First, Do No Harm? Pediatric Transgender Procedures, Detransition & Medical Ethics

What Actually Happened?

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0:54 Welcome back for the Monday edition of Doc G and the Discussants on sabbatical. In the studio is Sarah On the line is the professor, and today we have a fairly serious set of questions and a serious subject matter. The title of this show, the working title, is First Do No Harm. And it's meant to describe the situation with minors and transgender surgery. These are children who have to have surgeries approved by their parents in order to get the surgeries. The administration has taken a hard line against this.

1:59 Donald Trump and the rest of his administration are not fans at all as are most people on the right. The question boils down to who is responsible for protecting children? And it seems like there's about, I won't say half the country, but a big percentage of the country who don't believe that this is anything other than just a rite of passage at this point. Let's let, Ainsley Earhart, she was interviewing a doctor who has taken issue with this and the do no harm phrase, which is not actually in the Hippocratic Oath, but it's paraphrased.

2:52 Let's go to Ainsley. change hormones and the surgeries. 17 states currently cover some form of gender affirming care, and more than 3 ,000 such surgeries were performed on minors in the United States between 2016 and 2020. CMS Administrator Dr. Mehmet Oz says the decision is, quote, consistent with the Trump administration's commitment to protect children from experimental and life -altering sex -rejecting procedures that carry serious long -term health risks and lack sufficiently reliable evidence of clinical benefit.

3:33 Donald Trump, he put on truth. He said, we are not going to pay for our innocent children to undergo these barbaric surgeries and practices which result in unthinkable and irreversible harm to their young bodies. Thanks to our strong position and pressure on this issue over the past year and a half, dozens of US hospitals have already ended their so -called gender -affirming care and we expect many more to follow. Just think about all the young, innocent, and perhaps confused children with Donald Trump ending the federal funding.

3:59 Medicaid's not going to pay for this anymore. Do you think that will decrease the amount of surgeries we're going to see in our country? Or will parents find a way? Yeah, so let's look at how this all started. In 2016, New York State mandated that Medicaid provide these services so there was an explosion overnight so now all of a sudden these surgeries that were not being reimbursed we're currently we're now all of a sudden being reimbursed there's tremendous financial incentive for these institutions to provide these services and they need to get back to practicing medicine based on evidence not on ideology and certainly not based on money.

4:38 Yeah, so there's a couple of an opinion a doctor that said that during his residency he really didn't have much choice, but to support these things I as a legislative staffer watched several hearings over about six years Where little kids would be led into legislative hearings? House Senate hearings And I'm going to say something that's completely, really subjective, but it was the opinion of most. We saw a lot of little kids, and I'm talking about little kids, that didn't look very happy. Many times they were dirty.

5:23 We would see often little boys with painted fingernails that were chipped. in a dirty dress, little boys roll around the floor, those kinds of things. But they were always with parents who were gung -ho for their rights while the child sort of looked confused at best. And so it would always come to discussions in Little Circle, now who's fighting harder? Who really wants this? I think that this is a very common -sense thing and, spoiler alert, I am completely down with this policy. And I hope that they can put more teeth in it.

6:12 There's been some talk of criminalization. So just exactly what happened. What touched the idea off for this show was the Texas Children's Hospital settlement. And there, they reached a federal agreement involving pediatric gender transition surgery. I'm going to try not to use the word care. Because I don't think it's care at all So I'm gonna try to leave that out of there. That's politically charged speech words CMS has finalized a nationwide Medicare and ship funding restriction and the major medical associations continue to defend access to evidence -based gender affirming surgery those positions cannot simply be blended together easily.

7:05 So in the Texas children's case, the public settlement requires more than 10 million in payments, permanent secession of the specified pediatric procedures, a multidisciplinary detransition clinic to try to reverse some of this harm with qualifying care funded for that I will call care. uh... funded for five years and major compliance changes uh... texas children's however did not admit any liability five doctors were suspended permanently and there were different levels uh... that's uh... which is very interesting because some of these doctors are not allowed to practice in Texas children's ever again they have no privileges there while there are many others who were reprimanded they got things like things in their files those kinds of things but five were singled out and in the public settlement that I read There was no real reason why they were so much worse to the degree that they not only cannot work there anymore, but they can never be hired there again.

8:21 So, you know, it's not just Texas now. The DOJ later this week announced agreements with Cleveland Clinic and Connecticut Children's Hospital. At Connecticut Children's That became the third hospital in the DOJ's national investigation. And they agreed to stop specified procedures and provide an additional 500 ,000 in medical, again, I'll say care for people dealing with the consequences of prior treatment. So there you have it. That's sort of what happened all kind of at once. And we were saying a little bit earlier, and the doctor sort of affirmed some of our suspicions, I think the professor's suspicion in general.

9:15 Well, I don't know. Let's be left -wing and liberal. Go ahead and break up that baby in the uterus and vacuum it out. And that little boy over there, let's cut off his penis and testicles. By the way, don't forget you need to form some sort of vagina. So think blue. Go blue. Act blue. It's Dr. Frankenstein type of territory that we're in. I've always thought so. I've always felt so. I have to go back to parents though. I mean if my son at six decided that he wants to be. Well, he's a girl. I'm not going to let him wear a dress to school just because he thinks he wants to be a girl today because of the the things he's going to go to at school.

10:14 So I mean, I don't know. It just doesn't make any sense to me. I think as a parent I should have more responsibility than to let my child decide anything. that age because they might want to be a fireman today tomorrow he might want to be a Teenage Mutant Ninja Turtle I don't know that was a go away I'm sorry I'm sorry That's coming up in a segment down the road where we're going to try to assign who's actually responsible here. But no problem talking about it a little bit now. In fact, it's a great tease, but that's coming up.

11:00 I'll share this story. And another legislative hearing legislator asked a parent sort of the question you asked if your child decided that they wanted to be a kitty cat tomorrow What would be what would be the difference? Yeah, well and he asks very seriously, what is the difference? That was lambasted by everyone on the other side of the issue in the room as being insensitive, as whatever, homophobic, those sorts of things. But it was nothing wrong with the question. Why can't I be anything I imagine?

11:51 Why not? Yeah, and so, you know, what they'll do is when you ask a serious question about just how far will you go to indulge a childish wish at whatever particular point in their life. It may be even a little more than a wish, but they're still children. And that was discounted out of hand as somebody who is too insensitive to discuss the topic seriously. You're everything phobic. Right. And it was just discussed or dismissed out of hand. And that's how those debates are handled when you get down to the serious questions.

12:32 Well, we've got a lot of serious questions coming up. Got about a couple of minutes and we'll be back. When we do, let's take a look at Now the fight moves from individual hospitals to the evidence itself, because the federal government and the medical establishment are reaching opposite conclusions. The discussion continues in just a moment. While we take a break, go to docgandthediscussants .com. Meet the Discussants. Catch another episode. Support the show. Visit the shop or tell your favorite cast member exactly what's on your mind.

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Who Is Right About the Evidence?

16:59 to discuss, but I think it bears a strong look.

17:08 We've been seeing celebrities over the past 10 years or so deciding that their children can sort of pick their gender when they get old enough to do so. We see them dressed as little girls and then little boys and then back to little boys and you know the hodgepodge of whatever happens in between which I think is an abdication. of responsibility for certain, especially about such a personal issue, it's amazing. So the new federal rule that we talked about was the CMS, the Children's Medical Society, finalized a rule ending the federal Medicaid and CHIP share for specified puberty blockers.

17:55 cross -sex hormones and surgeries for minors. It takes effect October 13th with a limited tapering period for some current hormone therapy patients. It does not in itself make these procedures, as I said earlier, nationally illegal, and mental health services remain covered, however, which I'm gonna go pick a bone with right now. I'm not so sure it isn't the mental health services that cause this thing in the beginning. So what is the medical, what do they have to say? What does the medical establishment say?

18:37 The AMA says its policy is unchanged and continues to support gender -affirming surgeries as medically necessary when evidence -based. The American Association of Physicians likewise continues to support access to comprehensive gender -affirming surgeries and has criticized government restrictions as interference with the physician -patient relationship. So a lot of this was couched in suicide and self -harm. There were some phony studies that were proffered. I listened to them in hearings where they would come in and say, if these things are not done, we're looking at higher chances of suicide among adolescents who are going through these things.

19:31 Gender dysphoric young people can experience serious psychological distress and elevated suicidality. But elevated risk is not the same thing as proving that a particular intervention prevents suicide. So the key distinction here is high suicide risk does not by itself prove that a particular treatment prevents suicide. But Think a lot of very Impressional parents have been sold on the idea that if I don't do this That my young person is going to lose their life So now that adds another wrinkle Do we have terrified parents who are turning to this when all else fails at least in their mind?

20:19 How does that strike you Sarah? Well again, I'm the parent I just I don't think kids don't know what they want or what they need and that changes from day to day and as a parent I'm not going to allow it pure and simple I'm the parent it's my responsibility I mean you're gonna you're gonna let a little kid say well I'll run away oh I mean, it's kind of along the same line. It sort of is. It's a degree of magnitude or two higher. But I can see where it might influence a decision. Professor, ideas on this?

21:13 Yeah, I don't think today's parents are, frankly, in most cases, that bright. I don't think they were raised. By their parents, they were just allowed to grow and BS was placated and all that. Now, their parents, and they're susceptible to all kinds of crap. It seems like perversion and corruption have permeated the AMA, and the drug manufacturers make a lot of money, too. So really, all that matters is that the doctors and the drug makers are pulling in dollars. Why would they care about the well -being of the citizenry?

21:50 Yeah, that's what is, I guess, most distressing to me. Let's go back to Norman Rockwell's America, where you walk down the street to good old kindly Doc Smith. He gave you your physical for school, handed you a lollipop and a pep talk for your year, and was genuinely concerned about... you and your well -being and your family's well -being, that was his business. I don't think at least the Doc Smith I saw would have allowed this sort of thing and he certainly wouldn't have endorsed it in any way.

22:31 So just to add to the Doc Smith story a little bit, again, another legislative hearing where the question was DEI initiatives in medical school I saw medical school deans, students, presidents of particular colleges come in and say that this was essential for these physicians to know how to treat minority communities and communities of color, which shocked. me in that particular profession because the last I checked the human body is the human body and we're not getting into those sorts of issues and so there is sort of the explanation DEI has corrupted.

23:24 Even medical schools at this point, I saw it firsthand. It's not every American medical association that's going along with this without any question whatsoever. The American Society of Plastic Surgeons They seem to be taking a different take. Welcome back. The American Society of Plastic Surgeons has become the very first major medical group to oppose so -called gender -affirming surgeries for minors. Joining us now to talk about this is the author of The Miracles Among Us, Fox News senior medical analyst Dr. Mark Siegel.

23:58 Doctor, thanks for your time today. Good to see you, Bill. Likewise, so the American Society of Plastic Surgeons, what they say carries a lot of weight. They're made up of 11 ,000 plastic surgeries, which includes about 90 % of the plastic surgeons in both the United States and Canada. Here's the statement they're putting out on this quote. ASPS concludes there is insufficient evidence demonstrating a favorable risk benefit ratio for the pathway of gender related endocrine and surgical interventions in children and adolescents.

24:30 ASPS recommends that surgeons delay. gender -related breast slash chest genital and facial surgery until a patient is at least 19 years old. That puts them in line now with the United Kingdom and most of Europe and it's very important because as you said plastic surgeons tend to follow this and the American public is way on the side of this only 37 % of the American public believes that that any kind of gender -affirming care whether it's medical or surgical should be considered in minors under the age of 19, what HHS Secretary Kennedy says is the word irreversible.

25:09 That's what bothers him, and that's what bothers me, because I could make a case for some of the medication being used having long -term effects, but it's clear that surgery is very difficult to reverse, whether you're talking about, you know, breast surgery or genital surgery or even facial surgery. These are all on the... Dr. Mark Siegel, a Fox News contributor with Bill Mollugian on the difference between the society of plastic surgeons and the rest of what would seem to be the medical community, including the psychiatric community.

25:49 So that, again, sort of brings the question up, does that make any difference to us, that particular? stance on the issue from the plastic surgeons. Professor, any ideas? Well, I was just thinking. I thought it'd be kind of neat to have some guy that decides he wants to be made into a woman and he goes to the surgery. And I don't know I've read before that you can turn a penis inside and out and insert it in the lower body cavity and presto, you have a giant. I don't know if that's really true or not, but whatever.

26:24 Anyway, I would like to see some guy made into a woman and then As soon as she heals completely, then I want to see her decide to be made back into a man. Maybe she's healed in two or three months, maybe six months. And I'd like to see this person go back and forth. Like, the first half of the year, he's the she. The second half, she's the he. Then I'm going back. then I'm going back and forth and back and forth. Wouldn't that be kind of exciting? Put the breast implants in, take them out. Put them in, take them out.

26:55 Maybe leave them in and have inflatable bags with exterior ports. They can be sucked dry or filled. I think I'm all for this. This sounds like something I could consider as entertainment. Well, we were actually kind of... First, you know where I thought you were going, don't you? I thought we were headed back to the skin I live in for summer. I thought we were going to take a note, a little detour over that way, because that's how it started. But we were having a similar discussion in the night when I said to Sarah, why wouldn't it be permissible for a young lady of about 12 who tells their parents that they'd like to look more feminine?

27:39 and that they would like breast implants right this minute. That's less radical, is it not? I mean, it's sort of long. One more time. Well, I'm waiting for the day to start seeing tattoos on kids that are about 8, 9, 10 years old. I'm actually kind of surprised I'm not seeing it now. And then I think about the week after that we will start seeing maybe the type of surgery, the type of ridiculous thing that a child could ask a parent for and actually be granted that. that wish, but I am happy to see that the plastic surgeons, because they are the people who are doing this surgery, I would say more often than not, have decided that they don't like this.

28:35 Let me recommend the movie Idiocracy.

28:42 I really did think we were going to get a different kind of movie recommendation a little bit earlier. Sarah, did you have a final word before we head off to a break here? Well, I'm curious to know how much information was provided to the parents even the children but to the parents especially for for the really young ones how much information was provided what did they actually know what did they think was actually going to happen when and if they did go through this yeah well I know I kind of changed the subject there but I was sitting here and I'm like what information were they given what I mean Did they realize this was going to be a lifeline thing?

29:26 The professor has said minimal. I agree, but I also think there's probably folks that were quoted chapter and verse and wanted this done because of their political ideology. That's what I was going to say. So at that point, you have activist parents as well as activist physicians. Right. There you go. Yes. And I think that that's kind of where we're headed when we come back. Another issue entered the picture, billing, coding, and financial incentives. When we continue, you're listening to Doc G and the Discussance on sabbatical.

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34:16 Our subject today

The Child, the Parent, the Doctor the Hospita

34:17 is gender affirming, gender affirming, gender transgender surgery for children. Yes. Yes. Yes, sir. Do you remember years ago when Cher's daughter Chesney decided that she wanted to become Ches? And then there was a delay, though, because there wasn't a high -tech enough penis on the market at that time. Do you know, did Jazz ever find a high -tech penis? I think so. Wasn't it on, oh, that Larry David show? Yeah, Curb Your Enthusiasm. Curb Your Enthusiasm. They were talking about how big it was.

35:00 So evidently they did. Does high -tech mean that it... It can be stimulated and engorged to a larger size. I'm the wrong person to ask that question for certain. You know, you may need to seek expertise outside of this circle for that one because I... You know, like a baster and pump it up. That was in fact how some of those things used to work was... Was it not, if I remember right? You had like a little pump, like a marine gas tank pump that was externally... Wait a minute, did Elon Musk come up with some kind of brain chip?

35:42 Maybe that chip maybe cooked into the eyes or the... Or the nose, the sights, and the smells, and the sounds, and the ears, and that would trigger something else that would trigger yet something else. And presto, you have engorgement. Yeah. Well, you know, I certainly wouldn't put that bass, Mr. Musk. You probably put pretty good money -making idea in his head right there, as if he needs any more. But you know what, however much more Mr. Musk can make, I'm happy to see him make it if he earns it.

36:11 There aren't any socialists around here. Make it if you can, my man, and I'm happy to see you do so. Yeah, put it. So if we put a child, a parent and a physician in an examination room, they certainly do not have equal knowledge, authority or responsibility. Then add the hospital. and the insurer behind them. The child... Well, how fully can a young teenager understand the consequences involving puberty, fertility, sexual function, lifelong treatment, and... Let alone the stupid parents, let alone that.

36:51 Right. They probably are not much different in their ability to understand things. So, we're getting to the parent. The parent normally authorizes major treatment for minors, so what does a parent owe the child? How much may a parent responsibly rely on the physician's expertise? Let's move on to the physician. Well, I'm all with the Democrats. I think let's just leave the parents out of it. Why do the parents have to be involved? Send Bill off to school, and he comes back mandy. I mean, what's the problem?

37:23 Well, I think that they would love to do that. They would love to take them out of the equation. And as we've mentioned on some previous shows, If we hand them to the government to be raised now at age zero, we're likely to go a long way towards taking them out of the chain. Now let's talk about the physician. The doctor possesses specialized knowledge. The family does not. I don't know, chat, GPT, they might know about as much now. Then meaningful informed consent depends on an honest explanation of risks, expected benefits and alternatives and uncertainty.

38:02 shaded by activism, to bring up one of Sarah's words. Yeah. And for certain, that plays a part. I've seen it personally play a part. On August 13th, HHS, Secretary Kennedy released a report alleging questionable insurance coding. connected with pediatric gender procedures, including nearly 11 million in claims for patients aged 13 to 17 billed using precocious puberty diagnosis, which means they're basically over sexed at this particular age, and they were coding that as such. HHS says the findings warrant further review.

38:47 I should say so. These are government allegations. analysis not adjudicated facts at this point but I'm willing to go ahead and forecast an outcome there. I guess I'm kind of surprised because dealing with insurance companies when you do unspecified diagnosis or codes most times insurance will not pay. They do not like unspecified anything. So for them to have paid on claims like this really surprises me. So let's go a little further. How much was the insurance in on it? They're in on it. That's what I'm saying.

39:33 So why are they paying these with these diagnosis? They're in on it. But it's not that they didn't that it was nebulous. they had it coded as precocious. I mean, they had a legitimate code. They're finding another way to code this that looks legit, right?

40:05 Some of them were endocrinology codes, so that's not necessarily So again, the pages are patients ages 13 to 17 build using a precocious puberty diagnosis code. So they're being diagnosed by a physician, probably one of those who got booted out or some that were disciplined. But the way I understand it, that's a legitimate code, right? Depends on if it's unspecified. Yeah, well, but That one is certainly specified. Then there's the institutional question. If reimbursement rules or institutional incentives reward a particular course of treatment, who ensures that the medical recommendation remains centered on the patient rather than the system?

41:01 So we've basically broken down what everyone's role in this is from the children to the parents to the doctors to the insurance companies. And I'm not so sure that I'm any less convinced than when we started. Of who's responsible here. Hey, hey, don't forget the word of the day precocious puberty diagnosis code. I thought you'd like that. Did you like that? Precocious puberty diagnosis code. Here's, I'm gonna say this. Parents, and we're not talking about great big decisions like this anymore. We're talking about, let me throw a little story out here.

41:56 A little kid from up the block used to come to my brother's house for swimming. The kid would show up in a diaper. He's that little. We're talking about two, two and a half, something like that. He would should not be in a diaper. Well, OK. Opinion and probably right. Walks down the street with a phone in his hand, right? A phone. The kid had a phone now. My brother had kicked him out of his place a couple times for having a phone because his kids couldn't have phones. He didn't want them to have a phone.

42:32 A two -year -old. Yeah. And my brother had told the parents that he could come, but he could not bring his phone because kids at his place don't have phones. And his kids were quite a little bit older. That's what I'm talking about. I watched this little kid. Have you heard the Dave Chappelle joke about being in Detroit? I believe is the city and he's there at three o 'clock in the morning and he's in a limousine. He's in a bad part of town. He looks out his window and he said there's a baby standing on the corner selling, selling dope.

43:07 And that's what it put me in mind of watching this little thing walk up and down the street in the middle of the street with a phone in his hand. The phone is almost as big as the kid. So a long way around the block to say. We don't have judgment in the smallest things, either that or were extremely lazy. And if it's fashionable for the next door neighbor to have a child who's transitioning and you don't have one in your family yet, does that play a part? Oh, I think a lot of I think a lot of these people just want attention.

43:46 I mean. Really? We've all seen it. It's, oh, look at me. And if they don't get enough attention, this is how they're going to get it. Why do you think that is? I like people don't get enough attention. I don't know. I just think that there are some people that let me rephrase. Let me rephrase. Why would attention be so much more important to people than their child's well being and health? What has happened to society for? Tom weigh in whatever you think what has happened to society that parents don't pay attention to what their kids are doing anymore.

44:32 Well, didn't Sarah say lazy? I think that's part of it and earlier I said a lack of nurturing of the parents parents. So now we have in effect kids and adult bodies. producing kids. For real, for certain, and many of these homes are single parent homes. Dr. Siegel would go one step farther as would I. I believe I agree with him. Here he is on criminalization of this sort of behavior. National Society for Plastic Surgeons is saying we should police ourselves. They don't want this to be criminalized.

45:11 Almost half of the American public thinks it should be criminalized, but they would like this plastic surgeons to do this themselves, not because they're forced to, but because they think that they shouldn't do it. And I want to add one more point, Bill. Somewhere around 10 % or more of children who do transition then want to detransition. for whatever reason. So there's the question about political pressures that may be put here either by parents or schools that may actually lead to this in the first place at a time of gender confusion.

45:47 Right up against a break again, so we've got to get into a spot set and come back. But when we do come back, I don't want to leave that untouched this idea that schools may have part of the responsibility here. At the intersection of policy, politics, and culture on the World Wide Web, the Doctor is in. Doc G and the Discussants. If you'd like to introduce your business to our audience, we'd like you to consider our tremendous sponsorship opportunities. Choose from general admission, mezzanine, front row floor, backstage pass or executive producer.

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49:36 Imagine that. This is Doc G and the Discussance.

First, Do No Harm?

49:44 As we approach the last segment today, I didn't want to leave that lay in the street about schools and their possible responsibility here. That is something that has disappointed me greatly in that we have seen School boards, we've seen superintendents, we've seen principals, we've seen teachers. We have seen counselors hide what's going on with people's children at school under the pretense that if they were to divulge who they are at school, they may be disciplined at home or maybe even kicked out of their houses.

50:29 And that's the entire justification for that. So. These folks will ball face lie to parents about what's going on at school and that is certainly unethical. Anyway, you slice it. Ideas there.

50:53 I just don't know how one does not believe in a higher power than ethics. Nothing more than inefficiency. I agree, that's the subject of the Wednesday show when we sort of look at maybe a little bit more in depth about whose ethics are being profited here and who's paying the price. That's a more interesting question, although there's plenty of interesting questions here. There are schools, we've heard of them, and I'm going to give the pandemic proper credit here because it sort of drew the curtain back when parents could see through the computer to see what teachers were actually teaching, the sorts of things that kids were being taught at school and the things that they were being told.

51:49 Otherwise, I'm not sure we'd be quite as far along here, but. That's where we sort of got the idea that kids were going to school, they were changing their clothes in closets dedicated to that sort of thing, and then changing back before they got home so they could live their authentic truth at school, then come home and be who their parents thought they should be and who they were raising them to be, which I think is completely outrageous. I think criminalized. Here's Ira Stavetsky, a surgeon on do no harm.

52:31 I think that maybe this sort of says it. We're talking about children, the most vulnerable population of them all. And as physicians, we take an oath to do no harm and we failed them. I think that we also take pride on providing medicine based on evidence and if you're going to provide irreversible surgeries, life altering on minors, you better damn well have overwhelming evidence to support this and this just wasn't the case. Many of these surgeries are irreversible and how can we do that to children?

53:08 You know we absolutely need to be sure that we're doing the right thing and they're just is insufficient evidence. Yeah I was trying to find a statistic what percentage of minors that had the surgeries regretted it later in life and I asked you during the commercial do you know what that number is? I couldn't find it and what did you say? It will be very hard to find that data because these institutions are most likely going to brush it under the rug and Also, these patients may be very embarrassed to go back to the provider that had provided these surgeries, so they'll likely go somewhere else.

53:41 There is no national database that's tracking this, which I think when you're getting federally funded, I think we need to take careful analysis and records of these surgeries. That from the same Ainsley Earhart interview, that Dr. Ira Slavesky, who described during his internship that he really didn't feel comfortable saying that we are doing a disservice to children by doing this, allowing these sometimes irreversible surgeries. I would say in almost any circumstance irreversible to some degree, let alone your total dependence on drugs and hormone blockers and hormones for the remainder of your life.

54:32 This is just on its head. And I have to say the definition of evil manifest. What? Why would someone do this to a child? I'm not sure we should be doing this to adults. let alone children. Now, I saw a documentary not very long ago, and I wish I could recall the, I just now thought of it, the title of it. There were several children that were going through this transition. One of them in particular was a child that I saw in a legislative hearing, and their parents were really, really out there, advocates.

55:17 for this particular procedure. But the child, I'm going to say herself, kind of was not. And it just showed up. Then there was three or four others that were highlighted. And of the four or five, two of them had decided not to go through it by basically the end of the show. And thank God that it had gone no further than it had. or they'd be looking at a lifetime of surgeries in the other direction. I know a physician, Professor, you may know, that switched back and forth about three times. Well, it was a her, then a him, then a him, then a her, and the whole time, I believe, was a pediatrician.

56:12 And it was impossible for me to believe who would go to such a person when they couldn't make the most basic life decision for themselves to make monumental decisions for me. Now that was a long time before, you know, things got this heated. So here's some final questions. What does a child owe in this situation? What does a parent owe? Let's just start with that. What does a parent owe? We've been all around that, but what does a parent owe a child? An apology. I'm wondering if there's going to be recourse legally.

56:56 They're the person who gave the go ahead for these things. I'd like to see that. We're seeing parents go to jail for buying their children firearms that they then use irresponsibly. I see this as even more capability because they're making these decisions for their kids. I just disagree and I believe it's playing Dr. Frankenstein and I think there's a whole lot of folks out there doing it. Let's go to the professor for the final word on this one today. of NEA Today, that's National Education Association Today magazine.

57:44 On the cover it says, creating moments of awe, but wonder and curiosity soar in your classroom this school year. And it's bull -ass like that. I mean, this is supposed to be a responsible teacher, it's supposed to be nurturing a discipline. I look through the magazine and everything is buzzy. Everything is like an advertisement to go to maybe one of these. Bahamian resorts and have a good time at the bar on the beach. It's ridiculous. The whole education system is so far off base now that it seems like it's almost hopeless.

58:18 And as I said now two or three times, today's parents came up in a crap education system. They don't know what's going on. They're just kids raising kids. They think, oh, wow, let's have an enjoyable sexual experience. And if the child results, well, then I don't know. Try to cope with it. We'll do a lightspeed kid, and we can keep going on happy that way if we ignore the result of our indiscretion. We don't want any responsibility. We're certainly not going to nurture and guide and take the time and effort to point things out to the kid regarding reality and the way society is, the things to watch out for, and the way to grow successfully.

59:03 I can't disagree with a single word you've said and where education is concerned. It's creating moments of awe. We don't create enough moments of do your homework and have it finished when you come back to school and that some of this won't be very enjoyable, but it is nonetheless necessary. And it's grown ups. verbiage around school and how it should be fun and these kinds of things that have. You can't blame children for believing that it should be fun or another word useful to them. And when it's neither of those things, why wouldn't they check out?

59:49 There's a lot of learning, learning is not fun. Learning cannot be fun, can't be fun. Not real hard things are most of the time not any fun at all. Maybe finger plank class is fun. Maybe clay is fun. Maybe the field trip is fun. But there's a lot that isn't fun. And when we lead them to believe that it's all fun, we're asking for trouble. And we've done that for many, many years now. Well, wow. Once again, we're coming to the end of it. I want to thank Sarah and the professor for some fantastic conversation around this thing.

1:00:31 The truth is more interesting than fiction. Always remember that. And much more valuable than cliches or talking points. On the Wednesday show, we're going to find some problems with this argument. Doctors alter healthy bodies for cosmetic reasons all the time. While medicine usually resists requests to amputate healthy limbs, sometimes they do. Next time, where exactly is the line? You've been listening to Doc G and the Discussants. Join us next time. The discussion may be over, but there is plenty more waiting for you.

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