showed up
Dialogue: 0,0:05:42.98,0:05:44.56,Default,,0000,0000,0000,,as a man and a woman, and who knew?
Dialogue: 0,0:05:44.56,0:05:47.67,Default,,0000,0000,0000,,Right? (Laughter)
Dialogue: 0,0:05:47.67,0:05:51.38,Default,,0000,0000,0000,,And while I was confused about,
Dialogue: 0,0:05:51.38,0:05:53.80,Default,,0000,0000,0000,,I was confused, does this make so-and-so gay?
Dialogue: 0,0:05:53.80,0:05:55.68,Default,,0000,0000,0000,,Does this make so-and-so straight?
Dialogue: 0,0:05:55.68,0:05:58.15,Default,,0000,0000,0000,,I was getting sexual orientation
Dialogue: 0,0:05:58.15,0:06:01.18,Default,,0000,0000,0000,,confused with gender identity.
Dialogue: 0,0:06:01.18,0:06:03.67,Default,,0000,0000,0000,,And my patient said to me,
Dialogue: 0,0:06:03.67,0:06:05.33,Default,,0000,0000,0000,,"Look, look, look.
Dialogue: 0,0:06:05.33,0:06:08.56,Default,,0000,0000,0000,,If you just think of the following, you'll get it right.
Dialogue: 0,0:06:08.56,0:06:11.83,Default,,0000,0000,0000,,Sexual orientation is who you go to bed with.
Dialogue: 0,0:06:11.83,0:06:17.66,Default,,0000,0000,0000,,Gender identity is who you go to bed as."
Dialogue: 0,0:06:17.66,0:06:20.17,Default,,0000,0000,0000,,And subsequently I learned from the many adults
Dialogue: 0,0:06:20.17,0:06:22.89,Default,,0000,0000,0000,,— I took care of about 200 adults —
Dialogue: 0,0:06:22.89,0:06:24.95,Default,,0000,0000,0000,,I learned from them
Dialogue: 0,0:06:24.95,0:06:27.05,Default,,0000,0000,0000,,that if I didn't look, peek as to who
Dialogue: 0,0:06:27.05,0:06:29.36,Default,,0000,0000,0000,,their partner was in the waiting room,
Dialogue: 0,0:06:29.36,0:06:31.58,Default,,0000,0000,0000,,I would never be able to guess
Dialogue: 0,0:06:31.58,0:06:33.04,Default,,0000,0000,0000,,better than chance
Dialogue: 0,0:06:33.04,0:06:35.97,Default,,0000,0000,0000,,whether they were gay, straight, bi,
Dialogue: 0,0:06:35.97,0:06:39.66,Default,,0000,0000,0000,,or asexual in their affirmed gender.
Dialogue: 0,0:06:39.66,0:06:40.98,Default,,0000,0000,0000,,In other words,
Dialogue: 0,0:06:40.98,0:06:43.76,Default,,0000,0000,0000,,one thing has absolutely nothing to do
Dialogue: 0,0:06:43.76,0:06:45.36,Default,,0000,0000,0000,,with the other.
Dialogue: 0,0:06:45.36,0:06:47.73,Default,,0000,0000,0000,,And the data show it.
Dialogue: 0,0:06:47.73,0:06:49.81,Default,,0000,0000,0000,,Now,
Dialogue: 0,0:06:49.81,0:06:52.24,Default,,0000,0000,0000,,as I took care of the 200 adults,
Dialogue: 0,0:06:52.24,0:06:54.58,Default,,0000,0000,0000,,I found it extremely painful.
Dialogue: 0,0:06:54.58,0:06:57.62,Default,,0000,0000,0000,,These people were, many of them,
Dialogue: 0,0:06:57.62,0:07:01.82,Default,,0000,0000,0000,,had to give up so much of their lives.
Dialogue: 0,0:07:01.82,0:07:04.47,Default,,0000,0000,0000,,Sometimes their parents would reject them,
Dialogue: 0,0:07:04.47,0:07:06.80,Default,,0000,0000,0000,,siblings, their own children,
Dialogue: 0,0:07:06.80,0:07:08.58,Default,,0000,0000,0000,,and then their divorcing spouse
Dialogue: 0,0:07:08.58,0:07:12.55,Default,,0000,0000,0000,,would forbid them from seeing their children.
Dialogue: 0,0:07:12.55,0:07:15.89,Default,,0000,0000,0000,,It was so awful, but why did they do it
Dialogue: 0,0:07:15.89,0:07:18.30,Default,,0000,0000,0000,,at 40 and 50?
Dialogue: 0,0:07:18.30,0:07:22.82,Default,,0000,0000,0000,,Because they felt they had to affirm themselves
Dialogue: 0,0:07:22.82,0:07:25.18,Default,,0000,0000,0000,,before they would kill themselves.
Dialogue: 0,0:07:25.18,0:07:27.78,Default,,0000,0000,0000,,And indeed, the rate of suicide
Dialogue: 0,0:07:27.78,0:07:31.32,Default,,0000,0000,0000,,among untreated transgendered people
Dialogue: 0,0:07:31.32,0:07:34.76,Default,,0000,0000,0000,,is among the highest in the world.
Dialogue: 0,0:07:34.76,0:07:37.10,Default,,0000,0000,0000,,So what to do?
Dialogue: 0,0:07:37.10,0:07:40.17,Default,,0000,0000,0000,,I was intrigued in going to a conference
Dialogue: 0,0:07:40.17,0:07:42.78,Default,,0000,0000,0000,,in Holland, where they are experts in this,
Dialogue: 0,0:07:42.78,0:07:46.56,Default,,0000,0000,0000,,and saw the most remarkable thing.
Dialogue: 0,0:07:46.56,0:07:49.92,Default,,0000,0000,0000,,They were treating young adolescents
Dialogue: 0,0:07:49.92,0:07:52.53,Default,,0000,0000,0000,,after giving them the most intense
Dialogue: 0,0:07:52.53,0:07:55.61,Default,,0000,0000,0000,,psychometric testing of gender,
Dialogue: 0,0:07:55.61,0:07:57.42,Default,,0000,0000,0000,,and they were treating them by blocking
Dialogue: 0,0:07:57.42,0:07:59.98,Default,,0000,0000,0000,,the puberty that they didn't want.
Dialogue: 0,0:07:59.98,0:08:02.84,Default,,0000,0000,0000,,Because basically, kids look about the same,
Dialogue: 0,0:08:02.84,0:08:05.49,Default,,0000,0000,0000,,each sex, until they go through puberty,
Dialogue: 0,0:08:05.49,0:08:08.28,Default,,0000,0000,0000,,at which point, if you feel you're in the wrong sex,
Dialogue: 0,0:08:08.28,0:08:11.50,Default,,0000,0000,0000,,you feel like Pinocchio becoming a donkey.
Dialogue: 0,0:08:11.50,0:08:14.12,Default,,0000,0000,0000,,The fantasy that you had that your body will change
Dialogue: 0,0:08:14.12,0:08:16.82,Default,,0000,0000,0000,,to be who you want it to be with puberty
Dialogue: 0,0:08:16.82,0:08:21.56,Default,,0000,0000,0000,,actually is nullified by the puberty you get.
Dialogue: 0,0:08:21.56,0:08:24.88,Default,,0000,0000,0000,,And they fall apart.
Dialogue: 0,0:08:24.88,0:08:27.46,Default,,0000,0000,0000,,So that's why putting the puberty on hold—
Dialogue: 0,0:08:27.46,0:08:29.87,Default,,0000,0000,0000,,Why on hold? You can't just give them
Dialogue: 0,0:08:29.87,0:08:31.60,Default,,0000,0000,0000,,the opposite hormones that young.
Dialogue: 0,0:08:31.60,0:08:33.62,Default,,0000,0000,0000,,They'll end up stunted in growth,
Dialogue: 0,0:08:33.62,0:08:35.92,Default,,0000,0000,0000,,and you think you can have\Na meaningful conversation
Dialogue: 0,0:08:35.92,0:08:38.55,Default,,0000,0000,0000,,about the fertility effects of such treatment
Dialogue: 0,0:08:38.55,0:08:42.58,Default,,0000,0000,0000,,with a 10-year old girl, a 12-year old boy?
Dialogue: 0,0:08:42.58,0:08:44.89,Default,,0000,0000,0000,,So this buys time in the diagnostic process
Dialogue: 0,0:08:44.89,0:08:46.74,Default,,0000,0000,0000,,for four or five years
Dialogue: 0,0:08:46.74,0:08:49.80,Default,,0000,0000,0000,,so that they can work it out,
Dialogue: 0,0:08:49.80,0:08:52.48,Default,,0000,0000,0000,,they can have more and more testing,
Dialogue: 0,0:08:52.48,0:08:54.53,Default,,0000,0000,0000,,they can live without feeling their bodies
Dialogue: 0,0:08:54.53,0:08:56.16,Default,,0000,0000,0000,,are running away from them.
Dialogue: 0,0:08:56.16,0:09:00.35,Default,,0000,0000,0000,,And then, in a program they call 12-16-18,
Dialogue: 0,0:09:00.35,0:09:05.22,Default,,0000,0000,0000,,around age 12 is when they\Ngive the blocking hormones,
Dialogue: 0,0:09:05.22,0:09:07.88,Default,,0000,0000,0000,,and then at age 16 with retesting,
Dialogue: 0,0:09:07.88,0:09:09.99,Default,,0000,0000,0000,,they requalify.
Dialogue: 0,0:09:09.99,0:09:13.19,Default,,0000,0000,0000,,Now remember, the blocking\Nhormones are reversible,
Dialogue: 0,0:09:13.19,0:09:16.12,Default,,0000,0000,0000,,but when you give the hormones of the opposite sex,
Dialogue: 0,0:09:16.12,0:09:18.75,Default,,0000,0000,0000,,you now start spouting breasts and facial hair
Dialogue: 0,0:09:18.75,0:09:20.85,Default,,0000,0000,0000,,and voice, depending on what you're using,
Dialogue: 0,0:09:20.85,0:09:23.12,Default,,0000,0000,0000,,and those effects are permanent
Dialogue: 0,0:09:23.12,0:09:25.20,Default,,0000,0000,0000,,or require surgery to remove
Dialogue: 0,0:09:25.20,0:09:26.42,Default,,0000,0000,0000,,or electrolysis,
Dialogue: 0,0:09:26.42,0:09:28.79,Default,,0000,0000,0000,,and you can never really affect the voice.
Dialogue: 0,0:09:28.79,0:09:33.09,Default,,0000,0000,0000,,So this is serious, and this is 15, 16-year old stuff.
Dialogue: 0,0:09:33.09,0:09:36.25,Default,,0000,0000,0000,,And then at 18, they're eligible for surgery,
Dialogue: 0,0:09:36.25,0:09:40.59,Default,,0000,0000,0000,,and while there's no good surgery\Nfor females to males genitally,
Dialogue: 0,0:09:40.59,0:09:45.36,Default,,0000,0000,0000,,the male-to-female surgery\Nhas fooled gynecologists.
Dialogue: 0,0:09:45.36,0:09:48.12,Default,,0000,0000,0000,,That's how good it can be.
Dialogue: 0,0:09:48.12,0:09:51.98,Default,,0000,0000,0000,,So I looked at how the patients were doing,
Dialogue: 0,0:09:51.98,0:09:54.99,Default,,0000,0000,0000,,and I looked at patients who\Njust look like everybody else.
Dialogue: 0,0:09:54.99,0:09:57.43,Default,,0000,0000,0000,,They look, except they were pubertally delayed.
Dialogue: 0,0:09:57.43,0:09:59.49,Default,,0000,0000,0000,,But once they gave them the hormones
Dialogue: 0,0:09:59.49,0:10:01.100,Default,,0000,0000,0000,,consistent with the gender they affirm,
Dialogue: 0,0:10:01.100,0:10:03.98,Default,,0000,0000,0000,,they look beautiful.
Dialogue: 0,0:10:03.98,0:10:07.74,Default,,0000,0000,0000,,They look normal. They had normal heights.
Dialogue: 0,0:10:07.74,0:10:09.98,Default,,0000,0000,0000,,You would never be able to pick them out
Dialogue: 0,0:10:09.98,0:10:12.57,Default,,0000,0000,0000,,in a crowd.
Dialogue: 0,0:10:12.57,0:10:14.93,Default,,0000,0000,0000,,So at that point, I decided I'm going to do this.
Dialogue: 0,0:10:14.93,0:10:17.50,Default,,0000,0000,0000,,This is really where the pediatric,
Dialogue: 0,0:10:17.50,0:10:19.49,Default,,0000,0000,0000,,endocrine realm comes in,
Dialogue: 0,0:10:19.49,0:10:21.47,Default,,0000,0000,0000,,because in fact, if you're going to deal with it
Dialogue: 0,0:10:21.47,0:10:24.15,Default,,0000,0000,0000,,in kids age 10-12, 10-14,
Dialogue: 0,0:10:24.15,0:10:27.43,Default,,0000,0000,0000,,that's pediatric endocrinology.
Dialogue: 0,0:10:27.43,0:10:31.21,Default,,0000,0000,0000,,So I brought some kids in,
Dialogue: 0,0:10:31.21,0:10:33.87,Default,,0000,0000,0000,,and this now became the standard of care,
Dialogue: 0,0:10:33.87,0:10:36.63,Default,,0000,0000,0000,,and Children's Hospital was behind it,
Dialogue: 0,0:10:36.63,0:10:41.07,Default,,0000,0000,0000,,by my showing them the kids before and after,
Dialogue: 0,0:10:41.07,0:10:42.42,Default,,0000,0000,0000,,people who never got treated
Dialogue: 0,0:10:42.42,0:10:44.94,Default,,0000,0000,0000,,and people who wished to be treated,
Dialogue: 0,0:10:44.94,0:10:48.09,Default,,0000,0000,0000,,and pictures of the Dutch,
Dialogue: 0,0:10:48.09,0:10:49.22,Default,,0000,0000,0000,,they came to me and said,
Dialogue: 0,0:10:49.22,0:10:51.21,Default,,0000,0000,0000,,"You gotta do something for these kids."
Dialogue: 0,0:10:51.21,0:10:54.52,Default,,0000,0000,0000,,Well, where were these kids before?
Dialogue: 0,0:10:54.52,0:10:57.67,Default,,0000,0000,0000,,They were out there suffering, is where they were.
Dialogue: 0,0:10:57.67,0:11:03.98,Default,,0000,0000,0000,,So we started a program in 2007.
Dialogue: 0,0:11:03.98,0:11:06.14,Default,,0000,0000,0000,,It became the first program of its kind,
Dialogue: 0,0:11:06.14,0:11:08.73,Default,,0000,0000,0000,,but it's really of the Dutch kind,
Dialogue: 0,0:11:08.73,0:11:10.87,Default,,0000,0000,0000,,in North America.
Dialogue: 0,0:11:10.87,0:11:15.07,Default,,0000,0000,0000,,And since then, we have 160 patients.
Dialogue: 0,0:11:15.07,0:11:18.35,Default,,0000,0000,0000,,Did they come from Afghanistan? No.
Dialogue: 0,0:11:18.35,0:11:21.62,Default,,0000,0000,0000,,They came, 75 percent of them came
Dialogue: 0,0:11:21.62,0:11:26.69,Default,,0000,0000,0000,,from within 150 miles of Boston.
Dialogue: 0,0:11:26.69,0:11:30.09,Default,,0000,0000,0000,,And some came from England.
Dialogue: 0,0:11:30.09,0:11:33.90,Default,,0000,0000,0000,,Jackie had been abused in Midlands, England.
Dialogue: 0,0:11:33.90,0:11:35.92,Default,,0000,0000,0000,,She's 12 years old there,
Dialogue: 0,0:11:35.92,0:11:37.27,Default,,0000,0000,0000,,she was living as a girl
Dialogue: 0,0:11:37.27,0:11:39.42,Default,,0000,0000,0000,,but she was being beaten up.
Dialogue: 0,0:11:39.42,0:11:40.48,Default,,0000,0000,0000,,It was a horror show.
Dialogue: 0,0:11:40.48,0:11:42.47,Default,,0000,0000,0000,,They had to home school her.
Dialogue: 0,0:11:42.47,0:11:45.22,Default,,0000,0000,0000,,And the reason the British were coming was
Dialogue: 0,0:11:45.22,0:11:48.59,Default,,0000,0000,0000,,because they would not treat anybody
Dialogue: 0,0:11:48.59,0:11:50.53,Default,,0000,0000,0000,,with anything under age 16,
Dialogue: 0,0:11:50.53,0:11:52.32,Default,,0000,0000,0000,,which means they were consigning them
Dialogue: 0,0:11:52.32,0:11:55.78,Default,,0000,0000,0000,,to an adult body, no matter what happened,
Dialogue: 0,0:11:55.78,0:11:57.81,Default,,0000,0000,0000,,even if they tested them well.
Dialogue: 0,0:11:57.81,0:12:00.18,Default,,0000,0000,0000,,Jackie, on top of it, was,
Dialogue: 0,0:12:00.18,0:12:02.75,Default,,0000,0000,0000,,by virtue of skeletal markings,
Dialogue: 0,0:12:02.75,0:12:06.84,Default,,0000,0000,0000,,destined to be six feet five, okay?
Dialogue: 0,0:12:06.84,0:12:08.81,Default,,0000,0000,0000,,And yet, she had just begun
Dialogue: 0,0:12:08.81,0:12:10.96,Default,,0000,0000,0000,,a male puberty.
Dialogue: 0,0:12:10.96,0:12:14.41,Default,,0000,0000,0000,,Well, I did something a little bit innovative,
Dialogue: 0,0:12:14.41,0:12:16.36,Default,,0000,0000,0000,,because I do know hormones,
Dialogue: 0,0:12:16.36,0:12:18.43,Default,,0000,0000,0000,,and that estrogen is much more potent
Dialogue: 0,0:12:18.43,0:12:22.14,Default,,0000,0000,0000,,in closing epiphyses, the growth plates,
Dialogue: 0,0:12:22.14,0:12:25.45,Default,,0000,0000,0000,,and stopping growth, than testosterone is.
Dialogue: 0,0:12:25.45,0:12:27.84,Default,,0000,0000,0000,,So we blocked her testosterone
Dialogue: 0,0:12:27.84,0:12:30.40,Default,,0000,0000,0000,,with a blocking hormone,
Dialogue: 0,0:12:30.40,0:12:34.74,Default,,0000,0000,0000,,but we added estrogen, not at 16, but at 13.
Dialogue: 0,0:12:34.74,0:12:38.25,Default,,0000,0000,0000,,And so here she is at 16, on the left.
Dialogue: 0,0:12:38.25,0:12:40.25,Default,,0000,0000,0000,,And on her 16th birthday, she went to Thailand,
Dialogue: 0,0:12:40.25,0:12:42.40,Default,,0000,0000,0000,,where they would do a genital plastic surgery.
Dialogue: 0,0:12:42.40,0:12:44.30,Default,,0000,0000,0000,,They will do it at 18 now.
Dialogue: 0,0:12:44.30,0:12:47.16,Default,,0000,0000,0000,,And she ended up 5'11"
Dialogue: 0,0:12:47.16,0:12:50.47,Default,,0000,0000,0000,,but more than that, she has normal breast size,
Dialogue: 0,0:12:50.47,0:12:52.73,Default,,0000,0000,0000,,because by blocking testosterone,
Dialogue: 0,0:12:52.73,0:12:54.36,Default,,0000,0000,0000,,every one of our patients
Dialogue: 0,0:12:54.36,0:12:56.24,Default,,0000,0000,0000,,has normal breast size
Dialogue: 0,0:12:56.24,0:13:00.41,Default,,0000,0000,0000,,if they get to us at the appropriate age, not too late.
Dialogue: 0,0:13:00.41,0:13:02.69,Default,,0000,0000,0000,,And on the far right, there she is.
Dialogue: 0,0:13:02.69,0:13:04.41,Default,,0000,0000,0000,,She went public,
Dialogue: 0,0:13:04.41,0:13:07.49,Default,,0000,0000,0000,,semifinalist in the Ms. England competition.
Dialogue: 0,0:13:07.49,0:13:09.03,Default,,0000,0000,0000,,Okay?
Dialogue: 0,0:13:09.03,0:13:12.00,Default,,0000,0000,0000,,The judges debates as to, can they do this?
Dialogue: 0,0:13:12.00,0:13:13.87,Default,,0000,0000,0000,,Can they make her—?
Dialogue: 0,0:13:13.87,0:13:16.16,Default,,0000,0000,0000,,And one of them quipped, I'm told,
Dialogue: 0,0:13:16.16,0:13:18.21,Default,,0000,0000,0000,,"But she has more natural self
Dialogue: 0,0:13:18.21,0:13:20.14,Default,,0000,0000,0000,,than half the other contestants."
Dialogue: 0,0:13:20.14,0:13:22.11,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:13:22.11,0:13:26.32,Default,,0000,0000,0000,,And some of them have been rearranged a little bit,
Dialogue: 0,0:13:26.32,0:13:29.63,Default,,0000,0000,0000,,but it's all her DNA.
Dialogue: 0,0:13:29.63,0:13:32.95,Default,,0000,0000,0000,,And she's become a remarkable spokeswoman.
Dialogue: 0,0:13:32.95,0:13:36.96,Default,,0000,0000,0000,,And she was offered contracts as a model,
Dialogue: 0,0:13:36.96,0:13:38.80,Default,,0000,0000,0000,,at which point she teased me, where she said,
Dialogue: 0,0:13:38.80,0:13:41.50,Default,,0000,0000,0000,,"You know, I might have had a better chance
Dialogue: 0,0:13:41.50,0:13:43.61,Default,,0000,0000,0000,,as a model if you'd made me six feet one."
Dialogue: 0,0:13:43.61,0:13:48.06,Default,,0000,0000,0000,,Go figure. (Laughter)
Dialogue: 0,0:13:48.06,0:13:51.71,Default,,0000,0000,0000,,So this picture, I think, says it all.
Dialogue: 0,0:13:51.71,0:13:53.46,Default,,0000,0000,0000,,It really says it all.
Dialogue: 0,0:13:53.46,0:13:57.31,Default,,0000,0000,0000,,These are Nicole and brother Jonas,
Dialogue: 0,0:13:57.31,0:14:00.13,Default,,0000,0000,0000,,identical twin boys,
Dialogue: 0,0:14:00.13,0:14:02.70,Default,,0000,0000,0000,,and proven to be identical,
Dialogue: 0,0:14:02.70,0:14:05.19,Default,,0000,0000,0000,,in which Nicole had affirmed herself
Dialogue: 0,0:14:05.19,0:14:07.42,Default,,0000,0000,0000,,as a girl as early as age three.
Dialogue: 0,0:14:07.42,0:14:09.92,Default,,0000,0000,0000,,At age seven, they changed her name,
Dialogue: 0,0:14:09.92,0:14:13.13,Default,,0000,0000,0000,,and came to me at the very beginnings
Dialogue: 0,0:14:13.13,0:14:14.78,Default,,0000,0000,0000,,of a male puberty.
Dialogue: 0,0:14:14.78,0:14:16.34,Default,,0000,0000,0000,,Now you can imagine looking at Jonas
Dialogue: 0,0:14:16.34,0:14:18.10,Default,,0000,0000,0000,,at only 14 that male puberty
Dialogue: 0,0:14:18.10,0:14:20.62,Default,,0000,0000,0000,,is early in this family,
Dialogue: 0,0:14:20.62,0:14:22.87,Default,,0000,0000,0000,,because he looks more like a 16-year old,
Dialogue: 0,0:14:22.87,0:14:24.71,Default,,0000,0000,0000,,but it makes the point all the more
Dialogue: 0,0:14:24.71,0:14:26.37,Default,,0000,0000,0000,,why you have to be conscious
Dialogue: 0,0:14:26.37,0:14:28.32,Default,,0000,0000,0000,,of where the patient is.
Dialogue: 0,0:14:28.32,0:14:32.28,Default,,0000,0000,0000,,Nicole has done pubetal blockade in here,
Dialogue: 0,0:14:32.28,0:14:36.07,Default,,0000,0000,0000,,and Jonas has just going, biologic control.
Dialogue: 0,0:14:36.07,0:14:37.61,Default,,0000,0000,0000,,This is what Nicole would look like
Dialogue: 0,0:14:37.61,0:14:39.79,Default,,0000,0000,0000,,if we weren't doing what we were doing.
Dialogue: 0,0:14:39.79,0:14:42.18,Default,,0000,0000,0000,,He's got a prominent Adam's apple.
Dialogue: 0,0:14:42.18,0:14:45.89,Default,,0000,0000,0000,,He's got angular bones to the face, a mustache,
Dialogue: 0,0:14:45.89,0:14:47.41,Default,,0000,0000,0000,,and you can see there's a height difference
Dialogue: 0,0:14:47.41,0:14:48.71,Default,,0000,0000,0000,,because he's gone through
Dialogue: 0,0:14:48.71,0:14:50.75,Default,,0000,0000,0000,,a growth spurt that she won't get.
Dialogue: 0,0:14:50.75,0:14:52.63,Default,,0000,0000,0000,,Now Nicole is on estrogen.
Dialogue: 0,0:14:52.63,0:14:55.92,Default,,0000,0000,0000,,She has a bit of a form to her.
Dialogue: 0,0:14:55.92,0:14:59.23,Default,,0000,0000,0000,,This family went to the White House last spring
Dialogue: 0,0:14:59.23,0:15:01.85,Default,,0000,0000,0000,,because of their work
Dialogue: 0,0:15:01.85,0:15:05.24,Default,,0000,0000,0000,,in overturning an anti-discrimination,
Dialogue: 0,0:15:05.24,0:15:08.09,Default,,0000,0000,0000,,there was a bill that would block
Dialogue: 0,0:15:08.09,0:15:10.34,Default,,0000,0000,0000,,the right of transgender people in Maine
Dialogue: 0,0:15:10.34,0:15:12.02,Default,,0000,0000,0000,,to use public bathrooms,
Dialogue: 0,0:15:12.02,0:15:15.14,Default,,0000,0000,0000,,and it looked like the bill was going to pass,
Dialogue: 0,0:15:15.14,0:15:16.52,Default,,0000,0000,0000,,and that would have been a problem,
Dialogue: 0,0:15:16.52,0:15:20.13,Default,,0000,0000,0000,,but Nicole went personally\Nto every legislator in Maine
Dialogue: 0,0:15:20.13,0:15:22.21,Default,,0000,0000,0000,,and said, "I can do this.
Dialogue: 0,0:15:22.21,0:15:24.16,Default,,0000,0000,0000,,If they see me, they'll understand
Dialogue: 0,0:15:24.16,0:15:26.22,Default,,0000,0000,0000,,why I'm no threat in the lady's room,
Dialogue: 0,0:15:26.22,0:15:28.56,Default,,0000,0000,0000,,but I can be threatened in the men's room."
Dialogue: 0,0:15:28.56,0:15:31.100,Default,,0000,0000,0000,,And then they finally got it.
Dialogue: 0,0:15:31.100,0:15:35.02,Default,,0000,0000,0000,,So where do we go from here?
Dialogue: 0,0:15:35.02,0:15:37.41,Default,,0000,0000,0000,,Well, we still have a ways to go
Dialogue: 0,0:15:37.41,0:15:39.03,Default,,0000,0000,0000,,in terms of anti-discrimination.
Dialogue: 0,0:15:39.03,0:15:40.44,Default,,0000,0000,0000,,There are only 17 states that have
Dialogue: 0,0:15:40.44,0:15:42.51,Default,,0000,0000,0000,,an anti-discrimination law
Dialogue: 0,0:15:42.51,0:15:45.46,Default,,0000,0000,0000,,against discrimination in housing,
Dialogue: 0,0:15:45.46,0:15:48.27,Default,,0000,0000,0000,,employment, public accommodation,
Dialogue: 0,0:15:48.27,0:15:51.56,Default,,0000,0000,0000,,only 17 states, and five of them are in New England.
Dialogue: 0,0:15:51.56,0:15:53.35,Default,,0000,0000,0000,,We need less expensive drugs.
Dialogue: 0,0:15:53.35,0:15:54.79,Default,,0000,0000,0000,,They cost a fortune.
Dialogue: 0,0:15:54.79,0:15:56.96,Default,,0000,0000,0000,,And we need to get this condition
Dialogue: 0,0:15:56.96,0:15:59.00,Default,,0000,0000,0000,,out of the DSM.
Dialogue: 0,0:15:59.00,0:16:01.61,Default,,0000,0000,0000,,It is as much a psychiatric disease
Dialogue: 0,0:16:01.61,0:16:03.41,Default,,0000,0000,0000,,as being gay and lesbian,
Dialogue: 0,0:16:03.41,0:16:06.38,Default,,0000,0000,0000,,and that went out the window in 1973,
Dialogue: 0,0:16:06.38,0:16:08.22,Default,,0000,0000,0000,,and the whole world changed.
Dialogue: 0,0:16:08.22,0:16:10.95,Default,,0000,0000,0000,,And this isn't going to break anybody's budget.
Dialogue: 0,0:16:10.95,0:16:13.07,Default,,0000,0000,0000,,This is not that common.
Dialogue: 0,0:16:13.07,0:16:17.70,Default,,0000,0000,0000,,But the risks of not doing anything for them
Dialogue: 0,0:16:17.70,0:16:21.92,Default,,0000,0000,0000,,not only puts all of them at risk
Dialogue: 0,0:16:21.92,0:16:24.37,Default,,0000,0000,0000,,of losing their lives to suicide,
Dialogue: 0,0:16:24.37,0:16:27.07,Default,,0000,0000,0000,,but it also says something about
Dialogue: 0,0:16:27.07,0:16:30.86,Default,,0000,0000,0000,,whether we are a truly inclusive society.
Dialogue: 0,0:16:30.86,0:16:33.43,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:16:33.43,0:16:35.100,Default,,0000,0000,0000,,(Applause)