Dr. Kristopher Kaliebe returns to the podcast (his first visit was episode 158) to talk about the capture of psychiatry, and child and adolescent psychiatry in particular, by gender ideology. He is a child, general, and forensic psychiatrist at the University of South Florida, a former AACAP committee co-chair, one of the authors of the HHS review of pediatric gender medicine, and co-author of the first letter in the American Journal of Psychiatry to even mention the systematic reviews showing low-quality evidence for these interventions.
We start where so many of my parent coaching clients start: why is it nearly impossible to find a psychiatrist who won’t simply affirm a teenager’s declared gender identity? Dr. Kaliebe describes the spiral of silence, how taking over a single committee let activists speak for entire medical organizations, and why the same journals that discuss placebo effects for every other treatment refuse to mention them for gender medicine. We dig into the heuristics and biases driving clinicians (myside bias, availability bias, language manipulation), and I add a few from my own list: rationalizing versus being rational, the rescuer complex, and reaction formation.
We close on what good care would actually look like: treating somatic distress, recognizing OCD-style intrusive thoughts, and helping parents plan for the extinction burst that comes when they stop rewarding suicide threats.
Kristopher Kaliebe, MD, is a Professor of Psychiatry at the University of South Florida in Tampa, Florida. He is Board Certified in Psychiatry, Child and Adolescent Psychiatry, and Forensic Psychiatry. He is a Distinguished Fellow at the American Academy of Child and Adolescent Psychiatry (AACAP). His clinical work has been primarily in University clinics, Federally Qualified Health Centers and juvenile corrections. At USF, Dr. Kaliebe instructs medical students, psychiatry residents, child and adolescent psychiatry fellows, and forensic psychiatry fellows. From 2013-2021 he served as co-chair of AACAP's Media Committee. From 2016 to 2022 he was the liaison between the AACAP and the American Academy of Pediatrics. Dr. Kaliebe's publications and presentations include a wide range of topics, including the effects of digital technologies, gender, psychotherapy, corrections, mind-body medicine, nutrition, and mental health in primary care settings. He is concerned about naïve interventionalism and groupthink within the medical and mental health systems. Follow him on X @drkaliebe. Read the article, What AJP Just Published—and What It Didn’t.
[00:00:00] Start
[00:05:05] Why Parents Can't Find a Trustworthy Psychiatrist
[00:11:57] Treating a Kid Who Demands Affirmation
[00:16:07] The AJP Letter and the Silencing of Debate
[00:26:26] Heuristics and Biases Driving Clinicians
[00:36:05] Rationalizing, Rescuer Complex, and Reaction Formation
[00:45:32] Informed Consent and the Push for Activism
[00:52:32] Placebo and Nocebo Effects in Gender Medicine
[00:57:18] Why Belief in Treatment Shapes Outcomes
[01:01:16] Where Psychiatry Goes From Here
[01:09:41] Holistic Treatment, OCD, and Intrusive Thoughts
[01:16:30] Suicide Threats, Rewards, and Iatrogenic Harm
[01:21:22] Planning a Controlled Crisis
[01:24:05] Finding a Psychiatrist You Can Trust
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Show notes & transcript provided with the help of SwellAI.
Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.
Watch NO WAY BACK: The Reality of Gender-Affirming Care(our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order.Follow us on X @2022affirmation or Instagram at @affirmationgeneration.
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