This is the 30 minute TV version of Jan Jekielek’s interview with Pamela Garfield-Jaeger. The longer-form version was released on Epoch TV on April 22, 2025.
"I felt like I was a Rip Van Winkle therapist. I left my profession due to a health condition in 2017 ... In 2021, I came back, and it was radically different,” says licensed clinical social worker Pamela Garfield-Jaeger. “All the teens that I had worked with before had never talked about being trans, and then the new program I was working at, half the girls were identifying as trans.”
Known as “The Truthful Therapist,” she is the author of “A Practical Response to Gender Distress” and is featured in the Epoch Times documentary “Gender Transformation.”
How has the mental health profession changed in recent years? What’s behind the spike in teens identifying as transgender? Why has “affirmation” become the norm? What alternatives exist? What impact is the widespread prescription of antidepressants and other drugs having on teenagers?
CHAPTER TITLES 0:00:01 - Introduction: A Therapist's Perspective on Changing Landscape 0:01:00 - Radical Changes in Youth Mental Health 0:03:00 - The Power Dynamics in Modern Therapy 0:05:18 - Approaches to Gender Distress in Children 0:07:54 - The Sudden Emergence of Transgender Identities 0:09:41 - Proper Therapeutic Approach to Gender Distress 0:13:13 - The Overprescription of Psychiatric Drugs 0:16:20 - Finding the Right Therapist for Your Child 0:19:07 - A Practical Response to Gender Distress: The Book 0:22:29 - Socratic Method in Addressing Gender Identity 0:23:06 - Concluding Thoughts: Think for Yourself
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I felt like I was a root fan wrinkle therapist. I left my profession due to a health condition
in 2017 and then in 2021 I came back and it was radically different. All the teens that I had
worked with before had never talked about being trans and then the new program I was working at,
half the girls were identifying as trans. Pamela Garfield Yeager is a licensed clinical
social worker known as the truthful therapist. She's the author of A Practical Response to
Gender Distress and is featured in the Epoch Times documentary Gender Transformation. If you
are a parent looking for a therapist for your child, make sure that you are very involved and
if the therapist says no I need to you know have my special place with your child, that's a red
flag. There's so many elements to the mental health profession that has shifted and the
prescription of psychotropic drugs has really heavily increased. They're just passed out like
candy. This is American Thought Leaders and I'm Jan Jekielek.
Pamela Garfield, such a pleasure to have you on American Thought Leaders.
Thank you.
So you spent over 20 years working with young people in a clinical social work setting. Then
you had to take a bit of time off and you came back and you say things profoundly had changed.
What happened?
Wow, well I felt like I was a root fan wrinkle therapist. I left my profession due to a health
condition in 2017. Things were I guess starting to change but I hadn't noticed and then in 2021
I came back and it was radically different. There were all the teens that I had worked with
before had never talked about being trans and then the new program I was working at,
half the girls were identifying as trans. But you know what was most shocking was what the
professionals were doing or what they weren't doing which was exploring underlying issues
and helping them recognize what was going on. Helping them recognize that they were avoiding
things that are natural for anyone who's struggling but especially for teenagers
and they just weren't helping them address their issues and really they were using it as a power
move. The kids were because they were saying I'm transgender and if you don't go along with this
then you're a transphobe, you're a bigot. And so then it felt like the adults were kind of held
hostage by these kids and instead of the adults saying no, no, no we're here to help you, we're
explore what this could be, they just really essentially got really nervous and went along
with it and then criticized other adults that had questions like the parents.
How is it that these kids suddenly had this strange power over their therapist that they
didn't have before? I wish I fully understood that but I think it's about all the messages
that our culture were getting and it really came through during the lockdown period.
People were separated, people weren't able to have conversations and the adults that did have
different opinions were heavily silenced. They were canceled, they were not allowed to keep their
jobs. There are some prominent people even within WPATH which you know, I have some feelings about
WPATH but they're known to be the experts on the transgender protocols and even within WPATH
those who just had simple questions and wanted to have some guardrails for youth were ousted,
were pushed out. Like a transgender, it was a man who identifies as transgender named Erica
Anderson was pushed out. There's a man named Kenneth Zucker, a Canadian, he was part of
putting together the new DSM diagnosis in the statistic manual for psychology disorders.
In 2014, he was well established within this gender industry and even him, because he believed
in watchful waiting, he was canceled. He wasn't allowed to continue in his clinic anymore. He's
won a lawsuit since then. So even people who had more moderate views on transgender but still
believed in the belief system that some people might be born in the wrong body or that these
interventions might be helpful, even them, they were pushed out. So there was this sort of
tyrannical process that happened and my profession, people within it, they're agreeable for the most
part. They want to get along. I think that their empathy is weaponized. I think that they want to
believe that they are accepting and open and they want to do the right thing and then they're also
told this lie that kids will kill themselves if we don't give them these medications or at least
affirm their pronouns and their identities. And so they believe it because they believe that
what experts and authorities say, they believe it. And it's hard when that's all the messages
that they get because the dissenting voices have been taken out.
I'm just going to comment briefly, you mentioned this watchful waiting. So there's a few different
approaches to kids when they have what you describe as gender distress, right? And so
just maybe explain for the benefit of the audience what those approaches are.
Well, the common, the mainstream thing is to automatically affirm, to not question a child
because they know who they are, which fundamentally comes from a different cultural perspective that
kids know themselves and, you know, we need to hear what they have to say, that perhaps they
have some kind of gendered soul within them and they're expressing that. It even gets to the point
where they can express that when they're babies, even when they're pre-verbal. There's a psychologist
called Diane Aronsaft who said that boys who open up their onesies and dance around, they're
expressing that they really want to be girls because that's like a dress. Or if a girl is
pulling out the barrettes, a boy, girl, I'm getting it mixed up, pulls the barrettes out of
her hair that she doesn't want to be a girl, right? Which I think some of the common sense
would just look at, well, these are fussy babies that just don't want to wear barrettes or don't
want their onesie on, right? And that's sort of natural. The kids don't want to wear their shoes,
they throw off their shoes. Does that mean they don't want feet anymore? So, but that is the
philosophy. And a lot of people start to believe it because people with these fancy letters that
come from these fancy institutions repeat that over and over again. So that's been, that's become
the mainstream narrative. However, there are people like me and several others, and I think
more than I even know because they have been silenced, believe that kids don't really know
themselves, that they need adults to guide them. They need to be grounded in reality.
They need empathy and compassion, especially if they're struggling with being in their bodies,
but to help them figure out their reality. And generally speaking, when they have distress
over their gender, then we need to wait and see what happens. And usually they do grow out of it.
You argue that there's this social contagion at play, and that's
a major cause of the increase, right? Do you think the mental health professionals
were taught that this is the correct route all along? Like, this is the part that I have trouble.
It takes some years, right, to become a licensed social worker in a clinical setting. You know,
you have to kind of, you have to earn your chops. Right. I'm really curious how this suddenly
exploded onto the scene like this. Well, honestly, as someone who's been in the field
for so long, since the late 90s, this wasn't a thing. We didn't learn about it. I mean, it was
very niche, right? There were the gender clinics that were the gender specialists,
and those were the ones that were really mostly ignored because it was so rare. It wasn't something
that the everyday therapist encountered. Now, you talk to any therapist, they have encountered it
within their practice, no matter which field, especially if they're working with young people.
It's way more prevalent among young people. I worked with young people for so many years,
like I said, and never encountered a trans kid in the past, so I didn't have a lot of training.
My training was just common sense, right? Back then, I just hadn't thought about it that much,
to be honest. I never had a class on it. There are a lot of disorders you don't encounter,
and if it's something that you end up specializing in, maybe you learn more about it,
but this is not something that most regular people specialized in. But now, they've made
it such a mainstream thing, I think, because of all this top-down influence that we're all
encountering it. But no, this was not mainstream. I would say there was this,
yeah, let's be nice, but let's figure out what's happening, right? There was this both-and in the
past. Now that I've learned more about it, now that I know how harmful the hormones and the
surgeries really are, I didn't know that stuff before because it looks all glossy and pretty,
and you don't really think about it. You don't meet anybody that's been through it,
or you don't hear about it. You hear those accounts firsthand, you don't know. Once you
learn the truth, then all of a sudden, your eyes open, and you're like, wow, I can't believe that
we ever thought this was okay to do. Explain to me, in a situation where a child is
experiencing gender distress, what's the right way to deal with that in your mind?
Well, the right way to deal with it, usually a lot of it is about listening. A lot of adults
want to start lecturing. We're talking about a child, especially. They want to start lecturing
the person and saying, no, there are only two genders, stop it, right? But that will generally
push them further away, and they want to feel heard. A lot of what this is about is wanting
to be seen, wanting to be heard, which is natural within a young person's development,
especially one who might be struggling with something. A lot of it's about just sitting and
listening to them, but you don't affirm the new identity. You don't use the new name or pronouns,
but in the early stages, you also would not be confronting it, because if you do,
then you're not going to be able to establish that trust. Very basic therapy, one-on-one,
initially when you're trying to work with somebody, especially a child or a teenager,
is to establish trust with them so that they can work with you. You don't want to be combative,
which I think is how a lot of people get in the way. They say, oh, they need truth.
They need to know that they're made in God's image, and that might be true. However,
if they're not in that headspace, that's going to push them away, so you have to really be patient.
What you're really doing is you're looking into what's really going on. You're trying to just
look under the surface. The gender thing is really more of a symptom of something else,
and you want to figure out what that is. It could be multiple things. Usually, there might be some
struggles within the family, maybe some communication issues with the parents.
A lot of times, it's cultural clashes. I knew a family, a first-generation immigration family,
where the parents are much more traditional, and the child is struggling, dealing with the
culture clashes. That might be something that you'd be addressing as a therapist.
There are also some very common comorbidities that happen. One is sexual trauma. You want to
usually rule that out or figure out if there's been some kind of sexual trauma. You want to
figure out, are they dissociating from their body? Are they running away from something,
from their sexuality, because they're scared or they were hurt? Kids with autism tend to
gravitate towards this, and there are several reasons for that. A lot of it has to do with
their sensory issues. They don't like dressing a certain way. They also struggle socially,
so they want to feel like they fit in, and they have more rigid thinking. Of course,
you want to assess for how much Internet they're consuming, because most kids are getting these
ideas from the Internet. Those are a few things to consider when you're working with a child
with a transgender identity. It's very interesting that you mention
the dissociation from the body. Something I've started covering on the show recently
more is the overprescription of psychiatric drugs. My understanding is that across the board,
all age categories, it's very common as a first-line treatment to give people SSRIs,
including kids. This is just something that's grown a lot as an approach in the last decade.
I know one of the side effects of that is dissociation. Could there be a connection there?
I believe there's a strong connection. That's the other thing that's really changed. When you
asked me earlier what's changed so much, I talked about the trans, but there are so many elements
to the mental health profession that have shifted. The prescription of psychotropic
drugs has really heavily increased. When I was coming up the ranks, it was very rare for a
primary care doctor to prescribe any kind of psychiatric medication. If they did, it was very
temporary. Then they'd pass them on to a psychiatrist who was monitoring them and also
really understood more of how they can interact with other drugs. For a long time, you couldn't
even prescribe a psychiatric drug without counseling alongside with it. There are several
reasons for that. One is just the monitoring. When you start a new drug, you're going to have
mood and behavioral issues, and that needs to be monitored closely. There are studies out
there that show that drugs without any kind of counseling is way less effective. Nowadays,
they're just passed out like candy. I feel like we need to look at the effectiveness of these drugs
because I think that we're making assumptions. It's like this marketing name, antidepressants.
That means they resolve depression. Well, do they? Maybe sometimes. It's unclear.
Then, of course, it's used a lot for anxiety. They prescribe SSRIs for anxiety,
even if it's someone who's not depressed. They affect people very differently.
They were prescribed very cautiously for young people because there's a black box warning,
especially for teenagers, to be on an SSRI, that they become more suicidal.
That used to be- Across the board?
Across the board. Wow. I didn't know that.
So, they're prescribed very cautiously. When I was coming up the ranks, when I knew a kid that
was getting one of these drugs, they were in a residential program. They were being monitored
24 hours to make sure that they were safe. Now, they're being given outpatient all the time,
and they're not being monitored at all. We're talking about this mental health epidemic.
I'm just thinking out loud. I'm wondering if some of this is just the drugs that are creating
these suicidal thoughts. We say, oh, if you don't affirm, they'll kill themselves. But we don't
talk about, well, if you give them these drugs, they also might kill themselves. It's really very
messy, to be honest. That's the thing about the mental health profession. There are no clear
answers. People are individuals and react to things so differently. I would love to see more
long-term studies on these. I think there are less on youth, because it's still relatively new that
they're giving so many kids these drugs. They were designed for adults.
Pamela, one quick sec. We're going to take a break, and folks, we're going to be right back.
We're back with Pamela Garfield, author of A Practical Response to Gender Distress.
How does one go about finding a therapist in your mind if they feel they need one for their kid?
I'll tell the truth. It's not easy, especially if you want one in person.
I don't think Zoom therapy is the greatest, especially for kids. It's become very widespread,
and I don't think it's cracked up to be. People use it for convenience, but I don't know how
effective it really is. Sometimes that can be dangerous, depending on the severity of the
situation. There are some websites out there. There are some lists, some directories. There's
one directory called conservativecounselors.com, and they will not affirm your child.
There's also a group called Therapy First, and that's therapyfirst.org. They run some alternate
trainings, and they don't believe in affirming children instantly, although it depends on what
you believe because some believe that maybe eventually you should affirm. Some believe
that you should never affirm, so it really depends on what you believe as a parent. I think
when you're looking for a therapist, you should always screen very carefully,
and don't be afraid to ask questions, and also stay very involved in the process.
No therapist can ever fix your child. Even the best therapists in the world cannot fix your child
without you because they're only in your child's life temporarily, and their goal is to help you
connect, and they need to know what's happening with you and with your family and your child's
history. They need to really be involved to be able to help your child, so that's also a big
shift in the profession is just pushing the parents away. So if you are a parent looking
for a therapist for your child, make sure that you are very involved, and if the therapist says,
no, I need to, you know, have my special place with your child, that's a red flag. I mean, they do need
to have some connection with your child, of course, but they should be talking to you, and they should
be communicating with you. They should be talking to you, at the very least, about what are the
treatment goals? What are they seeing are the concerns? How are they conceptualizing the case?
What do they think is wrong? What do they think could help? What are the things that they think
you could do as a parent? You know, so they should be working with you. You should be working as a
team with that therapist, and that's a lot more work, and with these overworked, overstressed
therapists, even those that are honestly, I'd say, very ethical, it's still difficult to do all that,
to work with kids and have all that involvement, but that's really the best way.
Tell me, you know, I think your book is an incredibly valuable resource, and I just want,
absolutely, and just like, you know, where can people find it? What will they find in there?
Yeah, so this is, it's a practical response to gender distress. It's available on Amazon,
and it started off just as like a 10-page thing that was on my website. I have this website,
thetruthfultherapist.org, which I call The Parent's Guide to Mental Health, and it's on
there. It has a whole bunch of things just to understand what was appropriate mental health
care before things really got more radical and taken over by ideology, and I had a little section
on gender in there, and that was obviously the most popular one because it was such a hot topic,
so I thought, oh, I'll make a little booklet and print it out. Well, it expanded into a book,
and what this book has is all these different chapters that, with very succinct but thorough
facts on the different lies that the transgender movement has pushed without much pushback. So,
all the different things they say, for example, that intersex proves that that means we have
multiple genders. Well, it doesn't. That is, we still have two gametes. We're still male and
female. Even those who are intersex are still male and female, but they have a birth disorder,
right, and you can't always tell at birth whether they're male or female, so we don't have some
special third or mysterious types of gender. And then clownfish, the males lay the eggs, but,
I mean, I don't know all the biology on the fish, but it doesn't matter because human beings aren't
fish, right? So, it's things like that for people to just stop and think
because you get bamboozled real easy because they say it with confidence.
They have these scripts, and they say, so when you have a teenage child that has been listening for
hours and hours on all these different talking points, and you're like, well, I know what they're
saying is nonsense, but I don't know what to say right now, or I don't even know what to think.
My book will help you with that. It debunks the suicide lie and explains in lots of different
reasons why it's a lie, both through the data and then also just clinically, it's not clinically
sound to be talking about suicide with teenagers. And then the other thing that's different about
my book is because it's written for me, a therapist, a mental health professional that
has so much experience with teens and worked with so many acting out teens, teens that I actually
had to sometimes even restrain because their behavioral issues were that extreme. I know how
to talk to them. I know how to de-escalate them. I know how to talk to them in a way that's not
going to say, well, F you. Sometimes they do, but that's okay. But I have a section in the back
that has ideas on how to open up a conversation with a child who might be ready to talk about it
that's not confrontational. They're more open-ended questions so that the adult who
really cares about that child can talk to them and really do a lot more listening,
but also ask leading questions so that they can maybe figure out for themselves eventually,
plant some seeds. For example, what does it mean to be trans? Because it's ever-changing
and it's such a broad term. And then just asking more follow-up questions. What does it mean to
be a boy or a girl? How do you know? Some of them are kind of obvious.
Applying the Socratic method here.
Yes, exactly. So there's actually some prompting questions. But I also really emphasize in this
book that there is no script. There is no exact formula for you because there are so many different
situations within the family. And a lot of it is about figuring out what is happening within your
family. My overall message to families about mental health and maybe about everything is to
think for yourself and question experts and use your gut. Don't just go along just because you're
scared because they have some kind of authority. What a fantastic message. Pamela Garfield,
it's such a pleasure to have had you on. Thank you.
Thank you all for joining Pamela Garfield and me on this episode of American Thought Leaders.
I'm your host, Jan Jekielek.