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‘The Protocol’: 2025 anti-transgender podcast series

In June 2025, New York Times released The Protocol, about healthcare for gender diverse youth. The limited podcast series reflects the transphobic framing of other Times coverage by co-hosts Azeen Ghorayshi and Austin Mitchell.

Analysis

The flawed premise is that being transgender is a psychological disease rather than a trait. The podcast promotes psychologists and psychiatrists who believe they are treating a mental illness. Therefore, “psychological outcomes” are their measure of success.

Cisgender minors who receive the same gender-affirming care like hormones and surgery are not subjected to the same psychological gatekeeping. That’s because the only valid measures for the effectiveness of drugs and surgery that lead to somatic changes are physical function and cosmesis.

The podcast’s narrative is that transgender healthcare for minors used to have strict psychological and psychiatric gatekeeping. Ghorayshi and Mitchell imply that rejecting many trans people for care is worth it if that gatekeeping spares one young (read: cisgender) person from getting care they later regret. Ghorayshi and Mitchell believe that psychological gatekeeping in America has become too lax, and they want to see stricter controls or even bans on evolving models of care.

Journalists who have framed this as a public debate that should be decided by the lay public have allowed opponents of this care to use the media and government to restrict or ban this care, similar to how New York Times health journalist Jane Brody and Times contributors like Thomas Szasz helped get adult care shut down as “experimental” in 1979 after a decade of anti-trans reporting.

This podcast reflects a disgraceful unfolding chapter in American media that repeats the pattern from 50 years ago, and work like this will come to be seen in decades ahead for what it is: an assault on the rights and dignity of trans and gender diverse youth, spearheaded by ideologically-motivated cisgender journalists.

Production

According to the Times:

“The Protocol” was researched, written and reported by Azeen Ghorayshi. It was produced by Austin Mitchell, Larissa Anderson and Luke Vander Ploeg, with production help from Eli Cohen. It was edited by Lisa Tobin, Larissa Anderson and Paula Szuchman. Fact-checking by Caitlin Love, Jane Ackermann and Sharmila Venkatasubban. Mixing and mastering by Daniel Ramirez and Efim Shapiro. Our executive producers are Paula Szuchman and Lisa Tobin.

Part 1: The Beginning

The first section profiles “FG,” a conservative Dutch trans man who was the first documented patient to receive puberty blockers in a clinical setting in that country.

“FG” is a transmedicalist and transsexual separatist. In the interview, “FG” complains about how “insulting” the current trans community is to “pure, proper transsexuals”:

“It’s gone a bit extreme to the other side, so it makes a laughingstock of what it’s really about. It seems to be a fashion statement nowadays. It’s like when in the 70s you were a punker. We have to fight against something. We’re forging our identities as young people. We need to stand out, we need to have an opinion against a given society, because that’s our rite of passage. It feels like this has become another forum for that. It’s taken over that role. And for the group that is pure, proper transsexuals, this flirting with pronouns and gender identity is insulting. We spend all our time trying to just fit in, or be able to live the life we feel we should have had, and it’s not a great help when you’ve got people shouting from the barricades and trying to give you a different position of a third sex or whatever, and then talk about things we don’t need to talk about so that we can then identify you. But maybe that’s my own– I’m still stuck in my own paradigm. And maybe that shouldn’t be a taboo. Maybe we would break it open. That’s not how I feel, but intellectually I have to think about that. But I don’t take a lot of these people that seriously because it does seem to be a bit of a fashion statement.”

It also profiles Peggy Cohen-Kettenis, the Dutch psychologist who allowed “FG” to get puberty blockers.

New York Times suggested background reading for the episode:

Part 2: The Gender Kids

This episode focuses on Dutch psychiatrist Annelou de Vries and the development of what became known as the Dutch Protocol. As one would expect from a psychiatrist, de Vries strongly promotes disease models of gender diversity and considers psychiatric counseling critical. de Vries also believes the measure of “effectiveness” is directly linked to psychological outcomes. de Vries would screen out about 30% of prospective clients, whom de Vries considered to be gay, or had “psychological issues that needed to be dealt with first,” or comprised the 10% of young people whom de Vries diagnosed with “autism spectrum disorder.”

Ghorayshi and Mitchell then interview Manon, one of the 70 participants in de Vries’ 2011 study, featured in the book Gender Kids by Sarah Wong. de Vries had several criteria: early history of “gender identity disorder,” supportive parents, and a kind of “watchful waiting” because “most” kids would grow out of it, but they felt for “most” kids, the stress would dissipate until puberty. After a year, which included questions to Manon and seminal parent about sexual abuse, de Vries approved Manon of newxt steps.

de Vries described puberty blockers as “reversible,” but there were risks like “bone density and possibly brain development.” Mitchell says, “This is what the Dutch thought of as one of the radical innovation of the blockers: that it was just a pause that could be undone, and meanwhile Manon could think about what came next.” Manon took puberty blockers from age 12 to 16, then signed consent forms acknowledging loss of reproductive capacity.

Mitchell points out the central role of psychiatric gatekeeping in the protocol: “and critically, the mental health assessments that were designed to help figure out which kids should get medical intervention.” According to de Vries, assessment “takes at least half a year, but as we say, we take the time we need.”

de Vries found improvement in psychological function, but did not help with gender identity disorder. In a follow-up report on 55 of the 70 subjects, “were generally satisfied with their physical appearance, and none regretted treatment.” Their gender dysphoria had resolved, and their psychological functioning had continued to improve over time, with rate of clinical problems were now “indistinguishable from general population samples.” deVries cautioned about the small sample size and selection bias, and that a randomized clinical trial would have been preferable, but noting the ethical problems of withholding treatment from patients as a control.

Mitchell says, “Her final words sound now like a bit of a warning: ‘Clinicians should realize that it was not just the early medical intervention that led to the success of this study.”

deVries says, “It’s not only the medical approach, but it’s the whole approach. So it’s psychological assessment but also psychological counseling if necessary, really addressing psychiatric problems, family difficulties, family challenges…”

The guidelines were adopted by WPATH, and clinicians began visiting the clinic to learn more. Mitchell says in foreshadowing of their thesis: “And as they brought the care back to their countries, not everyone was following the protocol.”

Ghorayshi then reiterates the podcast thesis: “There is this fear that the Dutch approach has been this rigorous… There’s a process for evaluation, assessment is central, and the American affirmative approach and how it has played out in our fractured healthcare system, has somehow endangered everything. That it broke, maybe, something that you started.”

de Vries concludes: “It’s only recently that I’ve been convinced that yeah, maybe, especially in the United States, there is approaches that are different than the approach we are doing here.”

New York Times suggested background reading for the episode:

Part 3: The American Approach

Focuses on conservative American psychologist Laura Edwards-Leeper, who was hired as the therapist for the first American youth gender clinic, founded by Norman Spack. Edwards-Leeper visited de Vries for a week in 2007 and said, “They were following a very, very strict protocol, and that’s really what helped me figure out what to do when I got back to the US.”

New York Times suggested background reading for the episode:

Part 4: The Whistleblower

[in progress]

Focuses on anti-trans extremist Jamie Reed.

New York Times suggested background reading for the episode:

  • NYT: “In early 2023, Jamie Reed, a former case manager at the youth gender clinic at Washington University in St. Louis, filed a whistleblower complaint alleging that the center had hastily prescribed hormones to patients.”
  • NYT: “In response to Ms. Reed’s claims, Washington University conducted an internal review. It concluded that “allegations of substandard care causing adverse outcomes for patients” at the gender center were “unsubstantiated.””
  • NYT: “Citing Ms. Reed’s affidavit, Missouri lawmakers passed S.B. 49, a ban on gender-affirming care for minors, in May 2023.”

Part 5: The Review

[in progress]

Focuses on British anti-trans pediatrician Hilary Cass and the Cass Review.

New York Times suggested background reading for the episode:

Part 6: The Now

[in progress]

New York Times suggested background reading for the episode:

References

Urquhart, Evan (June 13, 2025). New York Times podcast on youth trans care leaves out the patients. The Objective https://objectivejournalism.org/2025/06/new-york-times-podcast-on-youth-trans-care-leaves-out-the-patients/

Molloy, Parker (June 4, 2025). The Quote That Reveals What’s Really Behind Anti-Trans “Concerns.” The Present Age https://www.readtpa.com/p/the-quote-that-reveals-whats-really

Reed, Erin (June 6, 2025). NYT Anti-Trans Podcast Finds Earliest Puberty Blocker Patient: Is Just Some Normal Happy Dude Now. Erin In The Morning https://www.erininthemorning.com/p/nyt-anti-trans-podcast-finds-earliest

Urquhart, Evan (June 5, 2025). Mom of trans child accuses New York Times’ ‘The Protocol’ podcast of exploitation. The Objective https://objectivejournalism.org/2025/06/mom-of-trans-child-accuses-new-york-times-podcast-the-protocol-of-exploitation/

Urquhart, Evan (June 5, 2025). ‘Who can I talk to that has a human heart?’: New York Times doubles down on harming trans people. The Objective https://objectivejournalism.org/2025/06/new-york-times-podcast-doubles-down-on-harming-trans-people/

Hollar, Julie; Riggio, Olivia (June 5, 2025). Activists Await NYT Podcast on Trans Care With Justifiable Dread. FAIR https://fair.org/home/activists-await-nyt-podcast-on-trans-care-with-justifiable-dread/

Molloy, Parker (June 4, 2025). The New York Times Is About to Do More Damage to Trans People. The Present Age https://www.readtpa.com/p/the-new-york-times-is-about-to-do

Caraballo, Alexandra (June 3, 2025). The New York Times’ War on Trans People. The Dissident https://www.thedissident.news/the-new-york-times-war-on-trans-people/

Anti-trans coverage

Singal, Jesse; Herzog, Katie (June 17, 2025). What We Thought Of “The Protocol.” Blocked & Reported https://www.blockedandreported.org/p/premium-what-we-thought-of-the-protocol

Hughes, Mia (June 15, 2025l). Beneath the Surface of The Protocol. Genspect https://genspect.org/beneath-the-surface-of-the-protocol/

Sapir, Leor (June 13, 2025). The New York Times’s Pediatric Gender Medicine Podcast Disappoints. City Journal https://www.city-journal.org/article/new-york-times-the-protocol-podcast-pediatric-gender-medicine-science

Davis, Lisa Selin (June 13, 2025). What “The Protocol” Got Wrong, Left Out, and Misrepresented. BROADview https://www.broadview.news/p/what-the-protocol-got-wrong-left

Davis, Lisa Selin (June 12, 2025). NYT trans podcast fails to grapple with detransitioners. UnHerd https://unherd.com/newsroom/nyt-trans-podcast-fails-to-grapple-with-detransitioners/

Lane, Bernard (June 9, 2025). Identity extremism. Gender Clinic News https://www.genderclinicnews.com/p/identity-extremism

Appel, Ben; Cohn, Cori; Davis, Lisa Selin; “Mondegreen, Eliza,” Reed, Jamie (June 8, 2025). Episode 28: Jamie Reed responds to the New York Times’s podcast, “The Protocol.” https://informeddissentpodcast.substack.com/p/episode-28-jamie-reed-responds-to

Appel, Ben; Cohn, Cori; Davis, Lisa Selin; “Mondegreen, Eliza,” Reed, Jamie (June 7, 2025). Episode 27: Dissecting “The Protocol.” Informed Dissent https://informeddissentpodcast.substack.com/p/episode-27-dissecting-the-protocol

Times coverage

Staff (June 6, 2025). Introducing ‘The Protocol,’ a New Podcast From The New York Times. New York Times https://www.nytco.com/press/introducing-the-protocol-a-new-podcast-from-the-new-york-times/

Ghorayshi, Azeen; Rudoren, Jodi (June 6, 2025). Our New Podcast: In “The Protocol,” we explore the controversial debate over health care for trans youth. New York Times https://www.nytimes.com/2025/06/06/briefing/the-protocol.html

Ghorayshi, Azeen; Mitchell, Austin (June 6, 2025). ‘The Protocol’: The story behind medical care for transgender kids. New York Times https://www.nytimes.com/2025/06/06/podcasts/the-daily/medical-care-transgender-kids.html

Staff (June 2, 2025). The Protocol. New York Times https://www.nytimes.com/2025/06/02/podcasts/trans-gender-care-protocol.html

Media

Cancel Me, Daddy with Katelyn Burns and Christine Grimaldi (July 2, 2025). We Debunked the New York Times Anti-Trans Podcast (ft. Sandy Allen). https://www.youtube.com/watch?v=vCrLZmrybdc

New York Times Podcasts (NYTPodcasts)