Sasha and Stella welcome Dr. Marieke den Ouden, a medical biologist and psychologist, to discuss the ongoing developments in pediatric gender medicine in the Netherlands. Despite the widespread belief that the Dutch Protocol ensures rigorous mental health evaluations before medicalizing children, Marieke reveals that the Netherlands is not consistently adhering to its own guidelines. Instead, gender transitions continue at an alarming rate, often disregarding critical psychological factors.
Marieke den Ouden is a second-wave feminist, medical biologist, and health and organization psychologist with a career spanning over 36 years in academia and private practice. She has dedicated her work to defending women's rights, challenging sex-role stereotypes, and promoting holistic approaches to mental health.
Currently, she collaborates with parents of RODG-affected children to improve diagnostic practices in gender clinics and advocates against policies like self-ID and anti-conversion laws. A mother of two, Marieke draws on her own experiences to highlight the importance of safeguarding children from ideologies that overlook biological and psychological complexities.
In this episode, Marieke shares insights from a parent’s perspective, making reference to a case she’s closely tied to, discussing a new survey designed to collect input from extended family members about a child's mental health history and gender identity development. The survey aims to broaden the lens by gathering input from multiple relational perspectives of the child and their history, so that a more comprehensive picture will emerge. However, this raises an important question: Can a survey like this truly capture objective reality, or will it always be shaped by the perspectives and emotions of those involved? The conversation examines the biases that influence both youth seeking medical transition and the adults reporting on their histories, highlighting the complexities of gathering objective information.
The discussion also explores how early pioneers in pediatric gender transition often had backgrounds in disorders of sexual development (DSDs). This may have influenced their thinking, operating under the assumption that gender identity must have an undiscovered biological basis - perhaps in hormones, chromosomes, or brain structures - leading them to see gender nonconformity or distress through a medicalized lens. The widespread cultural framing, lumping gender dysphoria with intersex conditions, has contributed to a rush toward medical interventions, fast-tracking children and adolescents into irreversible medical pathways, despite a lack of clear biological evidence justifying these treatments.
This episode presents fresh debates and critical insights into the ethical dilemmas surrounding pediatric gender transition and the protocols involved.
Resources & Links
@DrMariekedOuden on X
Gender Dysphoria Support Tool (The Parents’ Survey)
The Dutch Leaks: Trans Regret is Possibly 33%
The Genspect Parents' Survey: How It All Started
Part I: Three days at the European Professional Association for Transgender Health, By Eliza Mondegreen
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