Alice Dreger: Medical ethics, science, and sexuality

Alice Dreger: Medical ethics, science, and sexuality

Alice Dreger is a bioethicist, author, and powerful public voice in support of people born with atypical sex characteristics.

Alice Dreger is a bioethicist, historian, activist, and author of several influential books. She’s well known as a powerful public voice in support of rights of people born with atypical sex characteristics, such as intersex.

In this conversation, we explore the science, philosophy, and history of sex, gender, intersex, and similar topics, including:

  • Biological and social determinants of sex and gender

  • Medical treatment of people born with atypical sex characteristics

  • Ethics of sex and gender affirming medical interventions, especially in the case of children and adolescents

  • Conflicts between scientists and activists on matters relating to individual identity

… and other topics.

Watch on YouTube. Listen on Spotify, Apple Podcasts, or any other podcast platform. Read the full transcript here. Follow me on LinkedIn or Twitter/X for episodes and infrequent social commentary.

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0:00:00 Intro

0:02:20 Alice’s path to studying intersex

0:04:05 What are sex and gender?

0:08:20 Are sex and gender biologically determined?

0:10:14 Is intersex a “problem”?

0:13:00 Sexual orientation vs gender identity

0:16:34 How common is intersex?

0:22:24 Medical treatment of intersex people

0:30:23 Experience of people with intersex

0:41:21 Intersex in children and adolescents

0:44:32 Scientists vs activists

0:55:54 Galileo’s Middle Finger

0:58:21 Book recommendations

1:01:20 Advice for aspiring activists


A dialogue between science and activists

Before we get going with the conversation, I want to take a moment to acknowledge the weight of the topics we’re addressing today.

We’re exploring territory that is rife with controversy and misunderstanding, with a very dark history. This is an area that has been a place of suffering for many people, both past and present. It’s also a topic that tends to trigger and polarise people, and for this reason is one that many scientists tend to avoid.

But it's a hugely important topic, and it needs to be discussed more openly, and in public forums like this podcast. This is one of those topics that needs more science, and more open dialogue between scientists, activists, clinicians, and policy makers. Alice has been a world leading figure in championing this dialogue. It was a great pleasure to speak with her.

Thank you for reading Paradigm. This post is public so feel free to share it.



This transcript is AI-generated and may contain errors. It will be corrected and annotated with links and citations over time.

[00:00:00] Matt Geleta: I'm here with Alice Drager. Alice, thanks for joining me.

[00:00:02] Alice Dreger: Thanks so much for having me.

[00:00:03] Matt Geleta: Alice, uh, we're going to be talking about things that tend to make people a little uncomfortable. Uh, topics like intersex and transgender and autogardophilia and all those things. Many scientists and academics, uh, generally tend to shy away from these areas, as you very well know, because they can lead to very difficult scientific and personal, uh, lives.

Um, and you've experienced this firsthand at what I would say are relatively extreme levels. Uh, and yet, you continue to explore these topics, even today. I would love to, to start off with just hearing the story. What is the story? What drew you to exploring topics of this nature?

[00:00:41] Alice Dreger: Well, I really became interested in it in the mid 1990s. That's when I was doing my dissertation work at Indiana University in history and philosophy of science. And I was looking at the history of science and the history of medicine. And I was very interested in the question of what scientists and doctors did in the 19th century, so the 1800s. they came across a person who they called a hermaphrodite, so a person who had a blend of male and female sex characteristics. And the reason I was really interested in that was because it was a moment when doctors and scientists were very politically conservative and believed that there was nothing in between males and females, that they simply were two different, um, sexes that would never meet, and that's why the social culture had to remain having Separate roles for men and women. So I was really interested in what did they do when nature presented them, the fact that sex can be blurry. And so that's how I got interested in the topic. And then from there I became involved in the intersex rights movement and then ended up studying a controversy within transgender, et cetera, et cetera.

[00:01:42] Matt Geleta: Yeah, okay, well, let's, uh, let's, let's warm all the way into those, those, uh, contentious topics, but... Um, I think we should set the scene, um, about the basics of sex and gender before even getting there because I think most people feel they have a very intuitive understanding of these concepts. Um, you know, they might acknowledge that there is some vagueness in categorization of things like male and female, but, but I think on the whole, people feel that these concepts are relatively straightforward, uh, and then in reading your work, um, you know, it's quite clear that they're, that they're not, and there's a lot of nuance here.

Um, maybe let's start with the basics. You know, how should we define... sex and gender and why are these not so easy to define as categories?

[00:02:20] Alice Dreger: Well, so sex, we usually mean biological characteristics, and part of the reason it's not so easy to define is because, at least in humans, there are many different sex characteristics, and they can cross over in some circumstances. So, an example would be nipples, mammary glands, uh, genitals. Um, internal reproductive organs, like a prostate or a uterus, also sex chromosomes, various genes that contribute to sex, hormonal concentrations, so estrogen and testosterone, but also other hormones. all of these things exist in human as various kinds of bifurcated sex traits, but they're not perfectly bifurcated. In other words, they're not perfectly, you get one or the other, and you always get the perfect set. So even with sex chromosomes, we can have people who have XXY chromosomes or have XX in some of their cells and XY in some of the others of their cells, so they can be genetic mosaics. human sex in reality is pretty complicated, and most of us don't actually know much about our biological sex, except through the clues that we get. you know, by the time you reach my age, I'm 57, you've had enough scans to probably know what you've got internally and externally. But that doesn't mean I know what my chromosomes show, for example.

And I don't know what my genes would show. sex can be fairly complicated. That doesn't mean it's complicated in most people. In most people, they're either standard males or standard females. But in some percentage of folks, there's going to be crossovers or blending of various sex traits. then gender. Gender is something that used to be thought of as the same as sex. Until about the late 19th century, people thought of gender as being the same as sex. But then it became clear, partly because doctors were studying people who they call hermaphrodites, people we would now call intersex, that in fact, you could have a gender that was very clearly female.

So you were born, raised as a girl, have a girl role in society, be oriented towards men, all the things people would typically expect historically of girls. And yet inside you might have testes. And the opposite could be true also with male. So you would have somebody born obviously looking like a boy, raised as a boy, attracted to females, grew up to be in the male role, and yet later doctors would find out that person had ovaries inside. so gender really came in medicine out of the concept that couldn't quite be trusted, so sex could be sneaky and be surprising, and they wanted a very stable concept, which was a concept of gender, and that emerged around 1915, as I showed in my dissertation work, and in my first book, Hermaphrodites and the Medical Invention of Sex. So gender emerged within medicine really as a concern. not as a progressive concept, but over time, feminists took it and made it into a progressive concept by saying that we should not be judged by our bodies, we should be judged by our social roles in terms of allowing us to have broader social roles. women sort of discarded that. in the feminist movement, the idea that sex was what was important. They got rid of the idea that our ovaries, our hormones, all of that stuff is important to who we are and had instead the concept that our social roles were what is important and that we could change our social roles. Now that's obviously shifted again over time, right? Because now some feminists to the idea that they like sex and they want to have a concept of sex defining womanhood. So history has really done this sort of rollercoaster ride.

[00:05:58] Matt Geleta: Yeah, I mean that's exactly the question I was going to ask as a follow up because it is certainly sort of a very commonly stated thing today that many people believe that sex and certainly gender are almost completely divorced from anything biological. You know, they're not biologically determined and then it's a sort of very stark dividing line.

There's another camp that falls on the exact opposite side and then, you know. thinks that, uh, that sex and gender are both completely biologically determined. Um, so, so what's, what's going on here? To what extent are these concepts biologically determined versus not?

[00:06:34] Alice Dreger: Well, biology has a reality, obviously. But what we decide to do with that biological reality is a political decision. And so throughout history, people have waged debates and sometimes wars over the question of what sex is, and where you put the borders on it. That's obviously become much more intense today in our culture, so you've got a much more intense argument around that. But what I would say is that biology offers us a whole bunch of options, and humans decide where to draw those lines. biology is not going to decide for us where to draw those lines. So when people ask me, well, what is really a woman? I always say to them, I don't really know. I could tell you historically at a given moment what counts. And to me, that's what's interesting is that historically that definition keeps on changing. as you probably know from my work, my inclination is to let people be. That if they want to identify that way, I don't see a reason to have lots of, um, around it, except I am sympathetic to the idea that people want to have spaces that are safe, and they want to have the idea of women's sports being competitive within a certain biological class, and we can get into that, but my own feeling is if we want to maintain biological classes within sports, we should just be honest and call them hormonal classes.

We should have low T classes and high T classes and not call them men and women.

[00:07:53] Matt Geleta: Yeah, yeah. Well, is it a problem then that some people don't fall into one of those very clear sort of binary categories, whatever dimension you want to cut it, if it's hormonally, if it's, um, whatever, you know, on, on many characteristics of, of like a human life, you know, pick high to pick anything, um, we wouldn't consider it to be a problem in any sense if, if people don't fall into very specific categories, but for some reason, this topic in particular, Um, you know, it doesn't sort of have that flavor to most people and, uh, intersex in particular, you know, somebody who maybe is born with ambiguous sex characteristics, but is otherwise perfectly functioning, um, it should, I mean, to what extent is that actually a problem versus not?

And if not, why? Why is it treated as a problem to so many people?

[00:08:43] Alice Dreger: Yeah, being born intersex does not have to be a problem. And in various times and places, it was not such a problem as it is treated today. So that's part of what my work has been about is documenting intersex was Part of normal life. And in many cultures, it is. part of normal life. But once medicine and science got control over identity in many ways, then they were the ones controlling what was a problem and what was not a problem. Some forms of intersex, by the way, do come with medical problems. So I don't want to pretend that that's not the case. Some of the forms of intersex come with underlying hormonal problems that can be dangerous. Or they can come with very high risks of cancer of the gonads in some circumstances. But in many cases, intersex is benign, and it does not have to be, um, fixed socially or biologically. Obviously, if you want a system that categorizes people into only two categories, you have to decide where those people fit. And there's a decision made. And historically, that's what's happened, is people simply made that decision, which category to place a given child into. Today, doctors tend to do that, um, in terms of deciding who's going to be who. But, but really, I mean, it doesn't have to be a problem in the world and the way it is treated within medicine today is still as if it is somehow a terrible conundrum.

And you ask the question, why do we spend so much energy around this? I would say because really what we're getting at is eroticism. What really, the reason that sex and gender gets people upset is because it does invoke erotic life. And erotic life. involves parts of our brains that we can't control that are very impulsive that are that are very reactive. So I think part of what's going on is the gut level reaction people are having when people cross gender or cross sex or blend sex is that gut level reaction where something about their erotic nature is. being triggered in a way that makes them anxious or upset or angry or attracted in some circumstances. So it depends what's going on for them there.

[00:10:43] Matt Geleta: Yeah, well, I mean, let's explore that question, this relationship between gender identity and sexual orientation and one's erotic life. Again, I think this is one of those topics where, at the surface level, I think people feel like they have a relatively Good understanding of what's going on here and then one layer deeper and you realize it's a whole lot more complex.

Um, I learned some terms reading your work like autogynephilia, which I had not, I was not familiar with before. Um, and you know, I realized that I understand this topic, um, not very well at all. So what is the relationship then between gender identity and somebody's sexual orientation.

[00:11:21] Alice Dreger: It could differ for every single person and that's part of the challenge. I I think what is true is that for most of us, our gender identities implicate our orientations. And what I mean by that is for most of us, when we are having sex or when we're being erotically aroused. There's something about our gender happening there too.

So when I am attracted to a man as a woman because I'm a straight woman, there's something about being a woman in that circumstance. In other words, it's not just you could slot in a man or a woman and have the same type of sexuality, both of them being androphilic attractions to male. There's something about being a woman and feeling like a woman in that moment in terms of what it means to feel like a straight woman. people can obviously be gay, and so therefore sexual orientation and gender identity don't have to come in the standard format that 19th century doctors assumed, which was that the only normal format was for females to be attracted to males and males to be attracted to females. then there are folks for whom gender identity may be fluid. They may be attracted to more than one gender. They may be attracted specifically to somebody who has a blend of sexual characteristics. It really depends on the individual. But I do think it's the case that gender gets implicated when we are Dealing with our orientations when we're aroused and I put that once to Ray Blanchard, who's the sex researcher in Canada Who, um, coined the term autogynephilia and I said to him, you know, Ray, I really feel like it's the moment when we're the most aroused that our gender identity matters the most.

And he agreed with that. He said that seems to be the moment at which we have a sense of gender. That is a very particularly strong sense of gender. if you ask the average person, you know, do you feel like a woman right now? Do you feel like a man right now? A lot of people will say, no, I don't have a particularly gendered feeling in this very moment.

There may be moments when you feel your gender more or feel your gender less. you know, we were talking about the way that historically people have sort of. been gut level reactionary towards sex because it implicates eroticism. It's worth noting historically in many cultures, interracial relationships were also very fraught. People got very upset at the idea of a person of their type. So there again, the blurring triggered some kind of primal sexual fear or anxiety or protectiveness. We see the same thing I showed in my work on conjoined twins, that the same sort of reaction to conjoined twins even was about sex again. So it seems like every time an ambiguity comes up in human life, there's some ways in which it's triggering people at a level that they're reacting about sexual anxiety.

[00:14:03] Matt Geleta: Yeah, I definitely want to get to, to exploring that point in a little bit more detail. Um, in particular, when we come to the ethical questions around, um, you know, gender affirming interventions for, for minors and adolescents and children, because I think in that, in that in the context

of, of children who also feeling these, um, These feelings, um, maybe before, before getting there, it's worth just addressing a few misconceptions that I think are currently held. Um, One of them, which you address very early on in your book, you know, you say one of the first questions you get when exploring these topics is, you know, how common is it?

Um, and I think there's a misconception that most people assume, um, you know, all of this stuff is very, very rare in the population. Um, any atypical sex characteristics, it's, you know, one in many thousands. But, uh, as you state in your book, um, Galileo's middle finger, that's not... True at all, actually. And I mean, I've even seen stats that put the number of people born with relatively atypical characteristics as high as, you know, half a percent or one percent, which we consider a very high number.

Um, why, uh, why is it that you think our base rate estimates here are so outrageously wrong?

[00:15:23] Alice Dreger: Well, because we don't normally see intersex, right? So, types of intersex that are very obviously intersex relatively rarer, but also they get disappeared in childhood a lot of the time. So if a person is born with intersex genitals, then by the time they are a year or two old, typically they've already been subject to surgery made, designed to make them look more typically female or more typically male. So you would not see as much intersex in the human population if you saw everybody's genitals, but then we don't see everybody's genitals. typically, right? It's relatively rare. And a person who has intersex may be careful about showing their genitals. So you may see less of it for that reason as well. But some of the types of intersex we're talking about are quite subtle. So again, you can have a person who looks absolutely female on the outside, but inside she may have been born with testes and looks absolutely male on the outside, but inside he may have ovaries and they may not even know it. So you can sometimes not even find out about this until adulthood or even late adulthood. So I met a 19 year old man by telephone whose doctor suggested he call me and this was a guy who had been born a boy, raised a boy, had a girlfriend, blah, blah, blah, and he had been having uh, really intense abdominal pain and they were trying to figure out what was going on and they finally figured out that in fact he had ovaries and a uterus inside, but he had no vaginal canal, so he was menstruating internally, which is painful and dangerous and they had to deal with that. And the reason, the condition that he had was a very severe form of a condition called congenital adrenal hyperplasia, where you can get in between genitals or you can even skew very far in the masculine direction with a genetic female. Um, typically that's a dangerous condition if you have it in that severe a form.

And so it's interesting that he had made it through life that far without anybody picking it up. But it does sometimes happen. Today there's genetic screening for children in the United States in all 50 states for that condition, for CAH. In part because it's medically risky, but also because sometimes they otherwise would not pick up that these kids are internally female when they look so male. Another condition would be congenital, uh, sorry, complete androgen insensitivity syndrome, which was a condition where A person is born looking totally female, and the brain, in fact, developed along the feminine path. or sort of an ultra feminine pathway, because even though they have a Y chromosome in testes inside, they're making testosterone, they lack androgen receptors, so their cells don't respond to testosterone, and as a consequence, they develop along the female pathway most of the way. With the exception that they have testes inside, they have no uterus inside, but they're born with a vagina, they're born with a vulva, they're born with, um, hormones that end up affecting them as females. when we ask, how can we don't see intersex all over the place if it's relatively common, there's the disappearing of it by medicine, there's the fact that some of it's very subtle, there's the fact that an intersex person might be careful about showing their genitals because of social stigma, or because of privacy interests. then there are some types which are just incredibly subtle that if we count them, we get to that high number. So, for example, there's a condition in males called hypospadias, which is when the urinary opening is not on the end of the penis but is on the side of the penis or even way down low near the testicles. And in that circumstance, when we do all the numbers, hypospadias shows up somewhere in around 1 in 200 or 1 in 250, uh, born males. So if you count all of these different conditions, and you count all of the ones that you would never pick up unless you had lots of scans, plus all the ones that get fixed, plus all the very subtle ones.

That's how you get to that number of it being very common. But should all those conditions count as intersex? Well, that's a question. Doctors typically don't talk about hypospadias as intersex unless it also comes with a penis that formed incorrectly. Or it comes with some other type of intersex, um, condition. So, it really depends in that way, in terms of how you count that number. Again, nature doesn't decide for us how to count that number. So when people say to me, how common is intersex? I ask them, how big of a clitoris are you okay with before you say that's intersex? How small of a penis are you okay with before you say that's intersex?

How many different genetic variations are you willing to accept before you say, okay, wait, that's intersex? And if you do all of that, then you get a number, but people have calculated that number differently, depending on what they accept as normal male and normal female and intersex.

[00:19:52] Matt Geleta: Well, let's, let's zoom into this question of medical practice because I mean in that case you're kind of forced, or at least historically, doctors have had to make that decision and they've, maybe it's been arbitrary and maybe different, different medical practitioners have made different decisions about what does and does not count, but nonetheless, um, you know, there is a, there's a very long and interesting and fraught medical history of, of um, treatment of people with intersex characteristics, which again is um, is covered very well in your book, Galileo's Middle Finger.

Could you briefly run me through the history here, you know, what happened, why has it happened, um, what is the experience that people with these intersex or atypical characteristics have had in medical practice?

[00:20:39] Alice Dreger: Sure. Historically, it's really very interesting because before medicine became readily available, which started to happen in the late 1800s, Before it became readily available, obviously intersex people lived, right? some of them died from their conditions, but that was relatively rare to die of an intersex condition. many of them just grew up and ended up having sex lives and ended up having, you know, lives that were gendered either as male or female in the world, but their bodies didn't look exactly like people expected. But then once medicine really became controlling over bodily identity, which happened again in the late 19th century, coming into the 20th century, they started deciding who counted as what. Then physicians began having the concept that you really couldn't live this way, which is weird because historically, the truth is you absolutely could. Um, if they decided to change just the medical problems and leave the body alone until somebody decided that would have historically been not that.

different from the way the world had been. But what happened was in the 1930s, um, a fellow named Lawson Wilkins, who was a very, um, he was the founder of pediatric endocrinology, a really fine physician and researcher. figuring out how to treat the worst hormonal problems and save people's lives and also help their bodies stabilize in terms of, um, sex development because for some of the girls who had these rough hormonal conditions, they would masculinize over the course of their puberty and that was very difficult. so he was figuring out how to manage these kinds of conditions and as he did that, he became convinced sort of that he should dial back the time of intervention as Far as possible earlier and earlier and earlier in order to stabilize their sex lives basically. And by that I mean their sexed lives their bodies as sexual beings. Lawson Wilkins ended up teaming up with a very famous psychologist named John Money, who developed a concept of what was called the optimum gender of rearing model. And that was the idea that what you should do with every child born intersex was to try to squish them surgically and hormonally into whichever sex was going to be the most believable for them. And that typically meant making most of them into girls, because frankly, all these men in the medical profession had very high standards for penises and very low standards for vaginas. And so they did not feel you could surgically build a convincing penis, but they did feel you could surgically build a convincing vagina.

Um, as they used to put it, you could poke a hole, but you can't build a pole surgically. they actually used to say this to their medical students. So what they did over time was do more and more and more and more interventions on these children. And basically, for many of them, remove any chance of fertility.

So in the boys, they, the males, they would take out the testes in many cases, removing any chance that the child was ever going to be allowed to Be fertile naturally and do early intervention surgeries to avoid becoming babies so they try to make them look typical. The claim was this would allow their parents to accept them as boys and girls, and then their parents would treat them appropriatly as boys and girls, and so psychologically they would develop appropriately. What we know is that for many intersex people. This was a failure that in fact, it left them with damaged genitals, damaged uh, reproductive tissue, damaged relationships with their parents, damaged relationships with the medical profession because they were lied to and treated as if they were monstrous essentially.

And so it actually led to a huge problem, which ultimately in the. Late 1980s, early 1990s led to the intersex rights movement and the organization that I worked with for years, the Intersex Society of North America, which was one of the groups pressing for medical reform.

[00:24:17] Matt Geleta: Yeah, it's, uh, it's quite fascinating that, I mean, late 80s, late 90s, that's, that's yesterday, um, and, you know, people, people think about the history of malpractice in medicine going back many centuries, and I think we, we kind of forgive things that happened several hundred years ago, you know, practice like bloodletting and so on, but, um, I mean, 1990s, that's, uh, you, you would feel, you'd feel like we would have had a better grip on, um, um, The sort of like outcomes based approach to these things.

Um, I'm interested in your thoughts here. You know, there is one lens, um, which says, you know, medicine needs to be innovative and progressive and kind of try things. And, uh, yes, there are some bumps along the way, but... That's how learning happens. You know, that's the, the whole process works when things fail and activists come in and the medical practice, the medical industry is, is reformed.

Um, and then there's the other lens that says, you know, we need to be very conservative and it's first do no harm. And, um, where do you feel like these, these treatments fall on that spectrum is, is what we're seeing the standard sort of make mistakes, learn, improve type of, uh, of medical practice, or is there something different?

[00:25:28] Alice Dreger: Well, it depends on the clinic. Most intersex clinics are still doing fairly aggressive interventions, but they at least are better today in terms of tending to offer more psychosocial care for the families and for the children. And they're also better in terms of telling the truth to the patients more earlier and more honestly. So that part of it has improved, but in terms of surgical intervention, there's still a lot of try it and let's see if it works. Um, and so that certainly is a concern. You know, it's a difficult situation because Infancy allows an opportunity for the healing of tissue that is often much more successful. So if you're going to do an intervention on a person, the earlier you can do it in life, the better the healing will be, typically. That said, there's obviously a question, do you need to do these interventions? So this is particularly a question with regard to, for example, where you have a situation where a boy might not be able to pee standing up, but he could pee sitting down. And a lot of times doctors recommend that they do surgery early so that by the time the child is at the age of potty training where they're going to be peeing with other boys, that they're at the point where they can pee standing up like a typical boy. said, a certain percentage of those surgeries are going to fail and some of them are going to lead to damaged penises and then boys who have really rough relationships with their own genitals because of the fact that they're constantly going in for reform, for surgery to fix the problem that's been created by the surgery. Historically, in the 19th century, men who had hypospadias had no surgical options. So they just learned to deal with it and it ran in families. And so families often learned to deal with it. And obviously some of them were not happy about that. When surgery became offered, some of the men sought those surgeries, but you know, it is a difficult situation today.

Like should, should doctors be doing that? Well, if you're going to do it again, the earlier you do it, the better the healing. However, why are you doing it in the first place, is the question activists and myself would ask. Um, I mean, why are you bothering to fix something that is not medically broken? It's something that is a psychosocial concern, but my own feeling is that you shouldn't risk this kind of intervention on a child who has not been able to decide for themselves. Obviously, that's different from doing a type of surgery that, for example, is removing a gonad that's cancerous, or trying to fix a hormonal problem that actually can lead to hospitalization. These, these are the kinds of things that make sense, but those are medical issues that's different from doing these cosmetic treatments.

[00:28:02] Matt Geleta: Well, I guess a lot of that does pivot then on what the experience is of individuals living with intersex conditions today. Um, both those who don't receive any, any medical interventions or, um, or maybe very minor interventions and versus those who, who do receive some of those that you've mentioned. Um, what, what is that experience like today?

Is it, um, is it substantially better than it was in, in the 80s, 90s and, and how has it changed?

[00:28:30] Alice Dreger: I think most people, and I want to encourage people to go ahead and look on the internet for accounts by intersex people themselves because there's now a wonderful blossom of all sorts of accounts that are autobiographical and people with intersex talking about their own lives, which is very different, obviously, from the 1980s before that existed at all, um, where you had just one or two people doing that kind of work. You know, I, I think what they would say is that certainly the fact that there's a more of a social understanding that it's real and it exists has been a really good thing, but most children who go through these clinics are still getting interventions before they can consent, and so that hasn't really changed, and that's a source of great frustration to activists who really want to have a situation where people are allowed to decide for themselves what to do with their bodies. So, um, that part of it has not really changed. I, I do think that the consciousness around it has helped, but it's still the case that many parents feel, um, that if they're within a medical system, they're being, they're given the message that you've got to go surgical route or, or. know, you're not really making the responsible parental decision. And that is a big concern for me. That, in fact, I think parents can be empowered more to accept anatomical differences in their children and learn that the child can decide later. It, may be a more difficult decision later, again, in terms of the outcomes, but at least then the person is making the decision themselves whether or not to risk... fertility, risk sensation, risk pain for the rest of their lives, risk a whole lifetime of surgical attempts to undo the problems caused by the first surgery.

[00:30:08] Matt Geleta: Yeah, except here we do encounter sort of another, um, uh, unclear or vague dividing line, and I actually think this is, this is probably the area that I think gets the most, that gets people most riled up, you know, on the one hand, you can imagine a very, very young infant, you know, um, Of course, they can't consent, but they also can't understand.

Um, and in that case, I think whatever the decision is, it's very clear that it can't be the individual themselves making that decision. Um, and then all the way on the other end, you know, adults, um, fully able to give informed consent. Um, again, a bit clear, but there is this gray area in the middle, and it's also an area where...

Increasingly, um, you know, adolescent, adolescents, minors are presenting, um, to, you know, or they're, they're sort of seeking, um, gender affirming medical, um, assistance more than has ever happened historically, as far as I understand, um, and many people think that this is a, you know, a huge concern and, um, there is very, there's, there's no clear consensus on, on how to, Make decisions in this in this area.

Um, let's dig into that in that topic. You know, we're talking about the issues of informed consent. How do we think about that in the case of minors? You know, you can have a mental model of, let's say, a young, um, Biologically clear boy presenting to a parent or a psychiatrist claiming that they feel that they're in the wrong body, in the wrong gender.

How does that situation get addressed and how should it get addressed?

[00:31:46] Alice Dreger: It, you know, I mean, it's, it's, I'm going to state the obvious that it should be addressed with good care. And that means. People who are actually trained to deal with these issues and allow for the possibility that childhood exploration may go in multiple different directions, that children's outcomes are not um, in a simple fashion. you know, what, what's interesting to me, so when, when I was active in the intersex rights movement, which was in the 1990s and late 1990s into the early 2000s. We tried to find people who had been through the medical establishment system who were happy with what had happened to them. Because we wanted to talk to them and figure out what had happened to them that made them different from all the angry activists who had had terrible experiences. And we couldn't find anybody. And there were hundreds of journalists working on this topic, trying to find anybody that would speak on camera or even speak behind a potted plant with their face blurred. saying that they had been through this and they were glad their parents chose it and we couldn't find any and that to me was really significant.

Now, those people may have existed, but I think it's possible that nobody ever told them the truth about what had happened to their bodies. So they didn't know what had happened to them. And as a consequence, they didn't really have the opportunity to say, yes, I'm happy with what my parents chose and my doctors chose because they simply didn't know their own medical histories. Um, you know, I would frequently meet people who would find out from their records through chance of what had happened to them and otherwise didn't really know what had happened to them. It's interesting to me that the folks who are terribly worried about the idea of a non intersex child doing an intervention don't seem to be terribly worried about the fact that intersex children are having these decisions made for them all the time. If we have the concept that we should Allow children to grow up with healthy tissue and not allow them to choose interventions until they are, say, 18 or 21 years old. are the intersex children always exempted from that? And we say, well, because they look funny and they look different. Then it's okay to make that decision and risk all this stuff for them. part of my curiosity for a long time has been, why is it that the group of people objecting to earlier interventions for Children who are transgender don't seem to have the same concern for children who are intersex in terms of doing interventions that may be very ill advised in terms of the long term outcome for that person. We know with people with intersex that they are sometimes assigned a sex that doesn't work for them, that later in life it turns out that was the wrong sex assignment. They turn out to be people who technically count as both intersex and transgender because they've rejected the assignment that they got at birth. the assignment they got at birth really could have gone either way in some circumstances and the doctor chose the wrong one sometimes chose the wrong one and then did a whole lot of surgery that sort of cemented that wrong one and then they have to undo all that. There are many cases of this that we've documented in the literature. So, you know, the question of what to do with with children and especially younger children and then adolescents, I think it's a very difficult problem. I think we do want to have a circumstance where we're empowering children and adolescents to be actively involved in their own medical care. And yet, at the same time, it's very difficult to say that they can really understand.

and The risk that they're taking in terms of the loss of sensation, in terms of long term pain, in terms of, um, loss of fertility in some circumstances. So it does become really difficult. And for years, people thought Lupron was the magic approach, a hormone that you could give children, which would basically stall puberty. And if you could just give them that, then you could, you know, wait until they were older and then they could make a decision. Then you could send the puberty in the right direction. But we know that Lupron is not a benign drug and that. In fact, if what you want to have happen is for a child to mature psychologically, then their body's also going to have to mature.

So it is an incredibly difficult situation. And I don't think that there's an easy solution to it. But I, I do not like the situation that is occurring in the United States where basically, um, various states are outlawing the ability for caregivers to provide any care to these children and families. I think that's totally outrageous and really dangerous. You know, we mentioned earlier this question of like, so, so for a lot of us, certainly as adults, gender is implicated in our erotic lives when a child says that he or she doesn't feel that they have the right body, that they were, um, quote unquote, born into the wrong body. I think that's different, or at least has a different quality to it in terms of. It may be the case that what they are expressing is, in fact, an awakening towards a homosexual orientation that they're interpreting as a gender issue. And historically, we know that a certain segment of gay men started off their lives as feminine boys. And this is some of what Michael Bailey talked about in his book that caused the controversy that I ended up studying that became the book that became Galileo's middle finger.

But Michael Bailey looked at those kinds of circumstances where it's not uncommon for a, a boy who's going to grow up to be a gay man to have certain so called feminine interests. So to be interested in more things around the house, and to be interested in social games rather than games of sport. Um, to be more interested in hanging out with the girls than hanging out with the boys. Um, even to be interested in putting on girls clothes and playing that they are women. And This is not uncommon among boys who turn out to be gay men in the long run. So one of the questions that I know critics, I think, legitimately have is when a child is expressing, That they feel like their gender assignment is not the right one is in fact, what's happening is that they're awakening to an erotic life where they can't quite articulate that yet, but they have a sense that the type of the type of attraction they have is attraction to men.

And, is, you know, in our cultures, that's a concept that that's. That's a feminine thing, but also that biologically that maybe they are somewhat feminized. And, and so that's one of the concerns that people have. And I think that's really quite a legitimate concern. Then there's the whole question of, you know, when a, And when a child, even without that, without the question of, Maybe the self aware, beginning of the self awareness of, of orientation when they say, you know, I really feel more like a girl or more like a boy is what's happening that they are looking at the cultural options available and they really prefer the cultural options that are available. provided to the other gender and not provided to them. That's another concern. But we also know historically throughout time, there have been people who genuinely feel very much the other gender than the, than the sex into which they were born and have managed to quite heroically really over time live in the other gender in spite of the fact that they were not able to change their bodies at all.

And that that was a very dangerous thing to do in many circumstances, but they managed to do it because they felt that strongly about. being the gender that historically did not match their sex.

[00:38:59] Matt Geleta: I think a lot of people... feel that this is quite an urgent issue to solve, um, because the, the rates of cases like this are increasing so quickly. Um, you know, it's, it's not the, yeah, also I work in a medical field now in, in diagnostics and, um, You know, it's well understood that there's several different reasons why you can see rates of, you know, things increase.

Sometimes it's just a reclassification of what counts. And, um, and so people who wouldn't have been classified as having a certain condition now are, and it, you know, it, it manifests as a perceived increase in, um, prevalence. And, uh, sometimes it's that we have, you know, better diagnostics and so we can catch things we were missing before.

Um, but in this case, it's, it's not either, I don't think it's either one of those because we're actually having young people presenting, you know, self claiming that they're, that they're feeling different at higher rates than we were before. And I think that a lot of the concern in this is that, um, as you said, a lot of this, you know, to what extent is this driven by, um, uh, basically, you know, social conditioning or, um, you know, basically confused children who are hearing things that they don't fully understand and sort of

[00:40:14] Alice Dreger: inadequate tolerance of our culture for, um, gender categories. I mean, we, we could foist it upon the children, right? And say the children are confused. Another option is to say the culture is doing a poor job allowing for ambiguity. And that if the culture did a better job allowing for gender ambiguity, Then children might not feel that there's need to switch categories because they would feel comfortable being in a category and moving around within that category, maybe moving between categories.

And that wouldn't be that big a deal. But as it is, I think we've got a very. Sort of lockdown approach these days to gender and children are responding to that and saying I don't feel that and I can understand that you know I was I feel relatively lucky so I was born in 1966 which means I was born just as the women's movement and the women's health movement was coming into being and there was a very strong message in the culture at that time that a Girl could do boy things and it wasn't didn't mean you weren't a girl, right?

So I could do rough sports and I could do. Be interested in going into male professions. And I could do all that kind of stuff and play with boys. And there was very, a very clear message that that was about female impairment. But I think we've really lost that today. And there is very much the Barbie Ken model of life. And, you know, the Barbie Ken model of life, no wonder so many children look at that and say. That's not me. So I must be in the wrong category. So for all the people who are expressing anxiety over children switching, what I want to say to them was, well, what are you doing to signal to children that these categories are fluid and that we don't have to be locked down into these categories as men and women and boys and girls. And maybe if we were a lot more accepting of children who are fooling around with what we think of as gender, then they wouldn't be so inclined to say I'm in the wrong category because the categories would be significantly more blurry. That would be a good thing.

[00:42:11] Matt Geleta: Yeah, no, and I appreciate you sort of pointing out the, um, the, uh, sort of unclear mental model I was using there. And I think it actually leads very nicely to, um, you know, a broader question if we zoom out of this particular case a little bit. I think these questions of sex and gender are very good analogs for something much more general, which you've also, um, spent a lot of time thinking about, which is the tension that often exists between scientists and activists on all matters relating to personal identity.

And there are plenty of examples here. Um, some of the most contentious ones include, you know, things like the study of relationship between race and IQ scores. Um, that's gotten plenty of people into plenty of trouble. Um, and there, there's several others that you've, that you've also written about. And academics tend to avoid these questions like the plague, you know, you, you misspeak and, uh, you can get into a lot of trouble.

Um, I think what's, what's fascinating here is that in abstract, if you were to pose a problem to someone in completely abstract terms, one of the first things they want to do to solve that problem is to understand it fully. You know, you, you want to understand what, what are the causes, what are the solutions, what works, what doesn't.

And that very often means investigating it scientifically. Um. But when it comes to questions relating to identity, not only does that often not happen, I think often the exact opposite can happen. You know, people tend to actively avoid such, such problems. Uh, and you, you've, you've spent some time studying this.

You, you want a Guggenheim fellowship to study questions. Of this nature, um, would love you to tell me more about this, you know, what's what's going on here and and how do we get out of this? Uh this sort of aversion to studying questions relating to identity

[00:43:50] Alice Dreger: Yeah, you know, it's, funny because when I wrote Galileo's Middle Finger, I was hoping it would help this problem. And that what it would do would encourage people to have less fraught debates. And instead, I feel like it was almost a a prologue to what was about to happen culturally. It was an accidental prologue predicting cancel culture and the wars on campuses, the free speech wars and all of the rest of it. It is the case that American academics remain fairly obsessed with identity, and, um, it is the place, you're right, where activists absolutely get upset because it is, so much of activism is identity based activism, in the United States at least, and actually around the world, it's identity based activism. So how did we get here? Well, think. know, I'm a historian again, so I tend to think of the long term and what I see is historically, there's been this question of the tension between anatomy and identity, between what does the body mean to who you are. that gets debated in all sorts of different realms.

So that gets debated in terms of IQ and race and genetics and, uh, ethnicity and language and in terms of obviously gender and in terms of abnormality when a child is born, say, with cleft lip, or they're born with conjoined twinning, whatever it is, that, that there is this tension between the question of, okay, what does the body mean to the person?

And what does the person then mean to the social body in terms? So there's the, the body, the person, and then the social body. Historically, doctors and scientists kind of seized power over that in the late 19th century and then into the early 20th century. But what ended up happening over time was that people who were democratic activists, and I mean that with a small d, who were people interested in furthering human rights, that authority.

And they've continued to challenge that authority in ways that are quite powerful and I think quite good. Good. Um, and so, for example, the civil rights movement, the movement around racial rights, focused on that issue about whether or not racial differences can be used as the basis for different political rights.

The same thing obviously happened with the women's rights movement, challenging the idea that the biological categories. are to determine our rights. The same thing with the disability rights movement. The same thing with the gay rights movement. Very much rejected the idea at first that genetics mattered.

Now, the gay rights movement actually embraces the idea of born that way, which is incredibly interesting because historically.

when it started, they were not interested in born that way. That was a eugenical model. The idea of born that way was a route to eugenics, they thought. Now that's completely changed. But I, but I think what's going on here is that, Scientists continue to be interested in that question of the relationship between biology and behavior, and biology and selfhood, and biology and identity, and activists are very nervous about them working on that because they recognize that that kind of work can lead to dangerous laws, dangerous court decisions, can lead to, in fact, eugenics, and so activists are not wrong in being nervous about what scientists on and that's part of what I try to convey and Galileo's middle finger is that I actually think activism is necessary as a check on science. But what troubles me is when activism is deeply dishonest and that's part of what I was tracking in that book was incredibly dishonest activism where people specifically going after Michael Bailey and Ray Blanchard and Ann Lawrence knew that what they were saying about them was not true. So. You know, what do I wish I, I, I guess the way we could make the whole situation better would be as everybody paid more attention to the facts and that includes scientists who very frequently are kind of sloppy in terms of their claims, in terms of their use of data, in terms of checking what they actually are publishing and making sure that they're actually accurate. So I wish that all sides would actually be way more careful in terms of looking at the facts.

[00:48:11] Matt Geleta: Yeah, it's, it's so interesting though that in, in the cases of identity, I mean, we take for example, um, something like climate change there, it's a, it's a, it's a topic that has a lot of support or interest by activists and by scientists alike, and, and they happen to be fully aligned. There's not a, um, you know, you don't, you don't have activists.

worried that scientists will unveil something that will sort of get in the way of the mission of the activists. Um, and so there, there's such strong alignment, um, and it is the exact opposite in many of these cases of identity. So, you know, my question is why I understand that there is some aversion or hesitation to potential risks of, of, um, you know, science being used.

Uh, in malicious ways, you know, things like eugenics, as you mentioned. But there's also equally the risk that, you know, if we don't find the answers, we don't know what to do and, and we make the wrong decisions. And that could also be, um, you know, not in service of, of very good social change and all the ethical things that we want.

Um, so, so why is it then that the, um, the posture sort of skews towards, very often skews towards an aversion versus the other way around? Any of, any of the examples you mentioned are good, are good analogues. You know, why, why isn't it actually that activists are sort of pushing for more science versus the other way around?

[00:49:30] Alice Dreger: Well, historically, some have right? So I think the ones we're talking about, we're selecting the cases where activists and scientists are doing battle. And you point out correctly the case of climate change. But I would also point to, for example, the early AIDS patient rights movement, where they absolutely were pushing for more science. Um, the movement within women with breast cancer, where they absolutely were pushing against doctors towards more science, where they really felt strongly that physicians were being, uh, Treating women in problematic ways that were not evidence based and they pressed very strongly. Um, you can see the movement for home birth, which often is pushed through a very scientific lens and is very interested in looking at, for example, the problem that episiotomies are not actually in women's best interest, if you look at the data. that various kinds of interventions used during birth actually increase risk to mother and child rather than decreasing risk. And so demedicalization of birth, often you'll find people who are working on demedicalization of birth, actually pushing for more science. So I think that we're sort of picking a subset and the subset that I picked in the book were specifically. about activists who were very obsessed with the idea that they knew the truth about identity and that these researchers did not. I mean, the other thing to recognize, and there's no nice way to say this, that successful activists are often narcissists. They often are people who are quite obsessed with their own identity and quite obsessed with themselves and the reason they're successful is because they spent, they can spend an enormous amount of personal energy and even money because they're so self interested pursuing that particular cause. And I think the narcissism problem is one that actually has been, um, not well enough appreciated in terms of looking at the success of historical rights movements and the leaders of them often, often having displayed sort of classic narcissistic personality disorder. So part of the clashes that go on are people who are.

Quite obsessed with taking down another person because it gives them the sense that they are a larger individual. And you can certainly see that among some of the people that I dealt with, um, in my book in terms of the, the level of obsession that they reach with trying to take a researcher down. can be quite overwhelming.

That said, I mean, some scientists are also, of course, leaning towards narcissistic personality disorder, and they sometimes are the ones who get in the biggest fights. I, I, for years, I actually gave talks at various scientific conferences trying to explain to scientists how to stay out of trouble.

[00:52:08] Matt Geleta: Ha

[00:52:09] Alice Dreger: of course, it often doesn't work because a lot of them Aren't interested in staying out of trouble.

Um, they actually like the fights until it gets incredibly unpleasant. Then it's too late to do, to get out of it. Um, the other thing is that I think a lot of them do have what I call the Galilean personality, which is the idea that they believe as long as they're right, as long as they're following the science. Nothing truly terrible can happen to them. No matter how many times the universe proves them wrong, and

[00:52:40] Matt Geleta: ha ha ha. Ha ha ha.

[00:52:42] Alice Dreger: can happen to you for pursuing the truth, they still tend to believe that if they just keep pursuing the truth, then eventually the other side will come around and see the light.

You know, eventually they'll, they'll get it and everything will be fine.

[00:52:53] Matt Geleta: Yeah, I mean, maybe history has proven them right. It's just, it's just been longer than their lifetimes to realize that. Um, one, one quote from, from, ha ha ha.

[00:53:02] Alice Dreger: that's exactly why the book is called Galileo's Middle Finger, because it's him pointing to the universe basically saying, I was right. You know, he's pointing to the skies with his middle finger. And the inscription on the stone that this middle finger is, is sitting on basically says, you know, Galileo was right.

He was right about the heavens. And so it's that metaphor of, Yeah, you go to the grave thinking that, you know, you're going to be proven right. But it might be after the grave that your middle finger is finally put on a big pedestal and people say you were right.

[00:53:32] Matt Geleta: Yeah, um, I might, I might take the chance to sort of plug the book and, and show the cover here. Um, I've just, uh, I actually just finished reading the paperback this morning and you've got, uh, I mean, I won't give too much away, people should read the book, but, um, you've got a nice little afterword here that goes a bit more into your story and.

Uh, the events that happen immediately following this book, which are equally fascinating, so, uh, definitely worth a read. Um, I think it's a good segue then to turn to your current work and your current focus. Um, this book was written several years ago and since then you've continued to do very interesting work.

Um, what is it that you're currently focused on, um, without giving away, again, too much of how this book ends? Heh heh heh. Heh heh heh.

[00:54:16] Alice Dreger: these days in journalism and working on, uh, the problem of rescuing journalism in America, which has been a big problem. But I, I ended up sort of after this book kind of hiding locally and creating a local newspaper sort of as a hobby. And then it accidentally, um, worked took over my life for the last eight years or so. Um, and then I also write murder mystery novels in the middle of the night that include autogynephilic characters and that sort of thing that, um, to, to get out. Some of the things that you can't write in nonfiction, there, there are themes I've wanted to explore that are not possible to explore in nonfiction because you would be committing defamation, or you would be drawing connections between things that you can't really legitimately draw connections to, but one of the things I love about art is that you can actually play with facts and you can purposely play with questions and see where questions can lead without having to be bound by the facts. Um, non fiction. I love writing non fiction and I love doing journalism and history and I love being bound by the facts. But I also really love having space to do that are not at all bound by reality and that becomes really pleasurable. So I write, I write fiction in the middle of the night and I write non fiction during the day.

[00:55:38] Matt Geleta: Heh heh heh. And I believe you, you're right.

[00:55:40] Alice Dreger: middle of the night.

[00:55:41] Matt Geleta: You, you write, uh, you write nonfiction, you write fiction under a pseudonym. Is that right?

[00:55:47] Alice Dreger: Yes, Molly McCallan is my pseudonym for my fictional work. Yes,

[00:55:51] Matt Geleta: Ah, very good. Um, I will.

[00:55:53] Alice Dreger: fourth book in the murder mystery. Yes

[00:55:56] Matt Geleta: Ah, very good. Well, I'll, I'll, I'll link the whole lot to the, uh, to the show notes. Um, on the topic of books, this is, uh, actually brings us nicely to one of the questions I love to ask my guests as, as we come towards a close. Um, which is which book have you most gifted to, to other people and why?

[00:56:12] Alice Dreger: Yeah, actually the book lately I've gifted most to other people is my own novel because just Want people to think about this issue of anatomy and identity and the first book in the series takes place in a In Philadelphia, near a museum that is similar to the Mütter Museum, which is a museum of anatomical abnormalities from the 19th century. And it ends up exploring this whole question about what is the relationship between the body and the self, including for the main character who's sort of struggling with the question of her own meaning in life. Um, so that's one I've gifted a lot. But I must say the, the book I did not write that I've gifted the most is actually the Stephen Mitchell translation of the Tao Te Ching.

[00:56:53] Matt Geleta: Hmm.

[00:56:53] Alice Dreger: it is a really beautiful translation of the Tao and. Working on Galileo's middle finger, before I worked on Galileo's middle finger, I had been using that, um, translation of the Tao for many years to try to recognize the limits of my power in the world and to recognize the importance of, um, forgiving myself and others and letting go.

And recognizing that the universe is a flowing stream. after that book, it became that much more important because so many people attacked me and still to this day attack me. And so it is really, um, frustrating to have an identity that is so widely misrepresented online. I am, am frequently. Um, represented online as being virulently anti transgender rights, as being incredibly hateful towards transgender people. And if you look at what I actually have written and actually do, It's, quite the opposite. And in fact, I get a lot of criticisms from feminism, feminists who are, um, kind of anti trans in their own world. So I ended up getting kind of slammed for both sides. And it's a very. Strange situation to be in. So reading the Dow becomes even more important, but almost always a circumstance where I'm running into somebody who is struggling with trying to a situation.

They really cannot control. And that's why I give them that. Book, it's a, I get the little pocket edition and give it to them. And I always tell them to start with, um, chapter nine, which is the chapter that speaks of, um, recognizing that if you, you let other people, if you care about what other people think, you will be their prisoner.

And that you have to let go and recognize that you cannot fix everything in the world, especially the stuff immediately around you. So the Stephen Mitchell translation is my favorite translation.

[00:58:42] Matt Geleta: It's, uh, it's actually so interesting you mentioned that because, um, I have enjoyed the audio book version of, of that several times and, and also absolutely love it. So, um, great, great recommendation. Did not expect that, but, um, yeah, very, very good one. Um, I think, you know, one. One, one thing comes a lot of out of that book and everything you've done is, um, you know, wisdom, um, you know, imparting wisdom on people who have maybe not been there before.

And you've certainly seen a lot. And I imagine there'll be many people who look at this and. You know, listen to this conversation and they're feeling, you know, a bit motivated to, to kind of do something, um, to get involved, um, and are hesitant because again, this is difficult and it's, it's, it's proven to be dangerous.

My question is, what advice do you have for a person who wants to do something about any of the topics we've talked about? And. He's kind of sitting on the fence, he's a bit hesitant to get stuck in. What advice would you have for that type of person? Hehehe.

[00:59:48] Alice Dreger: things we can do is try to sit down and break bread with people who are on the other side of topics and really try to understand where they're coming from. Because even if we end up maintaining the view that we have, we at least understand better what the criticisms are and how. The arguments that we're making may be misunderstood because we're not articulating them correctly, or because we lack the data that we should try to seek. So, one of the things I often recommend to people is to try to find spaces of non partisanship and also intellectual humility, where you actually genuinely enter into a space where you doubt what you think, and meet people who very much disagree with you, allows you often to see. I think we are much better creatures in the world in terms of people of knowledge and people of, who seek wisdom and seek truth if we have humility and part of, part of that humility has to come from directly talking with people who disagree with us. So it's easy for me because my own family is this way.

I come out of a. Traditional Roman Catholic, very conservative family. And so it's not difficult for me to go visit that family and end up in these discussions where they think I'm crazy and I think they're backwards. And we have to sit down and break bread together discuss where it is we're all coming from.

So, um, for example, at my own newsletter. Which is, um, available for free online if you just subscribe, you don't have to pay anything to read it. I, when the Dobbs decision came out, basically reversing Roe versus Wade in the United States, so making abortion access much more difficult, I am very much pro abortion access and I did try to write a piece that helped explain to people like me where pro lifers are coming from, so that they get over this idea that pro lifers are simply crazy, controlling, awful people, that many of them actually do share values that we have.

It's just that they take the values and end up at a different place with those values. That's not to say we share all of the same values, but it's, it's things like that, that I think that is important for us to do to recognize. Sometimes we actually have the same values, but we come to completely different conclusions. And is it possible for us to find those spaces where we can understand? The common values and understand how to begin to dialogue with each other. Social media is not the place to do that. So,

[01:02:21] Matt Geleta: Hehehe.

[01:02:22] Alice Dreger: people ask me, what can I do in the world to effect change, I always say, don't do it on social media.

Because it may feel victorious and it may feel important and effective, but in a lot of ways, it's temporary and very, very shallow.

[01:02:36] Matt Geleta: Well, Alice, I think that's a, that's a really nice place to, to bring us to a close, um, before, before we jump off, I actually just want to say thank you. Um, your, um, you know, it's very clear that you've, you've made a lot of personal and professional sacrifices and continue to do so. for work that you believe in.

Um, and that's clearly important. That's clearly making a difference. So, uh, yeah, before, before jumping, I just want to say thank you for, for doing it, keep doing it. And, um, I hope that, uh, people are inspired when they listen to this too, to do something as well. Um, thank you so much for joining me today.

It's been an absolute pleasure.

[01:03:11] Alice Dreger: Thank you, Matt. This is very kind of you. I appreciate it.

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