Live Not By Lies: Reflections on the 2025 Genspect Conference
By Dwight Panozzo
“You’re the captain of your ship—be sure that you don’t steer it into the rocks.” — Stephen Levine, MD
I left the recent Genspect “Live Not by Lies” conference both heavy-hearted and unexpectedly hopeful. Heavy-hearted, because the pain of parents whose children have been drawn into the fast-moving current of transgender ideology is unmistakable. Hopeful, because I witnessed a growing network of clinicians, researchers, parents, and detransitioners determined to build a more reality-based path forward.
This post gathers some of the key insights I brought home—partly to inform, partly to invite. If you have wondered whether attending a future Genspect gathering is worth your time, I hope this reflection provides a gentle but persuasive “yes.”
A Community of Wounded but Courageous Parents
“The pain they experience is just below the surface—it can’t be missed.”
In hallway conversations, early coffees and elevator asides, I heard stories of children swept into identity crises seemingly overnight. Several fathers confided stories of sons and daughters who had been “ideologically captured.” Another described the ache of watching a previously vibrant teen retreat behind a screen name and a new set of pronouns. Each story was compelling. Each one had me wanting to share clinical insights from my own practice, though I tried to mostly listen.
No conference can magically remove the suffering of these parents, but Genspect offers something precious: mutual recognition. Parents discover they are not alone, clinicians share evidence-based resources, and everyone practices the difficult art of listening without rushing to fix.
Science Under the Microscope
A highlight for many attendees was the chance to hear from researchers who are willing to follow the data even when it cuts against political grain.
Lisa Littman, MD, MPH presented initial survey findings from an ongoing study. She related that for every one youth recruited into her new study, as many as ten parents were recruited. This is an unfortunate but not a surprising finding. One of the greatest challenges in dealing with youth trapped in gender ideology is the insularity and echo chamber nature of the movement. I have had the opportunity to interact with Dr. Littman on many occasions and have always experienced her as welcoming, inquisitive, resourceful, and cordial.
Unfortunately, her reputation precedes her in the world of gender. Having coined the term rapid onset gender dysphoria (ROGD), youth flee from her as yet another transphobe—the term of abuse for anyone who doesn’t automatically agree with whatever exists in the minds of those trapped in the ideology.
Littman also noted that roughly one-third of respondents carried an autism-spectrum diagnosis, a figure she suspects may under-represent undiagnosed neurodivergence. I had the opportunity to ask her about this during Q&A, as my own findings from working with more than three dozen of these youths in the past three years is that more than 90% have, or are presumptive for, an autism spectrum disorder diagnosis. Even when they present as militant and neurotypical in my office, zoom sessions repeatedly belie the truth of the matter as they delve into their special interests and offer an overabundance of unsought information about those interests from the safety of their homes.
When Empathy Is Hijacked
Clinical psychologist Lisa Duval offered one of the most bracing talks of the weekend. She described how the empathy of well-meaning teachers and therapists is often “hijacked by gender ideology.”
This caused me to reflect how much we function on System I thought, which is reflexive and virtually thoughtless while avoiding System II thought, the ponderous and labor intensive work of coming to terms with multiple streams of data in one’s mind (Kahnemann, 2011). If only the teachers and therapists were to look behind the curtain as I have done to see how very wrong we have been, how much pain and suffering we have likely caused. I thought the system is much more rooted in chains of trust, in knowledge transfer from others. This works fine when the knowledge is valid. It leads to disaster when it is unfalsifiable yet treated as though it were the Rock of Gibraltar.
Duval’s candor resonated with my own experience as a clinician. It is easier to affirm than to question, easier to trust professional consensus than to examine the evidence for oneself. As the conference title reminds us, living not by lies requires the slower, more effortful reasoning that protects patients and preserves professional integrity.
As he always does, Dr Stephen Levine conjured the soul of the therapeutic process with frank but compassionate descriptions of his clinical approach with trans-identified young people and their parents. He remains a gift to the profession, and I encourage readers, especially clinicians, to seek out his talks on YouTube.
The Limits of “Evidence-Based” Care
Several speakers challenged the oft-repeated claim that gender-affirming interventions are ‘evidence-based.’
Plastic and reconstructive surgeon Patrick Lappert clarified how what is described as ‘gender affirming surgery’ is actually the maiming and disfigurement of functioning bodies. Sadly, I cannot unsee the pictures of a phalloplasty surgery that he shared. Nor can I forget his words that gender surgeries, by definition, reduce human functioning and capacity by removing healthy tissue. Dr. Quentin VanMeter reviewed the corrupted informed-consent process by discussing the use of cross-sex hormones. Activist Corey Cohn went further: “If there was ever an evidence-based case for medicalization, it is now passed.”
The call was not for nihilism but for rigor. Standards of care should rest on Level III evidence or better—controlled studies, not retrospective surveys. Yet many existing protocols rely on the weakest forms of evidence, often without controlling for confounding variables such as autism, trauma, or co-morbid mental health conditions.
Fertility, Consent, and the Unknowable Future
One personal conversation with a young sociologist underscored the complexity of these debates. He had attended both Genspect and the USPATH (U.S. Professional Association for Transgender Health) meetings in Albuquerque that weekend, and he related that many USPATH counselors do urge caution—encouraging teens to consider fertility and long-term outcomes before transitioning.
I asked whether those clinicians likely believed in a category of ‘True Trans’ patients. He said yes. That belief, though sincerely held, raises a troubling question: how can anyone determine ‘true transness’ in the absence of objective, falsifiable biomarkers? Indeed, it’s something I’ve pointed out to multiple patients who are pondering medicalizing when I ask, “Do you think detransitioners who now deeply regret their decision to medicalize were any less certain of the rightness of their choice than you are today?”
The sociologist also pointed out the sincerity of the USPATH counselors who talked of exploring fertility issues with their teenage clients. He did, however, agree with me that it is not actually possible for almost anyone to weigh in on decisions related to their own fertility before they are of an age where family formation is a real issue—think late twenties at the earliest. This means that those earnest counselors are deluding themselves about what they are accomplishing. This brings us back to what Helen Joyce pointed out at Genspect 2024 in Lisbon, that gender ideology is based on “Tooth Fairy Science.”
Law and medicine have long recognized age-of-consent thresholds for alcohol, sterilization, and elective surgery. Yet in the realm of gender medicine, minors are asked to make decisions that often forecloses the possibility of biological parenthood. That paradox deserves far more public scrutiny than it currently receives.
Stories That Haunt and Inspire
Statistics inform policy, but stories change hearts. Detransitioners shared accounts that will stay with me for years.
The most harrowing was that of Jonni Skinner, who began medical transition at thirteen after a therapist suggested it would be “easier to be a straight woman than a gay man.” At that same age, he was taken to a shop selling breast forms, dildos, and bondage gear at the suggestion of his treatment team. He was prescribed puberty blockers that caused severe muscle spasms and a bladder ulcer, and later he was placed on high-dose estrogen to fuse his growth plates so he would not grow “too tall.”
“My endocrinologist said, ‘Welcome to womanhood’ when fluid began leaking from my chest,” Jonni recalled.
Michigan’s two-year statute of limitations on medical malpractice means he has no legal recourse. Yet his decision to share his story publicly is itself a form of justice. As author Lionel Shriver quipped in a related context: “Successfully passing as a woman is about as important as getting a bit part in your high school musical.”
Such gallows humor can feel jarring, but it captures the absurdity of a system that elevates performative identity over bodily integrity.
Rethinking Stigma
One of the controversial themes raised by Shriver was the role of stigma.
“There’s nothing wrong with stigma. Stigma attaches to things for a reason. Trans has to elicit an eyeroll on the peer level for things to change,” said Lionel Shriver.
The point was not cruelty but cultural feedback. When every expression of skepticism is labeled ‘hate,’ society loses the gentle social cues that help young people reconsider risky paths. Healthy stigma—like the quiet disapproval that surrounds drunk driving—can be protective.
Toward a Better Standard of Care
Speakers converged on several principles:
1. Sex-Rejecting, Not ‘Gender-Affirming,’ Care: Treatments that remove healthy organs are not neutral; they reject biological sex.
2. Due Process for Parents: Schools and clinics must not unilaterally label parents as ‘dangerous’ for questioning transition. Indeed, they may have acted criminally by hiding children’s transitions and encouraging them, unbeknownst to parents.
3. Developmentally Appropriate Consent: No child can meaningfully weigh lifelong fertility decisions.
4. Rigorous Evidence Standards: Policies should rest on controlled studies, not activist consensus.
Five Reasons for Hope in Women’s Sports
The fight for fairness in women’s athletics was front and center and illustrates how evidence and activism can align to cause positive change. I celebrated their successes by purchasing one of their tee-shirts. Though I must admit, it will be an act of bravery to wear it around others in LGB settings. Panelists outlined five strategies for winning:
1. Affirm that females are born in the right bodies.
2. Stage visible protests and peaceful demonstrations.
3. Lobby legislators and draft model bills.
4. Tell our own stories—centering the voices of female athletes.
5. Collaborate across differences of race, sexuality, and politics.
Why You Might Want to Attend
All of this—rigorous science, wrenching testimony, strategic activism—would be valuable enough on its own. But what makes Genspect truly special is the human atmosphere.
It is not a festival of outrage. It is a gathering of people who refuse to live by lies, who are willing to examine their own mistakes, and who believe that compassion and truth are not enemies but allies.
If you are a parent, a clinician, a policymaker, or simply a citizen concerned about the well-being of children, I cannot recommend the experience highly enough. You will leave informed, unsettled, and—paradoxically—encouraged.
Closing Reflection
“Discomfort does not mean that you have a disorder; it means that you have to change something.”
That line, offered by one panelist, has lingered with me. It applies not only to the teens questioning their identities but also to all of us who must confront uncomfortable truths about medicine, culture, and our own complicity.
To live not by lies is to embrace that discomfort—and to act for the greater good.
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