Not that long ago, the birds and the bees had a very simple job: there were males and females, and the most complicated part was deciding who would take out the trash.
But unless you live in a culturally isolated place, or on a very distant planet, it’s clear that those days are long gone.
“Peer review in youth gender medicine is completely dysfunctional. There is a small ideological group that runs the peer review and stifles academic exchange.”
Gender and sex now seem to have become the societal equivalent of advanced calculus, with everyone working with a different equation. In this brave new world, even the birds and the bees are questioning their own identities.
This is not just a passing fad, but a deep social change. The debate about gender, once based on biology and tradition, has transformed into an ideological battlefield where few, except for people like Dr. Christopher Caribe, dare to question the prevailing view.
Caribe, a renowned psychiatrist and professor at the University of South Florida, isn’t afraid to challenge the status quo. As a board-certified specialist in general psychiatry, forensic medicine, and child and adolescent psychiatry, Caribe has a deep understanding of the complexities involved in treating non-conforming and gender dysphoric youth. But he’s alarmed by what he’s currently seeing in the field.
Caribe argues that major professional organizations like the American Academy of Pediatrics and the American Psychiatric Association have become mouthpieces for political agendas, sidelining rigorous scientific debate in favor of pre-determined narratives.
Caribe’s critique is sharp and uncompromising. He points out that these organizations unilaterally endorse medical, affirmative treatment of gender dysphoria in minors, based on flimsy evidence from studies that are often riddled with methodological flaws. Worse, this endorsement has been made without the benefit of broad consent or vigorous, open debate among their members. The result, Caribe says, has been a stifling of academic skepticism, where dissent is ignored and important questions go unasked.
For Caribe, this is not just a professional concern, but a matter of intellectual integrity. Look at this Symptoms of what Jonathan Haidt describes as “structural stupidity” — a decline in intellectual rigor and an increase in groupthink driven by ideological conformity rather than objective analysis — the medical community, once committed to evidence-based practice, is now, in Caribe’s view, in danger of becoming an echo chamber where only politically convenient truths are heard.
Caribe speaks from experience.
“At the University of South Florida, I’ve always had support from trainees, colleagues, and administration,” he says. “I openly discuss these issues with students and trainees at all levels. We have a fun, rigorous, and open dialogue. There are no issues.”
But this intellectual freedom is not universal. “Unfortunately, I have heard from colleagues in the North and West that this is not the case at many other universities,” Caribe points out. He says he sees an even sadder situation in psychiatric professional organizations: “These organizations have chosen to assume a role primarily as advocacy groups, and have neglected their role as scientific organizations.”
Caribe’s attempts to voice his concerns have been met with resistance: He has submitted multiple letters and papers to the Journal of the American Journal of Child and Adolescent Psychiatry, but has been consistently rejected.
“Peer review in youth gender medicine is completely dysfunctional,” he argues. “You have a small ideological group that is running the peer review and stifling academic exchange.”
The implications of this ideological capture are significant, especially when it comes to treating adolescents who experience gender dysphoria, and Caribe stresses the need for a more nuanced, individualized approach.
First and foremost, he advocates for addressing the co-morbid conditions that often accompany gender dysphoria, such as depression, anxiety, PTSD, autism, ADHD, personality disorders, etc. He argues that treating these underlying issues should be a priority before considering more radical interventions such as social transition or hormone therapy.
Caribe is especially cautious about social transitioning minors, warning that it can hinder the natural resolution of gender identity. He suggests that young people continue to use their birth names and pronouns as they explore their identity, which can lead to a more thoughtful, less pressured developmental process. Family therapy and education are also important, as clinicians have a responsibility to support families while avoiding automatically encouraging medical transition.
Additionally, Caribe emphasizes the importance of mental and physical health in this context: engaging in vigorous physical activity, practicing mind-body techniques such as yoga and meditation, and cultivating a sense of common humanity beyond gender identity all play an important role in helping adolescents get through this difficult time.
Finally, Caribe calls for a reevaluation of the slogans that often dominate the debate around gender reassignment medicine. He warns that many young people and their families are unaware of the evidence that casts doubt on the safety and effectiveness of medical gender transition. Sexual orientation and trauma history also need to be carefully considered, as they may be important factors in the development of gender dysphoria.
In the end, Caribe’s message is clear: psychotherapy should be the primary approach to addressing deep-rooted gender dysphoria, ensuring that treatment plans are comprehensive, supportive, and based in rigorous science. His call for open, evidence-based debate within the medical establishment is not only a plea for intellectual honesty, but also a necessary step to avoid harm and restore credibility to a field that, in his view, has lost its way.
